15B31118R00000001_-_Solicitation.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30

1. REQUISITION NUMBER

5. SOLICITATION NUMBER

15B31118R00000001

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

12/15/2017

7. FOR SOLICITATION INFORMATION

CALL:

a. NAME b. TELEPHONE NUMBER (No collect calls) 8. OFFER DUE DATE / LOCAL

TIME

02/16/2018 2:00 PM CST

CODE 15BFA0

Federal Bureau of Prisons Field Acquisition Office U.S. Armed Forces Reserve Complex 346 Marine Forces Drive Grand Prairie, TX 75051

9. ISSUED BY X UNRESTRICTED OR SET ASIDE: % FOR

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS: 622110

SIZE STANDARD: $38,500,000

10. THE ACQUISITION IS

SEE

SCHEDULEX

11. DELIVERY FOR FOB DESTINATION

UNLESS BLOCK IS MARKED

NET 30

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER DPAS

(15 CFR 700)

13b. RATING

RFQ IFB X RFP

14. METHOD OF SOLICITATION

15B311CODE15. DELIVER TO

Federal Bureau of Prisons FPC Montgomery

MAXWELL AFB, BLDG 1249

MONTGOMERY, AL 36112

CODE 15B31116. ADMINISTERED BY

Federal Bureau of Prisons FPC Montgomery

MAXWELL AFB, BLDG 1249

MONTGOMERY, AL 36112

FACILITY

CODE

CODE

TELEPHONE NO.

17a. CONTRACTOR/

OFFEROR

15B311CODE18a. PAYMENT WILL BE MADE BY

Federal Bureau of Prisons FPC Montgomery

MAXWELL AFB, BLDG 1249

MONTGOMERY, AL 36112

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER SEE ADDENDUM

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS

CHECKED

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Comprehensive Medical Services for the Federal Prison Camp (FPC) Montgomery, Alabama

See Section 2, Schedule of Items; Section 2.1, Contract Pricing; and Section 2.2, Performance Work Statement

See Continuation Sheet(s) (Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA X ARE ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

X 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ____ COPIES TO

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE

TERMS AND CONDITIONS SPECIFIED.

29. AWARD OF CONTRACT: REF. _____________________________ OFFER

DATED _________________ . YOUR OFFER ON SOLICITATION (BLOCK 5)

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN,

IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

15B31118R00000001 Page 1 of 51

Vikram Sighamony (972) 352-4516

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: _________________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

PARTIAL FINAL

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

COMPLETE PARTIAL FINAL

36. PAYMENT 37. CHECK NUMBER

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print) 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

15B31118R00000001 Page 2 of 51

Table of Contents

Section Description Page Number

1 Solicitation/Contract Form 2 Commodity or Services Schedule

2.1 Contract Pricing/Sub-Contract Certification

2.2 Performance Work Statement

3 Contract Clauses 52.24-403-70 Notice of Contractor Personnel Security Requirements (OCT 2005)

52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE

2004)

52.218-000 CONTINUING CONTRACT PERFORMANCE DURING A PANDEMIC INFLUENZA

OR OTHER NATIONAL EMERGENCY (May 2008) 2852.223-70 Unsafe Conditions Due to the Presence of Hazardous Material (June 1996)

52.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR

2011) DJAR-PGD-15-03 Security of Department Information and Systems DJAR-PGD-14-05 Federal Workplace Responses to Domestic Violence, Sexual Assault, and Stalking 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997) 52.252-6 Authorized Deviations in Clauses (Apr 1984) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders--Commercial Items (Nov 2017) DJAR-PGD-15-02-2A Corporate Representation Regarding Felony Conviction Under Any Federal Law or Unpaid Delinquent Tax Liability - Award (DEVIATION 2015-02) (March 2015) DJAR-PGD-15-02-2B Contractor Internal Confidentiality Agreements or Statements Prohibiting or Restricting Reporting of Waste, Fraud, and Abuse - Award - (DEVIATION 2015-02) (March 2015) .23 DJAR-PGD-15-02-2C Contractor Certification of Compliance with Federal Tax Requirements - Award (DEVIATION 2015-02) (March 2015) 52.203-17 Contractor Employee Whistleblower Rights and Requirement To Inform Employees of Whistleblower Rights (Apr 2014) 52.204-21 Basic Safeguarding of Covered Contractor Information Systems (June 2016) 52.216-18 Ordering (Oct 1995) 52.216-19 Order Limitations (Oct 1995) 52.216-21 Requirements (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.232-19 Availability Of Funds For The Next Fiscal Year (Apr 1984)

4 List of Attachments

4.1 Special Contract Conditions

5 Solicitation Provisions

5.1 Tailoring

52.209-7 Information Regarding Responsibility Matters (Jul 2013) 52.209-12 Certification Regarding Tax Matters (Feb 2016)

5.2 Submission and Evaluation of Proposals

DJAR-PGD-15-02-1A Corporate Representation Regarding Felony Conviction Under Any Federal Law or Unpaid Delinquent Tax Liability - (DEVIATION 2015-02) (March 2015) DJAR-PGD-15-02-1B Contractor Internal Confidentiality Agreements or Statements Prohibiting or Restricting Reporting of Waste, Fraud, and Abuse - Solicitation - (DEVIATION 2015-02) (March 2015) DJAR-PGD-15-02-1C Contractor Certification of Compliance with Federal Tax Requirements - Solicitation - (DEVIATION 2015-02) (March 2015) 52.233-2 Service of Protest (Sept 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998)

52.27-103-71 FAITH-BASED AND COMMUNITY-BASED ORGANIZATIONS (AUG 2005)

52.252-5 Authorized Deviations in Provisions (Apr 1984) 52.212-2 Evaluation - Commercial Items (Oct 2014) 52.212-3 Offeror Representations and Certifications--Commercial Items (Nov 2017)

15B31118R00000001 Page 3 of 51

Section 2 - Commodity or Services Schedule

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 Comprehensive Medical Services for Federal Prison Camp (FPC) Montgomery, Alabama.

Base Year: Effective Date of Award (EDOA) through 12 months from EDOA.

12.000000 MO $____________ $___________________

0002 Comprehensive Medical Services for Federal Prison Camp (FPC) Montgomery, Alabama.

Option Year 1: 13 months from Effective Date of Award (EDOA) through 24 months from EDOA.

12.000000 MO $____________ $___________________

0003 Comprehensive Medical Services for Federal Prison Camp (FPC) Montgomery, Alabama.

Option Year 2: 25 months from Effective Date of Award (EDOA) through 36 months from EDOA.

12.000000 MO $____________ $___________________

0004 Comprehensive Medical Services for Federal Prison Camp (FPC) Montgomery, Alabama.

Option Year 3: 37 months from Effective Date of Award (EDOA) through 48 months from EDOA.

12.000000 MO $____________ $___________________

0005 Comprehensive Medical Services for Federal Prison Camp (FPC) Montgomery, Alabama.

Option Year 4: 49 months from Effective Date of Award (EDOA) through 60 months from EDOA.

12.000000 MO $____________ $___________________

0006 Comprehensive Medical Services for Federal Prison Camp (FPC) Montgomery, Alabama.

Option to Extend Services as Authorized by FAR 52.217-8.

6.000000 MO $____________ $___________________

2.1 Contract Pricing/Sub-Contract Certification

Blocks 19 Through 24 - Contract Pricing/Sub-Contract Certification

Overview Services are required to be provided in accordance with the Performance Work Statement included in this solicitation/contract. Offer-ors are required to submit, as a part of their business proposal, a completed copy of Schedule of Items/Sub-Contract Certification.

Pricing Methodologies

Except for services based on session rates, price proposals will be calculated from benchmarks utilizing Medicare reimbursement methodologies. For each category of services to be provided, offerors will be allowed to propose a variance from the benchmark Medicare rate in the form of a discount from or a premium to Medicare rates established by the Centers for Medicare and Medicaid Services. The rates established in the resulting contract shall not be construed as participation in the Medicare program; contract rates will merely be equated to Medicare rates of reimbursement without reductions for deductibles, copayments, or coinsurance. When ap-propriate, outlier payments calculated in accordance with Medicare reimbursement methodologies shall be made in recogni-tion of extemely costly stays. The outlier payment shall be calculated based upon the defined benchmark and will consist of the oper-ating portion only. This structuring of the pricing methodology is not intended to be restrictive of any offeror; offerors need only to propose that percentage discount from or premium to the Medicare benchmark rate which will reflect the desired level of payment for the category of services rendered. If during contract performance, it is determined that a necessary contract deliverable is not covered by Medicare reimbursement methodologies, a separate rate shall be negotiated for such deliverable(s).

Medicare Part A. The Medicare benchmark to be utilized for all services covered by Medicare Part A shall be the most current Basic MS-DRG payment (i.e., Operating Federal Rate) established for Core Based Statistical Area (CBSA) 33860, Montgomery, AL. The Basic MS-DRG calculation shall not include any provider-specific adjustments allowed under actual Medicare participation. Offerors may propose a discount from or a premium to Basic MS-DRG rates. (Refer to Attachment 1 of this solicitation.)

Medicare Part B Physician Services and Non-physician Services. The Medicare benchmark to be utilized for all physician and

15B31118R00000001 Page 4 of 51 non-physician services covered by Medicare Part B shall be those rates established in the most current Medicare Part B Fee Schedule for Payment Locality 00 for Alabama. The benchmark charges shall be those established for participating providers. Offerors may propose a discount from or a premium to the benchmark charges.

Medicare Part B Facility Services (including hospital outpatient services and ambulatory surgical centers). The Medicare benchmark to be utilized for all facility services covered by Medicare Part B shall be the most current APC and ASC rates calculated for CBSA 33860, Montgomery, AL. Offerors may propose a discount from or a premium to the benchmark charges.

Estimated Charges

Estimated quantities for the base year and all option years are detailed below. The estimated quantities provided are not a representa-tion to the offeror/contractor that the estimated quantities will be required or ordered or that conditions affecting requirements will be stable or normal.

Inpatient and Outpatient Facility and Physician Services

Base Year - Effective Date of Award (EDOA) through twelve (12) months from EDOA

Inpatient Days: 100 days (estimated) Outpatient Days: 850 days (estimated)

Option Year 1 - Thirteen (13) months through twenty-four (24) months from EDOA

Inpatient Days: 110 days (estimated) Outpatient Days: 870 days (estimated)

Option Year 2 - Twenty-five (25) months through thirty-six (36) months from EDOA

Inpatient Days: 120 days (estimated) Outpatient Days: 890 days (estimated)

Option Year 3 - Thirty-seven (37) months through forty-eight (48) months from EDOA

Inpatient Days: 130 days (estimated) Outpatient Days: 910 days (estimated)

Option Year 4 - Forty-nine (49) months through sixty (60) months from EDOA

Inpatient Days: 140 days (estimated) Outpatient Days: 930 days (estimated)

Outpatient Institution Services

Estimated quantities shall remain constant for the base year and all option years.

Prosthetics/Orthotics: Session duration 8 hours (approximate) Session quantity 12 per contract year

Note: Session-priced items which exceed the established session or are less than a full session shall be pro-rated to the nearest quarter hour.

Schedule of Items

Offerors shall complete the following Schedule of Items. All proposed pricing and participation targets will be evaluated in accord-ance with Federal Acquisition Regulation (FAR) 52.212-2, Evaluation - Commercial Items, and Section 5.2, Evaluation Proposals, of this solicitation.

Base Year

Effective Date of Award (EDOA) through twelve (12) months from EDOA

1a. Inpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part A 1b. Outpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part B

15B31118R00000001 Page 5 of 51

2a. Inpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2b. Outpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2c. Outpatient Institution Services:

2c1. Prosthetics/Orthotics Adjustments $ ____________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 1

Thirteen (13) months through twenty-four (24) months from EDOA

1a. Inpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part A 1b. Outpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2a. Inpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2b. Outpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2c. Outpatient Institution Services:

2c1. Prosthetics/Orthotics Adjustments $ ____________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 2

Twenty-five (25) months through thirty-six (36) months from EDOA

1a. Inpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part A 1b. Outpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2a. Inpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2b. Outpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2c. Outpatient Institution Services:

2c1. Prosthetics/Orthotics Adjustments $ ____________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 3

Thirty-seven (37) months through forty-eight (48) months from EDOA

1a. Inpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part A 1b. Outpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2a. Inpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2b. Outpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2c. Outpatient Institution Services:

2c1. Prosthetics/Orthotics Adjustments $ ____________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 4

Forty-nine (49) months through sixty (60) months from EDOA

1a. Inpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part A 1b. Outpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2a. Inpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2b. Outpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2c. Outpatient Institution Services:

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2c1. Prosthetics/Orthotics Adjustments $ ____________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option to Extend Services 52.217-8

Sixty-one (61) months through sixty-six (66) months from EDOA

1a. Inpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part A 1b. Outpatient Facility Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2a. Inpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2b. Outpatient Physician Services: - ____________ Discount or + _____________ Premium to Medicare Part B 2c. Outpatient Institution Services:

2c1. Prosthetics/Orthotics Adjustments $ ____________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

All offerors are hereby advised that the successful offeror's unit pricing (to include discount percentage from or premium percentage to the benchmark Medicare rate) for the base year and all option years is public information, in accordance with Federal Acquisition Regulation (FAR) 15.503(b)(1)(iv). Accordingly, all successful unit pricing will be released to unsuccessful offerors with the notifica-tion of award as well as to the general public when requested. Any party who objects to the release of their own unit pricing informa-tion, should they be awarded a contract in response to this solicitation, should not submit proposal in response to the solicitation.

Sub-Contract Certification:

This contract does ________ does not _________ provide for subcontracting possiblities.

If answer is in the affirmative, offeror will submit ________ a sub-contracting plan in accordance with the requirements of FAR 52.219-9, Small Business Subcontracting Plan.

2.2 Performance Work Statement

I. Background

The Federal Bureau of Prisons (BOP) was established in 1930 to provide more progressive and humane care for Federal inmates, to professionalize the prison service, and to ensure consistent and centralized administration. Today, the BOP is responsible for the cus-tody and care of approximately 185,000 Federal offenders. The Federal prison system is a nationwide system of prisons and detention facilities for the incarceration of inmates who have been sentenced to imprisonment for Federal crimes and detention of individuals awaiting trial in Federal court. It is the mission of the Federal Bureau of Prisons to protect society by confining offenders in the con-trolled environments of prisons and community-based facilities that are safe, humane, cost-efficient, and appropriately secure, and that provide work and other self-improvement opportunities to assist offenders in becoming law-abiding citizens.

As an agency under the Executive Branch of the United States Government, the BOP receives an annual appropriation of funds to ac-complish its assigned mission. The public trust demands that this annual appropriation be prudently managed. Thus, dollars spent to maintain the health of the inmate population must reflect the agency's best efforts to obtain cost-effective health care consistent with community standards.

In meeting the health care needs of a growing inmate population, the BOP provides essential medical, dental, and mental health ser-vices to Federal inmates with BOP resources. When a medical need arises which cannot be provided within prison walls by BOP re-sources, referrals are then made to community-based providers. It is the goal of this solicitation to establish a contractual agreement that will provide necessary professional and facility services for both inpatient admissions and outpatient encounters.

The Federal Prison Camp in Montgomery, Alabama (FPC Montgomery) intends to make a single award to a responsible entity for the provision of Comprehensive Medical Services as set forth in this solicitation/contract. FPC Montgomery currently houses male in-mates. FPC Montgomery is presently identified as a Care Level II BOP facililty, on a four level scale where Care Level I represents the healthiest inmates and Care Level IV represents inmates with serious health issues. FPC Montgomery's criteria for categorizing an inmate in the Care Level I category is included as Attachment 2. Despite this description of the general health of the inmate popula-tion, however, needs for inmate healthcare may arise at any time, in any specialty, and any level of complexity. Classification and designation of inmates is the sole responsibility for the BOP and may be changed at any time without consideration to the Contractor.

15B31118R00000001 Page 7 of 51

In evaluating offers, the Government will evaluate the proximity of the proposed community-based providers, in addition to other factors, and give preference to those providers located nearest FPC Montgomery. Although a mileage restriction has not been placed on this acquisition, the Government reserves the right to determine that the proposed driving distances/conditions to community-based providers pose an unacceptable cost or security risk and to find such offers unacceptable.

II. Organizational Conflict of Interest

The objective of this solicitation is to satisfy the BOP's requirement for the provision of health care to the inmates of FPC Mont-gomery. A potential organizational conflict of interest may arise if the awardee is an entity which also holds or participates in a separ-ate contract/agreement with the BOP as a medical claims adjudicator. A possible conflict of interest may exist if the awardee has dual responsibilities for the submission of medical claims for services rendered under the resulting contract and for the adjudication of those medical claims under a separate contract/agreement with the BOP.

Offers received from any firm which holds or participates in a separate contract/agreement for BOP medical claims adjudication ser-vices must address any potential organizational conflict of interest that may arise and must provide a detailed explanation of how such conflicts will be avoided. Offers received from any firm which holds or participates in a separate contract/agreement for BOP medical claims adjudication services which fail to adequately address/resolve potential conflicts of interest will be rejected without further consideration. This limitation on the eligibility of offerors has been imposed as authorized by Federal Acquisition Regulation (FAR) 9.506.

III. Statement of Output

Within this Performance Work Statement (PWS), necessary services are described in terms of output rather than specific task assign-ments. The BOP desires to make an award to the offeror who can provide the best value, considering the diversity of available ser-vices and price, among other criteria specified in Section 5.2, Submission and Evaluation of Proposals. Therefore, the Government may award any or all line items, may withhold award of any or all line items, or may award to an offeror who proposes less than the full complement of services contained in this solicitation. Accordingly, Output items 1 and 2 are optional deliverables while output items 3, 4, and 5 are applicable to all services provided. Offerors are encouraged to sbumit comprehensive proposals committing to provide all output listed in the solicitation. Offerors who propose less comprehensive approaches will be evaluated accordingly.

Output #1: Provide inpatient and outpatient facility services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of health care to members of the general public.

(Cross-referencing pricing categories 1a and 1b.)

Output #2: Provide professional services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of health care to members of the general public. (Cross-referencing pricing categories 2a, 2b, and 2c1.)

Output #3: Submit properly-priced invoice for services rendered.

Output #4: Manage medical record information in a manner which promotes continuity of care while observing restric-tions on the release of information.

Output #5: Maintain open avenues of communication, facilitating the exchange of information between the contract provider, contract facility, and the Government regarding the contract services.

IV. Compliance with Contract Requirements

The Contractor's efforts under this contract shall be monitored to ensure that the required output is achieved. The Government re-serves the right to inspect and evaluate in a reasonable manner alll services rendered during the performance of this contract. The Contractor's performance will be measured by the Government utilizing the outcome measure indicators provided in Attachment 3.

The Contractor is responsible for all management and quality control actions necessary to meet the quality standards set forth by this contract. Prior to commencing performance, the Contractor shall develop and submit a quality control plan (QCP) for FPC Mont-gomery's approval. Once the QCP is approved by FPC Montgomery, the Contractor shall utilize the QCP to guide and rigorously doc-ument the implementation of the required management and quality control actions to achieve the specified output.

V. Specific Requirements

Output #1: Provide inpatient facility and outpatient facility services which conform to community standards and all local, state and Federal laws and regulations applicable to the delivery of health care to members of the general public.

Output #1 is an optional deliverable. However, if the offeror proposes to provide these services, the following minimum requirements apply. Throughout the performance of this contract, the Contractor shall not utilize any provider that appears in the List of Excluded

15B31118R00000001 Page 8 of 51

Individuals/Entities (LEIE) maintained by the U.S. Department of Health & Human Services.

If proposed, the Contractor shall provide facility services on an as-needed basis in a manner which adheres to community standards of quality and cost-effective medical care. The services required to satisfy Output #1 may include inpatient facility, outpatient facility, including emergency room services. Inpatient visits for non-emergency services shall require private room accomodations with avail-able space for up to three armed or unarmed guards per inmate.

It is FPC Montgomery's preference to obtain the services of facilities that are accredited by the Joint Commission. Offerors utilizing facilities which maintain accreditation by the Joint Commission shall submit a copy of the current accreditation certificate as part of the offeror's technical proposal. If an offeror intends to utilize a facility which is accredited or certified by any other recognized pro-fessional accrediting body, the offeror shall submit documentation validating this accreditation or certification as a part of its proposal.

The offeror's technical proposal shall discuss in detail the diversity of services, as well as the proximity of facility providers to FPC Montgomery, that it is capable of providing to achieve Output #1.

Output #2: Provide professional services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of health care to members of the general public

Output #2 is an optional deliverable. However, if the offeror proposes to provide these services, the following minimum requirements shall apply. Throughout the performance of this contract, the Contractor shall not utilize any provider that appears in the List of Ex-cluded Individuals/Entities (LEIE) maintained by the U.S. Department of Health and Human Services.

Community-Based Services

Professional services resulting from a BOP referral are necessary to be performed in a community-based setting (e.g., hospital facility, surgical center, physician's office, etc.). If proposed, the Contractor shall provide the services of professional medical staff who have appropriate educational qualification, experience, licensure, and board certification (where required) to achieve Output #2.

If requested by the Contracting Officer, the Contractor shall be required to document primary source verification of the credentials for each provider including: current license from the appropriate State Board of Medical Examiners, education from professional schools or universities, evidence of completion of internships and/or residences as appropriate.

Whenever possible, appointments for specialty care should be available within 14 calendar days from the date of referral to the spe-cialty provider. This practice promotes the safety and security of the Federal prisoner, the escorting correctional staff, and the general public. The medical urgency of any referral must receive consideration in the scheduling and delivery of professional services.

For prescriptions to be filled by FPC Montgomery's pharmacy, contract providers shall only prescribe pharmaceutical drugs that are listed in the BOP Formulary. The BOP Formulary can be accessed athttps://www.bop.gov/resources/pdfs/formulary.pdf. Requests for exemptions shall be submitted to the Contracting Officer's Representative (COR), who shall obtain the required approvals. As part of the discharge instructions, the issuance of sample medication to any Federal inmate shall be prohibited.

The offeror's technical proposal shall discuss in detail the diversity of services, as well as the proximity of professional providers to FPC Montgomery, that is capable of providing to achieve Output #2.

Institution-Based Services

As an additional tool to satisfy Output #2, professional services may be performed within the confines of FPC Montgomery. If the resulting contract does not provide for telemedicine consultation or all of the on-site clinics listed, FPC Montgomery reserves the right to pursue such contracts. FPC Montgomery also reserves the right to determine the manner of an inmate's referral, i.e., via on-site clinic, via community-based referral, via telemedicine consult, or any other method FPC Montgomery determines to be reasonable and appropriate.

If the Contractor performs on-site specialty clinics at FPC Montgomery, the following minimum requirements shall apply. Contract services shall be provided on-site within the Health Services Unit of FPC Montgomery. Consultations shall be limited to the chief complaint on the BOP consultation form. Services shall include diagnosis and treatment of medical conditions with appropriate refer-ral, if necessary, to a specialist at the contract medical facility. Scheduling of clinics shall be subject to the mutual agreement of FPC Montgomery and the contract provider. Scheduling of inmates for on-site clinics shall be performed by FPC Montgomery.

Providers performing institution-based services shall be licensed to practice medicine in the State of Alabama. Providers performing these services shall apply for clinical privileges at FPC Montgomery. All clinical privileges shall be appropriate to the qualifications of the provider and the resources of the facility where care is provided. Any clinical privileges granted due to the award of this con-tract shall be contingent upon the continuation of this contract and upon the physician's continued affiliation with the Contractor or any subcontract. Continuation of privileges at FPC Montgomery shall be at the sole discretion of FPC Montgomery. Non-physician providers shall maintain active licenses from the State of Alabama, as applicable.

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The following specialty clinics/sessions may be conducted at FPC Montgomery, contingent upon an acceptable offer. The BOP re-serves the right to award some, all, or none of the following on-site clinics:

Orthotics/Prosthetics

In the event it becomes necessary for the Government to cancel a scheduled visit, FPC Montgomery will provide the contract provider with 48-hour written or verbal notice prior to cancelling a visit. However, certain circumstances beyond the control of FPC Mont-gomery (e.g., fog or other Acts of God, institution disturbances, etc.) may dictate the cancellation of a scheduled visit with less than 48 hours written or verbal notice. In the event it becomes necessary for the contract provider to cancel a scheduled visit, the Contractor may provide qualified replacement professional staff or may reschedule a mutually agreed upon replacement session. Prior to utiliz-ing replacement staff, the Contractor must obtain preliminary clearance from the Contracting Officer or Contracting Officer's Repres-entative (COR), in accordance with the security and privileging requirements of this contract.

All contract personnel providing services within the confines of FPC Montgomery shall have a complete background investigation conducted in accordance with BOP Program Statement 3000.03, Human Resource Management Manual. See also "Contract Security/ Investigative Requirements" contained within Section 4.1, Special Contract Conditions, of this solicitation/contract. All contract pro-viders and other applicable staff who will enter FPC Montgomery to perform services on a recurring basis shall be required to attend a four-hour institution ortientation course held at FPC Montgomery or a mutually acceptable site. A "refresher" orientation must be completed annually. The Contractor's costs for contract staff to attend this training shall be the responsibility of the Contractor. The Contracting Officer or COR will be responsible for scheduling training for all applicable contract staff.

Output #3: Submit properly-priced invoices for services rendered.

Overview. Upon completion of a treatment encounter, the Contractor shall prepare and submit proper invoices for services rendered under this contract. For the purpose of this contract, a specific definition for what documentation constitutes an invoice is provided below. A proper invoice shall include the information specified in FAR 52.212-4, Contract Terms and Contitions - Commercial items, paragraph (g). Services shall be invoiced in accordance with the terms and conditions of the contract, including the payment rate structures specified in the contract. Only invoices from the awarded Contractor will be accepted. Any third-party subcontractors used by the Contractor must submit invoices to the Contractor, who will then proces the invoices according to the contract with FPC Montgomery.

Invoice/Medical Claims Adjudication. FPC Montgomery will employ a process of invoice/medical claims adjudication to ensure, at a minimum, that the services billed by the Contractor were properly authorized and ordered by FPC Montgomery, are appropriately coded in compliance with Medicare coding policies (where applicable), are properly priced in accordance with the terms and condi-tions of the contract, and do not represent duplicate billings for payments already made. In addition, FPC Montgomery may utilized the services of a third-party medical claims adjudicator to review medical claims submitted by the Contractor under this contract.

When requested by FPC Montgomery, the Contractor shall comply with all reasonable requests for additional invoice/medical claim/ medical record documentation. All invoice payments shall be made by FPC Montgomery and any disagreements regarding the paid amount of any invoice shall be resolved with FPC Montgomery.

Invoice Definitions.

Line Items 1a - Inpatient Facility Services, 1b - Outpatient Facility Services, 2a - Inpatient Physician Services, and 2b - Outpa-tient Physician Services: At the outset of this contract, an invoice for services rendered under Line Items 1a, 1b, 2a, and 2b shall be an invoice containing not more than 50 individual medical claims. Each invoice shall be supported with copies of Universal Billing (UB)-04 forms or Centers for Medicare and Medicaid Services (CMS) 1500 forms, as applicable, for each medical claim included in the invoice.

Following written notification to the Contractor by the Contracting Officer that a third-party medical claims adjudication service will be utilized by FPC Montgomery, an invoice for services rendered under Line Items 1a, 1b, 2a, 2b, and 2c1 shall be a paper in-voice detailing not more than 50 individual medical claims which have been electronically transmitted to the BOP's medical claims adjudicator via American National Standards Institute (ANSI) 837 format that also conforms to Medicare and Health Insurance Port-ability and Accountability Act of 1996 (HIPAA) electronic billing standards. For each medical claim included on the invoice, the Contractor shall reference, at a minimum, the following information: YREGDOC number, inmate name and register number, date of service, provider of service, billed code, and contract amount billed. Medical claims detailed in the invoice shall be listed first in des-cending order by the YREGDOC number, second in alphabetic order by the inmate's last name, and third by ascending date of service (i.e., earliest to latest) when more than one medical claim is present for the same inmate within the same invoice.

If the Contractor's proposal encompasses the provision of community-based oral surgery and/or dental procedures, only those medical claims which represent adjunctive dental care will be submitted by the Contractor to the medical claims adjudication Contractor for processing.

The Contractor shall not submit a medical claim for processing that the Contractor knows nor has reason to believe contains inaccur-ate, incomplete, or misleading information. Medical claims which contain inaccurate, incomplete, or misleading information shall be held by the Contractor and not submitted until such time as all lines are deemed to be accurate and complete. At that time, the Con-

15B31118R00000001 Page 10 of 51 tractor may proceed with submitting the medical claim for processing and invoicing FPC Montgomery for all services represented by that medical claim.

Line Item 2c1 - Outpatient Institution Services - Prosthetics/Orthotics Adjustments: An invoice for services rendered under Line Item 2c2 shall be a paper invoice detailing the date(s) sessions were provided, the number of sessions provided, the unit pricing ap-plied, and the extended total amount due. The BOP will not use the services of a third-pary medical claims adjudicator for verification of these services.

Provider Information.

Submission of Provider Data to the BOP's Medical Claims Adjudicator: Within ten calendar days after notification that a third party medical claims adjudication service will be utilized by FPC Montgomery, the Contractor shall provide the BOP's medical claims adjudicator with a complete list of provider information, which will enable the medical claims adjudicator to accurately identify the correct payable amount for any provider performing services under the contract. Specific informational requirements are provided in Attachment 4. Provider information supplied to the BOP's medical claims adjudicator should be appropriately marked to identify the data as proprietary information so that it may be adequately protected by the BOP and its contracted medical claims adjudicator. Pro-vider information shall be submitted directly to the BOP's medical claims adjudicator. As individual providers are added to the Con-tractor's network, the Contractor shall provide the information listed in Attachment 4 to the medical claim adjudicator no less than three business days prior to filing medical claims electronically for services rendered by such new providers.

National Provider Identifier (NPI) Numbers: The Contractor shall utilize only providers who have a current National Provider Identifier (NPI) number.

Electronic Trading Partner Agreement. The BOP will execute the Electronic Trading Partner Agreement with the medical claims adjudicator (Attachment 5). The Contractor shall participate in the medical claims adjudication process described herein as a "Busi-ness Associate" of the BOP. As a Business Associate, the Contractor agrees to abide by all terms of the Trading Partner Agreement as it pertains to Business Associates.

Technical Data for Submission of Medical Claims. Prior to the submission of an invoice to FPC Montgomery, the Contractor shall electronically transmit the information found on each individual invoiced medical claim via ANSI 837 format only, to the BOP's med-ical claims adjudicator. After the Contractor's electronic transmission to the BOP's medical claims adjudicator, the Contractor shall promptly submit a paper copy of the invoice to FPC Montgomery. The Contractor will also post the ANSI 837 file in an FTP site set up and maintained by the BOP's medical claims adjudicator. The only exceptions to the electronic filing requirement shall be correc-ted medical claims for professional services. Information for the submission of a medical claim to the BOP's medical claims adjudic-ator is provided in Attachment 6, along with other pertinent details.

Procedures for Filing Corrected Medical Claims

Facility Services. If it becomes necessary to file a corrected medical claim for facility services, the Contractor shall electronically transmit the information found on each individual corrected medical claim via ANSI 837 format only, to the BOP's medical claims ad-judicator. After the Contractor's electronic transmission to the BOP's medical claims adjudicator, the contractor shall promptly submit a paper copy of the invoice or credit memo, as applicable, to FPC Montgomery. Invoices for corrected medical claims shall be clearly marked as such and shall be separate from routine invoices. Invoices or credit memos for corrected medical claims shall detail in-formation pertaining to the original medical claim submission (including any amount(s) previously paid and the associated invoice numbers) and shall bill only for the corrected medical claim submission or reflect the credit amount due for the corrected medical claim submission.

Physician/Professional Services. If it becomes necessary to file a corrected medical claim for physician/professional services, the Contractor shall submit the corrected medical claim in hard copy (i.e., paper) format to the BOP's medical claims adjudicator. The word "CORRECTED" shall be prominently displayed on the paper medical claim. After the Contractor's submission to the BOP's medical claims adjudicator, the Contractor shall promptly submit a paper copy of the invoice or credit memo, as applicable, to FPC Montgomery. Invoices for corrected medical claims shall be clearly marked as such and shall be separate from routine invoices. In-voices or credit memos for corrected medical claims shall detail information pertaining to the original medical claim submission (including any amount(s) previously paid and the associated invoice numbers) and shall bill only for the corrected medical claim sub-mission or reflect the credit amount due for the corrected medical claim submission.

Payment by FPC Montgomery. FPC Montgomery will pay all invoices directly to the Contractor. If the invoiced amount of a med-ical claim exceeds the adjudicated amount of that medical claim, FPC Montgomery will take an administrative deduction from the in-voice. FPC Montgomery will provide written notification to the Contractor when an administrative deduction is taken from an invoice payment.

If the Contractor is in disagreement with the paid amount of a medical claim, the Contractor will provide written notification to FPC Montgomery of the disagreement along with supportin documentation for why the Contractor believes the medical claims adjudicator to bring resolution to any disagreements. If it is determined that a medical claim was paid incorrectly by FPC Montgomery, interest on the underpayment will be paid when required by the Prompt Payment Act.

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Timeliness of Medical Claims. Medical claims shall be submitted/invoiced within 90 calendar days after an inmate's discharge or outpatient encounter or other service provided under this contract. Medical claims which are submitted/invoiced beyond the 90-day requirement shall constitute a performance deficiency under this output and shall be documented in the Contractor's performance eval-uations. Medical claims which are submitted/invoiced within the acceptable time period, but are found to contain errors or require fur-ther justification, will be rejected and shall be resubmitted/reinvoiced by the Contractor within 30 calendar days from the date of rejec-tion. Upon resubmission, invoices for corrected medical claims shall bear the new date of submission.

No later than November 1 of each year, the Contractor shall stimulate the billing process by reviewing its records, including those of subcontracted providers, to determine an estimated amount of outstanding charges for services provided through September 30 of that year. Based upon information generated through this review process, the Contractor shall provide a written estimate to FPC Mont-gomery of outstanding fiscal year obligations, supported by adequate documentation. This estimate and supporting documentation shall be provided to the Contracting Officer no later than December 1 of each year. The Contractor shall put forth its best efforts to ensure the accuracy of the annual estimate provided to the Government.

Output #4: Manage medical record information in a manner which promotes continuity of care while observing restric-tions on the release of information.

Upon request, authorized BOP staff shall have access to and obtain copies of all inmate medical records and evaluation and treatment reports prepared and maintained by the contract facility and/or contract providers. Inmate medical records will be subject to review by FPC Montgomery for validation of payment and verification of services rendered. Release of information shall only be made in ac-cordance with community standards, Joint Commission regulations, and the Privacy Act of 1974. Any request(s) for copies of an in-mate's medical records by the inmate or a third party shall be directed to the COR for processing.

Notwithstanding the above-restrictions on the release of information, medical record information shall be provided to FPC Mont-gomery in order to enhance inmate recovery as well as continuity of care. For inpatient admissions, a faxed report documenting treat-ment plans will be submitted to the FPC Montgomery's Medical Records Department no later than 8 a.m. each day. This form with the requested information will be provided to the Contractor by FPC Montgomery. At the completion of treatment, the Contractor shall provide FPC Montgomery with documented discharge instructions, as provided by the attending physician. Copies of all lab, x-ray, EKG, progress notes and emergency room working notes shall also accompany the patient or be faxed immediately to the COR.

A written report by the attending physician which documents the circumstances of the inpatient treatment, outpatient procedure, or other consultation shall be provided to the COR within ten business days of the inpatient discharge, outpatient procedure, or other con-sultation. All lab and consultations pending at time of discharge shall be faxed to the COR upon receipt but not later than ten calendar days past discharge.

Output #5: Maintain open avenues of communication, facilitating the exchange of information between the contract physician, contract facility, and the Government regarding the contract services.

The Contractor shall provide a Point of Contact (POC) who shall be responsible for facilitating the Contractor's delivery of health ser-vices under this contract. The POC shall have sufficient clinical knowledge to enable preliminary technical consultation, with referral to a specialist if necessary. The Contractor shall designate this individual in writing to the Contracting Officer prior to the start date of the contract. Alternate POC's may be designated; however, the Contract must identify those times when an alternate shall be the primary POC (i.e., after-hours and weekend referrals).

There shall be an open line of communication between the Contractor, its representatives, and FPC Montgomery to ensure that only those services ordered by the institution are provided, unless required for intervention in a life-threatening emergency. In the event of a life-threatening emergency, the Contractor shall contact the COR within a 24-hour time period or the next normal working day. All FPC Montgomery referrals shall be the sole responsibility and decision of the Government. No inmate may be transferred to another medical facility, with exception of emergency cases, without advanced approval by authorized FPC Montgomery medical staff.

A contract provider may discuss with the inmate…