SF 30 Amend 2_No Extend Pkg_SET.pdf

is not extended.

(a) By completing items 8 and 15, and returning or (c) By separate letter or telegram 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 your desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

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

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

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

IT MODIFIES THE CONTRACT/ORDER NO. 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 ORDER NO.

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)

15C. DATE SIGNED

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

16C. DATE SIGNED

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

PAGE OF PAGES

6. ISSUED BY CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) (X)

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

NSN 7540-01-152-8070

Previous edition unusable

2. AMENDMENT/MODIFICATION NO.

LaShundra D. Thomas

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

reness that Attachment the located in the solicitation package

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.

FEDERAL BUREAU OF PRISONS

Field Acquisition Office 346 Marine Forces Drive Grand Prairie, TX 75051

See Lines

9A. AMENDMENT OF SOLICITATION NO.

15BFA024R00000020

1 1

1 /0 /20

9B. DATED (SEE ITEM 11)

1 /0 /20

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:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers extended, LASHUNDRA THOMAS Digitally signed by LASHUNDRA THOMAS Date: 2024.11.04 08:43:28 -06'00'

Solicitation Attachment 1: Contract Pricing & Subcontract Certification FDC SeaTac – Comprehensive Medical Services

15BFA024R00000020

Overview

Services are required to be provided in accordance with the Performance Work Statement included in this solicitation/contract. Offerors are required to submit, as a part of their business proposal, a completed copy of the Schedule of Items and Subcontract Certification.

Pricing Methodology

Except for services based on session rate, price proposals will be calculated from benchmarks utilizing Medicare reimbursement methodologies. For each category of service 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 appropriate, outlier payments calculated in accordance with Medicare reimbursement methodologies shall be made in recognition of extremely costly stays. The outlier payment shall be calculated based upon the defined benchmark and will consist of the operating 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) 42644-Seattle-Bellevue-Everett-WA. 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 5 of this solicitation)

Medicare Part B Physician Services and Non-physician Services. The Medicare benchmark to be utilized for all physician and 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: 02, Seattle, Washington (King Cnty), all counties. 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 – 42644- Seattle-Bellevue-Everett-WA. Offerors may propose a discount from or a premium to the benchmark charges.

Estimated Quantities

Estimated quantities for the base year and all option years are detailed below. The estimated quantities provided are not a representation 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

FDC SeaTac

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

Inpatient Days: 173 days (estimated) Outpatient Visits: 219 visits (estimated)

Option Year 1 Inpatient Days: 173 days (estimated) Outpatient Visits: 219 visits (estimated)

Option Year 2 Inpatient Days: 173 days (estimated) Outpatient Visits: 219 visits (estimated)

Option Year 3 Inpatient Days: 173 days (estimated) Outpatient Visits: 219 visits (estimated)

Option Year 4 Inpatient Days: 173 days (estimated) Outpatient Visits: 219 visits (estimated)

Optional 6-month extension Inpatient Days: 87 days (estimated) Outpatient Visits: 110 visits (estimated)

Outpatient Institution Services

Estimated quantities shall remain constant for the base year and all option years. For Medicare-based services, duration of visits is listed for informational purposes only, as contracted rates will be based upon the Medicare allowable per procedure performed. Session based services shall be paid based upon the provision of defined sessions.

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.

Other Physicians:

Psychiatrist: Visit duration: 8 hours Visit quantity: 52 per contract year

Cardiologist: Visit duration: 8 hours Visit quantity: 6 per contract year

Podiatrist: Visit duration: 8 hours Visit quantity: 4 per contract year

General Surgeon: Visit duration: 8 hours Visit quantity: 4 per contract year

Gastroenterologist: Visit duration: 8 hours Visit quantity: 4 per contract year

Session Based Services:

Optometrist: Session duration 8 hrs. (approximately)

Session quantity 24 per contract year (estimated)

Offerors shall complete the following Schedule of Items. All proposed pricing will be evaluated in accordance with Federal Acquisition Regulation (FAR) 52.212-2, Evaluation - Commercial Products and Commercial Services, and Attachment 4: Submission and Evaluation of 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 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. Other Physicians: - __ Discount or + ___ Premium to Medicare Part B 2c2. Optometrist: $_____________ per eight (8) hour session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE,

INSERT APPLICABLE "-/+" PERCENTAGE. IF NO VARIANCE, ENTER "0".

Option Year 1

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. Other Physicians: - __ Discount or + ___ Premium to Medicare Part B 2c2. Optometrist: $_____________ per eight (8) hour session

Option Year 2

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. Other Physicians: - __ Discount or + ___ Premium to Medicare Part B 2c2. Optometrist: $_____________ per eight (8) hour session

Option Year 3

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. Other Physicians: - __ Discount or + ___ Premium to Medicare Part B 2c2. Optometrist: $_____________ per eight (8) hour session

Option Year 4

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. Other Physicians: - __ Discount or + ___ Premium to Medicare Part B 2c2. Optometrist: $_____________ per eight (8) hour session

INSERT APPLICABLE "-/+" PERCENTAGE. IF NO VARIANCE, ENTER "0"

Option to Extend Services as Authorized by FAR 52.217-8

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. Other Physicians: - __ Discount or + ___ Premium to Medicare Part B 2c2. Optometrist: $_____________ per eight (8) hour session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE,

INSERT APPLICABLE "-/+" PERCENTAGE. IF NO VARIANCE, ENTER "0".

All offerors are hereby advised 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 FAR 15.503(b)(1)(iv). Accordingly, all successful unit pricing will be released to unsuccessful offerors with the notification of award as well as to the public when requested. Any party who objects to the release of their own unit pricing information, should they be awarded a contract in response to this solicitation, should not submit a proposal in response to the solicitation.

Subcontract Certification

This contract { } does or { } does not, provide for subcontracting possibilities.

If answer is in the affirmative, offeror { }will, submit a subcontracting plan in accordance with the requirements of FAR 52.219-9.

Offerors are strongly encouraged to consult the following link to obtain assistance with subcontracting opportunities: https://www.sba.gov/federal-contracting/counseling-help/commercial-market-representatives