R -- BIPA 521 - Qualified Independent Contractor (QIC) and Administrative QIC

This notification is a Request for Information. Comments/questions are due on November 15, 2002. Comments/Questions should be submitted via the Internet at http://www.cms.hhs.gov/contracts/bipa521.asp. The Draft QIC and AdQIC SOWs can be found at that web site as well. You are invited and encouraged to submit comments on the QIC Draft SOW and the AdQIC Draft SOW. The QIC and AdQIC effort is envisioned by CMS as an important step in implementing the revised 2nd level appeals process as required by BIPA, Section 521. We would value your comments on any aspects of the SOWs, including areas that need further clarification, requirements that should be added or deleted, or any other concerns that you identify. BACKGROUND: BIPA Section 521 requires, among other things, the establishment of new entities known as Qualified Independent Contractors (QICs) to conduct reconsiderations of contractors? initial determinations or redeterminations. CMS has extensive information about BIPA on http://cms.hhs.gov/healthplans/bipa/bipafact.asp. CMS foresees two (2) major components of the BIPA Section 521 2nd level appeals contractor process. The QICs will adjudicate reconsiderations and expedited reconsiderations of initial determinations made by fiscal intermediaries, carriers, or quality improvement organizations, using established protocols; and, QICs will, collect and transmit information regarding the receipt and disposition of reconsiderations and expedited reconsiderations via the Reconsideration Tracking and Reporting System (RTRS). The second component will be an Administrative QIC or AdQIC. The AdQIC will provide technical support for the Reconsideration Tracking and Reporting System (RTRS); and, collect, track and distribute information regarding the receipt, processing and disposition of reconsiderations and expedited reconsideration requests. You are invited to submit comments/questions regarding both Draft SOWs. In addition, there are also several specific questions and SOW areas for which CMS is particularly interested in receiving comments/questions. These specific CMS questions are identified at the web site. CMS will evaluate comments received from the general public at the end of the comment period. CMS will not respond directly to any comments submitted, but will modify the QIC and AdQIC Draft SOWs based on the comments received before we begin any formal solicitation process. FAR CLAUSE 52.215-3 Solicitation for Information or Planning Purposes (Oct 1997) is hereby incorporated in accordance with FAR 15.207: (a) The Government does not intend to award a contract on the basis of this solicitation or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18, Bid and proposal costs, of the Federal Acquisition Regulation. (b) Although proposal and offeror are used in this Request for Information, your response will be treated as information only. It shall not be used as a proposal. (c) This solicitation is issued for the purpose of promoting a partnership by providing potential offerors the opportunity to comment on the Government?s requirement as it relates to industry standards. Please be advised that any innovative approach, methodology, strategy, or other information submitted pursuant to this request for comment(s) will become the property of CMS for its unlimited use. Persons and/or entities submitting any innovative approach, methodology, strategy, or other information to CMS for consideration waive any and all claim to such information. At this time, CMS has not yet finalized its plans for issuing a formal solicitation for the QIC and AdQIC effort. The information obtained from comments/questions received on the draft SOWs will allow CMS to make decisions regarding the program and a potential solicitation for contract award(s). Anyone who submits comments/questions on the draft SOWs will be notified when CMS issues a solicitation for submission of formal proposals. Any questions should be directed to Barbara Rufo, Contract Specialist, at (410)786-5589, or by sending e-mail to BRufo@CMS.HHS.Gov. E-mail communications should include company name, address, and point of contact, phone and fax numbers. Thank you in advance for your interest in this program. Your questions and comments on the QIC and AdQIC Draft SOWs are very valuable to CMS and your participation is greatly appreciated. Sincerely, LEISA S. BODWAY Contracting Officer