Award Number: HHSM-500-2004-00005I
Task/Delivery Order Number: HHSM-500-T0008
CMS seeks consideration to award a one (1) year period of performance extension of Renewal Period 2 from January 1, 2021 – December 31, 2021 in the following QIC jurisdiction: The Part A East.
QIC task order (HHSM-500-2004-00005I/HHSM-500-T0008) was competed amongst all the QIC IDIQ contract holders. The Medicare Appeals Demonstration activities were incorporated into the task order Statement of Work in April 2019 via Modification P00006 and effective May 2019. This work was authorized by the Office of Management and Budget (OMB) and extended to continue for an additional year through 2021. This work is highly specialized and must be completed in its entirety by C2C Innovative Solutions (Inc.)
Part A East QIC Task Order (HHSM-500-2004-00005I/HHSM-500-T0008): Awarded in December 2016 to C2C. The total funding obligated on the task order to date is approximately $81.3 million.
The revised period of performance is:
- Transition Period: December 13, 2016 – February 13, 2017
- Base Period: February 14, 2017 – February 13, 2018
- Renewal Period 1: February 14, 2018 – February 13, 2019
- Renewal Period 2: February 14, 2019 – December 31, 2021
The estimated value of the proposed action is $25,558,755.92.
The purpose of the proposed Part A East QIC task order extension is to process reconsiderations requested as a result of Medicare Administrative Contractors (MACs) redeterminations of Medicare Part A claims. This workload includes processing reconsideration requests for, at a minimum, hospital inpatient, home health, skilled nursing home, hospice, and other Part A services and claims. It also includes Part B services billed through MACs (sometimes referred to as “Part B of A”).
It shall be noted that the QIC is also responsible for reconsiderations based on “initial determinations” regarding Medicare Secondary Payer (MSP) recovery claims against beneficiaries or providers/suppliers where the redetermination was processed by a MAC. Such recovery claims against beneficiaries routinely include both Part A & Part B claims.
The activities under the proposed period of performance extension are essentially the same as the above listed Part A East QIC task order scope of work. As described in Section 2 above, the proposed period of performance extension of the Part A East QIC task order is necessary to continue to process reconsideration requests for, at a minimum, hospital inpatient, home health, skilled nursing home, hospice, and other Part A services and claims. It also includes Part B services billed through MACs (sometimes referred to as “Part B of A”). In addition, the proposed period of performance extension will continue to include activities performed under this TO in support of the QIC Appeals Telephone Discussion and Reopening Demonstration. The Demonstration, which was initially scheduled to end on 12/31/2020, has recently been extended by the OMB for 1 year and is now scheduled to end 12/31/2021. As a result of this extension, it is in the best interest of the government to continue, through completion of this effort, the Part A East QIC Demonstration activities which are performed under this effort.
Potential onboarding of a new contractor during the final months of the demonstration yields…
