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U -- U- Education and training Services (OB1996180) (2008-03-15)

SOURCES SOUGHT/REQUEST FOR INFORMATION

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.

10. Demonstrate the capability to engage in analyzing data to provide
descriptive statistics, trends, and patterns from Medicaid audit results.

THIS IS STRICTLY MARKET RESEARCH. THE CENTERS FOR MEDICARE & MEDICAID
SERVICES (CMS) WILL NOT ENTERTAIN QUESTIONS REGARDING THIS MARKET RESEARCH.

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