Sections B-M Draft clean

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

BRIEF DESCRIPTION OF SERVICES

The purpose of this contract is to obtain a Part A/Part B (A/B) Medicare Administrative Contractor (hereinafter referred to as “the contractor” or “MAC” or “A/B MAC”) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the “traditional” Medicare program (also known as the Medicare fee-for-service or FFS, program) for Jurisdiction 8 (J8). Jurisdiction 8 includes the states of Indiana and Michigan.

CONTRACT TYPE

The Centers for Medicare & Medicaid Services (CMS) anticipates awarding a Cost Reimbursement type contract. In accordance with FAR 16.101 (a) Policies, “Unless expressly prohibited by statute or this regulation, contract types that promote the best interests of the Government, but are not described in this regulation, are permitted for use in accordance with agency procedures (see 10 U.S.C. 3321(a) and 41 U.S.C. 3901). Ensure selection of contract type is consistent with the Guiding Principles for the System in 1.102The primary pricing arrangement is anticipated to be Cost- Plus- Award-Fee (CPAF).

AWARD FEE

The amount of award fee the Contractor earns, if any, will be based upon an evaluation by the Government of the contractor’s performance in accordance with the Performance Evaluation Award Fee Plan (Attachment J.07). The CMS Fee Determination Official (FDO) will determine the amount of award fee earned by the contractor for the evaluation period. The determination of the amount of the award fee for the evaluation period is a unilateral decision made solely at the discretion of the FDO. Upon receiving written notification from the FDO of the amount of award fee earned for the evaluation period, the Contractor may submit an invoice for the earned award fee. The Government may unilaterally change the Performance Evaluation Award Fee Plan at any time. However, any revisions to the evaluation factors in the Performance Evaluation Award Fee Plan shall be presented to the Contractor prior to the evaluation period in which it will be used.

The award fee evaluations will be performed on an annual basis with the actual evaluation beginning in the month immediately following the evaluation period. The award fee available for each period shall be a portion of the total award fee pool available for the entire contract period (see Section G.18). Award fee evaluations will not be applied to contract period of 6 months or less.