SOLICITATION NOTICE
R -- Error Rate Measurement
- Notice Date
- 8/4/2005
- Notice Type
- Solicitation Notice
- 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, Office of Acquisition and Grants Management, 7500 Security Blvd. C2-21-15, Baltimore, MD, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- C2-25-27
- Description
- Background CMS must estimate improper payments in the Medicaid program as directed by the Improper Payments Information Act of 2002 (IPIA). To implement error rate measurement in Medicaid, CMS will use a national contracting strategy. Under this strategy, CMS will engage three contractors: (1) a statistical contractor; (2) a documentation/database contractor; and (3) a review contractor. The statistical contractor will perform all statistical, sampling and error rate calculation functions. The documentation/database contractor will gather medical policies and other necessary information from States; will maintain a database of the medical policies (along with quarterly updates to these policies) and will gather medical records from providers. All information collected by the contractor will be maintained in electronic format. The review contractor will perform the data processing and medical reviews in those States selected for review. For Fiscal Year (FY) 2006, all three contractors will exchange information and will work together to produce the Medicaid fee-for-service (FFS) error rates. CMS anticipates a separate procurement for each of these contractors. Description A sole source procurement is contemplated for award to The Lewin Group Inc. of Falls Church, VA to perform all statistical, sampling, and calculation functions necessary to produce national and state-specific Medicaid FFS error rates for FY 2006. These duties include selecting the states to be reviewed, determining the total sample size and the sample size by strata, stratifying the claims data from each selected state, drawing the claims sample and calculating the state-specific error rates and national error rate for Medicaid FFS. The Lewin Group provided statistical and analytical services to CMS as needed to produce and report Medicare FFS error rates when CMS implemented the Comprehensive Error Rate Testing (CERT). In addition, from the onset of the Payment Accuracy Measurement project, CMS has contracted with Lewin to serve as the project?s technical and statistical consultant. Lewin assisted CMS in developing and refining the statistical methodology to estimate payment accuracy and payment error in Medicaid and SCHIP. Lewin also was responsible for reviewing, validating, and approving the sampling plans of the participating states. Lewin has also provided technical assistance to states in understanding and implementing both the payment accuracy and payment error rate models, for example, assisting states with stratifying the FFS claims by service type. In addition to the general statistical and consultation assignments, Lewin also developed a sample size calculator that each participating state used to estimate the number of sampling units it would need to achieve certain confidence and precision levels. Lewin also developed an error rate calculator that participating states have used to calculate their final payment accuracy and payment error rates. Lewin is uniquely qualified to perform the tasks in this procurement most economically and efficiently because it developed the statistical methodology used to calculate the Medicaid and SCHIP payment accuracy rates and payment error rates, is currently providing statistical support to CMS with the FY 2005 Payment Error Rate Measurement pilot project and will calculate the state-specific and national errors rates associated with this project. Lewin has worked extensively with CMS in each pilot project and has an understanding of the complexities in stratifying FFS claims, developing sampling plans, determining sample sizes, and calculating state-specific and national error rates. This sole source procurement is being conducted pursuant to the authority of 41 U.S.C. ? 253(c)(1) as implemented by FAR 6.302-1(a)(2), that only one responsible source and no other supplies or services will satisfy the agency?s requirements. CMS believes The Lewin Group is the only company that can provide CMS with timely and accurate technical support that will allow CMS to make the maximum effective use of the Medicaid FFS error rate findings. This contract will be awarded for a period of 26 months with no optional years. This is a notice of intent and not a request for quotations. Businesses that recognize and can provide the required service described above must provide supporting evidence. A determination by the Government not to compete this proposed acquisition based on responses to this notice is solely within the discretion of the Government. Information received will normally be considered solely for the purposes of determining whether to conduct a competitive procurement. The Government will consider all responses received NLT 3:00 PM EDT, 24 Aug 2005. Responses shall be submitted to Monica N. Carter.
- Place of Performance
- Address: Contractor's location.
- Record
- SN00862202-W 20050806/050804211838 (fbodaily.com)
- Source
-
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