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QIO 10th Statement of Work

Solicitation Number: CMS10thSOW
Agency: Department of Health and Human Services
Office: Centers for Medicare & Medicaid Services
Location: Office of Acquisition and Grants Management
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There have been modifications to this notice. To view the most recent modification/amendment, click here
Added: Mar 11, 2011 4:42 pm
The Centers for Medicare & Medicaid Services (CMS) plans to issue a Request for Proposal (RFP) pending the availability of funds for competitive proposals resulting in awards of separate contracts for Quality Improvement Organizations (QIOs), formerly known as Peer Review Organizations (PROs) for the States of Maine, Vermont, Idaho, Texas and the Territory of Virgin Islands. In order to be eligible to receive a QIO contract, an Offeror must: 1) satisfactorily demonstrate physician-sponsorship or physician access as defined in Sections 1152 and 1153 of the Act at the time its proposal is submitted; 2) must meet the definition of a utilization and quality control peer review organization as set forth in Section 1152 of the Social Security Act (the Act); and 3) be deemed a responsible entity in accordance with Federal Acquisition Regulation (FAR) Part 9.1. In addition, an Offeror must not be a health care facility, health care facility association, health care facility affiliate or payor organization; and must have a consumer representative on its governing board. QIOs are responsible for review of certain health care services furnished under Title XVIII of the Act in addition to working to improve the quality of care provided to Medicare beneficiaries. Each QIO is responsible for meeting all requirements as defined in the RFP and resultant contract. The period of performance will be for three (3) years. The RFP is anticipated to be released on the Federal Business Opportunities website within the next two to three weeks. Telephone or facsimile requests for the RFP will not be honored. CMS will host a Conference on March 28, 2011 from 9 a.m. to 5 p.m. (local prevailing time-Baltimore, MD) to discuss the recently released Draft 10th Statement of Work (Fed Biz Opps Special Notice Number CMS3411). The 10th Statement of Work Conference may be accessed by telephone, webinar, and in person. Further details concerning the Conference will be forthcoming in a separate posting on this website under this Solicitation Number. Offerors are further informed that in an earlier Federal Register announcement (FR Doc. 2010-28817 Filed 11-24-10; 8:45 am) published on November 24, 2010, CMS informed industry of the states in which there are no "In-State" QIOs. The current states where there are no "In-State" QIOs are: Maine, Vermont and Idaho. Offerors should note that the State of South Carolina was also named in this FR announcement but was included in error. To qualify as an "In-State" QIO, an organization must meet the definition of Section 1153(i)(3) of the Act which provides that an "In-State" organization is an organization that has its primary place of business in the State in which review will be conducted (or, which is owned by a parent corporation the headquarters of which is located in such state). In addition to meeting the previously stated eligibility requirements, Offerors electing to submit proposals for the States of Maine, Vermont and Idaho must also be deemed to have "In-State" status according to the Act. In the event there are no qualified "In-State" QIOs eligible to respond to the RFP for the States of Maine, Vermont and Idaho, CMS will only consider proposals from the QIOs who currently hold the 9th SOW contract for these states. For the State of Texas and the Territory of Virgin Islands, Offerors must meet the eligibility requirements of responsibility, physician-sponsorship or physician-access and may or may not be an "In-State" organization.
Added: Mar 18, 2011 2:39 pm
This Town Hall Meeting was formerly referred to as the 10th Statement of Work Conference under Solicitation Number CMS10thSOW and also mentioned in Special Notice Number CMS3411. The Centers for Medicare and Medicaid Services (CMS), Office of Clinical Standards and Quality (OCSQ), is excited to announce a Town Hall Meeting for the Quality Improvement Organization's (QIOs) 10th SOW on Monday, March 28, 2011 from 11:30 - 5:00 PM (local prevailing time-Baltimore). Meeting participation may occur either via Adobe Connect (Webinar) or guests are welcomed to join us in the CMS Auditorium. Pre-registration is required no later than Thursday, March 24th for both the webinar or if you plan to join us in person. Please note that CMS does not allow for onsite registration.
Instructions for how to register via Adobe Connect:
Please follow this link to register for the Webinar:

Once you have completed the registration process above you will receive an email confirmation and
log- in details. For those connecting via Adobe Connect, audio lines are available by calling the Conference Call Line at the time of the event:
Dial in Number: 1-877-267-1577
Meeting ID: 9574

We ask that you please share conference lines whenever possible.

Instructions for how to register to attend in person:
Registration is a requirement for those who are interested in attending in person. Attendance is restricted to two (2) individuals per company/organization/entity. Registration for the in-person attendees should be completed by email sent to Information required is: Company Name; Address; Point of Contact with Telephone Number and Facsimile Number; Full Name of Each Attendee with Respective Title. The list of attendees should be submitted no later than 3 p.m. (local prevailing time-Baltimore, MD) on Wednesday March 23, 2011. CMS is a secure facility and access as well as parking is limited. On the day of the conference, you should allow sufficient time to obtain a visitor's parking pass and registration at the Security Guard's Desk.

Added: Apr 06, 2011 2:10 pm
CMS is amending the 10th SOW Sources Sought Announcement to include:
1. A request for Offerors who registered and attended the CMS 10th SOW Town Hall Meeting to register on the Fed Biz Opps Interested Vendors List for this solicitation. This list may be used by vendors seeking subcontracting or partnering arrangements. CMS will not be posting the list of attendees from the Town Hall Meeting.
2. The Slides from the 10th SOW Town Hall Meeting held on March 28, 2011 (provided as attachment).
3. An Advance Notice Related to Renewal QIOs Only - CMS is requesting submission of Organizational Conflict of Interest (OCI) information in advance of the technical and business proposals for the QIO 10th scope. The advance notice includes the Organizational Conflict of Interest (OCI) Instructions and OCI Evaluation for Renewal Quality Improvement Organizations (QIOs) (provided as attachments). This Advance Notice only pertains to Renewal QIOs. Conflict of Interest submissions must be submitted in an original and three (3) paper copies, plus 2 CDs no later than 2 p.m. (Baltimore, MD time) on April 26, 2011. The submission address is as follows:
DHHS/Centers for Medicare & Medicaid Services
Attention: Ms. Naomi A. Haney-Ceresa
7500 Security Blvd., Mail Stop C2-21-15
Baltimore, MD 21244-1850
4. The official Request for Proposal (RFP) which will include instructions for the renewal and competitive QIOs is anticipated for release within the next few weeks. Offerors should continue to monitor Fed Biz Opps for future postings for the RFP.
Added: May 04, 2011 1:28 pm
Amendment Number 1 is issued--see new attachment.
Please consult the list of document viewers if you cannot open a file.

Conflict of Interest, Compliance Program, Instructions and Evaluation

Other (Draft RFPs/RFIs, Responses to Questions, etc..)
Conflict of Interest, Compliance Program, Instructions and Evaluation
Posted Date:
April 6, 2011
Description: Section H.11 Conflict of Interest
Description: Section H.12 Contract Violations and Integrity Issues
Description: Section J.X Compliance Attestation
Description: Section L.17 Conflict of Interest and Compliance Program Organization
Section L.18 Conflict of Interest and Compliance Program Proposal Instructions
Section M.X Evaluation of Conflict of Interest and Compliance Program
Description: March 28, 2011 Town Hall Meeting Slides

Amendment 1

Posted Date:
April 18, 2011
Description: QIO 10th SOW RFP for Competitive States/Territory and Renewal QIOs
Description: 10th SOW RFP Section J Attachments

Amendment 2

Posted Date:
May 4, 2011
Description: Amendment Number 1--Extension for Proposals for Virgin Islands Only

Amendment 3

Posted Date:
May 6, 2011
Cover letter.pdf (2,245.15 Kb)
Description: Amendment Number 2
Description: Summary of Changes to the RFP
Description: Industry Questions and CMS Responses
Description: Revised Section F
Description: Section J Attachment J-5a
Description: Section J Attachment J-10
Description: Section J Attachment J-23
Description: Revised Sections L & M

Amendment 4

Posted Date:
May 9, 2011
Description: Revised Section J-23 Business Proposal Forms and Schedules

Amendment 5

Posted Date:
May 11, 2011
Amendment 3.pdf (516.36 Kb)
Description: Proposal Submission Due Date and Time Extension for Renewal QIOs; States of ME, VT, ID, and TX and the Territory of VI.

Amendment 6

Posted Date:
May 12, 2011
Amendment 4.pdf (2,488.79 Kb)
Description: Amendment #4
Description: Corrected Industry Questions and Government Responses
Description: Revised Section J, Atachment J-10
Description: Revised Section J, Attachment J-23b
Description: QIO Manual Chapter 4 Technical Memo
Description: QIO Manual Chapter 7
Description: QIO Manual Chapter 9 Technical Memo
Description: EMTALA Technical Memo
7500 Security Blvd.
Baltimore, Maryland 21244-1850
As stated above.

United States
Naomi Haney-Ceresa,
Contracting Officer
Phone: 410-786-1607
Fax: 410-786-9088
Brian W. Hebbel,
Contracting Officer
Phone: 410-786-5159
Fax: 410-786-9922