15BFA025R00000055-0004 Solicitatio - FCI Cumberland - Updated attachment 2 PWS and New Response Date - See Amendment for details.pdf
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- Solicitation number
- 15BFA025R00000055
About this file
This is Amendment 0004 to Solicitation 15BFA025R00000055 issued by the Federal Bureau of Prisons for comprehensive medical services at FCI Cumberland in Cumberland, Maryland. The amendment reopens the solicitation with a new response deadline of December 9, 2026 at 2:00 PM ET. The primary change involves updating Attachment 2 (Performance Work Statement) to consolidate extended stay per diem requirements from two areas to one area on page six, with that section now highlighted. All other terms and conditions remain unchanged from the prior solicitation version.
The Performance Work Statement describes a single-award contract for comprehensive medical services supporting two male offender facilities (FCI Cumberland and SPC Cumberland), both classified as Care Level 2. The contract includes five outputs: (1) optional inpatient and outpatient facility services conforming to community standards with preference for Joint Commission-accredited facilities; (2) optional professional services including community-based physician consultations and institution-based specialty clinics (cardiology, surgery, dermatology, gastroenterology, neurology, podiatry, urology, orthopedics, optometry, physical therapy, oral surgery, and mobile diagnostic imaging units for MRI, CT, and ultrasound); (3) submission of properly-priced invoices within 90 days of service completion; (4) medical record management promoting care continuity and privacy compliance; and (5) maintenance of communication via a designated Point of Contact and an onsite scheduler. The contractor must comply with the BOP Formulary for prescriptions, provide PREA protocol documentation for sexual assault cases, ensure provider credentials verification, and accommodate facility requirements including 480-volt electrical service for mobile diagnostic units during weekday hours (7:00 AM to 3:00 PM, Monday–Friday).
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15BFA025R00000055/0004 Page 1 of 4
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
1. CONTRACT ID CODE PAGE OF PAGES
1 4
2. AMENDMENT/MODIFICATION NUMBER
3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)
15BCMSCODE
Federal Bureau of Prisons Field Acquisition Office U.S. Armed Forces Reserve Complex 346 Marine Forces Drive Grand Prairie, TX 75051
Jefferson Gregory
(O) 202-570-8404 J2gregory@bop.gov
6. ISSUED BY 15B107CODE
Federal Bureau of Prisons FCI Cumberland
14601 BURBRIDGE RD SE
Cumberland, MD 21502
7. ADMINISTERED BY (If other than Item 6)
9A. AMENDMENT OF SOLICITATION NUMBER
15BFA025R00000055
CODE FACILITY CODE
8. NAME AND ADDRESS OF CONTRACTOR (Number, street, country, state and ZIP Code) (X)
X 9B. DATED (SEE ITEM 11)
03/09/2026
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 ____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.)
REOPEN SOLICITATION WITH NEW RESPONSE DATE OF 12/9/2026 @ 2PM EST.
ATTACHMENT 2, PERFORMANCE WORK STATEMENT (PWS) HAS BEEN UPDATED ON PAGE SIX, CONCERNING EXTEDNED STAY PER DIEM LISTED IN TWO AREAS. ONLY ONE AREA NOW ON PAGE SIX OF THE PWS AND HIGHLIGHTED.
ALL ELSE REMAINS UNCHANGED.
THIS AMENDMENT EXTENDS THE SOLICITATION CLOSING DATE/TIME TO: 12/09/2026 - 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)
Jefferson Gregory 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
15BFA025R00000055/0004 Page 2 of 4
Table of Contents
Section Description Page Number
A Solicitation/Contract Form B Supplies or Services and Prices/Costs C Description/Specifications/Statement of Work D Packaging and Marking E Inspection and Acceptance F Deliveries and Performance G Contract Administration Data H Special Contract Requirements I Contract Clauses J List of Attachments K Representations, Certifications and Other Statements of Offerors L Instructions, Conditions and Notices to Offerors M Evaluation Factors for Award
15BFA025R00000055/0004 Page 3 of 4
Section B - Supplies or Services and Prices/Costs
CMCS-FCI CUMBERLAND - COMPREHENSIVE MEDICAL
SCHEDULE OF SUPPLIES/SERVICES
CONTINUATION SHEET
Section C - Description/Specifications/Statement of Work
No Clauses
Section D - Packaging and Marking
No Clauses
Section E - Inspection and Acceptance
No Clauses
Section F - Deliveries and Performance
No Clauses
Section G - Contract Administration Data
No Clauses
Section H - Special Contract Requirements
No Clauses
Section I - Contract Clauses
No Clauses
Section J - List of Attachments
15BFA025R00000055/0004 Page 4 of 4
Identifier Title Number of Pages
2 Attachment 2-Performance Work Statement - FCI Cumberland Updated Final - ADDED 10 2 Attachment 2-Performance Work Statement - FCI Cumberland Updated RFO.pdf - DELETED 10
Section K - Representations, Certifications and Other Statements of Offerors
No Clauses
Section L - Instructions, Conditions and Notices to Offerors
No Clauses
Section M - Evaluation Factors for Award
Solicitation Attachment 2: Performance Work Statement FCI Cumberland – Comprehensive Medical Services
15BFA025R00000055
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 154,853 Federal Inmates. 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 Inmates 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 Inmates 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 Correction Institution (FCI) (hereinafter referred to as “institution(s)”) is located in Cumberland, Maryland and includes the following institutions:
• FCI Cumberland – Male Offenders, Care Level 2
• SPC Cumberland – Male Offenders, Care Level 2
Presently, the institution is identified as Care Level 2 BOP facility. This medical classification indicates institutions house inmates that are stable outpatients who require primary or specialist evaluations, monthly to every 6 months. Criteria for categorizing an Inmate in the Care Level 2 category is included as Attachment 4:
Medical Care Level Classification. 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. 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. 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, 2c3, 2c4, 2c5, 2c6 and 2c7.)
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.
III. 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 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 Attachment 9 - BOP Formulary. Updated BOP Formularies will be posted to 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.
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.
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 outpatient institution service 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 outpatient institution service clinic, via community-based referral, via telemedicine consult, or any other method the institution determines to be reasonable and appropriate.
If the contractor performs outpatient institution service specialty clinics at the institution, the following minimum requirements shall apply. Contract services shall be provided outpatient institution service 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 outpatient institution service clinics. Providers performing institution-based services shall be licensed to practice medicine in the State of Maryland. 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 Maryland, 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 outpatient institution service clinics:
Cardiologist Podiatrist Mobile Ultrasound General Surgeon Urologist Optometrist Dermatologist Orthopedic Surgeon Physical Therapist Gastroenterologist Mobile CT Oral Surgery Neurologist Mobile MRI
Mobile MRI, CT, and Ultrasound Units:
The offeror shall provide Mobile MRI, CT, and Ultrasound services at the institution located at:
14601 Burbridge Road, SE Cumberland, MD 21502
FCI - The mobile unit will enter through rear gate and park behind the Safety Department’s corridor.
The institution will provide the following utilities: 480-volt 3 phase, 4 wire, 150-amp electrical hookup.
At the direction of the CO or COR, a schedule will be established and mutually agreed upon for services to be provided at the FCI. Entrance and exit will take place during the hours of 7:00 a.m. to 3:00 p.m., Monday through Friday.
The contractor shall provide, without limitation, all necessities required for the transportation, personnel, management and operation of all mobile units (MRI, CT, and Ultrasound) services.
The Mobile MRI Unit, Mobile CT Unit, and Mobile Ultrasound Unit capabilities shall allow the operator to readily complete an approximate number of patients per session at the discretion of Health Services and the CO.
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.” 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.
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 Deviation 52.212-4, Contract Terms and Conditions - Commercial Products and Commercial 15.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.
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, 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
15BFA025R00000055
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.
Outpatient Institution Services - 2c2 - Optometrist, Line Item 2c3 - Mobile CT, Line Item 2c4 - Mobile MRI, Line Item 2c5 - Physical Therapist, Line Item 2c6 - Mobile Ultrasound, and Line Item 2c7 - Oral Surgery: Invoices for services rendered under Line Item 2c2 Optometrist, Line Item 2c3 Mobile CT, Line Item 2c4 Mobile MRI, Line Item 2c5 Physical Therapist, Line Item 2c6 Mobile Ultrasound, and Line Item 2c7 Oral Surgery, 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.
Extended Stay Per Diem- Line Item 1c: Invoices for services rendered under Line Item 1c – extended stay per diem shall be a paper invoice detailing the date(s) of service provided, the per diem rate, 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.
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 8-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 bop40316 Highlight 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 8-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 the 10th of each month, the contractor shall initiate the billing review process by examining its records from the preceding months, including those of all subcontracted providers, to identify an estimated amount of expenditures for services rendered. Using the information gathered through this review, the contractor shall prepare and submit a written monthly estimate of Fiscal Year Obligations. The monthly estimate shall itemize projected amounts by fiscal year and by month, and shall include, at a minimum:
1. Dates of Service
2. Provider
3. Inmate Name
4. Register Number
5. Estimated Amount
6. Billed Amount
Each date of service shall be recorded on its own line. If an inmate has multiple encounters, each encounter shall be listed separately. Each monthly estimate shall address a single month only and shall not be combined with other months. Monthly estimates from prior periods shall be updated as additional services are rendered.
The contractor shall provide the written estimate to the institution no later than the 15th of each month. As invoices are paid, the contractor shall promptly remove them from subsequent estimates. The contractor shall use its best efforts to ensure all estimates submitted to the Government are accurate.
To ensure adequate funds are reserved before the fiscal year ends, the contractor shall provide early estimates for the final two months of the year. Specifically, the contractor shall submit an estimate of services anticipated for August no later than July 15th, and an estimate of services anticipated for September no later than August 15th.
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. 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 consultation. 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 services 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 CO prior to the start date of the contract. Alternate POC’s may be designated;
however, the contractor 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 the institution 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 period or the next normal working day. All institution 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 institution medical staff.
A contract provider may discuss with the Inmate patient only the diagnosis and possible treatment options directly related to the written consultation provided by the institution. The contract provider should not guarantee any future treatment to the Inmate or discuss future appointment dates. All consultant recommendations should be sent to the institution for review by the Primary Care Provider Team (PCPT) and/or Clinical Director (CD). The BOP PCPT and/or CD is under no obligation to follow consultant recommendations. All patient care information and/or treatment plans will be reviewed by the PCPT/CD and the final disposition will be relayed to the Inmate in accordance with BOP policies and procedures. In the event further care is approved, the contractor will be notified by the institution. The contractor shall not perform any treatment/procedures unrelated to the reason for consultation without receiving prior authorization from the institution.
The institution is requiring an Onsite Scheduler to assist in meeting this output. The contractor shall bear all costs associated with the Onsite Scheduler except for: offices located at the institution, phone line and computer. The contractor shall supply all other office supplies (paper, toner, pens, etc.) and equipment (fax, calculator, printer, etc.) necessary for the Onsite Scheduler to perform. Any and all equipment supplied by the contractor shall have prior written approval by the COR. The Onsite Scheduler shall meet and maintain any and all security clearances as required during the life of contract.
The offeror’s technical proposal shall discuss in detail, duties and work hours the Onsite Scheduler will perform to assist in achieving Output #5.
IV. Enhancements to the Basic Contract Requirements
Offerors are encouraged to propose enhancements to the basic contract requirements which will facilitate the institution’s ability to conform to the BOP’s stated mission. Due to security concerns inherent in transporting an Inmate into the community for medical care, it is the institution’s preference to treat Inmates within the confines of a secure perimeter whenever possible. Offerings which assist the institution in mitigating security concerns are considered beneficial to the Government and will be evaluated for merit. Enhancements are not additional line items. Pricing for offered enhancements must be absorbed in the line item structure established within Section 2. Offerings of enhancements that are separately priced line items will not be considered or accepted.
The Government reserves the right to reject any offered enhancements that are determined not to be in the best interest of the Government.
The offeror’s technical proposal shall discuss in detail any such enhancements proposed, including relevant terms and a detailed discussion of the merits of offered enhancements.
V. Prison Rape Elimination Act (PREA)
Institution Health Services staff are responsible for assessment, examination, documentation, and treatment of Inmate injuries arising from incidents of sexual abuse, including testing when appropriate for pregnancy, HIV, and other sexually transmissible infections. Where indicated, medical staff, trained in the collection of sexual assault evidence (e.g., “rape kit”) should conduct an examination for physical evidence that may be used later in formal investigations, or refer the Inmate to trained healthcare professionals from the local community or at the local community facility equipped (in accordance with local laws) to evaluate and treat sexual assault victims.
Should there be a need for the institution to refer the Inmate out into the community to a trained healthcare professional, the offeror’s technical proposal shall discuss in detail the protocol (including but not limited to, the facilities who offer these services, examiners’ certifications, and local laws/requirements) to help meet this requirement.
| Attachment 2-Performance Work Statement - FCI Cumberland Updated Final - Amendment 0004.pdf |
| III. Specific Requirements |
| 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. |
| Community-Based Services |
| Institution-Based Services |
| 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 physician, contract facility, and the Government regarding the contract services. |
| IV. Enhancements to the Basic Contract Requirements |
| V. Prison Rape Elimination Act (PREA) |
File details come from the government source that posted it. Updated .