Modification to a Previous Presolicitation Notice – Payment Error Rate Measurement Eligibility Review Contract
Notice Type: Modification to a Previous Presolicitation Notice
Posted Date:
Office Address:
Subject: Payment Error Rate Measurement Eligibility Review Contract
Classification Code: R - Professional, administrative, and management support services
Solicitation Number: CMS-2015-RFI-PERM-ERC
Contact:
Description:
REQUEST FOR INFORMATION CMS-2015-RFI-PERM-ERC PAYMENT ERROR RATE MEASUREMENT ELIGIBILITY REVIEW CONTRACTOR
THIS IS NOT A FORMAL REQUEST FOR PROPOSAL (RFP) AND DOES NOT COMMIT THE
Introduction: This is a Request for Information (RFI) and is issued solely for the purpose of planning and market research. This is NOT a solicitation for proposals, proposal abstracts, or quotations and does not obligate the Government to award a contract. The purpose of this notice is to obtain information regarding the availability and capability of large businesses and qualified small businesses (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business and woman-owned small business) to support the
Background:
CMS is currently administering a payment error rate measurement program in the
CMS implemented the Payment Error Rate Measurement (PERM) methodology to produce state and national error rates for fee-for-service claims, managed care capitation payments, and eligibility determinations. Currently, federal contractors perform the review of fee-for-service and managed care payments while states conduct their own review of eligibility determinations.
The Affordable Care Act created significant changes to
* Use of Modified Adjusted Gross Income (MAGI) methodologies for income determinations and household composition; * Use of a single streamlined application (or approved alternative) for intake of applicant information; * Availability of multiple channels to consumers for submitting application information (by mail, fax, phone or on-line); * Use of a HHS-managed data services hub for access to federal verification sources; * Need for account transfers and data sharing between the Marketplace,
These changes required redesign of many
Traditionally, states have been responsible for the PERM eligibility component, which has required states to develop universes of active and negative cases, randomly sample cases, conduct case reviews to determine whether eligibility was determined or redetermined correctly and collect payments associated with sampled cases. CMS is considering using a federal Eligibility Review Contractor (ERC) to conduct the eligibility reviews for the PERM measurement in all states. Using an ERC will improve the consistency of reviews and reduce the workload for states. Moreover, it will provide CMS with increased oversight of the PERM eligibility component. The ERC will be responsible for:
* Collecting, updating, and maintaining all state and federal policies related to
Overview of the Requirements
Interested parties should demonstrate that they possess the experience and/or the ability to provide the full range of services outlined below:
1) Conducting eligibility reviews for the 17 states in each PERM cycle, including assisting states with universe development, drawing a random sample of cases, conducting eligibility case reviews, and collecting payments associated with sampled cases; 2) Collecting, updating, and maintaining state and federal
Capability Statement Information Interested parties should demonstrate that they possess the following capabilities in their capability statements:
* Knowledge of IPERIA requirements and understanding of overall PERM goals; * Strong understanding of national and state
Please include the following in your response:
Your Business Information -
a) Dun & Bradstreet Number (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 as validated via the System for Award Management (SAM). All offerors must register in SAMs located at https://www.sam.gov/portal/public/SAM/ g)
This
Disclaimer and Important Notes:
This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization's qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. After a review of the responses received, a pre-solicitation synopsis and solicitation may be published in Federal Business Opportunities. However, responses to this notice will not be considered adequate responses to a solicitation.
Confidentiality:
No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).
Documents should be sent to the following:
Gina Romano Contract Specialist [email protected]
Nicole Hoey Contracting Officer [email protected]
Link/URL: https://www.fbo.gov/spg/HHS/HCFA/AGG/CMS-2015-RFI-PERM-ERC/listing.html
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