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MURIEL BOWSER
MAYOR
August 27 , 2025
Honorable Phil Mendelson
Chairman
Council of the District of Columbia
John A. Wilson Building
1350 Pennsylvania Avenue, NW, Suite 504
Washington, DC 20004
Dear Chairman Mendelson:
Pursuant to section 451 of the District of Columbia Home Rule Act (D.C. Official Code § 1 -
204.51) and section 202 of the Procurement Practices Reform Act of 2010 (D.C. Official Code §
2-352.02), enclosed for consideration and approval by the Council of the District of Columbia is
proposed Contract No. CW123727 with Public Consulting Group LLC (PCG) in the amount of
$2,319,000. The period of performance is from September 13, 2025, through September 12, 2026.
Under the proposed contract, PCG will provide operations and maintenance to the District’s
Administrative Services Organization system, a claims and payment management system that also
provides other administrative functions for the Department of Health Ca re Finance and partner
agencies that receive Medicaid reimbursements or are responsible for operational functions of the
Medicaid Program.
My administration is available to discuss any questions you may have regarding the proposed
contract. In order to facilitate a response to any questions you may have, please have your staff
contact Marc Scott, Chief Operating Officer, Office of Contracting and Procurement, at (202) 724-
8759.
I look forward to the Council’s favorable consideration of this contract.
Sincerely,
Muriel Bowser
1
GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of Contracting and Procurement
Pursuant to section 202(c) of the Procurement Practices Reform Act of 2010, as amended, D.C.
Official Code § 2-352.02(c), the following contract summary is provided:
COUNCIL CONTRACT SUMMARY
(Standard)
(A) Contract Number: CW123727
Proposed Contractor: Public Consulting Group LLC (PCG)
Proposed Contractor’s Principals: William Mosakowski, President
Tony Brown, Vice President
Jon Kanter, Chief Financial Officer
Contract Amount (Base Period): $2,319,000
Unit and Method of Compensation: Monthly
Term of Contract: September 13, 2025, through September 12, 2026
(Base Period)
Type of Contract: Firm Fixed Price
Source Selection Method: Competition Exemption
(B) For a contract containing option periods, the contract amount for the base period and for
each option period. If the contract amount for one or more of the option periods differs from
the amount for the base period, provide an explanation of the reason for the difference:
Base Period Amount: $2,319,000
Option Period 1 Amount: $2,388,900
Explanation of difference from base period (if applicable): The amount for option period one
exceeds the price for the base period due to inflationary factors related to rising costs.
Option Period 2 Amount: $2,460,789
Explanation of difference from base period (if applicable): The amount for option period two
exceeds the price for the base period due to inflationary factors related to rising costs.
2
Option Period 3 Amount: $2,534,673
Explanation of difference from base period (if applicable): The amount for option period three
exceeds the price for the base period due to inflationary factors related to rising costs.
Option Period 4 Amount: $2,610,856
Explanation of difference from base period (if applicable): The amount for option period four
exceeds the price for the base period due to inflationary factors related to rising costs.
(C) The goods or services to be provided, the methods of delivering goods or services, and any
significant program changes reflected in the proposed contract:
The District of Columbia (the “District”), Office of Contracting and Procurement, on behalf of
Department of Health Care Finance (DHCF) is seeking a contractor to provide operations and
maintenance (O&M) of the Administrative Services Organization (ASO) system, a claims and
payment management system and provide other administrative functions, for the DHCF and Partner
Agencies that receive Medicaid reimbursements or are responsible for operational functions of the
Medicaid Program which serves eligible District residents.
(D) The selection process, including the number of offerors, the evaluation criteria, and the
evaluation results, including price, technical or quality, and past performance components:
The Contracting Officer determined it to be in the best interest of the District to use the exempt
from competition procurement method to satisfy DHCF’s requirement to operate and maintain the
District’s ASO system pursuant to the Procurement Practices Reform Act of 2010, Section 413-8,
and D.C. Official Code § 2-354.13(8).
PCG provides the current services due to having proprietary ownership of the District’s ASO
system. PCG’s customized IT solution is the foundation of the District’s ASO and is the
intellectual property of PCG. No other vendor has the right to operate, alter, or maintain the PCG’s
proprietary system. Therefore, the Contracting Officer proposes to enter into an exempt from
competition contract with PCG to continue providing and administering the ASO system.
Upon Council approval, CW12372 will be awarded for the period of performance from September
13, 2025, through September 12, 2026.
(E) A description of any bid protest related to the award of the contract, including whether the
protest was resolved through litigation, withdrawal of the protest by the protestor, or
voluntary corrective action by the District. Include the identity of the protestor, the grounds
alleged in the protest, and any deficiencies identified by the District as a result of the protest:
None
(F) A description of any other contracts the proposed contractor is currently seeking or holds
with the District:
CW120781 Independent Verification and Validation for the Medicaid Management Information
System, base period April 1, 2025, through March 31, 2026
3
CW94459 DHS Asset Verification System Services, option period three October 1, 2024, through
September 30, 2025
CW85352 Administrative Services Organization (ASO) System, option period four September 13,
2024, through September 12, 2025
(G) The background and qualifications of the proposed contractor, including its organization,
financial stability, personnel, and performance on past or current government or private
sector contracts with requirements similar to those of the proposed contract:
The contractor is providing services to the satisfaction of the District under the current contract. The
contractor has performed these services for the District since 2010.
The contractor has demonstrated through past performance reports that their organization has the
history, organizational and technical experience, including the key personnel required to
successfully meet the requirements of the proposed contract. Likewise, it has been determined that
the contractor maintains the financial resources, accounting and operational controls to successfully
fulfill the District’s requirement. The contractor has been determined responsible in accordance
with the District’s standards for responsibility.
(H) A summary of the subcontracting plan required under section 2346 of the Small, Local, and
Disadvantaged Business Enterprise Development and Assistance Act of 2005, as amended,
D.C. Official Code § 2-218.01 et seq. (“Act”), including a certification that the subcontracting
plan meets the minimum requirements of the Act and the dollar volume of the portion of the
contract to be subcontracted, expressed both in total dollars and as a percentage of the total
contract amount:
A waiver was granted by the Department of Small and Local Business Development exempting the
contract from the 35% subcontracting requirement.
(I) Performance standards and the expected outcome of the proposed contract:
Performance is expected to be in accordance with the requirements set forth in the contract. The
expected outcome of the proposed contract is the continued ability of the ASO system to facilitate
the claims and payment management system and provide other administrative functions, for the
DHCF and Partner Agencies that receive Medicaid reimbursements or are responsible for
operational functions of the Medicaid Program which serves eligible District residents.
(J) The amount and date of any expenditure of funds by the District pursuant to the contract
prior to its submission to the Council for approval:
None
(K) A certification that the proposed contract is within the appropriated budget authority for the
agency for the fiscal year and is consistent with the financial plan and budget adopted in
accordance with D.C. Official Code §§ 47-392.01 and 47-392.02:
4
The DHCF Agency Fiscal Officer certified that funding in the amount of $2,319,000 is available to
DHCF to support the contract for the ASO.
(L) A certification that the contract is legally sufficient, including whether the proposed
contractor has any pending legal claims against the District:
The contract has been reviewed by the Office of the Attorney General and found to be legally
sufficient. The contractor has no pending legal claim against the District.
(M) A certification that the Citywide Clean Hands database indicates that the proposed contractor
is current with its District taxes. If the Citywide Clean Hands Database indicates that the
proposed contractor is not current with its District taxes, either: (1) a certification that the
contractor has worked out and is current with a payment schedule approved by the District;
or (2) a certification that the contractor will be current with its District taxes after the District
recovers any outstanding debt as provided under D.C. Official Code § 2-353.01(b):
The Citywide Clean Hands database certified that the Contractor is current with its District taxes.
(N) A certification from the proposed contractor that it is current with its federal taxes, or has
worked out and is current with a payment schedule approved by the federal government:
The contractor has self-certified, via the Bidder-Offeror Certification form, that it is current with its
federal taxes.
(O) A certification that the proposed contractor has been determined not to violate section 334a of
the Board of Ethics and Government Accountability Establishment and Comprehensive
Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a; and (2) A
certification from the proposed contractor that it currently is not and will not be in violation
of section 334a of the Board of Ethics and Government Accountability Establishment and
Comprehensive Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a:
The contractor has certified, via the Bidder-Offeror Certification form, that it is (1) not in violation
of section 334a of the Board of Ethics and Government Accountability Establishment and
Comprehensive Ethics Reform Amendment Act of 2011, D.C. Official Code § 1-1163.34a; and (2)
currently is not and will not be in violation of section 334a of the Board of Ethics and Government
Accountability Establishment and Comprehensive Ethics Reform Amendment Act of 2011, D.C.
Official Code § 1-1163.34a.
(P) The status of the proposed contractor as a certified local, small, or disadvantaged business
enterprise as defined in the Small, Local, and Disadvantaged Business Enterprise
Development and Assistance Act of 2005, as amended; D.C. Official Code § 2-218.01 et seq.:
The contractor is not a certified local, small or disadvantaged business enterprise.
(Q) Other aspects of the proposed contract that the Chief Procurement Officer considers
significant:
5
None
(R) A statement indicating whether the proposed contractor is currently debarred from providing
services or goods to the District or federal government, the dates of the debarment, and the
reasons for debarment:
The contractor does not appear on the Office of Inspector General Exclusions Database, the
District’s list of Debarred and Suspended Contractors or the Federal Excluded Parties List.
(S) Any determination and findings issues relating to the contract’s formation, including any
determination and findings made under D.C. Official Code § 2-352.05 (privatization
contracts):
Determination and Finding for Exempt from Competition
Determination and Finding for Contractor’s Responsibility
Determination and Finding for Price Reasonableness
(T) Where the contract, and any amendments or modifications, if executed, will be made
available online:
http://ocp.dc.gov
(U) Where the original solicitation, and any amendments or modifications, will be made available
online:
http://ocp.dc.gov
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GOVERNMENT OF THE DISTRICT OF COLUMBIA
DepartmentofHealthCareFinance
xk *
fester
OfficeoftheChiefFinancialOfficer Ea
MEMORANDUM
TO: NancyHapeman
ChiefProcurementOfficer
OfficeofContractingandProcurement
THRU: DeliciaV.MooreDeliciaV._ 2atisaretbvoniay.
AssociateChiefFimaeiabOfficerSis2esimozere
HumanSupportServicesCluster
FROM: DarrinShaffer DarrinA Shaffer23misnsteyunasate
AgencyFiscalOfficer
DepartmentofHealthCareFinance
DATE: August7,2025
SUBJECT: AdministrativeServicesOrganization(ASO)ContractSolicitation
TheOfficeoftheChiefFinancialOfficerherebycertifiesthatthesumof$2,319,000.00isincludedintheDistrict's
LocalBudgetandFinancialPlanforFiscalYear2025tofundthecostsassociatedwiththeDepartmentofHealth
CareFinance's(DHCF)ASO ContractSolicitation.Thiscertificationsupportsbaseyearcontractcostfrom
September13,2025toSeptember12,2026.ThiscertificationreplacesthecertificationdocumentsdatedMarch
25,2025andJune12,2025.Thefundallocationisasfollows:
Vendor:PublicConsultingGroupLLC ContractNumber:CW123727
FiscalYear2025Funding:ASO Solicitation9/13/25-09/30/25,DIFS| DIFSCost| DIFS DIFS A 7Agency!Pang Center| Program| Account|PFeieet|Award| SubTask| Allocation Total
TO | 4025002| 70262 100205_| 7132001_|200881| 2001984| 25.18 45% $350,494.35
TO | 1010001| 70262 100205| 7132001 35% $61,715.32FY25 Total $112,209.67,
FiscalYear2026Funding:ASO Solicitation10/01/25— 9/12/2026
DIFS| DIFSCost| _DIFS DIFS iAgency)PIS Conte.| program| Account| PPeiset|Award| SubTask| Allocation Total
TO | 4025002_| 70262 190205 _|_7132001_|200881| 2002472 [25.18 45% $993,055.65
HTO| 1010001| 70262 100205 [7132001 35% 31,213,734.68
FY26 Total $2,206,790.33,
UponapprovaloftheDistrict’sLocalBudgetandFinancialPlanbytheCouncilandtheMayorandcompletionof
thethirty-dayCongressionallayover,fundswillbesufficienttopayforfeesandcostsassociatedwiththecontract.
‘Thereisnofiscalimpactassociatedwiththecontract.
Shouldyouhaveanyquestions,pleasecontactmeat(202)442-9079.
4414®St.NW,Suite900South,Washington,D.C.20001(202)442-5988FAX(202)478-1373
400 6th Street NW, Suite 9100, Washington, DC 20001 (202) 727-3400
GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of the Attorney General
ATTORNEY GENERAL
BRIAN L. SCHWALB
Commercial Division
MEMORANDUM
TO: Tomás Talamante
Director
Office of Policy and Legislative Affairs
FROM: Robert Schildkraut
Section Chief
Government Contracts Section
DATE: June 24, 2025
SUBJECT: Approval of Contract for Operations and Maintenance Services of the
District of Columbia’s Administrative Services Organization System
Contractor: Public Consulting Group, LLC
Contract Number: CW123727
Contract Amount: $2,319,000.00
This is to Certify that this Office has reviewed the above- referenced Contract and that we have
found it to be legally sufficient.
If you have any questions in this regard, please do not hesitate to call me at (202) 724-4018.
______________________________
Robert Schildkraut
AWARD/CONTRACT
1. Solicitation Number Page of Pages
1 72
2. Contract Number 3. Effective Date 4. Requisition/Purchase Request/Project No.
CW123727 See box 20C.
5. Issued By: Code 6. Administered by (If other than line 5)
Office of Contracting and Procurement
Health Services Cluster
441 4th Street, NW; Suite 330 S
Washington, DC 20001
Department of Health Care Finance
Health Care Operations Administration
441 4th Street, NW; Suite 900S
Washington, DC 20001
7. Name and Address of Contractor (No. street, city, county, state, and Zip Code)
Public Consulting Group LLC
148 State Street, 10th Floor
Boston, Massachusetts 02109
8. Delivery
FOB Origin FOB Destination
9. Discount for prompt payment:
Net 30 days
10. Submit invoices to the Address shown in Section G.2
(2 copies unless otherwise specified)
DC Vendor Portal, https://vendorportal.dc.gov
11. Ship to/Mark For Code 12. Payment will be made by Code
Department of Health Care Finance
Health Care Operations Administration
441 4th Street, NW; Suite 900S
Washington, DC 20001
Department of Health Care Finance
13. Remit Address: 14. Accounting and Appropriation Data
ENCUMBRANCE CODE:
15A. Item 15B. Supplies/Services 15C. Qty. 15D. Unit 15E. Unit Price 15F. Amount
0001
Operations and Maintenance (O&M) -
Administration Services Organization (ASO)
System
1 Year $2,109,000 $2,109,000
0002 ASO System Change Hours 1 Year $210,000 $210,000
Amount of Contract $2,319,000
16. Table of Contents
(X) Section Description Page (X) Section Description Page
PART I – THE SCHEDULE PART II – CONTRACT CLAUSES
X A Award/Contract 1 X I Contract Clauses 54
X B Contract Type, Supplies/Services and
Price/Cost 2 PART III – LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS
X C Specifications/Work Statement 5 X J List of Attachments 71
X D Packaging and Marking 32 PART IV – REPRESENTATIONS AND INSTRUCTIONS
X E Inspection and Acceptance 33 K Representations, certification and other
statements of offerors X F Period of Performance and Deliverables 34
X G Contract Administration 37 L Instructions, conditions & notices to offerors
X H Special Contract Requirements 44 M Evaluation factors for award
Contracting Officer will complete Item 17 or 18 as applicable
17. CONTRACTOR’S NEGOTIATED AGREEMENT
(Contractor is required to sign this document and return (1) copy to the issuing
office.) Contractor agrees to furnish and deliver all items or perform all the services
set forth or otherwise identified above and on any continuation sheets, for the
consideration stated herein. The rights and obligations of the parties to this contract
shall be subject to and governed by the following documents: (a) this
award/contract, (b) the solicitation, if any, and (c) such provisions, representations,
certifications, and specifications, as are attached or incorporated by reference
herein. (Attachments are listed herein.)
18. AWARD
(Contractor is not required to sign this document.) Your offer on
Solicitation Number , including the additions or changes made by you
which additions or changes are set forth in full above, is hereby accepted
as to the items listed above and on any continuation sheets. This award
consummates the contract which consists of the following documents: (a)
the Government’s solicitation and your offer, and (b) this award/contract.
No further contractual document is necessary.
19A. Name and Title of Signer (Type or print) 20A. Name of Contracting Officer
Tracy Williams
19B. 19C. Date Signed 20B. District of Columbia
(Signature of Contracting Officer)
20C. Date Signed
Government of the District of Columbia Office of Contracting & Procurement
DC OCP 201 (7-99)
William S. Mosakowski, President and CEO
05/15/2025
CW123727
O&M – ASO System
Page 2 of 72
SECTION B: CONTRACT TYPE, SUPPLIES OR SERVICES AND
PRICE/COST
B.1 The District of Columbia (the “District”), Office of Contracting and Procurement, on
behalf of Department of Health Care Finance (DHCF) is seeking a contractor to provide
operations and maintenance of the Administrative Services Organization (ASO) system,
a claims and payment management system and provide other administrative functions,
for the DHCF and Partner Agencies that receive Medicaid reimbursements or are
responsible for operational functions of the Medicaid Program which serves eligible
District residents.
B.2 The District contemplates award of a firm fixed price contract in accordance with 27
DCMR, Chapter 24.
B.3 PRICE SCHEDULE
B.3.1 BASE YEAR – September 13, 2025 through September 12, 2026
Contract
Line-Item No.
(CLIN)
Item Description Total Price
0001 O&M - ASO System $2,109,000
0002 ASO System Change Hours – Modification Pooling Hours $210,000
Grand Total for Base Period B.3.1 $2,319,000
B.3.2 OPTION YEAR ONE – September 13, 2026 through September 12, 2027
CLIN Item Description Total Price
1001 O&M - ASO System $2,172,600
1002 ASO System Change Hours – Modification Pooling Hours $216,300
Grand Total for Option Period One B.3.2 $2,388,900
B.3.3 OPTION YEAR TWO – September 13, 2027 through September 12, 2028
CLIN Item Description Total Price
2001 O&M - ASO System $2,238,000
2002 ASO System Change Hours – Modification Pooling Hours $222,789
Grand Total for Option Period Two B.3.3 $2,460,789
CW123727
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B.3.4 OPTION YEAR THREE – September 13, 2028 through September 12, 2029
CLIN Item Description Total Price
3001 O&M - ASO System $2,305,200
3002 ASO System Change Hours – Modification Pooling Hours $229,473
Grand Total for Option Period Three B.3.4 $2,534,673
B.3.5 OPTION YEAR FOUR – September 13, 2029 through September 12, 2030
CLIN Item Description Total Price
4001 O&M - ASO System $2,374,500
4002 ASO System Change Hours – Modification Pooling Hours $236,356
Grand Total for Option Period Four B.3.5 $2,610,856
B.3.6 PRICE SCHEDULE SUMMARY
Price Schedule Period of Performance Total Price
B.3.1 Base Year $2,319,000
B.3.2 Option Year One $2,388,900
B.3.3 Option Year Two $2,460,789
B.3.4 Option Year Three $2,534,673
B.3.5 Option Year Four $2,610,856
GRAND TOTAL (B.3.6) $12,314,218
B.4 NONPROFIT FAIR COMPENSATION ACT OF 2020, D.C. Code § 2-222.01 et seq.
B.4.1 Nonprofit organizations, as defined in the Act, shall include in their rates the indirect
costs incurred in provision of goods or performance of services under this contract
pursuant to the nonprofit organization's unexpired Negotiated Indirect Cost Rate
Agreement (NICRA). If a nonprofit organization does not have an unexpired NICRA,
the nonprofit organization may elect to instead include in its rates its indirect costs:
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(1) As calculated using a de minimis rate of 10% of all direct costs under this
contract;
(2) By negotiating a new percentage indirect cost rate with the awarding agency;
(3) As calculated with the same percentage indirect cost rate as the nonprofit
organization negotiated with any District agency within the past 2 years;
however, a nonprofit organization may request to renegotiate indirect costs rates
in accordance with B.6.2; or
(4) As calculated with a percentage rate and base amount, determined by a certified
public accountant, as defined in the Act, using the nonprofit organization's
audited financial statements from the immediately preceding fiscal year, pursuant
to the OMB Uniform Guidance, and certified in writing by the certified public
accountant.
B.4.2 If this contract is funded by a federal agency, indirect costs shall be consistent with the
requirements for pass-through entities in 2 C.F.R. § 200.331, or any successor regulations.
B.4.3 The Contractor shall pay its subcontractors which are nonprofit organizations the same indirect
cost rates as the nonprofit organization subcontractors would have received as a prime
contractor.
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SECTION C: SPECIFICATIONS/WORK STATEMENT
C.1 SCOPE:
DHCF is seeking a Contractor to provide O&M of the ASO system, a claims
clearinghouse and payment management system and other administrative functions, for
DHCF and Partner Agencies that could receive Medicaid reimbursement or are
responsible for operational functions of the Medicaid Program which services eligible
District residents.
C.2 A PPLICABLE DOCUMENTS
C.2.1 All documents applicable to this contract and the resulting Contract are listed in
Section J.
C.2.2 The following documents are applicable to this procurement and are hereby incorporated
by this reference:
Item No. Document Type Title Date
1 Industry
Standards
Project Management Institute (PMI)
https://www.pmi.org/pmbok-guide-
standards/about
Most
Recent
2 Code of Federal
Regulations
HIPAA Privacy, Security, and Administrative
Simplification Regulations
45 C.F.R. §§ 160, 162, and 164
https://www.hhs.gov/hipaa/for-
professionals/privacy/laws-
regulations/combined-regulation-
text/index.html
Most
Recent
3 D.C. Code D.C. Mental Health Information Act
D.C. Code § 7-1201 et seq.
Most
Recent
4 Federal
Guidelines
Health Information Technology (HIT)
https://www.hhs.gov/hipaa/for-
professionals/special-topics/health-information-
technology/index.html
Most
Recent
5 Federal
Guidelines
Payment Error Rate Measurement (PERM)
http://www.cms.gov/PERM/
Most
Recent
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C.3 DEFINITIONS & ACRONYMS
These terms when used in this contract have the following meanings:
C.3.1 Administrative Services Organization (ASO): The contractor that provides DHCF and
Partner Agencies with operational services to perform claims submittal and related
administrative functions for Medicaid and non-Medicaid claims, including, but not
limited to design, development and operations of the transaction processing system that
complies with HIPAA and Medicaid requirements, documentation of services and billing
management, service delivery verification, training and oversight of Partner Agencies
non-DHCF staff and contracted providers related to billing and payment through
Medicaid to avoid duplication and/or inappropriate Medicaid payment, analysis and
reports of activities, accountability and results, interface with the MMIS and DCAS
systems, and other traditional components of ASO activities.
C.3.2 Automated Client Eligibility Determination System (ACEDS): The ESA’s eligibility
system that assists in making the determination of whether individuals or families are
eligible for a variety of human service programs including Medicaid. This system has
been replaced by the DC Access System (DCAS)
C.3.3 Award Date: The date on which the Contract Officer signed the Contract, as reflected in
Block 20C of Section A. To the extent that performance deadlines are calculated from
the Award Date, additional time shall be added to reflect any delay in the transmittal of
the executed Contract to the Contractor.
C.3.4 CFSA: Child and Family Services Agency
C.3.5 Claim: Form used by a provider to bill for services rendered.
C.3.6 CMS: Centers for Medicare and Medicaid Services
C.3.7 DHCF: Department of Health Care Finance
C.3.8 DCAS: DC Access System (formerly referred to as ACEDS)
C.3.9 DCPS: District of Columbia Public Schools
C.3.10 Health Information Technology (HIT): All forms of technology used to create, store,
exchange and utilize health information in its various forms including business data,
conversations, still images, motion pictures and multimedia presentations.
C.3.11 Health Insurance Portability and Accountability Act of 1996 (HIPAA): Federal
legislation establishing health insurance portability and coverage protections for
qualified individuals and authorizing the promulgation of Federal regulations related to
health information privacy, health information security, administrative simplification,
and the transfer of electronic health information among health care payers, plans, and
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providers and certain third parties. HIPAA also refers to the federal regulations
promulgated at 45 C.F.R. §§ 160-164.
C.3.12 Health Insurance Portability and Accountability Act Transaction and Code Sets
Standards: Federal requirements to standardize the format for electronic transactions
between providers and health plans and other entities set forth in the regulations
promulgated at 45 C.F.R. §§ 160 and 162.
C.3.13 Information Systems Development Methodology (ISDM): Methodology for
describing how system design and development will be accomplished, including the
specific analysis, documentation, and deliverable requirements.
C.3.14 Medicaid Information Technology Architecture (MITA) Framework: A blueprint
used to examine Medicaid business priorities, plan future improvements, and to acquire
technical applications that meet both the District’s needs and the objectives for the
MITA initiative.
C.3.15 MITA Maturity Model (MMM): A model that shows improvement and transformation
of business processes or systems over time. The model is used for establishing goals for
achieving progress over time. The model has five (5) levels showing a progression over
time starting with Level One (1) at the beginning and Level Five (5) when the business
process is fully mature.
C.3.16 MITA Self-Assessment (MITA SS-A): A process used to review strategic goals and
objectives, measure current business processes and capabilities against MITA business
capabilities, and ultimately develop target capabilities to transform the state’s Medicaid
enterprise to be consistent with MITA principles.
C.3.17 Medicaid Management Information System (MMIS): The District’s integrated group
of procedures and computer processing operations designed to adjudicate Medicaid
claims and process encounter data for the Medicaid program.
C.3.18 OSSE: Office of the State Superintendent of Education
C.3.19 Partner Agencies: The District Agencies that are involved with either billing or
providing services and administrative functions for which Medicaid reimbursement is
available. These include:
C.3.19.1 Children and Family Services Agency (CFSA);
C.3.19.2 Department of Behavioral Health (DBH);
C.3.19.3 Department on Disability Services (DDS);
C.3.19.4 Chartered Schools/Office of the State Superintendent of Education (OSSE);
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C.3.19.5 District of Columbia Public Schools (DCPS);
C.3.19.6 Department of Health (DOH),
C.3.19.7 Department of Corrections (DOC)
C.3.19.8 District Department of Environment (DDOE);
C.3.19.9 Fire and Emergency Medical Services (FEMS); and
C.3.19.10 Department of Youth Rehabilitative Services (DYRS).
C.3.20 Partner Agencies Billing Systems: Existing billing systems that some of the Partner
Agencies defined in Section C.3.19 have in place to process claims and assist in
administering the Agency programs.
C.3.21 Payment Error Rate Measurement (PERM): CMS program to measure improper
payments in the Medicaid program and the Children's Health Insurance Program (CHIP).
PERM (Applicable Document #5) is designed to comply with the Improper Payments
Information Act of 2002 (IPIA; Public Law 107-300).
C.3.22 Stakeholders: People or groups who have a stake, or an interest, in the outcome of the
ASO. Such parties will be designated by DHCF and shall include but not be limited to:
Partner Agencies, DHCF staff, and contractor key personnel and staff.
C.3.23 Standard: In accordance with 45 C.F.R. § 160.103, a rule, condition, or requirement that:
C.3.23.1 Describes the following information for products, systems, services or practices:
C.3.23.2 Classification of components;
C.3.23.3 Specification of materials, performance, or operations;
C.3.23.4 Delineation of procedures; or
C.3.23.5 Relates to the privacy of individually identifiable health information.
C.3.24 Successfully Paid Claim (SPC): A claim where the correct payment is received by the
Partner Agency’s provider and all applicable, complete and accurate reports,
documentation, and supporting information has been collected and directly maintained
by either the ASO or the Partner Agency.
C.3.25 Traceability Matrix: A table depicting the multiple relationships between the provider
requirements of a Partner Agency and the organizational needs of a Partner Agency to
demonstrate the completeness of the relationship.
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C.3.26 Transaction: In accordance with 45 C.F.R. § 160.103, the transmission of information
between two (2) parties to carry out financial or administrative activities related to health
care. It includes the following types of information transmissions:
C.3.26.1 Health care claims or equivalent encounter information;
C.3.26.2 Health care payment and remittance advice;
C.3.26.3 Coordination of benefits;
C.3.26.4 Health care claim status;
C.3.26.5 Enrollment and disenrollment in a health plan;
C.3.26.6 Eligibility for a health plan;
C.3.26.7 Managed Care Organization premium payments;
C.3.26.8 Referral certification and authorization;
C.3.26.9 First report of injury;
C.3.26.10 Health claims attachments; and
C.3.26.11 Other transactions that the Secretary of Health and Human Services may prescribe by
regulation.
C.3.27 Work Breakdown Structure (WBS): A project management tool that defines a project
and groups the project’s discrete work elements in a way that helps organize and define
the total scope of work for the project. WBS also provides the necessary framework for
detailed cost estimating and control.
C.4 BACKGROUND
C.4.1 DHCF is the single state agency responsible for the implementation and administration
of the District of Columbia’s Medicaid Program (Title XIX of the Social Security Act)
and State Children’s Health Insurance Program (SCHIP, Title XIX of the Social Security
Act). DHCF is also responsible for administering: (1) the D.C. Health Care Alliance
Program (Alliance), a health benefits program for low-income individuals who do not
qualify for Medicaid; (2) the Immigrant Children’s programs, which convers
undocumented children up to age 21 who do not qualify for Medicaid or SCHIP; (3) the
District’s Child and Adolescent Supplemental Security Income Program (CASSIP), the
District’s managed care program for children and adolescents with special health care
needs; and (4) the Healthy DC Program.
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C.4.2 DHCF completed a specific MITA SS-A related to claims management, specifically
limited to District Agencies and their providers. The MITA SS-A included both direct
staff and contracted staff and was released in August 2024 (Attachment J.10). The MITA
SS-A related to claims management fits in as a part of the overall MITA SS-A initiative
that is submitted to CMS.
C.4.3 DHCF, like other state Medicaid agencies, is constantly challenged to improve service
delivery, ensure appropriate reimbursement for Medicaid services, and fully utilize
Federal Financial Participation (FFP) with limited or no risk of audit repayment. In the
District, Partner Agencies play an instrumental role in the delivery of Medicaid services
either as a Medicaid provider or as delegated authority within the Medicaid program
operations. Partner Agencies retain their own information system, provider enrollment,
and administrative claiming as it relates to Medicaid and other locally funded health care
services. For these reasons, DHCF initiated an ASO Assessment of the Medicaid claims
management for Partner Agencies in 2008. (Attachment J.10)
C.4.4 The central recommendation of the ASO Assessment is that DHCF procure the services
of a single ASO to perform claims submittal, including proper documentation for each
claim and related administrative functions for the Partner Agencies. To maintain
continuity of standardized claiming, including proper documentation for each claim,
claims management procedures and related administrative functions for the partner
agencies, DHCF is procuring the services of a single ASO.
C.5 REQUIREMENTS
C.5.1 ASO Capabilities
The Contractor shall operate and maintain the ASO System and provide documentation
of:
C.5.1.1 Health care services delivered and billing management;
C.5.1.2 Service delivery verification and validation;
C.5.1.3 Training and oversight of Partner Agencies non-DHCF staff and contracted providers
related to billing and payment through Medicaid to avoid duplication or inappropriate
Medicaid payment;
C.5.1.4 Analysis and reports of activities;
C.5.1.5 Accountability of the activities and results of the activities;
C.5.1.6 Interface with the Medicaid Management Information System (MMIS) and Economic
Security Administration (ESA), DC Access System (DCAS); and
C.5.1.7 Other existing transaction systems being used by Partner Agencies and other traditional
components of ASO activity using a transaction processing system that complies with
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the Health Insurance Portability and Accountability Act (HIPAA) and Medicaid
requirements.
C.5.1.8 The Contractor shall not be financially responsible for payment of services delivered but
shall be qualitatively accountable for the validity and accuracy of the Medicaid
payments, oversight of the documentation submitted by providers for whom it processes
transactions, and administrative accountability. The Contractor shall perform claims
submittal and related administrative functions for Medicaid health care provider services
through payment of claims and remittance advice.
C.5.1.9 The Partner Agencies will initially include the District Public Schools (DCPS), Charter
Schools/Office of the State Superintendent of Education (OSSE), and Child and Family
Services Agency (CFSA), but The Contractor shall have the capacity to expand services
to all the remaining Partner Agencies, which includes: the Department of Behavioral
Health (DBH), Department on Disability Services (DDS), Department of Corrections
(DOC), Department of Health (DOH), District Department of Environment (DDOE),
Fire and Emergency Medical Services (FEMS), and Department of Youth Rehabilitative
Services (DYRS) as described in Section C.3.19.
C.5.1.10 The Contractor shall retain ownership of all proprietary systems used to provide the
professional services requested in the Contract. Any Customized System developed for
DHCF data is to remain the property of DHCF.
C.5.1.11 The Contractor shall operate and maintain the ASO system which is fully functional and
performs optimally in accordance with :
a. Planning and Feasibility Tasks as described in Section C.5.4;
b. Definition Tasks as described in Section C.5.5;
c. Design Tasks as described in Section C.5.6; and
d. Development Tasks as described in Section C.5.7
e. Implementation Tasks as described in Section C.5.8;
f. Turnover Tasks as described in Section C.5.9; and
g. Operations Tasks as described in Section C.5.11.
C.5.1.12 At the completion of each task, the Contractor shall obtain written approval
of satisfactory completion from DHCF prior to proceeding to the next task.
C.5.1.13 While the Contractor shall show its capability of providing services for all Partner
Agencies, the Contractor shall initially implement the project for one (1) of the Partner
Agencies within the first three (3) months of the contract award date and the remainder
of the Partner Agencies within six (6) months of the contract award date. The Partner
Agency to be first implemented is at the discretion of DHCF.
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C.5.2 The Contractor shall work together with the District to accomplish the following goals:
C.5.2.1 Reduce duplication of functions between DHCF and its Partner Agencies;
C.5.2.2 Standardize procedures for Medicaid claims management, including the creation,
documentation, processing, resolution and payment validation of Medicaid claims for
each of the Partner Agencies over time, beginning with a specific sub-set of
Departments;
C.5.2.3 Enforce standard data and transactions format, audits and edits for the creation of
Medicaid;
C.5.2.4 Reduce District overhead caused by the engagement of multiple intermediaries,
operation of proprietary claims systems, maintenance of District claims systems and
workarounds;
C.5.2.5 Work with the District to standardize provider rates and business processes for services,
regardless of the payment source;
C.5.2.6 Reduce the rate of federal recoupment from Medicaid-paid claims due to insufficient or
erroneous documentation, provider errors and avoidable mistakes; and
C.5.2.7 Ensure that all claims billed to Medicaid and other funding sources available to the
District are billed and paid in a timely manner to comply with federal prompt payment
requirements.
C.5.3 System Change Orders – Modification Pooling Hours
This section is applicable only to system change order(s) to optimize functionality of
the ASO System not otherwise identified as general O&M of the ASO System.
C.5.3.1 The contractor shall allow for up to a thousand (1,000) total modification pooling hours
per year for System Change Orders. The modification pooling hours can be used in any
of the base or option years. Any hours not used during a year of operation will be carried
over to the next year of operations.
C.5.3.2 When the District requests a System Change Order, the Contractor shall provide the
Level of Effort (LOE) detailing the number of hours needed to implement the requested
change. The cost breakdown must be provided in Word or PDF format with detailed line
items to support the number of hours and cost of the requested System Change Order.
C.5.4 Planning and Feasibility Tasks
C.5.4.1 Project Staffing Plan
C.5.4.1.1 The Contractor shall provide a draft Project Staffing Plan for review within two weeks
of contract award.
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C.5.4.1.2 The Contractor shall revise their Project Staffing Plan based on feedback from the CA,
and provide the revised Project Staffing Plan, within one month from date of award, to
include:
C.5.4.1.2.1 Designation of a Project Manager, who will be designated as Key Personnel as defined
in section H.12.2;
C.5.4.1.2.2 Identification and selection of the appropriate staffing mix of skill sets and experience;
C.5.4.1.2.3 Effective assignment of staff, on-site or off-site, for the duration of project; and
C.5.4.1.2.4 An overview of the various staffing positions and the responsibilities.
C.5.4.2 The Contractor shall ensure their Project Staffing Plan includes staff experienced with
Medicaid, claims management, information system development methodology, training,
operations, and customer and provider services including web-based services and call
center operations.
C.5.4.3 Key Personnel
The Contractor shall provide resumes for all proposed key personnel and all resumes
shall list the month and year for the corresponding start and end dates of each position.
C.5.4.3.1 The Contractor shall provide the following key personnel member, Project Manager
(PM), who shall have the following minimum qualifications:
C.5.4.3.1.1 A minimum of a degree in a health-related field and five (5) years of project
management experience in a project of scope and complexity similar to this ASO
project;
C.5.4.3.1.2 An overall understanding of claims management, and billing business and technical
processes for health services using state of the art technology; and
C.5.4.3.1.3 Experience in marketing, management, Medicaid payments, customer service, and
quality oversight.
C.5.4.3.2 The Contractor’s PM shall at a minimum fulfill the following responsibilities:
C.5.4.3.2.1 Supervise the day-to-day performance, obligations, and responsibilities under the
Contract and receive direction from DHCF;
C.5.4.3.2.2 Serve as the liaison between the District and the Contractor;
C.5.4.3.2.3 Provide consultation and technical assistance with issues arising out of the project;
C.5.4.3.2.4 Attend all project meetings and other meetings with designated District government staff
in person; and
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C.5.4.3.2.5 Implement the project plan, manage risks, communicate results and issues, and prepare
reports.
C.5.4.3.3 The Contractor shall engage additional staff as necessary to carry out the requirements of
the Contract. The Contractor shall identify such staff by area of responsibility and
sufficiency and shall submit this information to the District for prior approval.
C.5.4.3.4 The Contractor, and its subcontractor(s) if used, shall provide a resume of the key
personnel that will assist on this project with its proposal submission. The Contractor
shall provide contact information, specifically email and office addresses as well as
office and cellular phone numbers, for the designated Project Manager to the CA. The
Project Manager shall be the primary point of contact for the District.
C.5.4.3.5 The Contractor shall provide the CA contact information for other staff who will be
assigned to the contract, including email, office address, office and cellular phone
numbers.
C.5.4.3.6 The Contractor shall not reassign Key Personnel or appoint replacements prior to written
notification and justification to the CA. The change cannot occur until the CA has given
written consent to effectuate the change.
C.5.4.4 Project Meetings
C.5.4.1.1 The Contractor shall attend and facilitate regular Project Meetings to review and update
the Project Plan, project progress, review project schedule and timelines and address
problems within District specified timeframes. Project Meetings shall be held
minimally once a week.
C.5.4.5 Project Status Reports
C.5.4.5.1 The Contractor shall, on a weekly basis, prepare a complete suite of Project Management
Institute (PMI) reports including status of work on tasks, use of staff resources and
expenditures.
C.5.4.6 Project Management Plan
C.5.4.6.1 The Contractor shall submit a Project Management Plan to DHCF in accordance with
Project Management Institute (PMI) standards within one month from date of award.
C.5.4.6.2 The Project Management Plan shall require DHCF approval prior to implementation,
and shall include, at a minimum, the Contractor’s:
C.5.4.6.2.1 Approach to internal project management structure, including a functional
organizational chart;
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C.5.4.6.2.2 Communication plan detailing the Contractor’s method for keeping all project
stakeholders informed about the progress of the project in a timely manner;
C.5.4.6.2.3 Approach to interacting with District staff, other contractors and designated
stakeholders;
C.5.4.6.2.4 Plan for providing accurate and timely reporting, including but not limited, to reports on
percentage of completion of meaningful tasks, schedule variance reports, budget
variance and objective measure progress;
C.5.4.6.2.5 System for internal quality control monitoring to produce the required deliverables
accurately, efficiently, and in a timely manner;
C.5.4.6.2.6 Detailed project schedule with milestones that address activities required to accomplish
the required tasks;
C.5.4.6.2.7 Risk management plan to identify and assess project risks and risk mitigation strategies;
C.5.4.6.2.8 Project kick-off with DHCF and other stakeholders designated by the Contract
Administrator or designee;
C.5.4.6.2.9 Approach to maintaining compliance with HIPAA, as described in Section H.21
and the Privacy and Security rules in 45 C.F.R. Parts 160, 162 and 164, 42 C.F.R.
Part 2, and the D.C. Mental Health Information Act (D.C. Code § 7-1201 et seq.);
C.5.4.6.2.10 Approach to maintaining compliance with the HIPAA transactions requirements and
standardized formats, national definitions, and other standardized approaches specified
by the District; and
C.5.4.6.2.11 Approach to maintaining compliance with all applicable federal and District statutes and
regulations and audits.
C.5.4.7 Work Breakdown Structure
C.5.4.7.1 The Contractor shall create a Work Breakdown Structure (WBS) that is sufficiently
transparent to allow DHCF to determine and verify the various steps involved in the
completion of the Design and Development Segment.
C.5.4.7.2 The Contractor shall prepare a WBS and shall include the following requirements:
C.5.4.7.2.1 No line of the WBS may specify work requiring more than two hundred (200) person-
hours of work or spanning more than three (3) weeks; and
C.5.4.7.2.2 The Contractor’s WBS shall indicate staffing, schedule, and hours of work. The
Contractor shall report actual completion percentage and hours worked weekly in its
project management reports to DHCF.
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C.5.5 Definition Tasks
C.5.5.1 The Contractor shall identify and document the requirements of the ASO function in
accordance with the ASO Assessment (See Section J.10), and all relevant federal and
District statutes and regulations (as amended).
C.5.5.2 During the Definition Tasks of the Project, the Contractor shall, at a minimum:
C.5.5.2.1 Review the current claims billing systems used by the District’s fiscal agent and meet
with the fiscal agent to clarify the information systems being used and the capabilities
needed for proper interface and connectivity with the fiscal agent’s system;
C.5.5.2.2 Analyze the requirements obtained from the Partner Agencies and providers and
determine whether the requirements are in accordance with federal and District
requirements. The Contractor shall identify all compliance, clarity and ambiguity issues
and work to resolve them in conjunction with DHCF staff;
C.5.5.2.3 Record and document the requirements either as process specifications or use cases
(i.e., example of how system would work from the current program); and
C.5.5.2.4 Create a Traceability Matrix, in table format, to document the initial three (3) Partner
Agency/Provider requirements and the relationship between them and the Partner
Agency’s needs.
C.5.6 Design Tasks
C.5.6.1 The Contractor shall identify the information system and business processes that can
accomplish all the requirements of a claims management system while meeting the goals
outlined in Section C.5.2 The Contractor shall deliver the output of the Design Tasks in
the form of a PowerPoint presentation and written report to DHCF.
C.5.6.2 The Contractor’s systems, business processes, and operations design shall accomplish
the following:
C.5.6.2.1 Interface with the District’s fiscal agent and all other relevant systems in DHCF and the
Partner Agencies;
C.5.6.2.2 Ensure the system is auditable, uses standardized formats and terminology that
complies with HIPAA (45 C.F.R. §§ 160-164), Medicaid and national HIT
standards, is interoperable and connects with both the MMIS, Medicaid eligibility
system and appropriate District Department systems; and
C.5.6.2.3 Provides sufficient technical assistance and training to prevent avoidable errors.
C.5.6.3 The Contractor shall develop a written HIPAA and Medicaid Compliance Plan, which
shall address National Provider Identifier (NPI) requirements and other HIPAA
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transactions as well as privacy and security requirements. The Contractor shall submit
this plan to DHCF for prior approval within one (1) month of Contract award.
C.5.7 Development Tasks
C.5.7.1 The Contractor shall put the ASO operational systems and processes together in the
Development Tasks of the Project.
C.5.7.2 At a minimum, the Contractor shall conduct testing of the ASO system components and
interfaces. Testing shall include the following:
C.5.7.2.1 Testing of system components that affect external users, such as web portals, web-based
claims submission, claims software, and data entry by other contractors;
C.5.7.2.2 Testing of operational readiness, which shall include demonstrations, load testing and
results, staff readiness testing, and communications testing to ensure that the Contractor
is ready to perform the basic functions, which shall include, but is not limited to:
C.5.7.2.2.1 Documentation review;
C.5.7.2.2.2 Processing of all claims correctly;
C.5.7.2.2.3 Meeting all reporting requirements;
C.5.7.2.2.4 Using a properly functioning data communications network;
C.5.7.2.2.5 Meeting system performance and operational performance requirements;
and
C.5.7.2.2.6 Having a demonstrated backup capacity.
C.5.7.2.3 A readiness testing summary report that shall document the results of all testing. The
Contractor shall provide the report to DHCF for approval prior to proceeding to the
Operations Tasks in Section C.5.11.
C.5.7.2.4 Establishment of a help desk to verify eligibility and assist with claims resolution and
reconciliation. The help desk operations shall comply with industry standards related to
production and responsiveness, quality of service, and efficiency in its operations.
C.5.7.2.5 Establishment of two (2) web portals for:
C.5.7.2.5.1 Claims data submission; and
C.5.7.2.5.2 General information for providers and participants.
C.5.7.2.6 Training of ASO staff, DHCF staff, Partner Agency staff, and employed and contracted
District Partner Agency public providers in the use of ASO systems and processes. The
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Contractor shall administer training by web portal (computer-based), classroom and on-
site.
C.5.8 Implementation Tasks
C.5.8.1 The Contractor shall implement the ASO operational systems and business processes
during the Implementation Tasks of the Project.
C.5.8.1.1 The Contractor shall submit its implementation plan for all Partner Agencies and receive
prior approval from DHCF before commencement.
C.5.8.1.2 Prior to the commencement of any action, the Contractor shall receive input regarding
the Contractor’s implementation plan from the appropriate District Department,
specifically concerning the dates for rollout and start of full-scale operations.
C.5.8.2 During the Implementation Tasks, the Contractor shall:
C.5.8.2.1 Conduct a phased rollout of the operations beginning with three (3) Partner Agencies
with the start date no later than the date specified in the Implementation Plan approved
by DHCF in C.5.8.1.1;
C.5.8.2.2 Begin full-scale operations of the help desk;
C.5.8.2.3 Begin full-scale operations of the Web Portals;
C.5.8.2.4 Begin full-scale management of the operations;
C.5.8.2.5 Begin systems monitoring of all components using network performance measuring
tools;
C.5.8.2.6 Make system, systems procedural, and business processes corrections based on
outcomes of system monitoring and input from DHCF staff, Partner Agency staff, and
Partner Agency providers; and
C.5.8.2.7 Maintain a continuing process improvement plan for ongoing monitoring and
implementation of improvements as deficiencies or issues are identified.
C.5.9 Turnover Tasks
C.5.9.1 The Contractor shall provide to DHCF a Turnover Plan for the turnover of the ASO
operations to another contractor selected by DHCF.
C.5.9.2 The Contractor shall provide affirmative cooperation with any successor contractor.
C.5.9.3 The Contractor’s Turnover Plan shall, at a minimum:
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C.5.9.3.1 Detail the process for the continued provision of the Contractor’s services during the
turnover and the process for integrating and working with a successor Contractor;
C.5.9.3.2 Detail the process for the turnover of archival data and other material related to
operations;
C.5.9.3.3 Detail the contract close out process and the level of the Contractor services to be
provided during the close out; and
C.5.9.3.4 Detail how the Contractor shall continue to fulfill responsibilities towards existing staff,
facilities and other resources during the turnover.
C.5.10 Corrective Action Plan
C.5.10.1 The Contractor shall create a Corrective Action Plan (CAP) in the event that DHCF
determines that the Contractor has fallen more than one (1) day behind schedule for any
of the tasks.
C.5.10.2 The Contractor shall submit the CAP to DHCF for prior approval.
C.5.10.3 A CAP shall include, at a minimum, the following requirements:
C.5.10.3.1 Detailed project schedule with milestones that address activities required to accomplish
the required tasks in the new timeframe;
C.5.10.3.2 Method to recoup lost time and any expenses incurred by DHCF as a result of the
Contractor’s delay in performance;
C.5.10.3.3 Risk management plan to identify and assess project and risk mitigation strategies;
C.5.10.3.4 System for internal quality control monitoring to produce the required deliverables
accurately, efficiently, and in a timely manner; and
C.5.10.3.5 Communication plan detailing the Contractor’s method for keeping all project
stakeholders informed about the progress of the project in a timely manner.
C.5.11 Operation Tasks
C.5.11.1 The Contractor shall provide the following specific program management activities
throughout the duration of the Project to ensure that project resources are used efficiently
and that the project outcome delivers the desired product:
C.5.11.1.1 Updating and maintaining the Project Management Plan identified in Section C.5.4.6;
C.5.11.1.2 Conducting project meetings;
C.5.11.1.3 Monitoring progress toward key milestones identified in the Project Management Plan;
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C.5.11.1.4 Managing business processes, operational and technical issues identified in the review of
ASO system and processes;
C.5.11.1.5 Coordinating project team activities and briefing with DHCF, Partner Agencies and
stakeholders as directed by DHCF;
C.5.11.1.6 Managing the development and submission of deliverables; and
C.5.11.1.7 Timely submission of written monthly status reports on the progress of tasks against the
approved Work Plan.
C.5.11.2 Information System, Equipment, Facility and Training Requirements
C.5.11.2.1 The Contractor shall maintain an information system, operation and business processes,
operation and business management that, at a minimum, shall meet the following
requirements:
C.5.11.2.1.1 Includes a transaction processing system for DHCF and Partner Agencies via
a web-based system application that requires only an Internet connection for
each user; and
C.5.11.2.1.2 Includes a method to grant and control system access based on user identification (ID)
and password for all users authorized by DHCF, which shall:
C.5.11.2.1.2.1 Provide the details for the method to be used for authorized users and may not proceed
with implementation until approved by DHCF;
C.5.11.2.1.2.2 Include role-based security that allows authorized users to access only those parts of the
system necessary for the accomplishment of their authorized responsibilities, as
determined by DHCF;
C.5.11.2.1.2.3 Issue user IDs and passwords in a controlled manner that is first approved by DHCF and
that provides a master user for each provider and each recipient requesting access. This
system shall allow providers to limit access among their staff; and
C.5.11.2.1.2.4 Provide web portal services, including claims submission, free of charge to the Partner
Agency provider and recipient.
C.5.11.2.2 The Contractor shall maintain all HIPAA, Partner Agency specific (such as mental
health and substance abuse treatment) and industry-standard security, privacy,
confidentiality, encryption and data integrity requirements. The Contractor shall ensure
that all health information protection includes the most stringent of HIPAA, federal and
District of Columbia record retention policies.
C.5.11.2.3 The Contractor shall maintain a security system on the Contractor’s web portals to
control access to the following:
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C.5.11.2.3.1 Uploading or downloading of files;
C.5.11.2.3.2 Submission of claims;
C.5.11.2.3.3 Verification of eligibility; and
C.5.11.2.3.4 Performance of other functions that may be relevant to the particular recipient and
provider.
C.5.11.2.4 The Contractor shall analyze existing systems that are operated by Partner Agency,
create interfaces for these systems and convert data as necessary support operations.
C.5.11.2.5 The Contractor shall provide an automated process whenever DHCF, the Partner
Agencies, or providers can support it.
C.5.11.2.6 If entities outside the Contractor’s control cannot support an automated process, the
Contractor shall develop manual or alternative procedures.
C.5.11.2.7 All transactions that may affect claims submission or payment, including provider file
changes, reference file changes, recipient file changes and claims file changes shall be:
C.5.11.2.7.1 HIPAA compliant;
C.5.11.2.7.2 In a standardized format; and
C.5.11.2.7.3 Logged and tracked by the Contractor in an auditable method that shall identify the
following:
C.5.11.2.7.3.1 The entity or individual that made the change;
C.5.11.2.7.3.2 What change was made; and
C.5.11.2.7.3.3 When the change was made.
C.5.11.2.8 The Contractor shall not purge data during the lifetime of the Contract and shall retain
data through a data retention plan approved by DHCF and submitted within five (5)
months of Contract award.
C.5.11.2.9 The Contractor shall have the following:
C.5.11.2.9.1 Infrastructure to support the services being purchased in the Contract including
hardware, software, facilities, equipment, communications and staff necessary to meet
the requirements of all DDI, Operations and Turnover Tasks as set forth in Section C.
The Contractor shall retain ownership of all systems used to provide the professional
services requested in the Contract.
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C.5.11.2.10 Help Desk
C.5.11.2.10.1 The Contractor shall provide a help desk and call-center services to verify eligibility and
assist with billing, claims resolution, and reconciliation.
C.5.11.2.10.2 The help desk shall:
C.5.11.2.10.2.1 Have standardized hours, no less than seven (7) A.M. to six (6) P.M., Monday through
Friday;
C.5.11.2.10.2.2 Operate at locations approved by DHCF and the Partner Agencies;
C.5.11.2.10.2.3 Include a toll-free number for recipients, providers and Partner Agencies; and
C.5.11.2.10.2.4 Be sufficiently staffed to meet DHCF customer service standards related to
prompt answering of calls and level of resolution prior to completion of the call.
C.5.11.2.10.3 The Contractor shall provide notification to partner agencies about the availability of a
help desk and call center services through email communication and posting on the
Contractor’s website. The notifications should be sent to partner agencies on a regular
schedule as determined by the District and posting about help desk and call center
services operation hours, how to access, and location should be always made available
on the Contractor’s website
C.5.11.3 Recipient Eligibility Tasks
C.5.11.3.1 The Contractor shall record recipient information with regard to each Partner Agency
and Medicaid.
C.5.11.3.2 The Contractor shall verify eligibility for Medicaid and other Partner Agency programs
on a regular and automated basis.
C.5.11.3.3 The Contractor shall provide call-center services to assist participants with billing,
claims resolution, and reconciliation.
C.5.11.4 Provider Related Tasks
C.5.11.4.1 The Contractor shall maintain a provider file with provider data from all Partner
Agencies. This provider file shall create interfaces, processes and procedures to receive
and maintain provider updates.
C.5.11.4.2 The Contractor shall maintain a Web Portal for the following:
C.5.11.4.2.1 Claims data submission; and
C.5.11.4.2.2 General information for providers.
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C.5.11.5 Claims Related Tasks
C.5.11.5.1 The Contractor shall provide a comprehensive, uniform approach to medical Claims
preparation and the administrative claiming for the Partner Agencies that shall at
minimum accomplish the following tasks:
C.5.11.5.2 Claims Analysis
C.5.11.5.2.1 The Contractor, after analysis, shall define the documentation and Claims submission
requirements and make the appropriate tools available to the Partner Agencies to allow
them to efficiently report billable services.
C.5.11.5.3 Claims Data Management
C.5.11.5.3.1 The Contractor shall provide systems, methods, hardware and software to record billable
services rendered by each Partner Agency, including all required data and
documentation.
C.5.11.5.4 Claims Preparation
C.5.11.5.4.1 The Contractor shall provide uniform and coordinated Claim payment for services
rendered that will fully utilize FFP funding and draw down non-Medicaid funding when
appropriate.
C.5.11.5.5 Claims Submission
C.5.11.5.5.1 The Contractor shall be well versed with all applicable federal and District statutes and
regulations and shall oversee and enforce claim compliance with all applicable federal
and District laws and regulations. The Contractor shall ensure that prior to submission
all claims have received a regulatory evaluation and that each claim meets both the
requirements set forth by the applicable federal and state regulatory bodies and DHCF.
C.5.11.5.5.2 The Contractor shall be subject to sanctions for any submitted claim that is non-
compliant with the applicable federal and District statutes and regulations or DHCF
requirements set forth in section G.4.2.
C.5.11.5.5.3 The Contractor shall submit all billable services rendered electronically in an EDI format
by each Partner Agency either directly to the District’s fiscal agent or through an
established clearing house which has the proven capability to bill the District’s fiscal
agent and has no financial relationship to the ASO.
C.5.11.6 Imaging and Document Management
C.5.11.5.6.1 The Contractor shall receive, organize, and maintain documentation for claims submitted
in a single repository as a record of all transaction activity. The Contractor shall
maintain this repository and provide DHCF access to the repository.
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C.5.11.7 Claim reconciliation
C.5.11.5.7.1 The Contractor shall receive records of all reimbursement transactions and will
also receive reports on Claims payment from payors.
C.5.11.5.7.2 The Contractor shall reconcile reimbursements against Claims submitted.
C.5.11.5.7.3 The Contractor shall make corrections and resubmit Claims when appropriate.
C.5.11.5.7.4 The Contractor shall report Claims payment to Partner Agencies and work with Partner
Agencies to assure maximum eligible payment for services rendered from funding
sources in the priority determined by the District during claims analysis.
C.5.11.8 Performance Measures
C.5.11.5.8.1 The Contractor shall meet performance measures established by DHCF for claim
processing and as detailed in Section C.5.2. These shall be accomplished during the
Planning and Feasibility and Design Tasks of the Contract.
C.5.11.5.8.2 The Contractor shall provide evidence that it can:
C.5.11.5.8.2.1 During the Definition Tasks:
C.5.11.5.8.2.1.1 Complete each task to specifications established in the Project Management Plan and
as approved by DHCF;
C.5.11.5.8.2.1.2 Complete each task on time as established in the Project Management Plan and as
approved by DHCF; and
C.5.11.5.8.2.1.3 Complete each task within budget as established in the Project Management Plan and
as approved by DHCF;
C.5.11.5.8.2.2 During the Design and Development Tasks:
C.5.11.5.8.2.2.1 Complete the project on time;
C.5.11.5.8.2.2.2 Complete the project within budget;
C.5.11.5.8.2.2.3 Demonstrate the capability to:
C.5.11.5.8.2.2.3.1 Successfully ensure that no upfront denials occur;
C.5.11.5.8.2.2.3.2 Successfully process all claims through the MMIS;
C.5.11.5.8.2.2.3.3 Successfully validate that payments are received by providers, including handling
remittance advice;
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C.5.11.5.8.2.2.3.4 Successfully document a process to ensure that there are no incorrect payments
discovered at the time of the federal Payment Error Rate Measurement (PERM) audit
or DHCF internal audit for transactions that move through the ASO system;
C.5.11.5.8.2.3 During the Implementation Tasks:
C.5.11.5.8.2.3.1 Complete the project on time;
C.5.11.5.8.2.3.2 Complete the project within budget;
C.5.11.5.8.2.3.3 Demonstrate the capability to:
C.5.11.5.8.2.3.3.1 Successfully ensure that no upfront denials occur;
C.5.11.5.8.2.3.3.2 Successfully process all claims through the MMIS;
C.5.11.5.8.2.3.4 Successfully validate that payments are received by providers, including handling
remittance advice; and
C.5.11.5.8.2.3.5 Successfully document a process to ensure that there are no incorrect payments
discovered at the time of the federal PERM audit or DHCF internal audit for
transactions that move through the ASO system;
C.5.11.5.8.2.4 During the Operations Tasks, the Contractor shall:
C.5.11.5.8.2.4.1 On an ongoing basis, successfully ensure that deliverables and reports are submitted
within the time period specified in the contract;
C.5.11.5.8.2.4.2 On an ongoing basis, successfully ensure that the help desk and web portals meet
the requirements described in Section C.5.7.2.4 and C.5.7.2.5 respectively;
C.5.11.5.8.2.4.3 On an ongoing basis, successfully coordinate a relationship with the Partner
Agencies and maintain effective communication and access to Partner Agencies,
during all tasks of the contract, including meetings and reporting;
C.5.11.5.8.2.4.4 Successfully ensure that no Partner Agency submitted claims are denied upfront by
the MMIS;
C.5.11.5.8.2.4.5 Successfully ensure that all Partner Agency submitted claims are processed through
the MMIS for payment;
C.5.11.5.8.2.4.6 Successfully validate that payments are received by providers, including handling,
reconciling and posting against claims submitted for Partner Agency with the
related remittance advice and payment;
C.5.11.5.8.2.4.7 Successfully ensure that no incorrect payments are processed through the ASO
system; and
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C.5.11.5.8.2.4.8 Successfully ensure that no incorrect payments are discovered at the time of the
PERM audit or internal DHCF audit for transactions that move through the ASO
system. The Contractor shall be subject to sanctions for incorrectly paid claims as
set forth in Section G.4.2.
C.5.11.5.8.3 The Contractor shall provide ASO services in compliance with SLA requirements as
described in Attachment J.19 Appendix A – SLA.
C.5.11.5.8.3.1 The Contractor shall provide an SLA compliance report card of SLA numbers on a
monthly basis for status meetings and on an ad hoc basis for District review at any point
in time. See SLA requirements in Appendix A.
C.5.11.9 Reporting Tasks
C.5.11.5.9.1 The Contractor shall be responsible for a variety of financial reporting tasks including, at
a minimum, the creation of reports and maintenance of information necessary to support
auditing and claims review. The creation of reports and maintenance of information
shall include, at a minimum:
C.5.11.5.9.1.1 A report on the number of payments the Contractor disallowed that were submitted by
each agency;
C.5.11.5.9.1.2 A report on the number of claims submitted to MMIS Contractor from each agency; and
C.5.11.5.9.1.3 Maintenance of all electronic claims for the life of the contract.
C.5.11.5.9.2 The Contractor shall be responsible for the following general reporting tasks:
C.5.11.5.9.2.1 Provide effective program management and reports to improve the claims management
process, defend claims submitted, reduce recoupment, and meet all federal standards and
Medicaid guidelines; and
C.5.11.5.9.2.2 Provide reports on trending to demonstrate the effectiveness of improved billing, as well
as on the health outcomes of the participants as they span multiple programs as specified
by DHCF and on a timeline established by DHCF.
C.5.12 System Operations and Maintenance
C.5.12.1 The Contractor shall conduct O&M activities to ensure that the ASO system is fully
functional, and it performs optimally until the system reaches it end of life, manage
changes to the system to support end users, monitor system performance, perform
required security activities such as backups, contingency planning, and audits; and
continue end user support through training and documentation. The O&M tasks, at a
minimum, shall include but are not limited to:
C.5.12.1.1 Monthly status meetings;
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C.5.12.1.2 Manage health care service claims and payment;
C.5.12.1.3 Identify system defects;
C.5.12.1.4 Add additional services that require ASO validation;
C.5.12.1.5 Help Desk Support;
C.5.12.1.6 User Maintenance and Support;
C.5.12.1.7 Correction of submitted time;
C.5.12.1.8 Entry of missed start or stopped times;
C.5.12.1.9 Exception reporting;
C.5.12.1.10 Monitoring of system performance;
C.5.12.1.11 Claim files submission research and resolution;
C.5.12.1.12 Operational reports.
C.5.12.2 The Contactor shall submit the operational reports monthly or at DHCF request in
report, spreadsheet or PowerPoint format. The Operational reports shall include but not
limited to:
C.5.12.2.1 Monthly Status Reports
C.5.12.2.2 Project Management Plan
C.5.12.2.3 Project Staffing Plan
C.5.12.2.4 Work Breakdown Structure
C.5.12.2.5 HIPAA and Medicaid Compliance Plan
C.5.12.2.6 Traceability Matrix
C.5.12.2.7 Reading testing summary
C.5.12.2.8 Implementation Plan
C.5.12.2.9 Turnover Plan
C.5.12.2.10 Data Retention Plan
C.5.12.2.11 Corrective Action Plan
C.5.12.2.12 Monthly SLA compliance report
C.5.12.3 The Contractor shall communicate, in advance, to ASO stakeholders including
beneficiaries, workers, providers, DHCF and other District Agencies any system
modifications that are approved by the District or system modifications that are
necessary to comply with changes in Federally mandated or National Standards such as,
but not limited to CMS, HIPAA, or MITA, and to meet the deadlines imposed for such
changes, for the duration of this contract, as part of the Contractors normal system
maintenance of the ASO System pursuant to this Contract.
C.5.12.4 The Contractor shall make online training materials available to all ASO user groups
such as DHCF, DDS, Providers, workers (including direct service workers), case
management agencies, MCOs, and others as deemed necessary by DHCF as part of the
Contractors normal system maintenance of the ASO System pursuant to this Contract.
C.5.13 ASO SERVICE LEVEL AGREEMENT (SLA)
C.5.13.1 The Contractor shall ensure the following service levels for the ongoing operations of
ASO:
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C.5.13.1.1 The contractor shall provide active monitoring and technical support for all ASO system
24 hours per day, 7 days per week, 365 days per year.
C.5.13.1.2 Appendix A – ASO SLA (see Attachment J.19)
C.5.13.2 LIQUIDATED DAMAGES
C.5.13.2.1 It is agreed by the District and Contractor that:
C.5.13.2.1.1 If the Contractor does not provide or perform the requirements referred to or listed in
Attachment J.19, Appendix A – ASO SLA, damage(s) to the District will result.
C.5.13.2.1.2 Proving such damage(s) will be costly, difficult, and time consuming.
C.5.13.2.1.3 The damage figures listed in Attachment J.19, Appendix A – ASO SLA, represent a
good faith effort to quantify the range of harm that could reasonably be anticipated at the
time of the making of the Contract and such liquidated damages are not considered a
penalty.
C.5.13.2.1.4 Nothing in this provision shall be construed as relieving the Contractor from performing
all Contract requirements whether listed herein or not, nor is the District’s right to
enforce or to seek other remedies for failure to perform under any other Contract duty
hereby diminished.
C.5.13.2.1.5 Remedies of the District specified in this section or elsewhere in the Contract for breach
or failure of performance by the Contractor shall in no way limit any other remedies
available to the District under the Contract; under any statute or regulation; or at law or
in equity. All rights, powers and remedies shall be cumulative and concurrent. Any
failure of District to exercise a remedy shall not be a waiver of any breach or non-
performance by the Contractor nor shall it prevent District from later exercising that or
any other remedy.
C.5.13.2.1.6 The Contract will be used by District to monitor Contractor performance and will
provide the basis for determining liquidated damages.
C.5.13.2.2 LIQUIDATED DAMAGES ASSESSMENT: COLLECTIONS, WITHHOLDS
C.5.13.2.2.1 Once District has determined that liquidated damages are to be assessed, District will
notify the Contractor of the assessment (or assessments). At District discretion, the
assessment notice may direct payment of the assessment by the Contractor. If payment is
thus directed, the Contractor shall pay the assessment within thirty (30) calendar days of
receipt of the assessment notice unless directed otherwise by the District. If District
determines that any damage was caused in part by District or another Contractor, District
may reduce damage assessment against the Contractor proportionately.
C.5.13.2.2.2 Any liquidated damages assessment may also be collected, at District’s discretion, by
withholding the funds from any payment (or payments) due the Contractor after the date
of assessment.
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C.5.13.2.3 CONDITIONS FOR TERMINATION OF LIQUIDATED DAMAGES
As determined appropriate by the District, the following are the conditions under which
the Contractor may obtain relief from the continued assessment of liquidated damages
which have been imposed.
C.5.13.2.3.1 Except as waived by the District, no liquidated damages imposed on the Contractor shall
be terminated or suspended until the Contractor issues a written notice of correction to
the District, as acceptable in the sole discretion of the District, verifying the correction of
condition(s) for which liquidated damages were imposed.
C.5.13.2.3.2 The necessary level of documentation to verify corrections will be determined by the
District; the District is the sole judge of the accuracy of any such documentation
provided.
C.5.13.2.3.3 The Contractor shall certify that each SLA breach is corrected.
C.5.13.2.4 SEVERABILITY OF INDIVIDUAL LIQUIDATED DAMAGES CLAUSES
If any portion of any provision on liquidated damages in the Contract, including as set
forth in this Contract incorporated into it, is determined to be unenforceable in one or
more of its applications, the remaining portion remains in effect in all applications not
determined to be invalid that are severable from the invalid applications. If any portion
of this liquidated damages provision is determined to be unenforceable in total, the other
portions shall remain in full force and effect.
C.5.13.2.5 ASSESSMENT OF LIQUIDATED DAMAGES
District will not pay 100% of the contracted amount due to the Contractor in a month if
SLA measures achieved for the month are less than the percentages specified in
Attachment J.19, Appendix A – ASO O&M. For months in which SLA measures are not
met, the contracted payment for the month will be deducted in the percentages specified
in the table below. The percentage deductions correspond to the specific SLA ranges
achieved by the Contactor for the various requirements.
C.5.14 CONTRACT CLOSEOUT AND TRANSITION
The purpose of Transition and Contract Closeout is to ensure all ASO-related activities
will be transitioned to the District or successor Contractor.
C.5.14.1 Upon notification that the Contract shall not be renewed at the end of its contract period
or an option period is not renewed prior to its expiration for any reason, the Contractor
shall provide all reasonable transition assistance requested by DHCF to ensure a smooth
and orderly transfer of data. DHCF shall have any and all ownership rights in all data
associated with ASO since the inception of the program.
C.5.14.2 In the event any Contract resulting from this contract expires or is terminated for any
reason before the end of the Contract period, DHCF may require the Contractor to
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extend the services for a period up to one hundred eighty (180) days (time period is at
sole discretion of DHCF), or until such time as services of a new Contract is in effect
and implemented, as determined by and at the sole discretion of DHCF. Following this
transition period, the Contractor shall answer questions from DHCF during the duration
of the transition and close of the contract.
C.5.14.3 The Contractor shall cooperate with DHCF to assist with the orderly transfer of the
services, functions, data, and operational processes provided by the Contractor hereunder
to another District Contractor or to DHCF, based on DHCF approval. Transition to
DHCF requires transfer of all data and operational process documentation.
C.5.14.4 The Contractor personnel critical to the transfer efforts shall be identified by both
parties. The Contractor shall ensure the cooperation of its key employees during the
transfer process.
C.5.14.5 The Contractor shall develop a process to ensure that there are no disruptions and
continued compliance with federal and state laws and regulations during transition.
C.5.14.6 TRANSITION MANAGEMENT
C.5.14.6.1 The Contractor’s Project Manager shall lead and be responsible for the Contractor’s
overall performance of the transition assistance services and who shall be the primary
point of contact for DHCF during the End of Contract Transition. DHCF will identify a
Business Project Manager who will be the primary point of contact for DHCF during the
End of Contract Transition. Additionally, DHCF may identify a transition team to
review current services provided by the Contractor and work to facilitate an orderly
transition of services.
C.5.14.6.2 The Contractor shall implement the approved Turnover Plan, in accordance with Section
F.3, that at minimum, and shall lead the transition planning effort on behalf of DHCF.
C.5.14.6.3 The Contractor shall plan and facilitate discussions among stakeholders in the transition
including DHCF and the incumbent Contractor to make certain that all relevant activities
and milestones are captured in the Plan.
C.5.14.6.4 The Contractor shall be responsible for development of the Transition Plan,
consolidation of relevant sections of the incumbent Contractor‘s Transition Plan into the
Contractor’s Transition Plan, and maintenance of the consolidated Transition Plan.
C.5.14.7 CONTRACT CLOSEOUT REPORTING
C.5.12.7.1 The Contractor shall prepare and forward activity reports to DHCF that highlight the
overall contract accomplishments.
C.5.14.8 END OF TRANSITION
As part of the closeout, the Contractor shall:
C.5.14.8.1 Provide all non-proprietary District-specific documentation stored within the
documentation repository to DHCF;
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C.5.14.8.2 Provide the data from the Contractor’s system to the subsequent Contractor or DHCF;
C.5.14.8.3 Provide full cooperation with the subsequent Contractor or DHCF in the transition;
C.5.14.8.4 Provide all District-specific operational information requested by DHCF to ensure a
successful and smooth transition;
C.5.14.8.5 Provide a detailed report of current staffing levels necessary to perform requirements in
accordance with Section C.5, to include job titles and responsibilities;
C.5.14.8.6 Provide all records stored both electronically and in hard copy in accordance with
Contract requirements;
C.5.14.8.7 Transfer all District property, DHCF-operational information, documents, mail, and data
to the subsequent Contractor or DHCF;
C.5.14.8.8 Promptly correct, at no cost to DHCF, any problems which were caused by lack of
support at transition, as may be determined by DHCF (anything that causes negative
impact/financial damages/etc.);
C.5.14.8.9 The Contractor shall provide all reports within one (1) week, or as deemed necessary by
DHCF, to close the Contract.
C.5.14.8.10 The Contractor shall provide reasonable transition assistance requested by DHCF to
allow for the services to continue without disruption and to facilitate the transfer of such
services to the subsequent Contractor or DHCF. Failure to cooperate during the
transition may result in a reduction of final payment.
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SECTION D: PACKAGING AND MARKING
D.1 The packaging and marking requirements for this contract shall be governed by clause
number (2), Shipping Instructions-Consignment, of the Government of the District of
Columbia's Standard Contract Provisions for use with Supplies and Services Contracts,
dated July 2010. (Attachment J.1)
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SECTION E: INSPECTION AND ACCEPTANCE
E.1 The inspection and acceptance requirements for this contract shall be governed by clause
Number (6), Inspection of Services of the Government of the District of Columbia's
Standard Contract Provisions for use with Supplies and Services Contracts, dated July
2010. (Attachment J.1)
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SECTION F: PERIOD OF PERFORMANCE AND DELIVERABLES
F.1 TERM OF CONTRACT
The term of the contract shall be from September 13, 2025 through September 12, 2026.
F.2 OPTION TO EXTEND THE TERM OF THE CONTRACT
F.2.1 The District may extend the term of this contract for a period of four (4) one-year option
periods, or successive fractions thereof, by written notice to the Contractor before the
expiration of the contract; provided that the District will give the Contractor preliminary
written notice of its intent to extend at least thirty (30) days before the contract expires.
The preliminary notice does not commit the District to an extension. The exercise of this
option is subject to the availability of funds at the time of the exercise of this option. The
Contractor may waive the thirty (30) day preliminary notice requirement by providing a
written waiver to the Contracting Officer prior to expiration of the contract.
F.2.2 If the District exercises this option, the extended contract shall be considered to include
this option provision.
F.2.3 The price for the option period shall be as specified in the Section B of the contract.
F.2.4 The total duration of this contract, including the exercise of any options under this
clause, shall not exceed five (5) years.
F.3 DELIVERABLES
F.3.1 The Contractor shall perform the activities required to successfully complete the
District’s requirements and submit each deliverable to the Contract Administrator (CA)
identified in section G.9 in accordance with the following:
CLIN Deliverable Name Quantity Format/Method of
Delivery Due Date
0001
1001
2001
3001
4001
Project Management Plan
(C.5.4.1) 1 Word, PDF, and/or
Presentation
Within one (1)
month from Date of
Award
0001
Initial implementation of the
project for one (1) of the
Partner Agencies (C.5.3.3)
1 Word, PDF, and/or
Presentation
Three months
award contract
award
0001
Initial implementation of the
project for remaining Partner
Agencies (C.5.3.3)
1 Word, PDF, and/or
Presentation
Six months after
contract award
0001
1001
2001
Project Status Reports
(C.5.4.1)
Weekly suite of PMI reports
1 Word, PDF, and/or
Presentation
Within one (1)
month from Date of
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CLIN Deliverable Name Quantity Format/Method of
Delivery Due Date
3001
4001
Award and each
month thereafter
0001
1001
2001
3001
4001
Project Staffing Plan (C.5.4.3) 1 Word, PDF, and/or
Presentation
Within one (1)
month from Date of
Award
0001
1001
2001
3001
4001
Work Breakdown Structure
(C.5.4.7) 1 Word, PDF, and/or
Presentation
Within one (1)
month from Date of
Award
0001
1001
2001
3001
4001
HIPAA and Medicaid
Compliance Plan (C.5.6.3) 1 Word, PDF, and/or
Presentation
Within one (1)
month from Date of
Award
0001
1001
2001
3001
4001
Traceability Matrix
documenting relationship
between the Partner
Agency/Provider requirements
and Partner Agency needs
(C.5.5.2.4)
1 Word, PDF, and/or
Presentation
Within six (6)
weeks from Date of
Award
0001 Design Task Output & Report
Presentation (C.5.6) 1 Word, PDF, and/or
Presentation
Within six (6)
weeks from Date of
Award
0001 Readiness testing summary
report (C.5.7.2.3) 1 Word, PDF, and/or
Presentation
Within five (3)
months from Date
of Award
0001 Implementation Plan
(C.5.8.1.1) 1 Word, PDF, and/or
Presentation
Within two (2)
months from Date
of Award
0001 Turnover Plan (C.5.9.1) 1 Word, PDF, and/or
Presentation
Within five (5)
months from Date
of Award
0001 Data Retention Plan
(C.5.11.2.8) 1 Word, PDF, and/or
Presentation
Within five (5)
months of contract
award
0001 Corrective Action Plan
(C.5.10) 1 Word, PDF, and/or
Presentation
Within 5 days of
the one-day delay
0001
1001
2001
3001
4001
SLA Compliance Report Card
(C.5.8.3) 1 Word or PDF Monthly
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F.3.2 The Contractor shall submit to the District, as a deliverable, the report described in
section H.5.5 that is required by the 51% District Residents New Hires Requirements
and First Source Employment Agreement. If the Contractor does not submit the report
as part of the deliverables, final payment to the Contractor shall not be paid pursuant to
section G.3.2.
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SECTION G: CONTRACT ADMINISTRATION
G.1 INVOICE PAYMENT
G.1.1 The District will make payments to the Contractor, upon the submission of proper
invoices, at the prices stipulated in this contract, for supplies delivered and accepted or
services performed and accepted, less any discounts, allowances or adjustments provided
for in this contract.
G.1.2 The District will pay the Contractor on or before the 30th day after receiving a proper
invoice from the Contractor.
G.2 INVOICE SUBMITTAL
G.2.1 The Contractor shall create and submit payment requests in an electronic format through
the DC Vendor Portal, https://vendorportal.dc.gov.
G.2.2 The Contractor shall submit proper invoices on a monthly basis or as otherwise specified
in Section G.4.
G.2.2.1 To constitute a proper invoice, the Contractor shall enter all required information into
the Portal after selecting the applicable purchase order number which is listed on the
Contractor’s profile.
G.3 FIRST SOURCE AGREEMENT REQUEST FOR FINAL PAYMENT
G.3.1 For contracts subject to the 51% District Residents New Hires Requirements and First
Source Employment Agreement requirements, final request for payment must be
accompanied by the report or a waiver of compliance discussed in section H.5.
G.3.2 The District shall not make final payment to the Contractor until the agency CFO has
received the CO’s final determination or approval of waiver of the Contractor’s
compliance with 51% District Residents New Hires Requirements and First Source
Employment Agreement requirements.
G.4 PAYMENT
G.4.1 PAYMENT SCHEDULE
G.4.1.1 The District will pay the Contractor on or before the 30th day after receiving a proper
invoice from the Contractor.
G.4.2 Recoupment
G.4.2.1 The Contractor shall be responsible for the reimbursement of its fee for any claims that
must be paid back to Medicaid as a result of The Contractor’s negligence in the
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performance of its services under the Contract. the Contractor is liable to the District for
no other sanction on account of claims payments that are subject to recoupment.
G.4.2.2 The Contractor shall be responsible for any fines levied against the District by the
Department of Health and Human Services (HHS), the Centers for Medicare and
Medicaid Services (CMS) or any other applicable administrative body. The Contractor
shall also be responsible for the reimbursement of any funds that must be paid back to
these bodies as a result of the Contractor’s performance under the contract.
G.4.2.3 The Contractor shall be responsible for any recoupment of funds or sanctions imposed
by the federal government to the District that are related to the Contractor’s non-
compliance of any part of the contract.
G.4.2.4 The District shall notify the Contractor immediately in the event that any audit is
conducted or contemplated by any entity and shall afford the Contractor the opportunity
to attend and participate in related discussions.
G.4.3 PARTIAL PAYMENTS
Unless otherwise specified in this contract, payment will be made on partial deliveries of
goods and services accepted by the District if:
a) The amount due on the deliveries warrants it; or
b) The Contractor requests it and the amount due on the deliveries is in accordance with
the following:
• "Payment in the amount of one twelfth will be made on completion and
acceptance of CLIN 0001 for which the price is stated in the Schedule in
Section B".
• "Payment will be made on completion and acceptance of CLIN 0002 in
accordance with the agreed upon delivery schedule"; and
c) Presentation of a properly executed invoice.
G.4.4 LIQUIDATED DAMAGES
In addition to any other remedies available to the District, the District shall recover any
expense accrued from the late submission of a deliverable, poor performance, or penalties
for SLA noncompliance as described in the Contract terms , including Attachment J.19
ASO SLA, by Contractor or its subcontracted providers. Contractor shall be required to:
G.4.4.1 At the discretion of DHCF, contract with a DHCF-approved contractor to study what has
caused Contractor’s breach of performance under the contract;
G.4.4.2 Mitigate any further loss of productivity or expense to DHCF by taking corrective action,
including implementing a CAP, upon approval by DHCF, as described in Section C.5.10
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G.4.4.3 At the discretion of DHCF, require that, in accordance with Sections G.3 and G.4
Contractor pay a civil monetary penalty and liquidated damages either at a rate of
$1,000.00 per day to a limit of $25,000 or an amount up to a limit of $25,000, as applicable
to the circumstances, for:
G.4.4.3.1 Failing to adhere to acceptable financial practices and standards for operating claims
submittal and related administrative functions for Medicaid in the District of Columbia;
G.4.4.3.2 Failing to ensure that no incorrect payments are discovered at the time of the PERM audit
or internal DHCF audit for transactions that move through the ASO system;
G.4.4.3.3 Failing to ensure that deliverables and reports are submitted within the time period
specified in the contract;
G.4.4.3.4 Failing to ensure that the help desk, and web portal meet the requirements described in
section C.5.7.2;
G.4.4.3.5 Failing to coordinate a relationship with the Partner Agencies and maintain effective
communication and access to Partner Agencies, during all segments of the contract,
including meetings and reporting;
G.4.4.3.6 Failing to provide adequate oversight of the documentation submitted by providers
resulting in upfront denied claims;
G.4.4.3.7 Failing to provide adequate oversight of the validity and accuracy of claims for successful
processing through the MMIS for payment; and
G.4.4.3.8 Failing to ensure that no incorrect payments are processed through the ASO system.
G.5 ASSIGNMENT OF CONTRACT PAYMENTS
G.5.1 In accordance with 27 DCMR 3250, the Contractor may assign to a bank, trust company,
or other financing institution funds due or to become due as a result of the performance
of this contract.
G.5.2 Any assignment shall cover all unpaid amounts payable under this contract and shall not
be made to more than one party.
G.5.3 Notwithstanding an assignment of contract payments, the Contractor, not the assignee, is
required to prepare invoices. Where such an assignment has been made, the original
copy of the invoice must refer to the assignment and must show that payment of the
invoice is to be made directly to the assignee as follows:
“Pursuant to the instrument of assignment dated ___________, make payment of this
invoice to (name and address of assignee).”
G.6 THE QUICK PAYMENT ACT
G.6.1 Interest Penalties to Contractors
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G.6.1.1 The District will pay interest penalties on amounts due to the Contractor under the
Quick Payment Act, D.C. Official Code § 2-221.01 et seq., as amended, for the period
beginning on the day after the required payment date and ending on the date on which
payment of the amount is made. Interest shall be calculated at the rate of at least 1.5%
per month. No interest penalty shall be paid if payment for the completed delivery of the
item of property or service is made on or before the required payment date. The
required payment date shall be:
G.6.1.1.1 The date on which payment is due under the terms of the contract;
G.6.1.1.2 Not later than 7 calendar days, excluding legal holidays, after the date of delivery of
meat or meat food products;
G.6.1.1.3 Not later than 10 calendar days, excluding legal holidays, after the date of delivery of a
perishable agricultural commodity; or
G.6.1.1.4 30 calendar days, excluding legal holidays, after receipt of a proper invoice for the
amount of the payment due.
G.6.1.2 No interest penalty shall be due to the Contractor if payment for the completed delivery
of goods or services is made on or after:
G.6.1.2.1 3rd day after the required payment date for meat or a meat food product;
G.6.1.2.2 5th day after the required payment date for an agricultural commodity; or
G.6.1.2.3 15th day after any other required payment date.
G.6.1.3 Any amount of an interest penalty which remains unpaid at the end of any 30-day
period shall be added to the principal amount of the debt and thereafter interest penalties
shall accrue on the added amount.
G.6.2 Payments to Subcontractors
G.6.2.1 The Contractor must take one of the following actions within seven (7) days of receipt
of any amount paid to the Contractor by the District for work performed by any
subcontractor under the contract:
G.6.2.1.1 Pay the subcontractor(s) for the proportionate share of the total payment received from
the District that is attributable to the subcontractor(s) for work performed under the
contract; or
G.6.2.1.2 Notify the CO and the subcontractor(s), in writing, of the Contractor’s intention to
withhold all or part of the subcontractor’s payment and state the reason for the
nonpayment.
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G.6.2.2 The Contractor must pay any subcontractor or supplier interest penalties on amounts
due to the subcontractor or supplier beginning on the day after the payment is due and
ending on the date on which the payment is made. Interest shall be calculated at the rate
of at least 1.5% per month. No interest penalty shall be paid on the following if payment
for the completed delivery of the item of property or service is made on or before the:
G.6.2.2.1 3rd day after the required payment date for meat or a meat product;
G.6.2.2.2 5th day after the required payment date for an agricultural commodity; or
G.6.2.2.3 15th day after any other required payment date.
G.6.2.3 Any amount of an interest penalty which remains unpaid by the Contractor at the end of
any 30-day period shall be added to the principal amount of the debt to the
subcontractor and thereafter interest penalties shall accrue on the added amount.
G.6.2.4 A dispute between the Contractor and subcontractor relating to the amounts or
entitlement of a subcontractor to a payment or a late payment interest penalty under the
Quick Payment Act does not constitute a dispute to which the District is a party. The
District may not be interpleaded in any judicial or administrative proceeding involving
such a dispute.
G.6.3 Subcontract requirements. The Contractor shall include in each subcontract under this
contract a provision requiring the subcontractor to include in its contract with any lower-
tier subcontractor or supplier the payment and interest clauses required under paragraphs
(1) and (2) of D.C. Official Code § 2-221.02(d).
G.7 CONTRACTING OFFICER (CO)
Contracts will be entered into and signed on behalf of the District only by contracting
officers. The contact information for the Contracting Officer is:
Tracy Williams
Contracting Officer
Office of Contracting and Procurement
441 4th Street NW Suite 330S
Washington, DC 20001
202-899-3657
tracy.williams2@dc.gov
G.8 AUTHORIZED CHANGES BY THE CONTRACTING OFFICER
G.8.1 The CO is the only person authorized to approve changes in any of the requirements of
this contract.
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G.8.2 The Contractor shall not comply with any order, directive or request that changes or
modifies the requirements of this contract, unless issued in writing and signed by the
CO.
G.8.3 In the event the Contractor effects any change at the instruction or request of any person
other than the CO, the change will be considered to have been made without authority
and no adjustment will be made in the contract price to cover any cost increase incurred
as a result thereof.
G.9 CONTRACT ADMINSTRATOR (CA)
G.9.1 The CA is responsible for general administration of the contract and advising the CO as
to the Contractor’s compliance or noncompliance with the contract. The CA has the
responsibility of ensuring the work conforms to the requirements of the contract and
such other responsibilities and authorities as may be specified in the contract. These
include:
G.9.1.1 Keeping the CO fully informed of any technical or contractual difficulties encountered
during the performance period and advising the CO of any potential problem areas under
the contract;
G.9.1.2 Coordinating site entry for Contractor personnel, if applicable;
G.9.1.3 Reviewing invoices for completed work and recommending approval by the CO if the
Contractor’s costs are consistent with the negotiated amounts and progress is satisfactory
and commensurate with the rate of expenditure;
G.9.1.4 Reviewing and approving invoices for deliverables to ensure receipt of goods and
services. This includes the timely processing of invoices and vouchers in accordance
with the District’s payment provisions; and
G.9.1.5 Maintaining a file that includes all contract correspondence, modifications, records of
inspections (site, data, equipment) and invoice or vouchers.
G.9.2 The address and telephone number of the CA is:
Emilie Monroe
Management Analyst Office of Provider Services
Health Care Operations Administration
DC Department of Health Care Finance
441 4th Street NW, 10th Floor
Washington, DC 20020
202-442-8967 (Office)
Emilie.monroe@dc.gov
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G.9.3 The CA shall NOT have the authority to:
1. Award, agree to, or sign any contract, delivery order or task order. Only the CO shall
make contractual agreements, commitments or modifications;
2. Grant deviations from or waive any of the terms and conditions of the contract;
3. Increase the dollar limit of the contract or authorize work beyond the dollar limit of
the contract;
4. Authorize the expenditure of funds by the Contractor;
5. Change the period of performance; or
6. Authorize the use of District property, except as specified under the contract.
G.9.4 The Contractor will be fully responsible for any changes not authorized in advance, in
writing, by the CO; may be denied compensation or other relief for any additional work
performed that is not so authorized; and may also be required, at no additional cost to the
District, to take all corrective action necessitated by reason of the unauthorized changes.
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SECTION H: SPECIAL CONTRACT REQUIREMENTS
H.1 HIRING OF DISTRICT RESIDENTS AS APPRENTICES AND TRAINEES
H.1.1 For all new employment resulting from this contract or subcontracts hereto, as defined in
Mayor’s Order 83-265 and implementing instructions, the Contractor shall use its best
efforts to comply with the following basic goal and objectives for utilization of bona fide
residents of the District of Columbia in each project’s labor force:
H.1.1.1 At least fifty-one (51) percent of apprentices and trainees employed shall be residents of
the District of Columbia registered in programs approved by the District of Columbia
Apprenticeship Council.
H.1.2 The Contractor shall negotiate an Employment Agreement with the Department of
Employment Services (DOES) for jobs created as a result of this contract. The DOES
shall be the Contractor’s first source of referral for qualified apprentices and trainees in
the implementation of employment goals contained in this clause.
H.2 DEPARTMENT OF LABOR WAGE DETERMINATIONS
The Contractor shall be bound by the Wage Determination No. 2015-4281, Revision 32
dated December 23, 2024 issued by the U.S. Department of Labor in accordance with
the Service Contract Act, 41 U.S.C. § 351 et seq., and incorporated herein as Section J.2.
The Contractor shall be bound by the wage rates for the term of the contract subject to
revision as stated herein and in accordance with clause 24 of the SCP. If an option is
exercised, the Contractor shall be bound by the applicable wage rates at the time of the
exercise of the option. If the option is exercised and the CO obtains a revised wage
determination, the revised wage determination is applicable for the option periods and
the Contractor may be entitled to an equitable adjustment.
H.3 PREGNANT WORKERS FAIRNESS
H.3.1 The Contractor shall comply with the Protecting Pregnant Workers Fairness Act of
2016, D.C. Official Code § 32-1231.01 et seq. (PPWF Act).
H.3.2 The Contractor shall not:
(a) Refuse to make reasonable accommodations to the known limitations related to
pregnancy, childbirth, related medical conditions, or breastfeeding for an employee,
unless the Contractor can demonstrate that the accommodation would impose an undue
hardship;
(b) Take an adverse action against an employee who requests or uses a reasonable
accommodation in regard to the employee's conditions or privileges of employment,
including failing to reinstate the employee when the need for reasonable
accommodations ceases to the employee's original job or to an equivalent position with
equivalent:
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(1) Pay;
(2) Accumulated seniority and retirement;
(3) Benefits; and
(4) Other applicable service credits;
(c) Deny employment opportunities to an employee, or a job applicant, if the denial is
based on the need of the employer to make reasonable accommodations to the known
limitations related to pregnancy, childbirth, related medical conditions, or breastfeeding;
(d) Require an employee affected by pregnancy, childbirth, related medical conditions,
or breastfeeding to accept an accommodation that the employee chooses not to accept if
the employee does not have a known limitation related to pregnancy, childbirth, related
medical conditions, or breastfeeding or the accommodation is not necessary for the
employee to perform her duties;
(e) Require an employee to take leave if a reasonable accommodation can be provided;
or
(f) Take adverse action against an employee who has been absent from work as a result
of a pregnancy-related condition, including a pre-birth complication.
H.3.3 The Contractor shall post and maintain in a conspicuous place a notice of rights in both
English and Spanish and provide written notice of an employee's right to a needed
reasonable accommodation related to pregnancy, childbirth, related medical conditions,
or breastfeeding pursuant to the PPWF Act to:
(a) New employees at the commencement of employment;
(b) Existing employees; and
(c) An employee who notifies the employer of her pregnancy, or other condition covered
by the PPWF Act, within 10 days of the notification.
H.3.4 The Contractor shall provide an accurate written translation of the notice of rights to any
non-English or non-Spanish speaking employee.
H.3.5 Violations of the PPWF Act shall be subject to civil penalties as described in the Act.
H.4 UNEMPLOYED ANTI-DISCRIMINATION
H.4.1 The Contractor shall comply with the Unemployed Anti-Discrimination Act of 2012,
D.C. Official Code § 32-1361 et seq.
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H.4.2 The Contractor shall not:
(a) Fail or refuse to consider for employment, or fail or refuse to hire, an individual as an
employee because of the individual's status as unemployed; or
(b) Publish, in print, on the Internet, or in any other medium, an advertisement or
announcement for any vacancy in a job for employment that includes:
(1) Any provision stating or indicating that an individual's status as unemployed
disqualifies the individual for the job; or
(2) Any provision stating or indicating that an employment agency will not consider or
hire an individual for employment based on that individual's status as unemployed.
H.4.3 Violations of the Unemployed Anti-Discrimination Act shall be subject to civil penalties
as described in the Act.
H.5 51% DISTRICT RESIDENTS NEW HIRES REQUIREMENTS AND FIRST
SOURCE EMPLOYMENT AGREEMENT
Delete Article 35, 51% District Residents New Hires Requirements and First Source
Employment Agreement, of the Standard Contract Provisions dated July 2010 for use
with District of Columbia Government Supplies and Services Contracts and substitute
the following Section H.5, 51% DISTRICT RESIDENTS NEW HIRES
REQUIREMENTS AND FIRST SOURCE EMPLOYMENT AGREEMENT in its
place:
H.5 51% DISTRICT RESIDENTS NEW HIRES REQUIREMENTS AND FIRST
SOURCE EMPLOYMENT AGREEMENT
H.5.1 For contracts for services in the amount of $300,000 or more, the Contractor shall
comply with the First Source Employment Agreement Act of 1984, as amended, D.C.
Official Code § 2-219.01 et seq. (First Source Act).
H.5.2 The Contractor shall enter into and maintain during the term of the contract, a First
Source Employment Agreement (Employment Agreement) with the District of
Columbia Department of Employment Service’s (DOES), in which the Contractor shall
agree that:
(a) The first source for finding employees to fill all jobs created in order to perform the
contract shall be the First Source Register; and
(b) The first source for finding employees to fill any vacancy occurring in all jobs
covered by the Employment Agreement shall be the First Source Register.
H.5.3 The Contractor shall not begin performance of the contract until its Employment
Agreement has been accepted by DOES. Once approved, the Employment Agreement
shall not be amended except with the approval of DOES.
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H.5.4 The Contractor agrees that at least 51% of the new employees hired to perform the
contract shall be District residents.
H.5.5 The Contractor’s hiring and reporting requirements under the First Source Act and any
rules promulgated thereunder shall continue for the term of the contract.
H.5.6 The CO may impose penalties, including monetary fines of 5% of the total amount of the
direct and indirect labor costs of the contract, for a willful breach of the Employment
Agreement, failure to submit the required hiring compliance reports, or deliberate
submission of falsified data.
H.5.7 If the Contractor does not receive a good faith waiver, the CO may also impose an
additional penalty equal to 1/8 of 1% of the total amount of the direct and indirect labor
costs of the contract for each percentage by which the Contractor fails to meet its hiring
requirements.
H.5.8 Any contractor which violates, more than once within a 10-year timeframe, the hiring or
reporting requirements of the First Source Act shall be referred for debarment for not
more than five (5) years.
H.5.9 The contractor may appeal any decision of the CO pursuant to this clause to the D.C.
Contract Appeals Board as provided in clause 14 of the SCP, Disputes.
H.5.10 The provisions of the First Source Act do not apply to nonprofit organizations which
employ 50 employees or less.
H.6 DIVERSION, REASSIGNMENT AND REPLACEMENT OF KEY PERSONNEL
The key personnel specified in the contract are considered to be essential to the work
being performed hereunder. Prior to diverting any of the specified key personnel for any
reason, the Contractor shall notify the CO at least thirty (30) calendar days in advance
and shall submit justification, including proposed substitutions, in sufficient detail to
permit evaluation of the impact upon the contract. The Contractor shall obtain written
approval of the CO for any proposed substitution of key personnel.
H.7 AUDITS AND RECORDS
H.7.1 As used in this clause, “records” includes books, documents, accounting procedures and
practices, and other data, regardless of type and regardless of whether such items are in
written form, in the form of computer data, or in any other form.
H.7.2 Examination of Costs. If this is a cost-reimbursement, incentive, time-and-materials,
labor-hour, or price redeterminable contract, or any combination of these, the Contractor
shall maintain and the CO, or an authorized representative of the CO, shall have the right
to examine and audit all records and other evidence sufficient to reflect properly all costs
claimed to have been incurred or anticipated to be incurred directly or indirectly in
performance of this contract. This right of examination shall include inspection at all
reasonable times of the Contractor’s plants, or parts of them, engaged in performing the
contract.
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H.7.3 Cost or pricing data. If the Contractor has been required to submit cost or pricing data
in connection with any pricing action relating to this contract, the CO, or an authorized
representative of the CO, in order to evaluate the accuracy, completeness, and currency
of the cost or pricing data, shall have the right to examine and audit all of the
Contractor’s records, including computations and projections, related to:
a) The proposal for the contract, subcontract, or modification;
b) The discussions conducted on the proposal(s), including those related to negotiating;
c) Pricing of the contract, subcontract, or modification; or
d) Performance of the contract, subcontract or modification.
H.7.4 Comptroller General
H.7.4.1 The Comptroller General of the United States, or an authorized representative, shall have
access to and the right to examine any of the Contractor’s directly pertinent records
involving transactions related to this contract or a subcontract hereunder.
H.7.4.2 This paragraph may not be construed to require the Contractor or subcontractor to create
or maintain any record that the Contractor or subcontractor does not maintain in the
ordinary course of business or pursuant to a provision of law.
H.7.5 Reports. If the Contractor is required to furnish cost, funding, or performance reports,
the CO or an authorized representative of the CO shall have the right to examine and
audit the supporting records and materials, for the purpose of evaluating:
a) The effectiveness of the Contractor’s policies and procedures to produce data
compatible with the objectives of these reports; and
b) The data reported.
H.7.6 Availability. The Contractor shall make available at its office at all reasonable times the
records, materials, and other evidence described in clauses H.7.1 through H.7.5, for
examination, audit, or reproduction, until three (3) years after final payment under this
contract or for any shorter period specified in the solicitation, or for any longer period
required by statute or by other clauses of this contract. In addition:
a) If this contract is completely or partially terminated, the Contractor shall make
available the records relating to the work terminated until thee (3) years after any
resulting final termination settlement; and
b) The Contractor shall make available records relating to appeals under the Disputes
clause or to litigation or the settlement of claims arising under or relating to this
contract until such appeals, litigation, or claims are finally resolved.
H.7.7 The Contractor shall insert a clause containing all the terms of this clause, including this
section H.7.7, in all subcontracts under this contract that exceed the small purchase
threshold of $100,000, and:
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a) That are cost-reimbursement, incentive, time-and-materials, labor-hour, or price-
redeterminable type or any combination of these;
b) For which cost or pricing data are required; or
c) That requires the subcontractor to furnish reports as discussed in H.7.5 of this clause.
H.8 ADVISORY AND ASSISTANCE SERVICES
This contract is a “nonpersonal services contract”. The Contractor and the Contractor’s
employees: (1) shall perform the services specified herein as independent contractors,
not as employees of the government; (2) shall be responsible for their own management
and administration of the work required and bear sole responsibility for complying with
any and all technical, schedule, financial requirements or constraints attendant to the
performance of this contract; (3) shall be free from supervision or control by any
government employee with respect to the manner or method of performance of the
service specified; but (4) shall, pursuant to the government’s right and obligation to
inspect, accept or reject work, comply with such general direction of the CO, or the duly
authorized representative of the CO as is necessary to ensure accomplishment of the
contract objectives.
H.9 SUBCONTRACTING REQUIREMENTS
H.9.1 Subcontracting Requirements
H.9.1.1 The Director of the Department of Small and Local Business Development (DSLBD)
has approved a waiver of the mandatory subcontracting requirements for this contract.
H.9.1.2 A prime contractor that is a CBE and has been granted a bid preference pursuant to D.C.
Official Code § 2-218.43, or is selected through a set-aside program, shall perform at
least 35% of the contracting effort with its own organization and resources and, if it
subcontracts, 35% of the subcontracting effort shall be with CBEs. A CBE prime
contractor that performs less than 35% of the contracting effort shall be subject to
enforcement actions under D.C. Official Code § 2-218.63.
H.9.1.3 A prime contractor that is a certified joint venture and has been granted a bid preference
pursuant to D.C. Official Code § 2-218.43, or is selected through a set-aside program,
shall perform at least 50% of the contracting effort with its own organization and
resources and, if it subcontracts, 35% of the subcontracting effort shall be with CBEs. A
certified joint venture prime contractor that performs less than 50% of the contracting
effort shall be subject to enforcement actions under D.C. Official Code § 2-218.63.
H.9.1.4 Each CBE utilized to meet these subcontracting requirements shall perform at least 35%
of its contracting effort with its own organization and resources.
H.9.1.5 A prime contractor that is a CBE and has been granted a bid preference pursuant to D.C.
Official Code § 2-218.43, or is selected through a set-aside program, shall perform at
least 50% of the on-site work with its own organization and resources if the contract is
$1 million or less.
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H.9.2 RESERVED
H.9.3 RESERVED
H.9.4 Subcontracting Plan Compliance Reporting
H.9.4.1 If the Contractor has a subcontracting plan required by law for this contract, the
Contractor shall submit a quarterly report to the CO, CA, District of Columbia Auditor
and the Director of DSLBD. The quarterly report shall include the following
information for each subcontract identified in the subcontracting plan:
(A) The price that the prime contractor will pay each subcontractor under the
subcontract;
(B) A description of the goods procured or the services subcontracted for;
(C) The amount paid by the prime contractor under the subcontract; and
(D) A copy of the fully executed subcontract, if it was not provided with an earlier
quarterly report.
H.9.4.2 If the fully executed subcontract is not provided with the quarterly report, the prime
contractor will not receive credit toward its subcontracting requirements for that
subcontract.
H.9.5 Annual Meetings
Upon at least 30-days written notice provided by DSLBD, the Contractor shall meet
annually with the CO, CA, District of Columbia Auditor and the Director of DSLBD to
provide an update on its subcontracting plan.
H.9.6 Notices
The Contractor shall provide written notice to the DSLBD and the District of Columbia
Auditor upon commencement of the contract and when the contract is completed.
H.9.7 Enforcement and Penalties for Breach of Subcontracting Plan
H.9.7.1 A contractor shall be deemed to have breached a subcontracting plan required by law, if
the contractor (i) fails to submit subcontracting plan monitoring or compliance reports or
other required subcontracting information in a reasonably timely manner; (ii) submits a
monitoring or compliance report or other required subcontracting information containing
a materially false statement; or (iii) fails to meet its subcontracting requirements.
H.9.7.2 A contractor that is found to have breached its subcontracting plan for utilization of
CBEs in the performance of a contract shall be subject to the imposition of penalties,
including monetary fines in accordance with D.C. Official Code § 2-218.63.
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H.9.7.3 If the CO determines the Contractor’s failure to be a material breach of the contract, the
CO shall have cause to terminate the contract under the default provisions in clause 8 of
the SCP, Default.
H.10 FAIR CRIMINAL RECORD SCREENING
H.10.1 The Contractor shall comply with the provisions of the Fair Criminal Record Screening
Amendment Act of 2014, effective December 17, 2014 (D.C. Law 20-152) (the “Act” as
used in this section). This section applies to any employment, including employment on
a temporary or contractual basis, where the physical location of the employment is in
whole or substantial part within the District of Columbia.
H.10.2 Prior to making a conditional offer of employment, the Contractor shall not require an
applicant for employment, or a person who has requested consideration for employment
by the Contractor, to reveal or disclose an arrest or criminal accusation that is not then
pending or did not result in a criminal conviction.
H.10.3 After making a conditional offer of employment, the Contractor may require an
applicant to disclose or reveal a criminal conviction.
H.10.4 The Contractor may only withdraw a conditional offer of employment, or take adverse
action against an applicant, for a legitimate business reason as described in the Act.
H.10.5 This section and the provisions of the Act shall not apply:
(a) Where a federal or District law or regulation requires the consideration of an
applicant’s criminal history for the purposes of employment;
(b) To a position designated by the employer as part of a federal or District government
program or obligation that is designed to encourage the employment of those with
criminal histories;
(c) To any facility or employer that provides programs, services, or direct care to,
children, youth, or vulnerable adults; or
(d) To employers that employ less than 11 employees.
H.10.6 A person claiming to be aggrieved by a violation of the Act may file an administrative
complaint with the District of Columbia Office of Human Rights, and the Commission
on Human Rights may impose monetary penalties against the Contractor.
H.11 DISTRICT RESPONSIBILITIES
The Government of the District of Columbia will provide the following:
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H.11.1 The Contractor shall prepare a Compliance Plan that is consistent with current best
practices and applicable standards including those issued by HHS Office of Inspector
General. The Contractor shall also maintain ASO services in accordance with
Attachment J.19 ASO SLA and report SLA compliance monthly throughout the life of
the contract.
H.11.2 Each Partner Agency shall make all reasonable efforts to provide the Contractor access
to all staff, documents, and other resources necessary to develop a Contractor-authored
compliance plan that is consistent with current best practices and applicable standards
including those issued by Department of Health and Human Services (HHS) Office of
Inspector General.
H.11.3 Each Partner Agency shall make reasonable efforts to adhere to policies, processes, and
procedures established in the Contractor-authored compliance plan to ensure that all data
transmitted to the Contractor for purposes of claims submission is supported by
sufficient documentation and is otherwise accurate and complete to the best of the
Partner Agency’s knowledge and belief.
H.11.4 The District and each Partner Agency shall cooperate and timely respond to requests
reasonably made by the Contractor during the term of the contract. Such requests may
include, but are not limited to, specifications to automated claiming, medical record
documentation, clinical documentation, or similar systems; examples of paper and/or
electronic claiming files; historical claim results data, reference files such as provider
credential files, case load data, or client attendance records; access to personnel; and past
audit result findings.
H.11.5 Orientation for the Contractor relative to the terms of the contract and program
mandates.
H.11.6 Continuous contract performance evaluations and program monitoring.
H.11.7 Preparing any response or request for additional information or clarification from the
Contractor as it pertains to the Contractor’s compliance or noncompliance within fifteen
(15) business days of submission of deliverables.
H.11.8 Monitor and evaluate Contractor compliance with the requirements of this Contract and
impose sanctions when necessary.
H.11.9 Conduct a timely review of all materials submitted to the agency by the Contractor as
required.
H.11.10 Maintain adequate liaison and cooperation with the Contractor, including providing
timely management decisions and approvals of forms and procedures to enable the
Contractor to properly perform contractual duties.
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H.11.11 Attend required meetings with the Contractor to discuss issues, changes, deliverables’
status, and specific agenda items proposed by the District or the Contractor. The
Contractor shall be the default chair of the meetings; however, the CA shall retain the
option to chair the meetings, as necessary.
H.12 CONTRACTOR RESPONSIBILITIES
The Contractor for the District of Columbia will satisfy the following:
H.12.1 The Contractor shall prepare a Compliance Plan that is consistent with current best
practices and applicable standards including those issued by HHS Office of Inspector
General.
H.12.2 The Contractor shall provide sufficient staff devoted to delivering the requirements
outlined in this solicitation. The Contractor shall ensure that its staff responds to the CA
requests for documents and information. The Contractor’s staff shall respond to the
CA’s questions and requests in a timely and efficient manner.
H.12.3 All deliverables, materials or other submissions provided by the Contractor must meet
the form and content requirements specified by DHCF. Such deliverables or other
materials are subject to agency approval.
H.12.4 If DHCF determines that a deliverable cannot be approved, the Contractor will have a
cure period beginning with notice from the agency that the deliverable is not approved.
The cure period will last for ten (10) business days from the notice of deliverable
rejection. If, at the end of the cure period, the deliverable(s) submitted by the Contractor
cannot be approved by the agency, the agency may, at its sole discretion, withhold all or
part of the next monthly payment and any subsequent payments until the deliverable(s)
are acceptable to the agency.
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SECTION I: CONTRACT CLAUSES
I.1 APPLICABILITY OF STANDARD CONTRACT PROVISIONS
The Standard Contract Provisions for use with District of Columbia Government
Supplies and Services Contracts dated July 2010 (“SCP”) are incorporated as part of the
contract. To obtain a copy of the SCP go to http://ocp.dc.gov, under Quick Links click
on “Required Solicitation Documents”.
I.2 CONTRACTS THAT CROSS FISCAL YEARS
Continuation of this contract beyond the current fiscal year is contingent upon future fiscal
appropriations.
I.3 CONFIDENTIALITY OF INFORMATION
The Contractor shall keep all information relating to any employee or customer of the
District in absolute confidence and shall not use the information in connection with any
other matters; nor shall it disclose any such information to any other person, firm or
corporation, in accordance with the District and federal laws governing the
confidentiality of records.
I.4 TIME
Time, if stated in a number of days, will include Saturdays, Sundays, and holidays,
unless otherwise stated herein.
I.5 RIGHTS IN DATA
Delete Article 42, Rights in Data, of the Standard Contract Provisions dated July 2010
for use with District of Columbia Government Supplies and Services Contracts and
substitute the following Article 42, Rights in Data) in its place:
A. Definitions
1. “Products” - A deliverable under any contract that may include commodities, services
and/or technology furnished by or through Contractor, including existing and custom
Products, such as, but not limited to: a) recorded information, regardless of form or the
media on which it may be recorded; b) document research; c) experimental,
developmental, or engineering work; d) licensed software; e) components of the
hardware environment; f) printed materials (including but not limited to training
manuals, system and user documentation, reports, drawings); g) third party software; h)
modifications, customizations, custom programs, program listings, programming tools,
data, modules, components; and i) any intellectual property embodied therein, whether
in tangible or intangible form, including but not limited to utilities, interfaces, templates,
subroutines, algorithms, formulas, source code, and object code.
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2. “Existing Products” - Tangible Products and intangible licensed Products that exist
prior to the commencement of work under the contract. Existing Products must be
identified on the Product prior to commencement of work or else will be presumed to be
Custom Products.
3. “Custom Products” - Products, preliminary, final or otherwise, which are created or
developed by Contractor, its subcontractors, partners, employees, resellers or agents for
the District under the contract.
4. “District” – The District of Columbia and its agencies.
B. Title to Project Deliverables
The Contractor acknowledges that it is commissioned by the District to perform services
detailed in the contract. The District shall have ownership and rights for the duration set
forth in the contract to use, copy, modify, distribute, or adapt Products as follows:
1. Existing Products: Title to all Existing Licensed Product(s), whether or not embedded
in, delivered or operating in conjunction with hardware or Custom Products, shall
remain with the Contractor or third party proprietary owner, who retains all rights, title
and interest (including patent, trademark or copyrights). Effective upon payment, the
District shall be granted an irrevocable, non-exclusive, worldwide, paid-up license to
use, execute, reproduce, display, perform, adapt (unless Contractor advises the District
as part of Contractor’s bid that adaptation will violate existing agreements or statutes and
Contractor demonstrates such to the District’s satisfaction), and distribute Existing
Product to District users up to the license capacity stated in the contract with all license
rights necessary to fully effect the general business purpose of the project or work plan
or contract. Licenses shall be granted in the name of the District. The District agrees to
reproduce the copyright notice and any other legend of ownership on any copies
authorized under this paragraph.
2. Custom Products: Effective upon Product creation, Contractor hereby conveys,
assigns, and transfers to the District the sole and exclusive rights, title and interest in
Custom Product(s), whether preliminary, final or otherwise, including all patent,
trademark and copyrights. Contractor hereby agrees to take all necessary and appropriate
steps to ensure that the Custom Products are protected against unauthorized copying,
reproduction and marketing by or through Contractor.
C. Transfers or Assignments of Existing or Custom Products by the District
The District may transfer or assign Existing or Custom Products and the licenses
thereunder to another District agency. Nothing herein shall preclude the Contractor from
otherwise using the related or underlying general knowledge, skills, ideas, concepts,
techniques and experience developed under a project or work plan in the course of
Contractor’s business.
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D. Subcontractor Rights
Whenever any data, including computer software, are to be obtained from a
subcontractor under the contract, the Contractor shall use this clause, Rights in Data, in
the subcontract, without alteration, and no other clause shall be used to enlarge or
diminish the District’s or the Contractor’s rights in that subcontractor data or computer
software which is required for the District.
E. Source Code Escrow
1. For all computer software furnished to the District with the rights specified in section
B.2, the Contractor shall furnish to the District, a copy of the source code with such
rights of the scope as specified in section B.2 of this clause. For all computer software
furnished to the District with the restricted rights specified in section B.1 of this clause,
the District, if the Contractor either directly or through a successor or affiliate shall cease
to provide the maintenance or warranty services provided the District under the contract
or any paid-up maintenance agreement, or if the Contractor should be declared insolvent
by a court of competent jurisdiction, shall have the right to obtain, for its own and sole
use only, a single copy of the current version of the source code supplied under the
contract, and a single copy of the documentation associated therewith, upon payment to
the person in control of the source code the reasonable cost of making each copy.
2. If the Contractor or Product manufacturer/developer of software furnished to the
District with the rights specified in section B.1 of this clause offers the source code or
source code escrow to any other commercial customers, the Contractor shall either: (1)
provide the District with the source code for the Product; (2) place the source code in a
third party escrow arrangement with a designated escrow agent who shall be named and
identified to the District, and who shall be directed to release the deposited source code
in accordance with a standard escrow arrangement acceptable to the District; or (3) will
certify to the District that the Product manufacturer/ developer has named the District as
a named beneficiary of an established escrow arrangement with its designated escrow
agent who shall be named and identified to the District, and who shall be directed to
release the deposited source code in accordance with the terms of escrow.
3. The Contractor shall update the source code, as well as any corrections or
enhancements to the source code, for each new release of the Product in the same
manner as provided above, and certify such updating of escrow to the District in writing.
F. Indemnification and Limitation of Liability
The Contractor shall indemnify and save and hold harmless the District, its officers,
agents and employees acting within the scope of their official duties against any liability,
including costs and expenses, (i) for violation of proprietary rights, copyrights, or rights
of privacy, arising out of the publication, translation, reproduction, delivery,
performance, use or disposition of any data furnished under this contract, or (ii) based
upon any data furnished under this contract, or based upon libelous or other unlawful
matter contained in such data.
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I.6 OTHER CONTRACTORS
The Contractor shall not commit or permit any act that will interfere with the
performance of work by another District contractor or by any District employee.
I.7 SUBCONTRACTS
The Contractor hereunder shall not subcontract any of the Contractor’s work or services
to any subcontractor without the prior written consent of the CO. Any work or service
so subcontracted shall be performed pursuant to a subcontract agreement, which the
District will have the right to review and approve prior to its execution by the
Contractor. Any such subcontract shall specify that the Contractor and the subcontractor
shall be subject to every provision of this contract. Notwithstanding any such
subcontract approved by the District, the Contractor shall remain liable to the District for
all Contractor's work and services required hereunder.
I.8 INSURANCE
A. GENERAL REQUIREMENTS. The Contractor at its sole expense shall procure
and maintain, during the entire period of performance under this contract, the types of
insurance specified below. The Contractor shall submit a Certificate of Insurance to the
Contracting Officer (CO) giving evidence of the required coverage prior to commencing
performance under this contract. In no event shall any work be performed until the
required Certificates of Insurance signed by an authorized representative of the insurer(s)
have been provided to, and accepted by, the CO.
The Government of the District of Columbia shall be included in all policies, where
applicable and allowable by law, required hereunder to be maintained by the Contractor
and its subcontractors (except for workers’ compensation and professional liability
insurance) as an additional insureds for claims against The Government of the District of
Columbia relating to this contract, with the understanding that any affirmative obligation
imposed upon the insured Contractor or its subcontractors (including without limitation
the liability to pay premiums) shall be the sole obligation of the Contractor or its
subcontractors, and not the additional insured. The additional insured status under the
Contractor’s and its subcontractors’ Commercial General Liability insurance policies
shall be effected using the ISO Additional Insured Endorsement form CG 20 10 11 85
(or CG 20 10 07 04 and CG 20 37 07 04) or such other endorsement or combination of
endorsements providing coverage at least as broad and approved by the CO in writing.
All of the Contractor’s and its subcontractors’ liability policies (except for workers’
compensation and professional liability insurance) shall be endorsed using ISO form CG
20 01 04 13 or its equivalent so as to indicate that such policies provide primary
coverage (without any right of contribution by any other insurance, reinsurance or self-
insurance, including any deductible or retention, maintained by an Additional Insured)
for all claims against the additional insured arising out of the performance of this
Statement of Work by the Contractor or its subcontractors, or anyone for whom the
Contractor or its subcontractors may be liable. These policies shall include a separation
of insureds clause applicable to the additional insured.
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If the Contractor and/or its subcontractors maintain broader coverage and/or higher limits than
the minimums shown below, the District requires and shall be entitled to the broader coverage
and/or the higher limits maintained by the Contractor and subcontractors.
B. INSURANCE REQUIREMENTS
1. Commercial General Liability Insurance (“CGL”) - The Contractor shall provide evidence
satisfactory to the CO with respect to the services performed that it carries a CGL policy,
written on an occurrence (not claims-made) basis, on Insurance Services Office, Inc. (“ISO”)
form CG 00 01 04 13 (or another occurrence-based form with coverage at least as broad and
approved by the CO in writing), covering liability for all ongoing and completed operations of
the Contractor and under all subcontracts, covering claims for bodily injury, including without
limitation sickness, disease or death and mental anguish of any persons, broad form property
damage, including loss of use resulting therefrom, personal and advertising injury, and including
coverage for liability arising out of an Insured Contract (including the tort liability of another
assumed in a contract) and acts of terrorism (whether caused by a foreign or domestic source).
Such coverage shall have limits of liability of not less than $1,000,000 each occurrence, a
$2,000,000 general aggregate.
The Commercial General Liability shall be further endorsed to:
a) To the fullest extent permitted by law, provide additional insured coverage using ISO
form CG 2015 0413 (or it’s equivalent) to The Government of the District of
Columbia
b) Coverage available to the additional insureds shall apply on a primary and non-
contributing basis as respects any other insurance, deductibles, or self-insurance
available to the additional insureds
c) A waiver of subrogation in favor of The Government of the District of Columbia
d) Any Annual Aggregate shall apply on a per location or per project basis (where
applicable)
e) Defense costs shall be in addition to and not erode the limits of liability
2. Automobile Liability Insurance - The Contractor shall provide evidence satisfactory to the CO
of commercial (business) automobile liability insurance written on ISO form CA 00 01 10 13
(or another form with coverage at least as broad and approved by the CO in writing) including
coverage for all owned, hired, borrowed and non-owned vehicles and equipment used by the
Contractor in connection with work under this agreement, with a minimum combined single
limit of $1,000,000 for bodily injury or death and property damage, including loss of use
thereof. Such policy or policies of automobile liability insurance shall be written on an
"occurrence" (as opposed to a "claims made") basis.
Auto Physical Damage Coverage - The Contractor shall provide auto physical damage insurance
to cover "loss" to a covered "auto" or its equipment:
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a) Comprehensive - Fire, lightning or explosion; theft; windstorm, hail or earthquake;
flood; mischief or vandalism; or the sinking, burning, collision or derailment of any
conveyance transporting the covered "auto".
b) Collision Coverage - Caused by: The covered "auto's" collision with another object
or the covered "auto's" overturn.
The Commercial Auto Liability policy shall be further endorsed to:
a) To the fullest extent permitted by law, provide additional insured coverage to The
Government of the District of Columbia
b) Coverage available to the additional insureds shall apply on a primary and non-
contributing basis as respects any other insurance, deductibles, or self-insurance
available to the additional insureds
c) A waiver of subrogation in favor of The Government of the District of Columbia
d) Defense costs shall be in addition to and not erode the limits of liability
e) If applicable, include Form CA 99 48 03 06 Pollution Liability - Broadened
Coverage for Covered Autos - Business Auto, Motor Carrier and Truckers (or it’s
equivalent)
3. Workers’ Compensation Insurance - The Contractor shall provide evidence satisfactory to the
CO of Workers’ Compensation insurance in accordance with the statutory mandates of the
District of Columbia or the jurisdiction in which the contract is performed.
Employer’s Liability Insurance - The Contractor shall provide evidence satisfactory to the CO
of employer’s liability insurance as follows: $500,000 per accident for injury; $500,000 per
employee for disease; and $500,000 for policy disease limit.
The Workers Compensation and Employers Liability shall be further endorsed to:
a) Include a Waiver of Subrogation in favor of The Government of the District of
Columbia.
b) Where applicable, include United States Longshore and Harbor Workers Compensation
Act (USL&H)
c) Where applicable, include Jones Act Coverage for seamen or crew members on an “if
any” basis.
4. Technology Liability, Media Liability and Network Security/Privacy (Cyber) Liability
Insurance covering acts, errors, omissions, breach of contract, and violation of any consumer
protection laws arising out of Contractor’s operations or services with a limit of $5,000,000 per
claim and in the aggregate. Such coverage shall include but not be limited to, third party and
first party coverage for loss or disclosure of any data, including personally identifiable
information and payment card information, network security failure, violation of any consumer
protection laws, unauthorized access and/or use or other intrusions, infringement of any
intellectual property rights (except patent), unintentional breach of contract, negligence or
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breach of duty to use reasonable care, breach of any duty of confidentiality, invasion of privacy,
or violations of any other legal protections for personal information, defamation, libel, slander,
commercial disparagement, negligent transmission of computer virus, or use of computer
networks in connection with denial of service attacks. Such coverage shall include regulatory
defense and fines/penalties in any jurisdiction anywhere in the world. Such coverage shall
include contractual privacy coverage for data breach response and crisis management costs that
would be incurred by Contractor on behalf of The Government of the District of Columbia in
the event of a data breach including legal and forensic expenses, notification costs, credit
monitoring costs, and costs to operate a call center. Contractor shall maintain coverage in force
during the term of this Agreement and for an extended reporting period of not less than two (2)
years after.
5. Professional Liability Insurance (Errors & Omissions) - The Contractor shall provide
Professional Liability Insurance (Errors and Omissions) to cover liability resulting from any
error or omission in the performance of professional services under this Contract. The policy
shall provide limits of $1,000,000 per claim or per occurrence for each wrongful act and
$2,000,000 annual aggregate. The Contractor warrants that any applicable retroactive date
precedes the date the Contractor first performed any professional services for the Government of
the District of Columbia and that continuous coverage will be maintained or an extended
reporting period will be exercised for a period of at least ten years after the completion of the
professional services. Limits may not be shared with other lines of coverage.
6. Commercial Umbrella or Excess Liability - The Contractor shall provide evidence satisfactory
to the CO of commercial umbrella or excess liability insurance with minimum limits of
$5,000,000 per occurrence and $5,000,000 in the annual aggregate, following the form and in
excess of all liability policies. All liability coverages must be scheduled under the umbrella
and/or excess policy. The insurance required under this paragraph shall be written in a form that
annually reinstates all required limits. Coverage shall be primary to any insurance, self-
insurance or reinsurance maintained by The Government of the District of Columbia and the
“other insurance” provision must be amended in accordance with this requirement and
principles of vertical exhaustion.
7. Crime Insurance (3rd Party Indemnity) - The Contractor shall provide a Crime policy including
3rd party fidelity to cover the dishonest acts of Contractors, its employees and/or volunteers
which result in a loss to the District. The Government of the District of Columbia shall be
included as loss payee. The policy shall provide a limit of $50,000 per occurrence.
C. SUBCONTRACTOR INSURANCE REQUIREMENTS
Any and all subcontractors engaged by Contractor for work under this agreement shall be
required to have the same insured required of Contractor. Should the Contractor wish to
propose different insurance requirements than outlined below, then, prior to commencement of
work by the subcontractor, the Contractor shall submit in writing the name and brief description
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of work to be performed by the subcontractor on the Subcontractors Insurance Requirement
Template provided to the Office of Risk Management (ORM). ORM will determine the
insurance requirements applicable to the subcontractor and promptly deliver such requirements
in writing to the Contractor. In either instance, the Contractor must provide proof of the
subcontractor's required insurance prior to commencement of work by the subcontractor.
D. PRIMARY AND NONCONTRIBUTORY INSURANCE
The insurance required herein shall be primary to and will not seek contribution from any other
insurance, reinsurance or self-insurance including any deductible or retention, maintained by the
Government of the District of Columbia.
E. DURATION. The Contractor shall carry all required insurance until all contract work is
accepted by The Government of the District of Columbia and shall carry listed coverages for ten
years for construction projects following final acceptance of the work performed under this
contract and two years for non-construction related contracts.
F. LIABILITY. These are the required minimum insurance requirements established by The
Government of the District of Columbia. However, it is understood that The Government of the
District of Columbia does not in any way represent that the insurance or the limits of insurance
specified herein are sufficient or adequate to protect your interests or liabilities and will not in
any way limit the contractor’s liability under this contract.
G. CONTRACTOR’S PROPERTY. Contractor and subcontractors are solely responsible for any
loss or damage to their personal property, including but not limited to tools and equipment,
scaffolding and temporary structures, rented machinery, or owned and leased equipment. A
waiver of subrogation shall apply in favor of The Government of the District of Columbia.
H. MEASURE OF PAYMENT. The Government of the District of Columbia shall not make any
separate measure or payment for the cost of insurance and bonds. The Contractor shall include
all of the costs of insurance and bonds in the contract price.
I. NOTIFICATION. The Contractor shall ensure that all policies provide that the CO shall be
given thirty (30) days prior written notice in the event of cancellation, non-renewal, or material
changes to the extent such cancellation or material changes results in Contractor no long
complying with the above requirements. The Contractor shall provide the CO with ten (10) days
prior written notice in the event of non-payment of premium. The Contractor will also provide
the CO with an updated Certificate of Insurance should its insurance coverages renew during the
contract. The Government of the District of Columbia may reasonably change the above
insurance coverage requirements during the Term by giving Contractor at least 30 days’ notice
of the change. Contractor must comply, at your expense, and deliver to the CO evidence of
compliance before the change becomes effective.
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J. CERTIFICATES OF INSURANCE. The Contractor must send to CO, at least 10 days after
execution of this Agreement, certificates of insurance evidencing the required insurance
coverage and endorsements required herein. Contractor must also provide us with evidence of
renewal before the expiration date of each insurance policy. Contractor is responsible for
providing us with 30 days advanced written notice if the certificate of insurance by the insurer
has been canceled, reduced in coverage, or otherwise altered. .
Certificates of insurance must reference the corresponding contract number. Evidence of
insurance shall be submitted to:
The Government of the District of Columbia
And mailed to the attention of:
Tracy Williams
Contracting Officer
Office of Contracting and Procurement
441 4th Street NW Suite 330S
Washington, DC 20001
202-899-3657
tracy.williams2@dc.gov
The CO may request and the Contractor shall promptly deliver updated certificates of insurance,
endorsements indicating the required coverages, and/or certified copies of the insurance
policies. If the insurance initially obtained by the Contractor expires prior to completion of the
contract, renewal certificates of insurance and additional insured and other endorsements shall
be furnished to the CO prior to the date of expiration of all such initial insurance. For all
coverage required to be maintained after completion, an additional certificate of insurance
evidencing such coverage shall be submitted to the CO on an annual basis as the coverage is
renewed (or replaced).
K. DISCLOSURE OF INFORMATION. The Contractor agrees that The Government of the
District of Columbia may disclose the name and contact information of its insurers to any third
party which presents a claim against The Government of the District of Columbia for any
damages or claims resulting from or arising out of work performed by the Contractor, its agents,
employees, servants or subcontractors in the performance of this contract.
L. CARRIER RATINGS. All Contractor’s and its subcontractors’ insurance required in
connection with this contract shall be written by insurance companies with an A.M. Best
Insurance Guide rating of at least A- VII or better (or the equivalent by any other rating agency)
and licensed in the District of Columbia.
M. WARRANTIES. When applicable, the Contractor should be named as an additional insured on
the applicable manufacturer’s/distributer’s Commercial General Liability policy using Insurance
Services Office, Inc. (“ISO”) form CG 20 15 04 13 (or another occurrence-based form with
coverage at least as broad). CO should collect, review for accuracy, and maintain all warranties
for goods and services.
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I.9 EQUAL EMPLOYMENT OPPORTUNITY
In accordance with the District of Columbia Administrative Issuance System, Mayor’s
Order 85-85 dated June 10, 1985, the forms for completion of the Equal Employment
Opportunity Information Report are incorporated herein as Section J.3. An award
cannot be made to any offeror who has not satisfied the equal employment requirements.
I.10 ORDER OF PRECEDENCE
The contract awarded will contain the following clause:
ORDER OF PRECEDENCE
A conflict in language shall be resolved by giving precedence to the document in the
highest order of priority that contains language addressing the issue in question. The
following documents are incorporated into the contract by reference and made a part of
the contract in the following order of precedence:
(1) An applicable Court Order, if any
(2) Contract document
(3) Standard Contract Provisions
(4) Contract attachments other than the Standard Contract Provisions
(5) Proposal
I.11 DISPUTES
Delete Article 14, Disputes, of the Standard Contract Provisions dated July 2010 for use
with District of Columbia Government Supplies and Services Contracts and substitute
the following Article 14, Disputes, in its place:
14. Disputes
All disputes arising under or relating to the contract shall be resolved as provided herein.
(a) Claims by the Contractor against the District: Claim, as used in paragraph
(a) of this clause, means a written assertion by the Contractor seeking, as a
matter of right, the payment of money in a sum certain, the adjustment or
interpretation of contract terms, or other relief arising under or relating to the
contract. A claim arising under a contract, unlike a claim relating to that
contract, is a claim that can be resolved under a contract clause that provides
for the relief sought by the claimant
(1) All claims by a Contractor against the District arising under or relating to a
contract shall be in writing and shall be submitted to the CO for a decision. The
Contractor’s claim shall contain at least the following:
(i) A description of the claim and the amount in dispute;
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(ii) Data or other information in support of the claim;
(iii) A brief description of the Contractor’s efforts to resolve the dispute prior to
filing the claim; and
(iv) The Contractor’s request for relief or other action by the CO.
(2) The CO may meet with the Contractor in a further attempt to resolve the claim by
agreement.
(3) The CO shall issue a decision on any claim within 120 calendar days after receipt
of the claim. Whenever possible, the CO shall take into account factors such as
the size and complexity of the claim and the adequacy of the information in
support of the claim provided by the Contractor.
(4) The CO’s written decision shall do the following:
i. Provide a description of the claim or dispute;
ii. Refer to the pertinent contract terms;
iii. State the factual areas of agreement and disagreement;
iv. State the reasons for the decision, including any specific
findings of fact, although specific findings of fact are not
required and, if made, shall not be binding in any subsequent
proceeding;
v. If all or any part of the claim is determined to be valid,
determine the amount of monetary settlement, the contract
adjustment to be made, or other relief to be granted;
vi. Indicate that the written document is the CO’s final decision;
and
vii. Inform the Contractor of the right to seek further redress by
appealing the decision to the Contract Appeals Board.
(5) Failure by the CO to issue a decision on a contract claim within 120 days of
receipt of the claim will be deemed to be a denial of the claim, and will authorize
the commencement of an appeal to the Contract Appeals Board as provided by
D.C. Official Code § 2-360.04.
(6) If a contractor is unable to support any part of its claim and it is
determined that the inability is attributable to a material misrepresentation
of fact or fraud on the part of the Contractor, the Contractor shall be liable
to the District for an amount equal to the unsupported part of the claim in
addition to all costs to the District attributable to the cost of reviewing
that part of the Contractor’s claim. Liability under this paragraph (a)(6)
shall be determined within six (6) years of the commission of the
misrepresentation of fact or fraud.
(7) Pending final decision of an appeal, action, or final settlement, the Contractor
shall proceed diligently with performance of the contract in accordance with the
decision of the CO.
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(b) Claims by the District against the Contractor: Claim as used in paragraph
(b) of this clause, means a written demand or written assertion by the District
seeking, as a matter of right, the payment of money in a sum certain, the
adjustment of contract terms, or other relief arising under or relating to the
contract. A claim arising under a contract, unlike a claim relating to that
contract, is a claim that can be resolved under a contract clause that provides
for the relief sought by the claimant.
(1) The CO shall decide all claims by the District against a contractor arising
under or relating to a contract.
(2) The CO shall send written notice of the claim to the contractor.
The CO’s written decision shall do the following:
i. Provide a description of the claim or dispute;
ii. Refer to the pertinent contract terms;
iii. State the factual areas of agreement and disagreement;
iv. State the reasons for the decision, including any specific
findings of fact, although specific findings of fact are not
required and, if made, shall not be binding in any
subsequent proceeding;
v. If all or any part of the claim is determined to be valid, determine
the amount of monetary settlement, the contract adjustment to be
made, or other relief to be granted;
vi. Indicate that the written document is the CO’s final
decision; and
vii. Inform the Contractor of the right to seek further redress by
appealing the decision to the Contract Appeals Board.
(3) The CO shall support the decision by reasons and shall inform the
Contractor of its rights as provided herein.
(4) Before or after issuing the decision, the CO may meet with the
Contractor to attempt to resolve the claim by agreement.
(5) The authority contained in this paragraph (b) shall not apply to a claim or
dispute for penalties or forfeitures prescribed by statute or regulation
which another District agency is specifically authorized to administer,
settle or determine.
(6) This paragraph shall not authorize the CO to settle, compromise, pay, or
otherwise adjust any claim involving fraud.
(c) Decisions of the CO shall be final and not subject to review unless the
Contractor timely commences an administrative appeal for review of the
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decision, by filing a complaint with the Contract Appeals Board, as authorized
by D.C. Official Code § 2-360.04.
(d) Pending final decision of an appeal, action, or final settlement, the
Contractor shall proceed diligently with performance of the contract in
accordance with the decision of the CO.
I.12 CHANGES
Delete clause 15, Changes, of the Standard Contract Provisions dated July 2010 for use
with District of Columbia Government Supplies and Services Contracts and substitute
the following clause 15, Changes in its place:
15. Changes:
(a) The CO may, at any time, by written order, and without notice to the surety, if any,
make changes in the contract within the general scope hereof. If such change causes
an increase or decrease in the cost of performance of the contract, or in the time
required for performance, an equitable adjustment shall be made. Any claim for
adjustment for a change within the general scope must be asserted within ten (10)
days from the date the change is ordered; provided, however, that the CO, if he or
she determines that the facts justify such action, may receive, consider and adjust
any such claim asserted at any time prior to the date of final settlement of the
contract. If the parties fail to agree upon the adjustment to be made, the dispute shall
be determined as provided in clause 14 Disputes.
(b) The District shall not require the Contractor, and the Contractor shall not require a
subcontractor, to undertake any work that is beyond the original scope of the
contract or subcontract, including work under a District-issued change order, when
the additional work increases the contract price beyond the not-to-exceed price or
negotiated maximum price of this contract, unless the CO:
(1) Agrees with Contractor, and if applicable, the subcontractor on a price for
the additional work;
(2) Obtains a certification of funding to pay for the additional work;
(3) Makes a written, binding commitment with the Contractor to pay for the
additional work within 30-days after the Contractor submits a proper
invoice; and
(4) Provides the Contractor with written notice of the funding certification.
(c) The Contractor shall include in its subcontracts a clause that requires the Contractor
to:
(1) Within 5 business days of its receipt of notice the approved additional
funding, provide the subcontractor with notice of the amount to be paid to
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the subcontractor for the additional work to be performed by the
subcontractor;
(2) Pay the subcontractor any undisputed amount to which the subcontractor
is entitled for the additional work within 10 days of receipt of payment
from the District; and
(3) Notify the subcontractor and CO in writing of the reason the Contractor
withholds any payment from a subcontractor for the additional work.
(d) Neither the District, Contractor, nor any subcontractor may declare another party
to be in default, or assess, claim, or pursue damages for delays, until the parties
to agree on a price for the additional work.
I.13 NON-DISCRIMINATION CLAUSE
Delete clause 19, Non-Discrimination Clause, of the Standard Contract Provisions dated
July 2010 for use with District of Columbia Government Supplies and Services
Contracts and substitute the following clause 19, Non-Discrimination Clause, in its
place:
19. Non-Discrimination Clause:
(a) The Contractor shall not discriminate in any manner against any employee or
applicant for employment that would constitute a violation of the District of
Columbia Human Rights Act, effective December 13, 1977, as amended (D.C. Law
2-38; D.C. Official Code § 2-1401.01 et seq.) (“Act”, as used in this clause). The
Contractor shall include a similar clause in all subcontracts, except subcontracts for
standard commercial supplies or raw materials. In addition, the Contractor agrees,
and any subcontractor shall agree, to post in conspicuous places, available to
employees and applicants for employment, a notice setting forth the provisions of
this non-discrimination clause as provided in section 251 of the Act.
(a) Pursuant to Mayor’s Order 85-85, (6/10/85), Mayor’s Order 2002-175 (10/23/02),
Mayor’s Order 2011-155 (9/9/11) and the rules of the Office of Human Rights,
Chapter 11 of Title 4 of the D.C. Municipal Regulations, the following clauses apply
to the contract:
(1) The Contractor shall not discriminate against any employee or
applicant for employment because of actual or perceived: race,
color, religion, national origin, sex, age, marital status, personal
appearance, sexual orientation, gender identity or expression,
family responsibilities, genetic information, disability,
matriculation, political affiliation, or credit information. Sexual
harassment is a form of sex discrimination which is prohibited by
the Act. In addition, harassment based on any of the above
protected categories is prohibited by the Act.
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(2) The Contractor agrees to take affirmative action to ensure that
applicants are employed, and that employees are treated during
employment, without regard to their actual or perceived: race,
color, religion, national origin, sex, age, marital status, personal
appearance, sexual orientation, gender identity or expression,
family responsibilities, genetic information, disability,
matriculation, political affiliation, or credit information. The
affirmative action shall include, but not be limited to the following:
(a) employment, upgrading or transfer;
(b) recruitment, or recruitment advertising;
(c) demotion, layoff or termination;
(d) rates of pay, or other forms of compensation; and
(e) selection for training and apprenticeship.
(3) The Contractor agrees to post in conspicuous places, available to
employees and applicants for employment, notices to be provided
by the contracting agency, setting forth the provisions in paragraphs
19(b)(1) and (b)(2) concerning non-discrimination and affirmative
action.
(4) The Contractor shall, in all solicitations or advertisements for
employees placed by or on behalf of the Contractor, state that all
qualified applicants will receive consideration for employment
pursuant to the non-discrimination requirements set forth in
paragraph 19(b)(2).
(5) The Contractor agrees to send to each labor union or representative
of workers with which it has a collective bargaining agreement or
other contract or understanding, a notice to be provided by the
contracting agency, advising the said labor union or workers’
representative of that contractor’s commitments under this
nondiscrimination clause and the Act, and shall post copies of the
notice in conspicuous places available to employees and applicants
for employment.
(6) The Contractor agrees to permit access to its books, records, and
accounts pertaining to its employment practices, by the Chief
Procurement Officer or designee, or the Director of the Office of
Human Rights or designee, for purposes of investigation to
ascertain compliance with the Act, and to require under terms of
any subcontractor agreement each subcontractor to permit access of
such subcontractors’ books, records, and accounts for such
purposes.
(7) The Contractor agrees to comply with the provisions of the Act and
with all guidelines for equal employment opportunity applicable in
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the District adopted by the Director of the Office of Human Rights,
or any authorized official.
(8) The Contractor shall include in every subcontract the equal
opportunity clauses, i.e., paragraphs 19(b)(1) through (b)(9) of this
clause, so that such provisions shall be binding upon each
subcontractor.
(9) The Contractor shall take such action with respect to any
subcontract as the CO may direct as a means of enforcing these
provisions, including sanctions for noncompliance; provided,
however, that in the event the Contractor becomes involved in, or is
threatened with, litigation with a subcontractor or vendor as a result
of such direction by the contracting agency, the Contractor may
request the District to enter into such litigation to protect the
interest of the District.
I.14 COST AND PRICING DATA
Delete Article 25, Cost and Pricing Data, of the Standard Contract Provisions dated July
2010 for use with District of Columbia Government Supplies and Services Contracts.
I.15 CONTINUITY OF SERVICES
I.15.1.1 The Contractor recognizes that the services provided under this contract are vital to the
District and must be continued without interruption and that, upon contract expiration or
termination, a successor, either the District or another contractor, at the District’s option,
may continue to provide these services. To that end, the Contractor agrees to:
Furnish phase-out, phase-in (transition) training; and
I.15.1.2 Exercise its best efforts and cooperation to effect an orderly and efficient to a successor.
I.15.1 The Contractor shall, upon the CO’s written notice:
I.15.2.1 Furnish phase-in, phase-out services for up to 90 days after this contract expires and
I.15.2.2 Negotiate in good faith a plan with a successor to determine the nature and extent of
phase-in, phase-out services required. The plan shall specify a training program and a
date for transferring responsibilities for each division of work described in the plan and
shall be subject to the CO’s approval.
I.15.2 The Contractor shall provide sufficient experienced personnel during the phase-in,
phase-out period to ensure that the services called for by this contract are maintained at
the required level of proficiency.
I.15.3 The Contractor shall allow as many personnel as practicable to remain on the job to help
the successor maintain the continuity and consistency of the services required by this
contract. The Contractor also shall disclose necessary personnel records and allow the
successor to conduct on-site interviews with these employees. If selected employees are
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agreeable to the change, the Contractor shall release them at a mutually agreeable date
and negotiate transfer of their earned fringe benefits to the successor.
I.15.4 Only in accordance with a modification issued by the CO, the Contractor shall be
reimbursed for all reasonable phase-in, phase-out costs (i.e., costs incurred within the
agreed period after contract expiration that result from phase-in, phase-out operations)
and a fee (profit) not to exceed a pro rata portion of the fee (profit) under this contract.
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SECTION J: ATTACHMENTS
The following list of attachments is incorporated into the contract by reference:
Attachment
Number Document
J.1
Government of the District of Columbia Standard Contract Provisions for Use
with the Supplies and Services Contracts (July 2010)
available at http://ocp.dc.gov, under Quick Links click on “Required Solicitation
Documents”
J.2 U.S. Department of Labor Wage Determination 2015-4282, Revision 32, dated
December 23, 2024
J.3
Equal Employment Opportunity Employer Information Report and Mayor’s Order
85-85 available at http://ocp.dc.gov, under Quick Links click on “Required
Solicitation Documents”
J.4
Department of Employment Services First Source Employment Agreement
available at http://ocp.dc.gov, under Quick Links click on “Required Solicitation
Documents”
J.5 Way to Work Amendment Act of 2020 - Living Wage Notice available at
http://ocp.dc.gov, under Quick Links click on “Required Solicitation Documents”
J.6 Way to Work Amendment Act of 2020 - Living Wage Fact Sheet available at
http://ocp.dc.gov, under Quick Links click on “Required Solicitation Documents”
J.7 Tax Certification Affidavit available at http://ocp.dc.gov, under Quick Links click
on “Required Solicitation Documents”
J.8 Subcontracting Plan available at http://ocp.dc.gov, under Quick Links click on
“Required Solicitation Documents”
J.9 First Source Initial Employment Plan available at http://ocp.dc.gov, under Quick
Links click on “Required Solicitation Documents”
J.10
ASO Assessments
1) George Washington University, Department of Health Policy ASO Assessment
2) MITA SS-A
J.11 Past Performance Evaluation Forms available at www.ocp.dc.gov under Quick
Links click on “Required Solicitation Documents”
J.12 Certificate of Clean Hands available at http://mytax.dc.gov
J.13 Business License available at https://dlcp.dc.gov, DC Department of Licensing and
Consumer Protection
J.14 Bidder/Offeror Certification Form available at http://ocp.dc.gov, under Quick
Links click on “Required Solicitation Documents”
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Attachment
Number Document
J.15 DHCF HIPAA Business Associate Agreement
J.16 BAA Exhibit A - Identity and Procedure Verification
J.17 Business Associate (BA) HIPAA Compliance Status Questionnaire
J.18 Certificate of Insurance (COI), based upon insurance requirements in Section
I.8 Insurance
J.19 Appendix A – ASO Service Level Agreement