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Fiscal Intermediary Services for the Indian Health Service

Solicitation Number: SOLFI2010
Agency: Department of Health and Human Services
Office: Program Support Center
Location: Division of Acquisition Management
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SOLFI2010
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Solicitation
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Added: May 28, 2009 3:42 pm
The Program Support Center, Division of Acquisition Management, Department of Health and Human Services on behalf of the Indian Health Service (IHS), Office of Resource Access and Partnerships is seeking a Fiscal Intermediary (FI) to operate a centralized medical and dental claims processing and payment system to ensure that payments are made accurately and timely according to contractual requirements and maintain a centralized medical and dental claims reimbursement system. The FI will also collect, compile, organize workload and financial data, and provide statistical and financial reports to IHS. The Contractor shall calculate Medicare and other reimbursement rates to support IHS negotiation of Medicare pricing contracts and assist IHS in coordinating benefits. The IHS has a responsibility for providing health care services to American Indian and Alaska Natives. Direct Health care services are provided through a series of IHS-operated and Tribal-operated hospitals, clinics and health care programs. However, most IHS facilities are small and are unable to provide a wide range of health care services to their clientele. Therefore, IHS supplements its direct health care services by purchasing basic and specialty health care services from non-IHS health care providers through its CHS program.



The CHS program is limited by Congressional appropriations and, therefore, must rely on compliance with medical and dental priorities and regulations found at 42 CFR 136.1 through 136.25 and 136.61 to ensure the most effective use of CHS dollars. Regulations require CHS purchases to be approved in advance by authorized individuals, except in emergencies.



The authority for a fiscal agent is contained in the Consolidated Omnibus Budget Reconciliation Act of 1985, Public Law 99-272, Section 17003; . . .provides authority for the Secretary of the Department of Health and Human Services to contract with fiscal agents to perform claims payment, processing and audit functions with respect to services purchased on a contract basis by the Public Health Service . . . Fiscal Agents must either be entities which could qualify as carriers for Medicare purposes, or Indian tribes or Tribal organizations acting under the Indian Self-Determination Act contracts. While the fiscal agents need not be Medicare carriers, they must meet the same requirements as Medicare carriers regarding efficiency and effectiveness of operations, surety bonds, and financial controls.



This procurement is full and open. The awardee must meet the conditions in accordance with the Consolidated Omibus Budget Reconciliation Act of 1985, Public Law 99-272, Section 17003. It is anticipated that a Firm Fixed Price Contract will be awarded with a base year and four 12-month option years. The solicitation will be available on or about June 13, 2009, with a tentative closing date of July 13, 2009.
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Solicitation 1

Type:
Solicitation
Posted Date:
June 29, 2009
RFP SOL2010.doc (592.00 Kb)
Description: Sections B-M
Description: Attachment 2

Amendment 1

Type:
Mod/Amendment
Posted Date:
June 30, 2009
Description: SF-33
Description: Attachment 1

Amendment 2

Type:
Mod/Amendment
Posted Date:
July 6, 2009
Description: Amendment 1 to SOLFI2010
Exhibit A.pdf (162.81 Kb)
Description: Exhibit A
Exhibit B.pdf (34.28 Kb)
Description: Exhibit B
Exhibit C.pdf (55.00 Kb)
Description: Exhibit C
exhibit D.pdf (216.51 Kb)
Description: Exhibit D
Exhibit E1.pdf (158.83 Kb)
Description: Exhibit E
Description: Attachment A - Model Subcontracting Plan Outline
Description: Attachment D - Past Performance Questionnaire
Description: Attachment C - Past Performance Cover Sheet

Responses to Questions

Type:
Other (Draft RFPs/RFIs, Responses to Questions, etc..)
Label:
Responses to Questions
Posted Date:
July 24, 2009
Description: Responses to Questions

Amendment 3

Type:
Mod/Amendment
Posted Date:
July 24, 2009
Description: Amendment 2

Responses to Questions - Batch 2

Type:
Other (Draft RFPs/RFIs, Responses to Questions, etc..)
Label:
Responses to Questions - Batch 2
Posted Date:
July 27, 2009
Description: Responses to Questions

Amendment 4

Type:
Mod/Amendment
Posted Date:
July 27, 2009
Description: Amendment 3

Amendment 5

Type:
Mod/Amendment
Posted Date:
July 29, 2009
Description: Amendment 4

Responses to Questions

Type:
Other (Draft RFPs/RFIs, Responses to Questions, etc..)
Label:
Responses to Questions
Posted Date:
July 29, 2009
Description: Responses to questions

Attachment F

Type:
Other (Draft RFPs/RFIs, Responses to Questions, etc..)
Label:
Attachment F
Posted Date:
July 29, 2009
Description: Attachment F

Attachment H

Type:
Other (Draft RFPs/RFIs, Responses to Questions, etc..)
Label:
Attachment H
Posted Date:
July 29, 2009
C367633E.pdf (1,072.39 Kb)
Description: Attachment H

Amendment 6

Type:
Mod/Amendment
Posted Date:
July 30, 2009
Description: Amendment 5
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Parklawn Building Room 5-101
5600 Fishers Lane
Rockville, Maryland 20857
:
Allison C Ford,
Contract Specialist
Phone: 301-443-0101
Fax: 301-443-1004
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Janet Miller,
Contracting Officer
Phone: 301-443-2478
Fax: 301-443-3238