Solicitation__16-100-SOL-00004(corrected).pdf

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotations are being requested and a written solicitation will not be issued.

The solicitation number is 16-100-SOL-00004 and this solicitation is issued as a Request for Quotation (RFQ) and incorporates provisions and clauses of Federal Acquisition Circular 2005-83, with an effective date of November 1, 2015 This procurement is being conducted under FAR 12 – Acquisition of Commercial Items.

This is NOT a small business set aside. The associated NAICS code is 524291, Claim Adjusting and small business size standard in number of employees is $20.5M. This award will be made as a Requirements Contract. Firm Fixed Price and/or Cost Reimbursement Task Orders may be awarded under this IDIQ.

The Statement of Work is attached to this posting (ATTACHMENT 1). The period of performance will be a 60-days base period from date of award and one 30-day Optional Period. See Contract Line Item Numbers [CLIN] Structure Table below for services/items, quantities and units of measure, (including option(s).

CLIN STRUCTURE TABLE

BASE PERIOD – 60 DAYS

CLIN DESCRIPTION UNIT UNIT PRICE TOTAL PRICE

0001 Pre-Activation Phase 1 $ $

0002 Activation Phase 1 $ $

0003 Post-Activation Phase 1 $ $

Total $

OPTION PERIOD – 30 DAYS

CLIN DESCRIPTION UNIT UNIT PRICE TOTAL PRICE

Pre-Activation Phase

Activation Phase

Total

FAR 52.212-1, Instructions to Offerors—Commercial, applies to this acquisition. In addition, the Offeror shall include a Cover Letter and the information posted in this notice. The cover letter shall include, at a minimum, the Offeror’s name, address, and point of contact with phone number and email address.

Written quotes shall be submitted in two distinct Parts respectively labeled as "Part I" and, "Part II", and submitted as two distinct, clearly labeled electronic files. Each quote Part shall be further divided into sections as described.

Quote text must be formatted for 8 ½ by 11 inch paper. Minimum margins for top, bottom, and sides are (1) inch, excluding headers and footers. The font and print size selected shall make the quotation easily readable.

Information may be formatted for single or double-sided sheets, but shall not exceed the applicable page limitations.

The type color for all documents submitted (including charts and graphs) shall be black. Bolding, underlining, and italics may be used to identify topic demarcations or points of emphasis. Graphic presentations, including pricing https://acquisition.gov/far/current/html/Subpart%2012_6.html%23wp1088488 https://acquisition.gov/far/current/html/Subpart%2012_6.html%23wp1088488 https://acquisition.gov/far/current/html/52_212_213.html%23wp1179124 and other tables, while not subject to the margin and page size restrictions, shall use spacing and text that is easily readable. Information that exceeds the applicable page limitations will not be considered.

PART I – TECHNICAL QUOTATION must be divided into the sections corresponding to the numbering structure below and must not exceed 20 pages. Appendices and Attachments are excluded from the page limit. The technical approach shall, at a minimum, be prepared in a format consistent with the evaluation criteria for award set forth in the addendum to FAR clause 52.212-2, of this RFQ. The Technical qualification shall be a stand-alone document containing all information necessary for the Government to perform a complete technical evaluation.

1) Technical Approach - The Offeror shall provide its approach to successfully performing in accordance to the Statement of Work. The response approach shall include the following:

a. Pre-Activation Phase

b. Activation Phase

c. Post-Activation Phase

2) Project Management Approach - The Offeror shall identify the management approach in use in performance of this effort. The Offeror shall state the percentage of time these key personnel will devote to work on this effort, if less than 100% (i.e. the percentage of the person’s weekly work time that the Offeror expects will be devoted to this order).

3) Past Performance - Past performance should be an important element of every evaluation and contract award for commercial items. Contracting officers should consider past performance data from a wide variety of sources both inside and outside the Federal Government in accordance with the policies and procedures contained in Subpart 9.1, 13.106, or Subpart 15.3, as applicablePast performance will used for informational purposes only and not evaluated.

a. The Offeror shall send the past performance survey (ATTACHMENT 2) to up to three references and have them submit completed surveys to the contracting officer via email prior to the date for submission of quotes. Offeror s shall provide surveys to references for which they provided work similar in size, scope, and nature to that required in the statement of work as prime contractors or significant subcontractors, whether for Government or private entities. The surveys will not count towards the page limitation.

b. The Offeror shall submit with its quote the name and address of the firms to whom the questionnaires were sent (This is included in the page limitation).

c. If the Offeror has no relevant past performance, it should state so in this section. Under this factor, the Government shall consider information made available in the questionnaires and may consider information from Government databases and other Government sources.

d. Vendors must include a completed copy of the provision at 52.212-3, Offeror Representations and

Certifications—Commercial Items, with their quotations. (This is not included in the page limitation)

PART II – BUSINESS/COST QUOTATION must consist of all pricing, and price-related information only.

Labor categories and applicable rates should be shown in back up documentation so that the level of effort can be assessed during the price review to ensure that the labor-mix meets the Government expectation. The Offeror shall use the CLIN Structure Table provided above/as part of this RFQ and Attachment 3 when submitting response.

Please note: The proposed pricing reflected for both the CLIN table above and Attachment 3 should coincide. Each Offeror’s quote shall also, as appropriate, disclose, describe, or submit the following information in Part II:

• Any pricing assumptions made in development of such quote (pricing assumptions that deviate from requirements in the SOW will be regarded as deficiencies in the quote).

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/09.htm%23P4_435 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/13.htm%23P118_16939 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/15.htm%23P223_35945 https://www.acquisition.gov/far/current/html/52_212_213.html%23wp1179194

• Offerors must include labor categories, number of hours, and fully burden labor rates so that the government may review how the price was derived for each Labor CLIN.

• Offerors must provide the pricing excel spreadsheet (ATTACHMENT 3) when submitting pricing.

• Contact information for the person most responsible for composing this quote, including his or her name, telephone number and e-mail address.

EVALUATION PROCESS

FAR 52.212-2, Evaluation—Commercial Items applies to this acquisition and specific evaluation criteria is included in paragraph (a) below:

The Government will award a contract resulting from this RFQ to the responsible offeror whose offer conforming to the RFQ will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

MANDATORY CRITERIA FOR ELIGIBILITY - The Offeror shall provide a dedicated section entitled “Mandatory Criteria” in the Technical Proposal that addresses the following mandatory criteria for eligibility:

o Ability to become fully operational to perform EPAP within 10 days of contract being awarded.

o Ensure the EPAP program is activated and operational within 48 hours of receiving activation notification or task order.

o Ensure all enrolled pharmacies in the affected areas are notified of EPAP activation through fax, email message, and/or text message.

o Ensure access to covered prescription drugs, medical supplies, and DME determined by preset formulary for eligible individuals who present a valid prescription at enrolled pharmacies across the nation during a qualifying event, at no cost to the affected individual.

o Implement or use existing systems that enables real-time point-of-sale eligibility checks and edits for claims where the pharmacist has found no coverage or limit coverage (co-payment) dispensing of EPAP covered drugs, specific medical supplies, and DME to eligible individuals.

o Provide timely reports and relevant information of EPAP claims, eligibility checks, call-center activities, pharmacy communications, and pharmacy payments to ASPR.

o Participate in disaster-related conference calls, as identified by ASPR, to facilitate communications.

o Adjudicate payment of legitimate pharmacy claims from network pharmacies on an as-needed basis.

o Solicit enrollment of legitimate pharmacies (to include during activation) into EPAP nation-wide network

FACTOR 1: TECHNICAL APPROACH - The offeror will provide a detail methodology to be used to achieve the objectives and deadlines described in the SOW; including how it interprets the requirements of the SOW in sufficient detail to demonstrate an understanding of the services required and to allow OIG to evaluate the offeror’s approach. Offeror shall identify any potential problems that could be encountered in implementing its approach.

The offeror shall identify its internal procedures for monitoring the progress of assigned tasks.

Sub Factor 1.1 – Claims Payment (1 page maximum) - The contractor will be required to establish a claims payment system for real time/point of sale pharmacy payment of eligible claims. Funds for payment will be managed via advanced payment to the contractor for a predetermined amount for a specific activation and duration. Advanced payment for the contractors will be determined by the Government.

Sub Factor 1.2 – Approach to Handling Multiple Disasters or Large Scale Events (3 pages maximum): The Offeror shall describe their approach to expanding their solution to accommodate a large scale disaster or the possibility of multiple disasters requiring reimbursement services simultaneously. Please describe your ability and approach to https://acquisition.gov/far/current/html/52_212_213.html%23wp1179178 adjudicating claims to be defined as part of the base contract. If the Offeror plans to subcontract as part of its solution, please describe the role and scope of the subcontractor. Ratings will be based upon the plan itself, and the ability that the offeror demonstrates in how they plan to handle multiple disasters.

Sub Factor 1.3 – Claims Processing Technology (4 pages maximum): The Offeror should have access to a claims processing software system capable of adjudicating claims. The Offeror shall name their network of partner(s) in which they will utilize for claims processing and shall detail how this network of partner(s) will be utilized. The most accurate, efficient, and innovative systems shall receive the highest ratings.

Sub Factor 1.4 – Claims Adjudication Process (5 pages maximum): The Offeror shall detail the proposed workflow for processing claims once received. The workflow should outline how the Offeror intends to validate that the pharmacies have validated to participate in the EPAP. Plans that utilize the most logical, efficient distribution of resources shall receive the highest ratings.

Sub Factor 1.5 – Provider Payment Processing (4 pages maximum): The Offeror shall detail how it will make payments to pharmacies for adjudicated claims approved by the Government. The response should describe the payment techniques available and any vendor registration process required by the Offeror from providers. Please describe the content of a remittance advice and other communication to be provided by the Offeror to providers that will facilitate payment posting and reconciliation by providers. The Offeror should describe what documents will be submitted to the Government as proof of payment. Offerors that address all the necessary documentation and provide an efficient reimbursement system that pays providers within the timeframes established in the SOW shall receive the highest ratings.

Sub Factor 1.6 – Data Access and Reporting (2 pages maximum): The Government’s assumption is that the adjudication of claims and production of remittance advices will occur using systems from the Offeror. Please describe the content and format of any information regarding claims, remittance advices and payments that can be supplied to the Government in electronic format to facilitate tracking, claim denial reviews and further investigation as needed.

Sub Factor 1.7 – Customer Service and Communication Process (2 pages maximum): In order to communicate information about the program to providers and pharmacies, the Offeror shall be responsible for establishing dedicated phone lines. Describe how inquiries from providers will be tracked, serviced and escalated as needed.

The Offeror shall detail all other customer service techniques and tools it plans to implement to support the program.

The most comprehensive customer service communication plans will be rated most highly.

Sub Factor 1.8 – Fraud and Abuse Prevention (3 pages maximum): The Offeror shall detail those processing and due diligence steps required to meet or exceed the Government’s minimum requirements for Fraud and Abuse Prevention. Using the assumptions about access to patient lists and previous claims as outlined in the Statement of Work, the Offeror shall describe how these data sources will be combined with the Offeror’s own processes and tools to facilitate Fraud and Abuse Prevention before claim payment is made. The comprehensiveness of the plans and its relation to the Government’s minimum standard shall be the basis for this rating.

FACTOR 2: PROJECT MANAGEMENT APPROACH

Sub Factor 2.1 – Management Structure (3 pages maximum not including resumes): The Offeror shall identify the management structure for this project--including the project manager and the corporate executive who will be responsible for the account. A draft organization chart will be provided outlining the roles and resources which are planned to support the account. Resumes shall be provided as attachments to the proposal for the project manager and the corporate executive. The experience of the management team, the clarity of the roles and responsibilities, and the manner in which those roles and responsibilities will affect the desired outcomes of the statement of work shall be the basis for this rating.

Sub Factor 2.2 – Project Management Plan (Draft Project Management Plan) (3 pages maximum): A draft Project Management Plan shall be provided as an attachment to the proposal. The Project Management Plan shall include the Offeror’s approach for risk management, and identify the top risks and associated mitigation strategies that the Offeror sees for the project. The clarity and the relation with how the plan will aid in achieving the goals of this program shall be the basis for the rating of this element.

EVALUATION METHODOGY

Responses will be evaluation using Lowest Price Technically Acceptable approach. Technical capability is first important/more than the Price factor. Each offeror will be evaluated using the Mandatory Criteria above as Acceptable or Unacceptable. Unacceptable responses will not be considered. Once a pool of technically acceptable offerers is established, the Offeror that presents the lowest price quote to the Government will be selected.

EVALUATION RATING DEFINITIONS

• Acceptable:

o Ability to become fully operational to perform EPAP within 10 days of contract being awarded.

o Ensure the EPAP program is activated and operational within 24 hours of receiving activation notification or task order.

o Ensure all enrolled pharmacies in the affected areas are notified of EPAP activation through fax, email message, and/or text message.

o Ensure access to covered prescription drugs, medical supplies, and DME determined by preset formulary for eligible individuals who present a valid prescription at enrolled pharmacies across the nation during a qualifying event, at no cost to the affected individual.

o Implement or use existing systems that enables real-time point-of-sale eligibility checks and edits for claims where the pharmacist has found no coverage or limit coverage (co-payment) dispensing of EPAP covered drugs, specific medical supplies, and DME to eligible individuals.

o Provide timely reports and relevant information of EPAP claims, eligibility checks, call-center activities, pharmacy communications, and pharmacy payments to ASPR.

o Participate in disaster-related conference calls, as identified by ASPR, to facilitate communications.

o Adjudicate payment of legitimate pharmacy claims from network pharmacies on an as-needed basis.

o Solicit enrollment of legitimate pharmacies (to include during activation) into EPAP nation-wide network

• Unacceptable:

o Inability to become fully operational to perform EPAP within 10 days of contract being awarded.

o Inability to ensure the EPAP program is activated and operational within 24 hours of receiving activation notification or task order.

o Inability to meet any of the acceptable technical requirements.

Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party.

Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

SOLICITATION PROVISIONS:

FAR 52.212-3, Offeror Representations and Certifications—Commercial Items - Offerors must include a completed copy of the provision at with its offer.

FAR 52.212-4, Contract Terms and Conditions—Commercial Items, applies to this acquisition and a statement regarding any addenda to the clause.

FAR 52.212-5, Contract Terms and Conditions Required To Implement Statutes or Executive Orders—Commercial Items, applies to this acquisition. In addition, the following provisions also are applicable to the acquisition:

FAR 52.203-6, Restrictions on Subcontract Sales to the Government FAR 52.203-13, Contractor Code of Business Ethics and Conduct FAR 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards FAR 52.209-6, Protecting the Governments Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment FAR 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters FAR 52.219-6, Notice of Total Small Business Set-Aside FAR 52-222-3, Convict Labor FAR 52.222-19, Child Labor – Cooperation with Authorities and Remedies FAR 52.222-21, Prohibition of Segregated Facilities FAR 52.222-26, Equal Opportunity FAR 52.222-35, Equal Opportunity for Veterans FAR 52.222-36, Equal Opportunity for Workers with Disabilities FAR 52.222-37, Employment Reports on Veterans FAR 52.222-40, Notification of Employee Rights Under the National Labor Relations Act FAR 52.222-51 Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment - Requirements FAR 52.222-54, Employment Eligibility Verification FAR 52.225-3, Buy American – Free Trade Agreements – Israeli Trade Act FAR 52.225-13, Restrictions on Certain Foreign Purchases FAR 52.232-33 Payment by Electronic Funds Transfer – System for Award Management

ADDITIONAL CLAUSES:

FAR 52.216-19 -- Order Limitations (Oct 1995)

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than _____________ [insert dollar figure or quantity], the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor --

(1) Any order for a single item in excess of _____________ [insert dollar figure or quantity];

(2) Any order for a combination of items in excess of ______________ [insert dollar figure or quantity];

or

(3) A series of orders from the same ordering office within _____________ days that together call for quantities exceeding the limitation in subparagraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within _____ days after issuance, with written notice stating the Contractor’s intent not to ship the item (or items) called for https://acquisition.gov/far/current/html/52_212_213.html%23wp1179194 https://acquisition.gov/far/current/html/52_212_213.html%23wp1179465 https://acquisition.gov/far/current/html/52_212_213.html%23wp1203358 and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

FAR 52.216-21 – Requirements (Oct 1995)

(a) This is a requirements contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies or services specified in the Schedule are estimates only and are not purchased by this contract. Except as this contract may otherwise provide, if the Government’s requirements do not result in orders in the quantities described as “estimated’’ or “maximum” in the Schedule, that fact shall not constitute the basis for an equitable price adjustment.

(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. Subject to any limitations in the Order Limitations clause or elsewhere in this contract, the Contractor shall furnish to the Government all supplies or services specified in the Schedule and called for by orders issued in accordance with the Ordering clause. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.

(c) Except as this contract otherwise provides, the Government shall order from the Contractor all the supplies or services specified in the Schedule that are required to be purchased by the Government activity or activities specified in the Schedule.

(d) The Government is not required to purchase from the Contractor requirements in excess of any limit on total orders under this contract.

(e) If the Government urgently requires delivery of any quantity of an item before the earliest date that delivery may be specified under this contract, and if the Contractor will not accept an order providing for the accelerated delivery, the Government may acquire the urgently required goods or services from another source.

(f) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor’s and Government’s rights and obligations with respect to that order to the same extent as if the order were completed during the contract’s effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after _________________ [insert date].

FAR 52.217-3 -- Evaluation Exclusive of Options (Apr 1984).

The Government will evaluate offers for award purposes by including only the price for the basic requirement; i.e., options will not be included in the evaluation for award purposes.

FAR 52.217-5 -- Evaluation of Options (Jul 1990) Except when it is determined in accordance with FAR 17.206(b) not to be in the Government’s best interests, the Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. Evaluation of options will not obligate the Government to exercise the option(s).

FAR 52.217-8 -- Option to Extend Services.

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within ______ [insert the period of time within which the Contracting Officer may exercise the option].

FAR 52.217-9 -- Option to Extend the Term of the Contract.

(a) The Government may extend the term of this contract by written notice to the Contractor within _____ [insert the period of time within which the Contracting Officer may exercise the option]; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least ___ days [60 days unless a different number of days is inserted] before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed ___________ (months)(years).

Quotes and Submissions must be received no later than 5:00 P.M. EST, October 13, 2015. Quotes and Quotation/proposal submissions received after the time and date specified will be determined to be late and may not be considered.

Questions and Comments: The Government welcomes questions regarding this RFQ. Questions and comments will be accepted by the point of contact identified herein via email until 5:00 P.M. EST, October 9, 2015. No other form of questions or comments will be accepted. Responses to all questions will be publicly posted to www.fbo.gov.

ASPR prefers that all submittals, including attachments, be submitted electronically to roshawn.simpson@hhs.gov and Francine.hemphill@hhs.gov.

If e-mail is your method of submission, please include “HHS/ASPR EPAP REQUIREMENT – SHORT TERM” Quotation/proposal/Quote Submission (Contractors Name and DUNS)/CIPP)” in the subject line of your e-mail. Information provided will not be released but please mark PROPRIETARY on all documents submitted.

Attach a copy of System for Award Management (SAM) Report no later than the response date stated in this notice.

http://www.fbo.gov/ mailto:roshawn.simpson@hhs.gov mailto:Francine.hemphill@hhs.gov