U -- U- Education and training Services

SOURCES SOUGHT/REQUEST FOR INFORMATION *INFORMATION ITEM #10 HAS BEEN DELETED FROM PREVIOUS NOTICE* The Centers for Medicare & Medicaid Services (CMS) is seeking to identify businesses, in particular Small Business sources, (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business, and women-owned small business) that can provide the activities required by the Medicaid Integrity Program provisions in the Deficit Reduction Act. The information from this market research will help CMS plan their acquisition strategy. Please be sure to indicate if you have a GSA Schedule contract. Background: Medicaid was enacted in 1965 as Title XIX of the Social Security Act (hereinafter referred to as the Act). Title XIX of the Act is a Federal/State entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources. Medicaid is a cooperative venture jointly funded by the Federal and State governments (including the District of Columbia and the Territories) to assist States in furnishing medical assistance to eligible needy persons. Medicaid is the largest source of funding for medical and health-related services for America??s poorest people. Within broad national guidelines governed by Federal statutes, regulations, and policies, each State: (i) establishes its own eligibility standards, (ii) determines the type, amount, duration, and scope of services, (iii) sets the rate of payment for services, (iv) and administers its own program. While State participation in Medicaid is voluntary, all States have chosen to participate. The federal government supports state administration by providing matching funds and establishing general programmatic guidelines. In accordance with the statute, the Medicaid program by law is the payer of last resort. Third party liability (TPL) refers to the legal obligation of third parties to pay all or some of the health care costs of Medicaid services provided under a State Plan. Examples of third parties are: private health insurers, employer-sponsored health insurance, Medicare, workers?? compensation, liability settlement, medical-support orders, long-term-care insurance, and estate recovery. Billions of dollars each year are reported by states to CMS as Medicaid savings attributed to third party liability activities. These programs are complex and include activities associated with the eligibility-determination process, claims-payment system, and reimbursement methodologies developed by state Medicaid programs. The TPL policies and procedures are governed by both federal and state laws. Section 6034 of the Deficit Reduction Act (DRA) of 2005, signed February 8, 2006, established the Medicaid Integrity Program (MIP). Under this contract, MIP functions are to be performed by the MIC. The MIP offers a unique opportunity to identify, recover, and prevent overpayments. It will also support the efforts of State Medicaid agencies through a combination of oversight and technical assistance. While CMS has a wealth of experience in the financial management of the Medicaid program, the auditing of those who provide direct services to Medicaid beneficiaries has always been the responsibility of the States. The Education of Provider Medicaid Integrity Contractor (MIC) shall be prepared to provide Educational efforts or training that may take place in any State (including the District of Columbia and the Territories) that is receiving Federal funds under Medicaid. The Contractor will be required to travel to all locations to which training is to be provided. The Contactor will also be required to gather and / or create a compilation of all educational and training material into one or several training manuals/guides, a Frequently Asked Questions (FAQs) guide, as appropriate. All of the items above will be updated as the information becomes available and/or as appropriate. Standard templates for educational materials and efforts in coordination with CMS to ensure consistency and branding of MIC educational efforts may also be required. The Contractor may communicate with individuals and entities only after having received written approval from CMS. An example of these communications may be, but not limited to, the following: CMS Website, CMS List server, Provider Partner Emails, Exhibits at association conferences, and national training calls. CMS requests capability statements to this Sources Sought/RFI from particularly Small Businesses. Based on the market research, CMS anticipates soliciting for multiple award Indefinite Delivery Indefinite Quantity (IDIQ) contracts. The contractor will need to furnish the necessary services and qualified personnel, facilities, equipment, materials, and supplies not specifically provided by the government under the terms of this requirement or as indicated in each individual Task Order. The Contractor will provide all the necessary resources required for performance as a full Contractor within 30 days from contract award and within 10 days of issuance of a Task Order for all tasks as may be identified, unless otherwise specified in each Task Order. At a minimum, your capability statement shall include the following information: 1. Business Information: a. DUNS: b. Company Name; c. Company Address; d. Type of Company (i.e. small business, 8(a) woman owned, veteran owned, etc.) As validated via the CCR. All offerors must register on the Central Contractor Registration located at http://www.ccr.gov/index.asp. e. Company Point of Contact, Phone and E-mail address of individuals who can verify the capabilities/experience identified in the responses. Teaming Arrangements: All teaming arrangements shall also include the above-cited information and certifications for each entity on the proposed team. Teaming arrangements are encouraged. Responses must be submitted electronically to the contract specialist listed below not later than March 22, 2008. Capability statements will not be returned and will not be accepted after the due date. The maximum number of pages for submission is 10 pages. This Sources Sought Notice is 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. Capability statements will not be returned and will not be accepted after the due date. Contact information: Contracts Specialist, David Barbato, david.barbato@cms.hhs.gov , 410-786-5145. Contracting Officer, William Tate, william.tate@cms.hhs.gov , 410-786-1535. 2. Address your ability to develop educational materials that include, but are not limited to, both aggregate data and specific risk areas that may include topics related to Medicaid fraud, waste, and abuse of individuals or entities furnishing items or services under the Medicaid program; and identification of improper payments to individuals or entities receiving Federal funds under Medicaid. 3. Discuss your development and demonstrative educational efforts that emphasize prevention of program integrity risks identified by a wide variety of sources, including but not limited to, MIC auditors and audits, State Agencies, MFCUs, OIG, GAO, SURS, provider associations and other industry stakeholders, and feedback from a variety of sources including self assessments. 4. Demonstrate the ability to develop content and provide education to providers using a variety of education vehicles depending on the specific training required and number of participants that need the training: o In-person or live training, such as: ?X One-on-one / in-office training; ?X Group training; ?X Conferences; and ?X Interactive online training modules such those used in a learning management system. ?X 5. The experience and capability to provide: o Distance learning mechanisms, such as: ?X Teleconferences; ?X Online tutorials; and ?X Webcasts. 6. Also to provide: o Independent learning mechanisms, such as: ?X List servers; ?X Newsletters and ?X Articles 7. Demonstrate the ability to undertake tasks and initiatives to raise the overall awareness of the Medicaid Integrity Program (MIP), the MICs performing reviews and audits of providers, and the impact that the MIP will have. This awareness may take the form of an awareness campaign or other non-routine communication. If a conference setting is required, the Contractor may be responsible for all of the conference arrangements including, but not limited to the following: coordinating and registering of participants; securing conference sites; and arranging participants travel, hotel, and per diem, if necessary. 8. Discuss the ability to utilize Protocols to develop appropriate educational materials and training services, as determined by CMS, in accordance with Medicaid laws and regulations. These Protocols focus on four process elements to education: 1) Identification the opportunities for education (through Audit MICs and others examining Medicaid service provider claim transactions); 2) Creation of the education / training materials; 3) Approval of the materials / education by CMS; and, 4) Dissemination of the materials or education 9. The contractor shall demonstrate the knowledge and experience and/or ability to: a) Address knowledge of applicable Federal and State laws, regulations, and policies, including, but not limited to, Medicaid laws, Medicaid regulations, Medicaid manuals, the Federal Managers?? Financial Integrity Act (FMFIA), Government Auditing Standards (GAS), the Chief Financial Officer (CFO) Act of 1990, and others as may be identified herein. b) Discuss your survey, evaluation and feedback mechanisms for provider education processes to continually improve education efforts and also be able to establish performance metrics to assess the effectiveness of the program. THIS IS STRICTLY MARKET RESEARCH. THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) WILL NOT ENTERTAIN QUESTIONS REGARDING THIS MARKET RESEARCH.