SOURCES SOUGHT
R -- Payment Error Rate Measurement (PERM) Medicaid and Children’s Health Insurance Program (CHIP) Statistical Contractor (SC) - Draft Statement of Work
- Notice Date
- 1/28/2010
- Notice Type
- Sources Sought
- NAICS
- 541990
— All Other Professional, Scientific, and Technical Services
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, Office of Acquisition and Grants Management, 7500 Security Blvd., C2-21-15, Baltimore, Maryland, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- CMS-SSN-2010-APP100768
- Archive Date
- 2/26/2010
- Point of Contact
- Amy D Duckworth, Phone: 410-786-3111, Donald M Knode, Phone: 410-786-1046
- E-Mail Address
-
amy.duckworth@cms.hhs.gov, donald.knode@cms.hhs.gov
(amy.duckworth@cms.hhs.gov, donald.knode@cms.hhs.gov)
- Small Business Set-Aside
- N/A
- Description
- Draft Statement of Work Introduction: The Centers for Medicare & Medicaid Services (CMS) is hereby conducting market research to determine the availability and capability of potential sources (both large and small) including small disadvantaged businesses ( i.e., 8(a), service-disabled veteran owned small business, HUBZone small business, veteran-owned small business, and women-owned small business) that can provide services in support of Medicaid and CHIP Payment Error Rate Measurement program (PERM). The information/Capability Statements obtained from this market research will be considered in planning the appropriate acquisition strategy. Please be sure to indicate if you have a GSA schedule contract, a contract on GSA 8(a) STARS, or a contract on GSA VETS GWAC. THIS IS STRICTLY MARKET RESEARCH TO ASSIST IN DETERMINING THE APPROPRIATE ACQUISTION STRATEGY TO OBTAIN CONTRACTOR SUPPORT SERVICES TO PERFORM THE SAME OR SIMILAR REQUIREMENTS TO THOSE DESCRIBED IN THE ATTACHED DRAFT SOW. THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) MAY OR MAY NOT ISSUE A REQUEST FOR PROPOSAL. RESPONSES TO THIS SOURCES SOUGHT NOTICE SHALL BE THE SUBMISSION OF A CAPABILITY STATEMENT; ACCORDINGLY, CMS WILL NOT ENTERTAIN QUESTIONS REGARDING THIS MARKET RESEARCH. Background: CMS is currently administering a payment error rate measurement program in the Medicaid and the Children's Health Insurance Program (CHIP) programs. CMS must estimate payment error rates in Medicaid and CHIP as directed by the Improper Payments Information Act (IPIA) of 2002 (Public Law 107-300). The IPIA directs each executive agency, in accordance with the Office of Management and Budget (OMB) guidance, to review all of its programs and activities annually, identify those that may be susceptible to significant improper payments, estimate the annual amount of improper payments, and submit those estimates to Congress. The IPIA defines improper payments as: (a) any payment that should not have been made or that was made in an incorrect amount, including both overpayments and underpayments, under statutory, contractual, administrative, or other legally applicable requirements; and (b) payments made to an ineligible beneficiary, any duplicate payments, payments for services not received, and any payment that does not account for credit for applicable discounts. CMS implemented the Payment Error Rate Measurement (PERM) methodology to produce FY 2006 through FY 2010 State error rates for fee-for-service claims, managed care capitation payments, and eligibility determinations. This is the methodology that CMS intends to continue to use into the foreseeable future to produce national error rates that comply with the requirements of IPIA. CMS hired a contractor to serve as the project's technical and statistical consultant. This contractor, known as the PERM statistical contractor, assisted CMS in developing and refining the overall methodology to estimate payment rate errors. They also assisted CMS in providing technical assistance to States in understanding and implementing the PERM project; identified sample sizes needed to determine error rates; and calculated error rates. It has also been their responsibility to review, validate, and approve the eligibility sampling plans of the participating States, even though the States are reviewing their own eligibility determinations under PERM. The current PERM methodology currently engages two Federal contractors as follows: (1) a statistical contractor (SC); and (2) a review contractor (RC). This contracting strategy has been designed to allow concentration of assignments, fluidity between tasks, and timely completion of projects; and as such, it is imperative that all PERM contractors maintain open communication with CMS and amongst one another. The standard operating procedure for the contractors administering the PERM program is as follows: 1) SC initiates the tasks for PERM by contacting the selected States, obtaining the necessary claims information, and pulling the statistical samples; and, if necessary, the SC requests and receives full claims detail from the States; 2) RC requests State medical policies and requests medical records from Medicaid/CHIP providers; 3) RC uses the policies and medical records to perform the medical reviews and also visits State offices to perform data processing reviews; 4) RC provides its findings to the SC who calculates State and national error rates based on the information received from the RC; and 5) RC and the SC jointly write the Medicaid and CHIP final reports that are submitted to CMS. The SC must work effectively and efficiently with CMS and the RC, as well as Medicaid/CHIP State representatives. During the spring of 2009, in order to improve the PERM process and introduce efficiencies to reduce State burden, CMS tested the concept of a minimum dataset to fulfill the PERM data submission requirements. The goal of the minimum dataset initiative was to reduce the burden placed upon states by the PERM program by shifting the majority of the universe programming tasks from the states to the SC and by requiring only a single data submission per quarter. During the minimum dataset pilot, states submitted claims, recipient, and provider files from which a CMS contractor was able to successfully identify PERM sampling units and create PERM Fee-for-Service and Managed Care universes that contained all data necessary for the rest of the PERM process. Due to the positive outcome of the Minimum Dataset Proof of Concept Special Study, CMS will allow selected states to utilize the minimum dataset data submission method in the FY 2011 PERM cycle and beyond. Response Information: In order to respond to this notice, contractors must be able to indicate experience and/or the ability to provide all of the numbered points below. Give enough detail so your response clearly indicates that you can provide the following: • Creation of accurate and complete Medicaid and CHIP universes from submitted state provider, claim, and recipient files using your familiarity and understanding of the PERM requirements and methodology; • Ability to perform statistical functions and provide statistical guidance in accordance with agency standards; • Knowledge of state-specific Medicaid and CHIP programs, state-specific Medicaid and CHIP data characteristics, and unique state nuances in Medicaid and CHIP programs and data; • Strong working knowledge of Medicaid/CHIP policy, claims processes, payment systems, Medicaid/CHIP-specific claiming situations, and managed care programs. Please include the following in your response: Business Information -- a. DUNS b. Company Name c. Company Address d. Current GSA Schedules appropriate to this Sources Sought e. Do you have a Government approved accounting system? If so, please identify the agency that approved the system. f. Type of Company (i.e., small business, 8(a), woman owned, veteran owned, etc.) as validated via the Central Contractor Registration (CCR). All offerors must register on the CCR located at http://www.ccr.gov/index.asp g. Company Point of Contact, Phone and Email address Teaming Arrangements: All teaming arrangements should also include the above-cited information and certifications for each entity on the proposed team. Teaming arrangements are encouraged. Responses must be submitted no later than 2:00PM on Thursday, February 11, 2010, via email to the Contract Specialist at Amy.Duckworth@cms.hhs.gov. Capability statements will not be returned and will not be accepted after the due date. The maximum number of pages for submission is 15 pages. This Sources Sought Notice is for information and planning purposes only and is not to be construed as a commitment by the Government. This is not a solicitation announcement for proposals and no contract will be awarded from this Notice. No reimbursement will be made for any costs associated with providing information in response to this Notice. Respondents will not be notified of the results of this evaluation. Contact information: Contracts Specialist, Amy Duckworth, e-mail: Amy.Duckworth@cms.hhs.gov; phone 410-786-3111. Contracting Officer, Donald Knode; e-mail: Donald.knode@cms.hhs.gov
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/spg/HHS/HCFA/AGG/CMS-SSN-2010-APP100768/listing.html)
- Place of Performance
- Address: TBD, United States
- Record
- SN02051741-W 20100130/100128234815-02339867f9845a433fb5ba508c54ce05 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
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