Premium Review Grants_STCs_081710

STANDARD GRANT CONDITIONS

1. The HHS/Office of Consumer Information and Insurance Oversight (OCIIO) Program Official, assigned with responsibility for technical and programmatic questions from the grantee is: Jacqueline Roche, [email protected] at OCIIO.

2. The HHS/OCIIO Grants Management Specialist, assigned by the GMO, with

responsibility for the financial and administrative aspects (non-programmatic areas) of grants administration questions from the grantee is Gladys Bohler at [email protected] at OCIIO.

3. HHS Grants Policy Statement. This award is subject to the requirements of the HHS

Grants Policy Statement (HHS GPS). The HHS Grants Policy Statement is available at http://www.hhs.gov/grantsnet/adminis/gpd/index.htm. Please read carefully the following: (1) fraud, waste, and abuse (toll free number 800-424-5454), page I-7; (2) lobbying, page I-15; (3) costs, pages II-30 to II-44; (4) financial management systems and procedures, page II-61; (5) re-budgeting/prior approval, pages II-50 to II-57; and (6) publications, page II-73.

3. Code of Federal Regulations:

This grant is subject to the requirements as set forth in 45 CFR Part 92 (for State, local, and federally recognized tribal government) available at http://www.hhs.gov/opa/grants/toolsdocs/45cfr92.html.

3. Cost Principles for State, Local and Indian Tribal Governments (OMB Circular A-87):

This grant is subject to the requirements as set forth in Title 2 Part 225, State, Local, and Indian Tribal Governments (previously A-87)

3. Public Reporting: When issuing statements, press releases, requests for proposals, bid solicitations, and documents describing this project, clearly state: (1) the percentage of the total cost of the project financed with Federal money, (2) the dollar amount of Federal Funds for the project, and (3) the percentage and dollar amount of the total costs of the project that is financed by nongovernmental sources.

3. Policy Requirements: Debarment and Suspension as well as Drug Free Workplace are now standard terms and conditions of the award. These requirements no longer require separate certifications; however, by signing the application (either electronic signature credentials or face page of the SF-424A) the applicant certifies they are meeting the requirements of 45 CFR Part 76 (Debarment and Suspension) and 45 CFR Part 82 (Drug-Free Workplace).

Special Terms of Award (STC) - Programmatic

1. Acceptance Letter and Assurance: The grant award is subject to the recipient providing OCIIO a letter as acknowledgement of the award and the acceptance of all Standard and Special Terms and Conditions (STCs) within 30 days of the date of issuance of the award package. With the acceptance of this grant award, the Grantee agrees to ensure that the project is administered in accordance with the grant requirements as indicated in these STCs and that the Grantee is in compliance with the requirements of the grant funding opportunity announcement.

2. Budget and Project Period: The project and budget period for Premium Review Grants - Cycle 1 is from August 9, 2010 through September 30, 2011. The start date for the grants is on or after August 9, 2010. No grant funds can be used for expenses incurred prior to August 9, 2010.

3. Revised Budget: When the Notice of Grant Award requires the Grantee to submit a revised budget (e.g., a revised timeline, budget narrative and SF-424A section b only), these documents must be submitted within 60 days of the start of the grant period, (August 9, 2010). OCIIO will advise states of the approval of such documents within 60 days from the date the revised draft documents are received by the OCIIO.

4. Collaborative Responsibilities: At the request of the OCIIO, Grantees may be required to participate in scheduled activities and communications to identify and share “best practices” for health insurance premium review, including discussion of state proposals and sharing of information via public websites. The OCIIO will post general summaries of the state proposals on the OCIIO website. Quarterly and Final reports may also be posted on the OCIIO website. The Grantee is required to participate in all required communications (e.g., monitoring calls, guidance calls) as requested by the OCIIO.

5. Required Financial Reports: A Financial Status Report (FSR) (SF 269A – Short Form) is required from the recipient within 90 days after the end of the project period. Records of expenditures and any program income generated must be maintained in accordance with the provisions of 45 CFR 74.53 or 92.42. In addition, an Interim SF 269 report must be submitted after the first 12 months of grant activity (July). The Grantee will submit the FSR to the OCIIO Grant Specialist listed on this Notice of Grant Award with a copy to the OCIIO Project Officer. (The SF-269A may be accessed at the following site: http://www.whitehouse.gov/omb/grants/sf269a.pdf).

Effective January 1, 2010, grantees are to report cash transaction data via the Payment Management System (PMS) using the Federal Financial Report (FFR or Standard Form 425) cash transaction data elements. The FFR must be filed within 30 days of the end of the quarter (instead of the 45 days allowed for filing the PSC 272).  Reporting cash transaction data using the FFR replaces the use of the Federal Cash Transaction Report (SF-272/SF272A).  Additional information and training are available on the Division of Payment Management website:  http://www.dpm.psc.gov/. 

A Quick Reference Guide for completing the FFR in the PMS is at http://www.dpm.psc.gov/grant_recipient/guides_forms/ffr_quick_reference.aspx

6. Required Grant Reporting

1. Requirement to Report Data to the Secretary. For Cycle I, each grant awardee

is required to provide certain rate filing data to the Secretary of Health and Human Services. Included as Attachment C is the template for providing the required premium data to HHS. Operational processing and data exchange with the State awardees using the enclosed data format will begin in December 2010 to support required reporting for Cycle I grants. States unable to provide the rate filing data as required under these terms and conditions of award and as outlined in the template must provide an explanation of their inability to do so. As stated in the FOA, States are permitted to use grant funds to enhance their authority and capacity to collect and report the required data. The Office of Oversight will provide technical assistance to all state awardees over the course of the grant period to fulfill the data reporting requirements.

2. Quarterly and Final (Progress) Reports

1. The Grantee is required to submit three quarterly progress reports and one final report to the OCIIO Grant Specialist and to the OCIIO Project Officer. Quarterly progress reports are due within 30 days after the end of the quarter (see STC #7 for dates). These reports must comply with the format in Attachment B: Grants to States for Health Insurance Premium Review-Cycle I Template for Quarterly Progress Reports.

2. The Grantee is required to submit a Final Report to the OCIIO Grant Specialist, with a copy to the OCIIO Project Officer, within 90 days after the project period ending date (December 31, 2011). A template for the final report will be forthcoming.

3. In each progress report (quarterly and final), the Grantee will describe the progress, and provide data on, the Grantee’s impact on enhancing the rate review process for health insurance premiums in the state and efforts to report data on health insurance premiums to the HHS Secretary. The Grantee will describe each activity performed in the quarter/year and how that activity was linked to enhanced rate review practices.

4. All quarterly and final (progress) reports must be submitted electronically.

7. Data Center Requirements: As outlined in the FOA, up to $50,000 in grant funds are permitted to be used to fund an optional data center as described in Section 2794 of the Public Health Service Act. All states choosing to use grants funds to support a data center must provide the following information by October 31, 2010.

1. Name, location and governance of Data Center. Please make certain that

the data center meets the requirements as outlined in the Affordable Care Act.

2. Full Description of Data Centers current mission;

3. Described function and scope of work for data center;

4. Describe how proposed research will add to existing body of available fee

schedule data;

5. Plans for public disclosure of data; and

6. Full and/or modified budget for the data center with a line-item breakout.

The Office of Oversight will be working with each state applicant on an individual basis to make certain the proposed data center is aligned with the requirements under the Affordable Care Act and advances the directives of this grant program.

8. The Grantee is required to notify the OCIIO Project Officer and the OCIIO Grant Specialist within thirty (30) days of any personnel changes affecting the grant’s Project Director, Assistant Project Director, or the Financial Officer who is responsible for completing the Financial Status Report (SF-269A) and the Federal Cash Transactions Report (PSC-272).

9. All funds provided under this grant will be used by the Grantee exclusively for the Grants to States for Health Insurance Premium Review as defined in Section 1003 of the Affordable Care Act and as described in the grant funding opportunity announcement. If the Grantee uses these funds for any purpose other than those awarded through the OCIIO Premium Review Grants – Cycle I (or those modifications that have the prior written approval of the OCIIO Project Officer), then all funds provided under this grant may be required to be returned to the United States Treasury.

ATTACHMENT A:

Grants to States for Health Insurance Premium Review – Cycle I

TIMELINE

November 1, 2010– September 29, 2011

ACTIVITY TIMELINE

Grant award (anticipated) October 29, 2010

Grant period begins November 1, 2010

Accept award package December 1, 2010

Notify OCIIO of Fiscal Agent/Officer November 1, 2010

Responsible for completing the SF-269A

and PSC-272

Revised Budget and SF-424A Due within 60 days of award

(when applicable)

Financial Status Report Due 30 days after the first 12 months (July 31)

Required Data Center Information December 30, 2010

Quarterly Progress Reports Due 30 days after the end of each Federal fiscal quarter (e.g., January 31, April 30, July 31, and October 31, 2011)

Awardees must respond to requests As required by the OCIIO

necessary for the evaluation of the

Health Insurance Premium Review Grants

as requested

Guidance Call for Preparation of the Final Report To be scheduled by the OCIIO Project Officer approximately 60 days before end of grant year (e.g. July 31, 2011)

Final Report Due 90 days after the conclusion of the grant project period (December 31, 2011)

Liquidation of all Obligations Due 90 days after the grant period end date and prior to filing of the final Fiscal Status Report

Final Financial Status Report (FSR) Due 30 days after the first 12 months of grant activity and 90 days after the grant period end date (December 31, 2011)

No Cost Extension Request Should the State need a no cost extension, a written request to the Project Officer must be received no later than September 30, 2011.

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