Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC)

Section J:

Exhibit E.2 – PPI MEDIC Questions Submission Template has been replaced with Exhibit E.2 PPI MEDIC Questions Response - Amendment 1 and includes answers to questions that CMS determined to be necessary for proposal preparation.

Exhibit E.8 – Business Proposal Template - Amendment 1- has been updated to removed text from row 152 that was unintentionally included in the template.

Exhibit E.8 – Business Proposal Template - Amendment 1- has been updated to provide clarification to Offeror’s that they should incorporate the costs associated with Task 1 in Attachment J.1 - PPI MEDIC - Statement of Work under Task 6 - Administrative Requirements.

Attachment J.1 – PPI MEDIC – Statement of Work – Amendment 1 – Section 2.6 – Audits – has been updated to provide clarification on Remedy Action Plans (RAPs) and Corrective Action Plans (CAPs).

Attachment J.1 – PPI MEDIC – Statement of Work – Amendment 1 – Section 2.6.2 – Program Integrity (PI) Audits – has been updated to include "and/or", to ensure flexibility in audit location (i.e. virtual or onsite).

Attachment J.1 – PPI MEDIC – Statement of Work – Amendment 1 – Section 3.1 – Incoming Transition Requirements– has been updated to include additional transition clarifications.

Attachment J.1 – PPI MEDIC – Statement of Work – Amendment 1 – Section 3.2 – Outgoing Transition Requirements– has been updated to include additional transition clarifications.

Attachment J.1 – PPI MEDIC – Statement of Work – Amendment 1 – Appendix A- Deliverables Schedule– has been updated to include additional transition-out deliverables associated with SOW Section 3.2.

Attachment J.1 – PPI MEDIC – Statement of Work – Amendment 1 – Appendix A- Deliverables Schedule– has been updated to renumber deliverables 19-32.

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The PPI MEDIC serves as a national contractor responsible for providing oversight of the Medicare Parts C and D programs to ensure the protection of the Medicare Trust Fund. CMS seeks to contract with an external entity to support CMS audits and program integrity oversight activities related to fraud, waste, and abuse efforts within the Medicare Parts C and D programs. Its tasks include data analysis, audits and reviews of Medicare Advantage Organizations (MAOs),  including Medicare Advantage Prescription Drug (MA-PD) plan sponsors and Prescription Drug Plan (PDP) sponsors, as well as outreach, education, and referrals to law enforcement.