15BFA023R00000022-Amendment 0002.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE

0002 10/03/2024

6. ISSUED BY CODE 15BFA0

Federal Bureau of Prisons

Field Acquisition Office Evan Corley

U.S. Armed Forces Reserve Complex (0) 202-913-1602

346 Marine Forces Drive ecorley@bop.gov

Grand Prairie, TX 75051

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, country, state and ZIP Code)

CODE I FACILITY CODE

15BFA023R00000022/0002 Page 1 of 2

1. CONTRACT ID CODE

I PAGE OF PAGES

1 I 2

4. REQUISITION/PURCHASE REQUISITION NUMBER

5. PROJECT NUMBER (lfspp/kBb/BJ

15Bl 1423PR000127

7. ADMINISTERED BY (If other than Item 6) CODE I 15B301 Federal Bureau of Prisons

USP Atlanta

601 McDONOUGH BL VD., SE

Atlanta, GA 30315

(X)

9A. AMENDMENT OF SOLICITATION NUMBER

15BF A023R00000022

X 9B. DATED (SEE ITEM 11)

08/01/2024

10A. MODIFICATION OF CONTRACT/ORDER

NUMBER

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

� The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers @ is extended, D is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing items 8 and 15, and returning __ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

-------1 ORDER NUMBER IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor □ is not, □ is required to sign this document and return ___ copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

FCI Atlanta's Compressive Medical Services Solicitation 15BFA023R00000023 is amended as follows: Attachment 5: Computation of Basic MS

DRG Payment changed to reflect 12054-Atlanta-Sandy Springs-Roswell, GA Wage Index 0.9916.

All other Terms, Conditions, and Line Items remain the same.

THIS AMENDMENT EXTENDS THE SOLICITATION CLOSING DATE/TIME TO: 10/15/2024 - 14:00 CT US/Central

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED

(Signature of person authorized to sign)

Previous edition unusable

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

Evan Corley

Contract Specialist

16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

By (Signature of Contracting Officer) 10/03/2024

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

X

Attachment 5: Computation of Basic MS-DRG Payment

FCI Atlanta-Comprehensive Medical Services

15BFA023R00000022

Attachment 5 Computation of Basic MS-DRG Payments (i.e., Operating Federal Rate)

CBSA Code 12054 - Atlanta-Sandy Springs-Roswell, GA

Calculation of the Operating Federal Rate:

Step 1: Select the applicable average standardized amount for the full update

Step 2: Multiply the labor-related portion of the standardized amount by the applicable wage index for the geographic area

Step 3: For hospitals in Alaska and Hawaii, multiply the nonlabor-related portion of the standardized amount by the applicable cost-of-living adjustment factor

Step 4: Add the amount from Step 2 and the nonlabor-related portion of the standardized amount (adjusted, if applicable, under Step 3)

Step 5: Multiply the final amount from Step 4 by the relative weight corresponding to the applicable MS-DRG

Index Figures: Obtained from the Centers for Medicare and Medicaid Services for discharges on/after October 1, 2024

Step 1 Enter CBSA Code in Cell B29 12054

Table 4A, Wage Index for Rural Areas by CBSA Table: 0.9916

Area Name: Atlanta-Sandy Springs-Roswell, GA

Table 1A or 1B (Full Update) National Adjusted Operating Standardized Amount:

Labor-related: $4,096.04 Non-labor-related: $2,510.47

Table 5, MS-DRG Relative Weight (MS-DRG 76, Viral Meningitis w/o CC/MCC): 0.9169

Step 2 Labor-related x Wage Index 4,061.63$

Step 3 Only applicable for HI & AK

Step 4 Total of Step 2 + Non-labor related 6,572.10$

Step 5 Total of Step 4 x MS-DRG Relative Weight 6,025.96$

Payment for MS-DRG 076 under the contract would be 6,025.96$ plus or minus any premium or discount established as the contract rate.

Updated: 10/03/22