15BFA025R00000023_Allenwood_Solicitation-Amendment 0001.pdf

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AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE PAGE OF PAGES

1 3

2. AMENDMENT/MODIFICATION NUMBER

3. EFFECTIVE DATE

06/23/2025

4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

BFAOCODE

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

Kristen Fisher

(O) 570-522-7532 kmfisher@bop.gov

6. ISSUED BY 15B201CODE

Federal Bureau of Prisons FCC Allenwood

ROUTE 15

2 MILES NORTH OF ALLENWOOD

Allenwood, PA 17810

7. ADMINISTERED BY (If other than Item 6)

9A. AMENDMENT OF SOLICITATION NUMBER

15BFA025R00000023

CODE FACILITY CODE

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

X 9B. DATED (SEE ITEM 11)

05/23/2025

10A. MODIFICATION OF CONTRACT/ORDER

NUMBER

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X XThe above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, 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 __1__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

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.)

This amendment 0001 is issued to adjust the pricing methodology for skilled nursing and to extend the date of proposals. The new proposal deadline is July 8, 2025, 2:00pm, Eastern Standard Time. Attachment 1 and SOW are updated and attached. No other changes have been made.

Skilled Nursing Facility:

The Contractor shall provide the BOP with a per diem rate that includes all skilled nursing facility services, such as room and board, nursing care, and therapy services. No separate charges shall be permitted for routine or ancillary services included in the standard scope of care.

THIS AMENDMENT EXTENDS THE SOLICITATION CLOSING DATE/TIME TO: 07/08/2025 - 14:00 ET US/Eastern

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

Kristen Fisher Contracting Officer

(Signature of person authorized to sign)

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED

By (Signature of Contracting Officer)

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

Previous edition unusable STANDARD FORM 30 (REV. 11/2016) Prescribed by GSA FAR (48 CFR) 53.243 bop46973 Highlight

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Table of Contents

Section Description Page Number

Solicitation/Contract Form 1 Commodity or Services Schedule 2 Contract Clauses 3 List of Attachments 4 Solicitation Provisions

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Section 1 - Commodity or Services Schedule

CMCS-FCC ALLENWOOD -COMPREHENSIVE MEDICAL

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

Section 2 - Contract Clauses

No Clauses

Section 3 - List of Attachments

No Clauses

Identifier Title Number of Pages

1 Attachment 1-updated.pdf - ADDED 2 Attachement 2 - updated.pdf - ADDED

Section 4 - Solicitation Provisions

No Clauses

Solicitation Attachment 1: Contract Pricing & Subcontract Certification FCC Allenwood - Comprehensive Medical Services

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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) 48700-Williamsport, PA. 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 99, Pennsylvania, Rest of State, All Other 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 – 48700 – Williamsport, PA. Offerors may propose a discount from or a premium to the benchmark charges.

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Skilled Nursing Facility:

The Contractor shall provide the BOP with a per diem rate that includes all skilled nursing facility services, such as room and board, nursing care, and therapy services. No separate charges shall be permitted for routine or ancillary services included in the standard scope of care.

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

FCC Allenwood

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

Inpatient Days: 396 days (estimated) Outpatient Visits: 2610 visits (estimated) Skilled Nursing: 242 days (estimated)

Option Year 1 Inpatient Days: 396 days (estimated) Outpatient Visits: 2610 visits (estimated) Skilled Nursing: 242 days (estimated)

Option Year 2 Inpatient Days: 396 days (estimated) Outpatient Visits: 2610 visits (estimated) Skilled Nursing: 242 days (estimated)

Option Year 3 Inpatient Days: 396 days (estimated) Outpatient Visits: 2610 visits (estimated) Skilled Nursing: 242 days (estimated)

Option Year 4 Inpatient Days: 396 days (estimated) Outpatient Visits: 2610 visits (estimated) Skilled Nursing: 242 days (estimated)

Optional 6-month extension Inpatient Days: 195 days (estimated) Outpatient Visits: 1305 visits (estimated) Skilled Nursing: 121 days (estimated)

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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:

Physiatrist Electromyography Services: Visit duration: 8 hours Visit quantity: 12 per contract year

General Surgeon: Visit duration: 4 hours Visit quantity: 12 per contract year

Ophthalmologist: Visit duration: 8 hours Visit quantity: 24 per contract year

Orthopedic Surgeon: Visit duration: 8 hours Visit quantity: 12 per contract year

Cardiologist: Visit duration: 4 hours Visit quantity: 12 per contract year

Gastroenterologist: Visit duration: 4 hours Visit quantity: 24 per contract year

Nephrologist: Visit duration: 4 hours Visit quantity: 24 per contract year

Urologist: Visit duration: 4 hours Visit quantity: 48 per contract year

Session duration 4 hrs. (approximately) Session quantity 48 per contract year (estimated)

Session Based Services:

Mobile Ultrasound:

Physical Therapist:

Updated: 06-05-2024

Session duration 4 hrs. (approximately)

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Session quantity 36 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 1c. Skilled Nursing $_____________ per diem 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.Physical Therapist: $_____________ per four (4) hour session 2c3. Mobile Ultrasound $_____________ per four (4) 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 1c. Skilled Nursing $_____________ per diem 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.Physical Therapist: $_____________ per four (4) hour session 2c3. Mobile Ultrasound $_____________ per four (4) hour session

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

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

Updated: 06-05-2024 Page 5 of 6

Option Year 2

1a. Inpatient Facility Services: - __ Discount or + ___ Premium to Medicare Part A 1b. Outpatient Facility Services: - __ Discount or + ___ Premium to Medicare Part B 1c. Skilled Nursing $_____________ per diem 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.Physical Therapist: $_____________ per four (4) hour session 2c3. Mobile Ultrasound $_____________ per four (4) hour session

Option Year 3

1b. Outpatient Facility Services: - __ Discount or + ___ Premium to Medicare Part B 1c. Skilled Nursing $_____________ per diem 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.Physical Therapist: $_____________ per four (4) hour session 2c3. Mobile Ultrasound $_____________ per four (4) hour session

Option Year 4

1b. Outpatient Facility Services: - __ Discount or + ___ Premium to Medicare Part B 1c. Skilled Nursing $_____________ per diem 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.Physical Therapist: $_____________ per four (4) hour session 2c3. Mobile Ultrasound $_____________ per four (4) hour session

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

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Option to Extend Services as Authorized by FAR 52.217-8

1b. Outpatient Facility Services: - __ Discount or + ___ Premium to Medicare Part B 1c. Skilled Nursing $_____________ per diem 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.Physical Therapist: $_____________ per four (4) hour session 2c3. Mobile Ultrasound $_____________ per four (4) 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

Solicitation Attachment 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 custody and care of approximately 158,842 Federal inmate. 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 the detention of individuals awaiting trial in Federal court. It is the mission of the BOP to protect society by confining inmate in the controlled 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 inmate 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 accomplish 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 healthcare consistent with community standards.

In meeting the healthcare needs of a growing inmate population, the BOP provides essential medical, dental, and mental health services to Federal inmates with BOP resources. When a medical need arises which cannot be provided within prison walls by BOP resources, 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 Field Acquisition Office intends to make a single award to a responsible entity for the provision of Comprehensive Medical Services as set forth in this solicitation/contract. The Federal Correctional Complex (FCC) (hereinafter referred to as “institution(s)”) is located in Allenwood, Pennsylvania and includes the following institutions:

• USP Allenwood – Male Inmate, Care Level 3

• FCI Allenwood – Male Inmate, Care Level 3

• LSCI Allenwood – Male Inmate, Care Level 2

Presently, the institution is identified as Care Level 3 BOP facility. This administrative classification indicates that the institution houses inmates having more complex medical conditions and are more fragile. They require frequent clinical contacts with Health Services employees and more visits to community medical specialists.

They may also periodically require hospitalization to stabilize their conditions.

Criteria for categorizing an inmate in the Care Level 3 category is included as Attachment 6: Medical Classification – Care Level. Despite this description of the general health of the inmate population, the need for inmate healthcare may arise at varying levels of complexity. Classification and designation of inmates is the sole responsibility of the BOP and may change at any time without consideration to the contractor.

A mileage restriction has not been placed on this acquisition. The BOP reserves the right to determine if 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 healthcare to the inmates of the institution. A potential organizational conflict of interest may arise if the awardee is an entity which also holds or participates in a separate 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 services 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 fails 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 assignments. The BOP desires to make an award to the offeror who can provide the best value, considering the diversity of available services and price, among other criteria specified in Attachment 4:

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 submit 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 healthcare to members of the general public. (Cross-reference pricing categories 1a, 1b and 1c.)

Output #2: Provide professional services which conform to community standards and all local, state and Federal laws and regulations applicable to the delivery of healthcare to members of the general public. (Cross-reference pricing categories 2a, 2b, 2c1, 2c2 and 2c3.)

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

Output #4: Manage medical record information in a manner which promotes continuity of care while observing restrictions 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 reserves the right to inspect and evaluate in a reasonable manner all 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 7: Performance-Based Outcome Measures.

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 the institution’s approval. Once the QCP is approved by the institution, the contractor shall utilize the QCP to guide and rigorously document the implementation of the required management and quality control actions to achieve the specified output.

V. Specific Requirements

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 healthcare 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 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 and outpatient facility, including emergency room services. Inpatient visits for non-emergency services shall require private room accommodations with available space for up to three armed or unarmed guards per inmate.

It is the institution’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 professional 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 the institution, 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 healthcare 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 LEIE.

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. This output specifically excludes the provision of

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radiological interpretations of BOP-provided films, images, or other media.

If requested by the Contracting Officer (CO), 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 specialty 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 the institution’s pharmacy, contract providers shall only prescribe pharmaceutical drugs that are listed in the approved BOP Formulary. The BOP Formulary can be accessed at 2023_winter_formulary_part_1.pdf (bop.gov). 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 the institution.

Institution-Based Services

As an additional tool to satisfy Output #2, professional services may be performed within the confines of the institution. If the resulting contract does not provide for telemedicine consultation or all the on-site clinics listed, the institution reserves the right to pursue such contracts. The institution 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 the institution determines to be reasonable and appropriate.

If the contractor performs on-site specialty clinics at the institution, the following minimum requirements shall apply. Contract services shall be provided on-site within the Health Services Department of the institution.

Consultations shall be limited to the chief complaint on the BOP consultation form.

Services shall include diagnosis and treatment of medical conditions with appropriate referral, if necessary, to a specialist at the contract medical facility. Scheduling of clinics shall be subject to the mutual agreement of the institution and the contract provider. The institution will schedule inmates for on-site clinics. Providers performing institution-based services shall be licensed to practice medicine in the State of Pennsylvania.

Providers performing these services shall apply for clinical privileges at the institution. 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 contract shall be contingent upon the continuation of this contract and upon the physician’s continued affiliation with the contractor or any subcontractor.

Continuation of privileges at the institution shall be at the sole discretion of the institution. Non-physician providers shall maintain active licenses from the State of Pennsylvania, as applicable.

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

https://www.bop.gov/resources/pdfs/2023_winter_formulary_part_1.pdf

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Nephrologist Urologist Mobile Ultrasound Physical Therapist

General Surgeon Ophthalmologist Orthopedic Surgeon Cardiologist Gastroenterologist

In the event it becomes necessary for the Government to cancel a scheduled visit, the institution will provide the contract provider with 48-hour written or verbal notice prior to canceling a visit. However, certain circumstances beyond the control of the institution (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 utilizing replacement staff, the contractor must obtain preliminary clearance from the CO or COR, in accordance with the security and privileging requirements of this contract.

All contract personnel providing services within the confines of the institution shall have a complete background investigation conducted in accordance with BOP Program Statement 3732.01, “BOP Identifications and Background Investigation.” See also “Contract Security/Investigative Requirements” contained within this solicitation/contract, see Attachment 3: Special Contract Conditions. All contract providers and other applicable staff who will enter the institution to perform services on a recurring basis shall be required to attend a four-hour institution orientation course held at the institution 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 CO or COR will be responsible for scheduling training for all applicable contract staff.

Specific Institution Based Services Requirements:

Ophthalmologist. All equipment necessary to perform ophthalmologic testing and treatment, including, without limitation, a portable retinal imaging system, retinoscope, ophthalmoscope, transilluminator, autorefractor/keratometer, and portable slit lamp, shall be supplied by the Contractor unless otherwise agreed upon in advance with FCC Allenwood. All supplies intended for use inside the secure perimeter by the Contractor will be listed on an inventory sheet and approved by FCC Allenwood in advance. Items required for services and not permitted on the Contractor's inventory will be supplied by FCC Allenwood.

Physiatrist Electromyography Services. All equipment necessary to perform Electromyography testing, including testing equipment and monitoring equipment, shall be supplied by the Contractor unless otherwise agreed upon in advance with FCC Allenwood. All supplies intended for use inside the secure perimeter by the Contractor will be listed on an inventory sheet and approved by FCC Allenwood in advance. Items required for services and not permitted on the Contractor's inventory will be supplied by FCC Allenwood.

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 clause 52.212-4, Contract Terms and Conditions - Commercial Products and Commercial Services, 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.

Physiatrist Electromyography Services

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Invoice/Medical Claims Adjudication. The institution 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 the institution, are appropriately coded in compliance with Medicare coding policies (where applicable), are properly priced in accordance with the terms and conditions of the contract, and do not represent duplicate billings for payments already made. In addition, the institution may utilize the services of a third-party medical claims adjudicator to review medical claims submitted by the contractor under this contract.

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

Invoice Definitions.

Line Items 1a - Inpatient Facility Services, 1b - Outpatient Facility Services, 2a - Inpatient Physician Services, 2b - Outpatient Physician Services, and 2c1 - Outpatient Institution Services - Other Physicians: At the outset of this contract, an invoice for services rendered under Line Items 1a, 1b, 1c, 2a, 2b, and 2c1 shall be a paper version of an invoice containing not more than 50 individual medical claims. Each invoice shall be supported with paper 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 CO that a third-party medical claims adjudication service will be utilized by the institution, an invoice for services rendered under the Line Items identified in the previous paragraph shall be a paper invoice. Each invoice shall not detail 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 Portability 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: Task Order number, inmate name, register number, date of service, provider of service name and NPI number, billed code, and contract amount billed. Medical claims detailed in the invoice shall be listed first in descending order by the Task Order 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.

A copy of the invoice including the same fields listed above will also be provided to the institution in Microsoft Excel or comma-separated values (CSV) format. The electronic copy of the invoice shall be submitted to the institution using an encrypted email service.

If the contractor’s proposal encompasses the provision of 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. Oral surgery and/or dental procedures which are not considered to be adjunctive dental care will be submitted to the institution for verification.

The contractor shall not submit a medical claim for processing that the contractor knows or has reason to believe contains inaccurate, incomplete, or misleading information. Additionally, the contractor shall only submit Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) provided by medical service providers. 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 contractor may proceed with submitting the medical claim for processing and invoicing the institution for all services represented by that medical claim.

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Outpatient Institution Services - Line Item 2c2 – Physical Therapist and Line Item 2c3 – Mobile Ultrasound:

Invoices for services rendered under Line Item 2c2 – Physical Therapist and Line Item 2c3 – Mobile Ultrasound shall be a paper invoice detailing the date(s) sessions were provided, the number of sessions provided, the unit pricing applied, and the extended total amount due. The BOP will not use the services of a third-party medical claims adjudicator for verification of these services.

Skilled Nursing Facility- Line Item 1c: Invoices for services rendered under Line Item 1c – skilled nursing facility shall be a paper invoice detailing the date(s) of service provided, the per diem rate, and the extended total amount due.

Provider Information

Submission of Provider Data to the BOP’s Medical Claims Adjudicator: Within 10 calendar days after notification that a third-party medical claims adjudication service will be utilized by the institution, 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 10-A: List of Provider Information Requirements.

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. Provider information shall be submitted directly to the BOP’s medical claims adjudicator. As individual providers are added to the contractor’s network, the contractor shall provide the information listed on the List of Provider Information Requirements to the medical claims adjudicator no less than three business days prior to filing claims electronically for services rendered by such new providers.

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

Technical Data for Submission of Medical Claims: Prior to the submission of an invoice to the institution, the contractor shall electronically transmit the information found on each individual invoiced medical claim via ANSI 837 format only, to the BOP’s medical claims adjudicator. Any claims submitted to the medical claims adjudicator’s claims clearinghouse with missing or invalid provider information will be automatically rejected in a 277CA Claims Acknowledgement message noting the missing or invalid provider information received. 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 the institution. The contractor will also post the ANSI 837 file in an FTP site set up and maintained by the BOP’s medical claims adjudicator. Address information for the submission of a paper claim to the BOP’s medical claims adjudicator is provided in Attachment 10-B: Information Requirements for Medical Claims, along with other pertinent details.

Procedures for Filing Corrected Medical Claims

A corrected claim is a replacement of a previously submitted claim with claim line level denials or issues.

Previously submitted claims that were completely rejected or denied should be sent as a new claim rather than a corrected claim.

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 837i format only, to the BOP’s medical claims adjudicator. Institutional Provider corrected claims should include a value of ‘7’ (Replacement of Prior Claim) in Loop 2300, Segment CLM05‐3.

Physician/Professional Services: If it becomes necessary to file a corrected medical claim for professional services, the contractor shall electronically transmit the information found on each individual corrected medical claim via ANSI 837p format only, to the BOP’s medical claims adjudicator. Professional Service Provider corrected claims should include a value of ‘7’ (Replacement of Prior Claim) in Loop 2300, Segment CLM05‐3.

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 the institution. 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 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 submission or reflect the credit amount due for the corrected medical claim submission.

Payment by the Institution: The institution will pay all invoices directly to the contractor. If the invoiced amount of a medical claim exceeds the adjudicated amount of that medical claim, the institution will take an administrative deduction from the invoice. The institution 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 the institution of the disagreement along with the reasons why the contractor believes the medical claim was paid incorrectly. The institution will interface between the contractor and the medical claims adjudicator to bring resolution to any disagreements. If it is determined that a medical claim was paid incorrectly by the institution, interest on the underpayment will be paid when required by the Prompt Payment Act.

Timeliness of Medical Claims

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 Assessment Report in the Contractor Performance Assessment Reporting System (CPARS). Medical claims which are submitted/invoiced within the acceptable time but are found to contain errors or require further justification, will be rejected and shall be resubmitted/re-invoiced by the contractor within 30 calendar days from the date of rejection. 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 30 September of that year. Based upon information generated through this review process, the contractor shall provide a written estimate to the institution of outstanding fiscal year obligations, supported by adequate documentation. This estimate and supporting documentation shall be provided to the CO no later than 1 December of each year. The contractor shall put forth its best efforts to ensure the accuracy of the annual estimate provided to the Government.

Prompt Payment to Healthcare Providers: In accordance with FAR 12.213 Other Commercial Practices, the contractor shall implement commercial practices for healthcare payers in the surrounding community for prompt payment of all healthcare providers performing services under this contract. Such prompt payment terms shall be a material part of all subcontracts/agreements awarded by the contractor. The contract shall ensure that all healthcare providers acknowledge the following notice upon award of a subcontract/agreement for performance under this contract.

Notice to Healthcare Providers: All healthcare providers are hereby advised that the BOP maintains no privity of contract with any party other than the prime contractor regarding performance of the above-referenced contract. Notwithstanding FAR 52.212-4(b), a subcontract or other agreement between the prime contractor and a healthcare provider is a private-party contract. As such, the BOP will not intervene in disputes between prime contractor and any subcontractor/healthcare provider on any issue, including payment disputes. All subcontractors/healthcare providers are advised that payments due from the BOP for performance under the prime contract will be paid only to the prime contractor. Accordingly, the prime contractor is responsible for remitting payments to subcontracts/healthcare providers in accordance with the terms of the negotiated subcontract/agreement, if any. By submitting a response to the solicitation and or by accepting this award the contractor acknowledges as such, the prime contractor and subcontractors/healthcare providers should look to the remedies afforded them under any such negotiated subcontract/agreement.

If the contractor fails to make prompt payment to healthcare providers, the CO will consider any “unjustified failure(s)” by the contractor to make prompt payments to a healthcare provider when evaluating the contractor’s performance. Any unjustified failures to make prompt payments to healthcare providers will be reported in the CPARS. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the prime contractor, of if the prime contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance.

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

Upon request, authorized BOP staff shall have access to and obtain copies of all inmate medical records to include evaluation and treatment reports prepared and maintained by the contract facility and/or contract providers. Inmate medical records will be subject to review by the institution for validation of payment and verification of services rendered. Release of information shall only be made in accordance with community standards, Joint Commission regulations, and the Privacy Act of 1974. Any request(s) for copies of an inmate’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 the institution to enhance inmate recovery as well as continuity of care. For inpatient admissions, a faxed report documenting treatment plans will be submitted to the institution Medical Records Department no later than 8 am each day. This form with the requested information will be provided to the institution by the contractor. At the completion of treatment, the contractor shall provide the institution 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.