SOURCES SOUGHT
R -- Actuarial Support Services Under MMA
- Notice Date
- 11/22/2004
- Notice Type
- Sources Sought
- NAICS
- 541611
— Administrative Management and General Management Consulting Services
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, formerly known as the Health Care Financing Administration, Acquisition and Grants Group, 7500 Security Blvd. C2-21-15, Central Building, Baltimore, MD, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- Reference-Number-CMS050001MW
- Response Due
- 12/15/2004
- Point of Contact
- Mark Werder, Contract Specialist, Phone 410-786-7839, Fax 410-786-9922, - Carol Sevel, Contracting Officer, Phone 410-786-7437, Fax 410-786-9922,
- E-Mail Address
-
mwerder@cms.hhs.gov, CSevel@cms.hhs.gov
- Description
- Review of Bids Submitted by Medicare Advantage and Prescription Drug Plan Sponsors Background The recently-enacted Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) has expanded the role of private entities in providing benefits to Medicare beneficiaries. First, the law adds a new section to the Social Security Act, 1860D (“Part D”), that offers prescription benefits beginning in 2006 through Prescription Drug Plans (PDPs). Secondly, the statute allows for payments to Medicare Advantage (MA) “local plans”, formerly Medicare Plus Choice (M+C) plans, and creates a new type of private plan, “Regional” MA plans. Finally, the legislation specifies that, beginning with contract year 2006, organizations bidding for contracts or with contracts that offer PDP and MAs must annually submit bids that support the actuarial basis of its pricing. The 2006 bids are to be submitted to the Centers for Medicare & Medicaid Services by June 6, 2005. CMS’ Office of the Actuary has been assigned the responsibility to review the submitted bids for reasonableness against CMS guidelines and instructions, conformity with the statute, and compliance with the appropriate Actuarial Standards of Practice. Given the required coordination of the actuarial bid reviews with related activities to be performed by other CMS components, OACT’s assessment of the bids must be completed in relatively short timeframe (approximately 6 weeks). However, OACT does not have adequate number of staff members required to review and approve the anticipated volume of bids within this timeline. As a result, CMS/OACT intends to procure advisory and assistance services from independent actuarial firm(s) to assist with the review of the 2006 MA and PDP actuarial bids. Contractor responsibility Contractor will review the reasonableness of assigned bids in consideration of (i) CMS’ bid submission instructions, (ii) CMS’ bid review guidelines, and (iii) professional actuarial standards. The reviews will be performed within a set bid review process to be established by CMS. Some of the main components of the process are listed below. For each assigned bid, the process will contain a representation of the original submitted bid supplemented with additional data such as statistical distribution of key values across all peer plans and an overview of the filed benefit package. Additionally, the bid review process will provide an e-mail communication link to actuary that developed the bid. Finally, contractor is to communicate to CMS the result of his reviews by completing the appropriate status section of the review process. CMS’ review guidelines highlight the most important areas for the bid reviews for both Part D and other benefits (that is, Part A, Part B, and non-Medicare covered). The most important areas to be examined are the (i) base period data, (ii) projection of base period data to the contract year, (iii) manual projection data if base period data is absent or deemed to be less than fully credible, and (iv) components of resulting bid for the contract year. The review of the bids will take place between June 8, 2005 and September 2, 2005, with the bulk of the work to be completed by July 30, 2005. Additionally, the contractor will be required to attend a training session in May 2005 (date TBD) and provide CMS with a written evaluation of their experience with the bid reviews by September 30, 2005. At this time, neither the bid form nor the bid review specifications are available for release. However, the draft bid form will be posted on CMS’ web site on or about November 29, 2004 at http:/cms.hhs.gov, or may be obtained by sending an e-mail request to actuarial-bid@cms.hhs.gov. Additionally, the specifications for the bid review system process will be contained in the Request for Contract package (to be sent in early 2005). Type of Procurement CMS anticipates issuance of multiple awards of indefinite-quantity contracts under the forthcoming single solicitation to two or more sources using Firm Fixed Price task orders with a minimum order to gear up and complete training requirements and a maximum order limitation to be determined based on feedback from this RFI. It is also anticipated that these awards will be issued with a base year and 3 options. However, CMS does reserve the option to use any other procurement instrument as deemed appropriate at the time of the official solicitation. Response requested from prospective contractors CMS would like you to respond to this RFI with the following information. 1. Your firm’s experience, establishing and reviewing pricing of managed health care plans, including prescription drug benefits. Please provide examples of establishing and reviewing pricing by specifying the type of health care plans (for example, Medicare Advantage programs, Medicaid, commercial, and retiree health). Also, if applicable, please provide a description of your experience in subcontracting with other actuarial consulting firms. 2. As a rough measure of workload capability, please provide the average weekly hours of labor that could be committed to this work from June 8, 2005 through July 31, 2005. 3. Please provide the information on the staff and/or subcontractors or consultants that would be assigned to the work described above. Specifically, grouped by job classification, please provide an indication of the (i) general qualification /experience for each job classification, (ii) proportion of the project workload (described in # 2) to be performed by staff assigned to each classification, and (iii) average hourly billing rate, including overhead. Examples of job classification are principal, senior consultant, consultant, actuary, actuarial student, technician, etc. 4. Indication of other consulting engagements, or other situations that may prevent organization from performing unbiased review of bids submitted on behalf of specific organizations. In other words, please describe potential conflicts of interest or apparent conflicts of interest with this project. For example, we want to know of any direct involvement you have with clients by offering pricing or consulting regarding the MMA-created Medicare Advantage plans or Prescription Drug plans. Also, provide information on your non-Medicare engagements with clients that currently offer Medicare Advantage products. Instructions for responses Interested offerors should provide their responses to the following: 1. Email your responses addressing the above specific requests to mwerder@cms.hhs.gov with a carbon copy to RCoyle@cms.hhs.gov on or before 12:00 PM local time Baltimore, MD Wednesday, December 15, 2004. Please be advised that email transmitted files over 5 megabytes are not delivered during standard working hours and are only released from the CMS server after 5:00 PM EST and may impact the timeliness of your response. 2. In this regard please limit your electronic document to the following Page Size, Font Type and Size, Spacing and Page Numbering – Preference for Microsoft Word document with page size 8.5 by 11 inches. Font shall be Times New Roman Size 10-12 with no less than single spacing between lines. The number of pages shall be limited to ten (10) electronic pages. 3. All transmitted information marked proprietary will be treated as such; however CMS does reserve the right to utilize any non-proprietary technical information in the anticipated SOW or solicitation. 4. Respondents should be aware that this RFI is being issued for marketing purposes and any responses thereto or lack thereof will not constitute a commitment by CMS to treat any offeror more or less favorably in the anticipated forthcoming solicitation and/or ultimate award(s). 5. Additionally, the anticipated contract action will require prospective interested offerors to be registered on the Central Contractor Registration located at http://www.ccr.gov/index.asp . NOTE: THIS NOTICE MAY HAVE POSTED ON WWW.FEDBIZOPPS.GOV ON THE DATE INDICATED IN THE NOTICE ITSELF (22-NOV-2004). IT ACTUALLY APPEARED OR REAPPEARED ON THE FEDBIZOPPS SYSTEM ON 20-JAN-2005, BUT REAPPEARED IN THE FTP FEED FOR THIS POSTING DATE. PLEASE CONTACT fbo.support@gsa.gov REGARDING THIS ISSUE.
- Web Link
-
Link to FedBizOpps document.
(http://www.eps.gov/spg/HHS/HCFA/AGG/Reference-Number-CMS050001MW/listing.html)
- Record
- SN00737887-F 20050122/050120214128 (fbodaily.com)
- Source
-
FedBizOpps.gov Link to This Notice
(may not be valid after Archive Date)
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