36C10B22R0021_4.docx

36C10B22R0021

GENERAL INFORMATION

SET-ASIDE

Technology Acquisition Center

23 Christopher Way Eatontown NJ 07724

POINT OF CONTACT*

Contract Specialist Joseph Vivolo Joseph.Vivolo1@va.gov 848-377-5105

PLACE OF PERFORMANCE

ADDRESS

POSTAL CODE

COUNTRY

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

DESCRIPTION

Amendment to a Previous Combined Solicitation

Amendment to a Previous Combined Solicitation This amendment is to correct the due date in box 8 of form SF 1449 to 8/19/2022 at 1PM EDT.

Page 1 of

Amendment to a Previous Combined Solicitation

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C10B22R0021 Joseph Vivolo 848-377-5105 08- -2022 p m

EDT

C 10B Department of Veterans Affairs Technology Acquisition Center 23 Christopher Way Eatontown NJ 07724 X N/A X See Delivery Schedule

C 10B Department of Veterans Affairs Technology Acquisition Center 23 Christopher Way Eatontown NJ 07724

C B Department of Veterans Affairs Technology Acquisition Center Financial Services Center PO Box 149971 Austin TX 78714-8971 See Section B Contract Type: Firm-Fixed Price Contracting Officer: Kendra Casebolt, Kendra.Casebolt@va.gov Contract Specialist: Joseph Vivolo, Joseph.Vivolo@va.gov Clearinghouse Services Period of Performance: 12 Months from Date of Award and four

(4) 12-month option periods X X Kendra M.

Casebolt Contracting Officer Page 1 of Page 1 of Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: TBD

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 SUBCONTRACTING COMMITMENTS-MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

B.3 GOVERNING LAW CLAUSE

Federal law and regulations, including the Federal Acquisition Regulations (FAR), shall govern this Contract. Commercial license agreements may be made a part of this Contract but only if both parties expressly make them an addendum hereto. If the commercial license agreement is not made an addendum, it shall not apply, govern, be a part of or have any effect whatsoever on the Contract; this includes, but is not limited to, any agreement embedded in the computer software (clickwrap), any agreement that is otherwise delivered with or provided to the Government with the commercial computer software or documentation (shrinkwrap), or any other license agreement otherwise referred to in any document. If a commercial license agreement is made an addendum, only those provisions addressing data rights regarding the Government’s use, duplication and disclosure of data (e.g., restricted computer software) are included and made a part of this Contract, and only to the extent that those provisions are not duplicative or inconsistent with Federal law, Federal regulation, the incorporated FAR clauses and the provisions of this Contract; those provisions in the commercial license agreement that do not address data rights regarding the Government’s use, duplication and disclosure of data shall not be included or made a part of the Contract. Federal law and regulation including, without limitation, the Contract Disputes Act (41 U.S.C. § 7101 et seq.), the Anti-Deficiency Act (31 U.S.C. § 1341 et seq.), the Competition in Contracting Act (41 U.S.C. § 3301 et seq.), the Prompt Payment Act (31 U.S.C. §3901 et seq.), Contracts for Data Processing or Maintenance (38 USC § 5725), and FAR clauses 52.212-4, 52.227-14, 52.227-19 shall supersede, control, and render ineffective any inconsistent, conflicting, or duplicative provision in any commercial license agreement. In the event of conflict between this Clause and any provision in the Contract or the commercial license agreement or elsewhere, the terms of this Clause shall prevail. Claims of patent or copyright infringement brought against the Government as a party shall be defended by the U.S. Department of Justice (DOJ). 28 U.S.C. § 516. At the discretion of DOJ, the Contractor may be allowed reasonable participation in the defense of the litigation. Any additional changes to the Contract must be made by contract modification (Standard Form 30) and shall only be effected by a warranted Contracting Officer. Nothing in this Contract or any commercial license agreement shall be construed as a waiver of sovereign immunity.

B.4 SOFTWARE LICENSE, MAINTENANCE, AND TECHNICAL SUPPORT:

1. Definitions.

(a) Licensee. The term “licensee” shall mean the U.S. Department of Veterans Affairs (“VA”) and is synonymous with “Government.”

(b) Licensor. The term “licensor” shall mean the contractor having the necessary license or ownership rights to deliver license, software maintenance and support of the computer software being acquired. The term “contractor” is the party identified in Block 17a on the SF1449. If the contractor is a reseller and not the Licensor, the contractor remains responsible for performance under this Contract.

(c) Software. The term “software” shall mean the licensed computer software product(s) cited in the Schedule of Supplies/Services.

(d) Maintenance. The term “maintenance” is the process of enhancing and optimizing software, as well as remedying defects. It shall include all new fixes, patches, releases, updates, versions and upgrades, as further defined below.

(e) Technical Support. The term “technical support” refers to the range of services providing assistance for the software via the telephone, email, a website or otherwise.

(f) Release or Update. The term “release” or “update” are terms that refer to a revision of software that contains defect corrections, minor enhancements or improvements of the software’s functionality. This is usually designated by a change in the number to the right of the decimal point (e.g., from Version 5.3 to 5.4). An example of an update is the addition of new hardware.

(g) Version or Upgrade. The term “version” or “upgrade” are terms that refer to a revision of software that contains new or improved functionality. This is usually designated by a change in the number to the left of the decimal point (e.g., from Version 5.4 to 6).

1. Software License

(a) Unless otherwise stated in the Schedule of Supplies/Services, the Performance Work Statement or Product Description, the software license provided to the Government is a perpetual, nonexclusive license to use the software

(b) The Government may use the software in a networked environment.

(c) Any dispute regarding the license grant or usage limitations shall be resolved in accordance with the Disputes Clause incorporated in FAR 52.212-4(d).

(d) All limitations of software usage are expressly stated in the Schedule of Supplies/Services and the Performance Work Statement/Product Description.

1. Software Maintenance and Technical Support

(a) If the Government desires to continue software maintenance and support beyond the period of performance identified in this contract or, the Government will issue a separate contract for maintenance and support. Conversely, if a contract for continuing software maintenance and technical support is not received the contractor is neither authorized nor permitted to renew any of the previously furnished services.

(b) The contractor shall provide software support services, which includes periodic updates, enhancements and corrections to the software, and reasonable technical support, all of which are customarily provided by the contractor to its commercial customers so as to cause the software to perform according to its specifications, documentation or demonstrated claims.

(c) Any telephone support provided by contractor shall be at no additional cost.

(d) The contractor shall provide all maintenance services in a timely manner in accordance with the contractor’s customary practice or as defined in the Performance Work Statement/Product Description. However, prolonged delay (exceeding 2 business days) in resolving software problems will be noted in the Government’s various past performance records on the contractor (e.g., www.ppirs.gov).

(e) If the Government allows the maintenance and support to lapse and subsequently wishes to reinstate it, any reinstatement fee charged shall not exceed the amounts that would have been charged if the Government had not allowed the subscription to lapse.

1. Disabling Software Code. The Government requires delivery of computer software that does not contain any code that will, upon the occurrence or the nonoccurrence of any event, disable the software. Such code includes but is not limited to a computer virus, restrictive key, node lock, time-out or other function, whether implemented by electronic, mechanical, or other means, which limits or hinders the use or access to any computer software based on residency on a specific hardware configuration, frequency of duration of use, or other limiting criteria. If any such disabling code is present, the contractor agrees to indemnify the Government for all damages suffered as a result of a disabling caused by such code, and the contractor agrees to remove such code upon the Government’s request at no extra cost to the Government. Inability of the contractor to remove the disabling software code will be considered an inexcusable delay and a material breach of contract, and the Government may exercise its right to terminate for cause. In addition, the Government is permitted to remove the code as it deems appropriate and charge the Contractor for consideration for the time and effort expended in removing the code.

Manuals and Publications. Upon Government request, the contractor shall furnish the most current version of the user manual and publications for all products/services provided under this contract or order at no additional cost.

B.5 PRICE SCHEDULE

NOTE: Vendors are instructed to complete Section B.5 and submit with their quote.

Vendors are cautioned that alterations to the line items as specified below may render quotes unacceptable. All questions shall be directed to the Contract Specialist, Joseph Vivolo, Joseph.Vivolo1@va.gov, (848)-377-5105 prior to the closing date and time specified in Block 8 on page 1 of the SF 1449.

Base Period Period of Performance shall be 12 months from date of award.

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Due within six (6) months from award date.

Due at least 30 days prior to the scheduled assessment

Due five (5) days after receipt of Government comments, in hard copy.

Due five (5) days after receipt of Government comments, in hard copy.

Updates shall be with input, coordination and approval from an assigned agency Information Security Officer (ISO) and an agency Service, Delivery, and Engineering (SDE) representative.

Updates to the roster are requested per change in staffing/personnel after the initial roster submission 3 days after contract award. Requires COR/PM confirmation.

Option Period One Period of Performance shall be 12 months from date of exercise.

This 12-month option period may be exercised in accordance with FAR 52.217-9 Option to Extend the Term of the Contract (MAR 2000). Work shall not commence until, and unless, a formal modification is issued by the Contracting Officer. If exercised, this option period shall commence immediately after expiration of the Base Period.

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Option Period Two Period of Performance shall be 12 months from date of exercise.

This 12-month option period may be exercised in accordance with FAR 52.217-9 Option to Extend the Term of the Contract (MAR 2000). Work shall not commence until, and unless, a formal modification is issued by the Contracting Officer. If exercised, this option period shall commence immediately after expiration of Option Period One.

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Total Option Period Two

Option Period Three Period of Performance shall be 12 months from date of exercise.

This 12-month option period may be exercised in accordance with FAR 52.217-9 Option to Extend the Term of the Contract (MAR 2000). Work shall not commence until, and unless, a formal modification is issued by the Contracting Officer. If exercised, this option period shall commence immediately after expiration of Option Period Two.

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Total Option Period Three

Option Period Three Period of Performance shall be 12 months from date of exercise.

This 12-month option period may be exercised in accordance with FAR 52.217-9 Option to Extend the Term of the Contract (MAR 2000). Work shall not commence until, and unless, a formal modification is issued by the Contracting Officer. If exercised, this option period shall commence immediately after expiration of Option Period Two.

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B.6 PERFORMANCE WORK STATEMENT

36C10B22R0021

Page 1 of Page 1 of Page 1 of Page 1 of Page 1 of

PERFORMANCE WORK STATEMENT (PWS)

DEPARTMENT OF VETERANS AFFAIRS

Financial Services Center Financial Healthcare Service

Clearinghouse Services

Date: 7/8/22

VA-22-00078220

PWS Version Number: 2.0

36C10B19R0029

Page 1 of

1.0 BACKGROUND

The Department of Veterans Affairs (VA), Financial Services Center (FSC) is authorized by the Government Management Reform Act of 1994 (Public Law 103-356) to provide common administrative support services on a reimbursement basis to VA and Other Government Agencies (OGA’s), as a Franchise Fund. The goals of the Franchise Fund organization include:

One of the FSC product offerings is receipt and processing of medical claims. The FSC currently utilizes a Contractor to transmit incoming and outgoing electronic transactions to the national Payer community. Various transaction formats are utilized, such as HIPAA Healthcare Claim Payment (X12 5010) and National Council for Prescription Drug Program (NCPDP) transactions. FSC transactions are completed as batch and real-time transfers. The Contractor provides reports to VHA on transaction activity for reconciliation, auditing and billing purposes.

2.0 APPLICABLE DOCUMENTS

In the performance of the tasks associated with this Performance Work Statement, the Contractor shall comply with the following:

1. 44 U.S.C. § 3541-3549, “Federal Information Security Management Act (FISMA) of 2002”

2. “Federal Information Security Modernization Act of 2014”

3. Federal Information Processing Standards (FIPS) Publication 140-2, “Security Requirements For Cryptographic Modules”

4. FIPS Pub 199. Standards for Security Categorization of Federal Information and Information Systems, February 2004

5. FIPS Pub 200, Minimum Security Requirements for Federal Information and Information Systems, March 2016

6. FIPS Pub 201-2, “Personal Identity Verification of Federal Employees and Contractors,” August 2013

7. 10 U.S.C. § 2224, "Defense Information Assurance Program"

8. Carnegie Mellon Software Engineering Institute, Capability Maturity Model® Integration for Development (CMMI-DEV), Version 1.3 November 2010; and Carnegie Mellon Software Engineering Institute, Capability Maturity Model® Integration for Acquisition (CMMI-ACQ), Version 1.3 November 2010

9. 5 U.S.C. § 552a, as amended, “The Privacy Act of 1974”

10. Public Law 109-461, Veterans Benefits, Health Care, and Information Technology Act of 2006, Title IX, Information Security Matters

11. 42 U.S.C. § 2000d “Title VI of the Civil Rights Act of 1964”

12. VA Directive 0710, “Personnel Security and Suitability Program,” June 4, 2010, https://www.va.gov/vapubs/index.cfm

13. VA Handbook 0710, Personnel Security and Suitability Program, May 2, 2016, https://www.va.gov/vapubs/index.cfm

14. VA Directive and Handbook 6102, “Internet/Intranet Services,” August 5, 2019

15. 36 C.F.R. Part 1194 “Information and Communication Technology Standards and Guidelines,” January 18, 2017

16. Office of Management and Budget (OMB) Circular A-130, “Managing Federal Information as a Strategic Resource,” July 28, 2016

17. 32 C.F.R. Part 199, “Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)”

18. National Uniform Billing Committee (NUBC), http://www.nubc.org/

19. National Uniform Claim Committee (NUCC), http://www.nucc.org/

20. 16. National Council for Prescription Drug Programs (NCPDP), https://www.ncpdp.org/

21. NIST SP 800-66 Rev. 1, An Introductory Resource Guide for Implementing the Health Insurance Portability and Accountability Act (HIPAA) Security Rule, October 2008

22. Sections 504 and 508 of the Rehabilitation Act (29 U.S.C. § 794d), as amended, January 18, 2017

23. Homeland Security Presidential Directive (12) (HSPD-12), August 27, 2004

24. VA Directive 6500, “VA Cybersecurity Program,” January 24, 2019 VA Handbook 6500, “Risk Management Framework for VA Information Systems – Tier 3: VA Information Security Program,” March 10, 2015

25. VA Handbook 6500.2, “Management of Breaches Involving Sensitive Personal Information (SPI)”, July 28, 2016

26. VA Handbook 6500.3, “Assessment, Authorization, And Continuous Monitoring Of VA Information Systems,” February 3, 2014

27. VA Handbook 6500.5, “Incorporating Security and Privacy into the System Development Lifecycle”, March 22, 2010

28. VA Handbook 6500.6, “Contract Security,” March 12, 2010

29. VA Handbook 6500.8, “Information System Contingency Planning”, April 6, 2011

30. VA Handbook 6500.11, “VA Firewall Configuration”, August 22, 2017

31. OI&T Process Asset Library (PAL), https://www.va.gov/process/ . Reference Process Maps at https://www.va.gov/process/maps.asp and Artifact templates at https://www.va.gov/process/artifacts.asp

32. One-VA Technical Reference Model (TRM) (reference at https://www.va.gov/trm/TRMHomePage.aspx)

33. VA Directive 6508, “Implementation of Privacy Threshold Analysis and Privacy Impact Assessment,” October 15, 2014

34. VA Handbook 6508.1, “Procedures for Privacy Threshold Analysis and Privacy Impact Assessment,” July 30, 2015

35. VA Handbook 6510, “VA Identity and Access Management”, January 15, 2016

36. VA Directive and Handbook 6513, “Secure External Connections”, October 12, 2017

37. VA Directive 6300, Records and Information Management, September 21, 2018

38. VA Handbook, 6300.1, Records Management Procedures, March 24, 2010

39. NIST SP 800-37 Rev 1, Risk Management Framework for Information Systems and Organizations: A System Life Cycle Approach for Security and Privacy, December 2018

40. NIST SP 800-53 Rev. 4, Security and Privacy Controls for Federal Information Systems and Organizations, January 22, 2015

41. OMB Memorandum, “Transition to IPv6”, September 28, 2010

42. VA Directive 0735, Homeland Security Presidential Directive 12 (HSPD-12) Program, October 26, 2015

43. VA Handbook 0735, Homeland Security Presidential Directive 12 (HSPD-12) Program, March 24, 2014

44. OMB Memorandum M-06-18, Acquisition of Products and Services for Implementation of HSPD-12, June 30, 2006

45. OMB Memorandum 04-04, E-Authentication Guidance for Federal Agencies, December 16, 2003

46. OMB Memorandum 05-24, Implementation of Homeland Security Presidential Directive (HSPD) 12 – Policy for a Common Identification Standard for Federal Employees and Contractors, August 5, 2005

47. OMB memorandum M-11-11, “Continued Implementation of Homeland Security Presidential Directive (HSPD) 12 – Policy for a Common Identification Standard for Federal Employees and Contractors, February 3, 2011

48. OMB Memorandum, Guidance for Homeland Security Presidential Directive (HSPD) 12 Implementation, May 23, 2008

49. Federal Identity, Credential, and Access Management (FICAM) Roadmap and Implementation Guidance, December 2, 2011

50. NIST SP 800-116 Rev 1, Guidelines for the Use of Personal Identity Verification (PIV) Credentials in Facility Access, June 2018

51. OMB Memorandum M-07-16, Safeguarding Against and Responding to the Breach of Personally Identifiable Information, May 22, 2007

52. NIST SP 800-63-3, 800-63A, 800-63B, 800-63C, Digital Identity Guidelines, December 2017

53. NIST SP 800-157, Guidelines for Derived PIV Credentials, December 2014

54. NIST SP 800-164, Guidelines on Hardware-Rooted Security in Mobile Devices (Draft), October 2012

55. Draft National Institute of Standards and Technology Interagency Report (NISTIR) 7981 Mobile, PIV, and Authentication, March 2014

56. VA Memorandum, VAIQ #7100147, Continued Implementation of Homeland Security Presidential Directive 12 (HSPD-12), April 29, 2011 (reference https://www.voa.va.gov/documentlistpublic.aspx?NodeID=514)

57. IAM Identity Management Business Requirements Guidance document, May 2013, (reference Enterprise Architecture Section, PIV/IAM (reference https://www.voa.va.gov/documentlistpublic.aspx?NodeID=514)

58. VA Memorandum “Personal Identity Verification (PIV) Logical Access Policy Clarification,” July 17, 2019, https://www.voa.va.gov/DocumentView.aspx?DocumentID=4896

59. Trusted Internet Connections (TIC) Reference Architecture Document, Version 2.2, Federal Interagency Technical Reference Architectures, Department of Homeland Security, June 19, 2017, https://www.dhs.gov/sites/default/files/publications/TIC_Ref_Arch_v2.2_2017.pdf

60. OMB Memorandum M-08-05, “Implementation of Trusted Internet Connections (TIC), November 20, 2007

61. OMB Memorandum M-08-23, Securing the Federal Government’s Domain Name System Infrastructure, August 22, 2008

62. VA Memorandum, VAIQ #7497987, Compliance – Electronic Product Environmental Assessment Tool (EPEAT) – IT Electronic Equipment, August 11, 2014 (reference Document Libraries, EPEAT/Green Purchasing Section, https://www.voa.va.gov/documentlistpublic.aspx?NodeID=552)

63. Sections 524 and 525 of the Energy Independence and Security Act of 2007, (Public Law 110–140), December 19, 2007

64. Section 104 of the Energy Policy Act of 2005, (Public Law 109–58), August 8, 2005

65. Executive Order 13834, “Efficient Federal Operations”, dated May 17, 2018

66. Executive Order 13221, “Energy-Efficient Standby Power Devices,” August 2, 2001

67. VA Directive 0058, “VA Green Purchasing Program”, July 19, 2013

68. VA Handbook 0058, “VA Green Purchasing Program”, July 19, 2013

69. Office of Information Security (OIS) VAIQ #7424808 Memorandum, “Remote Access”, January 15, 2014, https://www.voa.va.gov/DocumentListPublic.aspx?NodeId=28

70. Clinger-Cohen Act of 1996, 40 U.S.C. §11101 and §11103

71. “Veteran Focused Integration Process (VIP) Guide 3.2”, December 2018, https://www.voa.va.gov/DocumentView.aspx?DocumentID=4371

72. VA Memorandum “Proper Use of Email and Other Messaging Services”, January 2, 2018, https://www.voa.va.gov/DocumentListPublic.aspx?NodeId=28

73. X12 Technical Standard 005010X222A2, https://x12.org/products

74. X12 Technical Standard 005010X223A1, https://x12.org/products

75. X12 Technical Standard 005010X224A2, https://x12.org/products

76. X12 Technical Standard 005010X214, https://x12.org/products

77. X12 Technical Standard 005010X221A1, https://x12.org/products

78. X12 Technical Standard 005010X231A1, https://x12.org/products

79. X12 Technical Standard 005010X279A1, https://x12.org/products

80. X12 Technical Standard 005010X212, https://x12.org/products

3.0 SCOPE OF WORK

The Financial Services Center (FSC) requires electronic clearinghouse support services. The Contractor shall provide support for all of FSC’s current electronic transactions across the United States and its territories. The Contractor shall implement electronic transactions and to support printing of standard claim forms in certain situations where electronic transmission is not feasible, to assist the FSC in continuing its mission to. As such, FSC is required to comply with the Health Insurance Portability and Accountability (HIPPA) Act of 1996 Transaction and Code Set (TCS) regulations.

4.0 PERFORMANCE DETAILS

4.1 PERFORMANCE PERIOD

The period of performance for the one (1), 12-month base period with four (4), 12- month option periods.

Any work at the Government site shall not take place on Federal holidays or weekends unless directed by the Contracting Officer (CO).

There are ten (11) Federal holidays set by law (USC Title 5 Section 6103) that VA follows:

Under current definitions, five are set by date:

If any of the above falls on a Saturday, then Friday shall be observed as a holiday. Similarly, if one falls on a Sunday, then Monday shall be observed as a holiday.

The other six are set by a day of the week and month:

4.2 PLACE OF PERFORMANCE

Tasks under this PWS shall be performed at Contractor facilities. The Contractor shall identify the Contractor’s place of performance in their proposal submission.

4.3 TRAVEL

The Government does not anticipate any travel.

5.0 SPECIFIC TASKS AND DELIVERABLES

The Contractor shall perform the following:

5.1 PROJECT MANAGEMENT

5.1.1 PROJECT KICK-OFF MEETING

The Contractor shall conduct a project kick-off meeting with a project advisory group comprised of key stakeholders and subject matter experts (SMEs) to be identified by the VA PM. The Contractor shall schedule the kick-off meeting to be held within ten (10) business days after task order award. At the Kick-Off Meeting, the Contractor shall present the details of its intended approach, work plan and project schedule including deliverable dates for review and approval by the advisory group. Work shall not commence until the VA PM approves the approach/methodology, work plan and schedule on behalf of the project advisory group. The Contractor shall produce and distribute pertinent information that documents the conduct, actions, and decisions resulting from the kick-off meeting as part of the monthly status report.

5.1.2 REPORTING REQUIREMENTS

The Contractor shall provide a Daily Status report. The Daily Status Report shall consist of the following elements:

1. 837 Claims sent (Institutional, Professional, Dental) by batch, Payer ID and source.

2. 837 Claims rejected (Institutional, Professional, Dental) by batch, Payer ID and source.

The Contractor shall provide a Weekly Status Report. The Weekly Status Report shall consist of the following elements:

The Contractor shall provide a Monthly Status Report. The Monthly Status Report shall consist of the following elements:

The Contractor shall deliver on an annual basis rendered images of electronic claims received for auditing purposes, which shall consist of the following elements:

Deliverables:

5.1.3 VA PRIVACY AND HIPAA TRAINING

The Contractor shall complete HIPAA and VA Privacy and Information Security Awareness training for all individuals engaged on the task. The status reporting shall identify; a single Contractor Security POC, the names of all personnel engaged on the task, their initial training date for training, and their next required training date.

The Contractor shall submit training certificates in accordance with Section 9, Training, from Appendix C of the VA Handbook 6500.6, “Contract Security”.

Deliverable:

A. HIPAA and VA Privacy and Information Security Training Certificates

5.2 KEY REQUIREMENTS

1. The Contractor shall adhere to Federal Information Security Management Compliance (FISMA) at the time of proposal submission and maintain compliance for the duration of the contract.

2. The Contractor shall be a fully “Accredited Healthcare Network” (HNAP-EHN and ePAP-EHN accredited) by the Electronic Healthcare Network Accreditation Commission (EHNAC) (https://www.ehnac.org/) at the time of proposal submission and maintain accreditation for the duration of the Contract.

3. The Contractor shall be certified by the Council for Affordable and Quality Healthcare (CAQH), as a CORE Phase II Certified Contractor for both batch and real-time eligibility benefits HIPAA Eligibility Transactions (270/271) and maintain certification for the duration of the Contract.

4. The Contractor shall work towards future Committee of Operating Rules and Information Exchange (CORE Phase III) and any other future phase certifications within two (2) years from the award date.

5. An Interconnection Security Agreement (ISA)/Memorandum of Understanding (MOU) (ISA/MOU) and Business Associate Agreement (BAA) are required. The Contractor shall be required to work with the necessary VA staff to complete these documents and support the approval process for the ISA/MOU within six (6) months from award date.

5.3 CLEARINGHOUSE SERVICES

The Contractor shall perform the following tasks within the base period of performance and option periods, if exercised:

1. Receive and document receipt date of electronic medical claims from providers.

2. Validate the electronic medical claims data using FSC provided required information (a.k.a. edits). FSC will provide business rules and edits upon award. Business rules may vary between paper claims and electronic claims.

3. Create HIPAA compliant 837 transaction files based on the validated electronic medical claims data.

4. Receive encrypted TIFF images from the FSC and convert those TIFF images into HIPAA compliant 837 transaction files within two (2) business days of receipt of the TIFF images. For scanned images, the Contractor shall use the date the claim was scanned into a TIFF image for the BHT04 field. The Contractor shall include an index file for each batch of paper claims scanned. Index files shall include the following data elements, at a minimum: Patient ID, Document Locator Number (DLN), Provider’s Tax ID Number (TIN), either HCFA1500 or UB92, Patient First Name and Patient Last Name.

5. Electronically transmit the encrypted HIPAA compliant 837 transaction files to the FSC. Contractor shall have the ability to include, exclude, or alter the content of any segment or data element in the claim files to meet VAFSC’s business needs. Contractor shall have the ability to consume response transactions (999, 277CA, and 835) created by FSC for both paper and electronic claims and deliver such data back to claim submitters.

6. Contractor shall have the ability to transmit, receive, and consume health care transactions in the currently adopted HIPAA X12 5010 format from various entities, including providers, central billing offices, billing services, and health care claim clearinghouses. In addition, Contractor shall have the ability to create and deliver HIPAA-compliant 277CA transactions for all claims received from other entities, reporting the acceptance or rejection of those claims with the associated rejection reasons.

7. Support at a minimum the following transactions and relevant code sets as applicable:

a. CMS-1500 Claims Optical Character Recognition (OCR)

b. CMS-1450 Claims Uniform Billing (UB) Optical Character Recognition (OCR)

c. ADA Dental Forms Optical Character Recognition (OCR)

d. 837 Health Care Claims (Institutional, Professional, Dental)

e. 835 Health Care Claim Payment/Advice

8. Send and receive electronic acknowledgements for X12 Interchange Envelopes and Standard Conformance for HIPAA X12 transactions to and from FSC or its submitters.

9. Implement the following transactions with FSC:

a. 837 Professional, Dental, Institutional using batch transactions

b. Acknowledgements 999, 824, 277CA for both paper and electronic claims. The Contractor shall send acknowledgements for paper claims to the billing provider via first class mail.

c. Coordination of Benefits (COB) payer to payer claims

d. Healthcare Financing Administration (HCFA) OCR Dental, 270/271, 275 transactions, including all attachments, 276/277 and 278.

10. Provide and implement plans to migrate to future adopted versions of paper institutional and noninstitutional health care claims 90 days prior to the deadline imposed by industry. The transition process shall allow VA and the Contractor 30 days for testing of the new versions to assure compliance with the National Uniform Billing Committee (NUBC), National Uniform Claim Committee (NUCC) and National Council for Prescription Drug Programs (NCPDP) mandated requirements.

11. Contractor shall have the ability to apply validation rules (edits) to submitted claims based on the Workgroup for Electronic Data Interchange (WEDI) Strategic National Implementation Process (SNIP) up to WEDI-SNIP level 5 (external code set testing). Contractor shall also have the ability to immediately enable or disable any WEDI-SNIP edit at VAFSC’s request. Contractor must be able to construct and apply additional custom claims edits, with logic defined by FSC, for the validation of claim data. Contractor shall reject claims failing to meet the requirement of any edit, and exclude such claims from the data ultimately delivered to FSC. When rejecting claims, the Contractor shall notify the submitter why the claim was rejected.

12. The Contractor shall perform its proposed step by step methodology for its validation process which includes business rules that can be changed through configuration management instead of code changes and describing how code changes are tested in a pre-production environment before going live with the change.

13. Contractor shall have the ability to reprocess, upon request from FSC, any number of individual claims, with such reprocessing including re-application of edits and/or the reconstruction of claim files for consumption by FSC. Contractor shall possess the necessary infrastructure to effectively reconcile all transactions processed. Contractor shall have the ability to deliver to VAFSC various reports about processed transactions, with content defined by VAFSC, in a manner defined by VAFSC, to recipients defined by VAFSC.

14. The Contractor shall have the ability to prevent sending duplicate claims/files to the FSC.

5.3.1 TRANSACTIONS

The Contractor shall complete the quantity of transactions as provided below.

Table 1: Anticipated Number of Transactions

Images 0-1,000 Images 0-1,000 Images 0-1,000 Images 0-1,000 Images

The Government may modify the contract to add additional transactions anytime during the period of performance, as long as the number of transactions does not exceed the ceiling limitations in the table below.

Table 2: Annual Transaction Ceilings

5.3.2 INVOICING

The Contractor shall submit invoices by Payer ID on a monthly basis given the quantity of transactions completed during each month.

5.4 TEMPORARY AUTHORITY TO OPERATE (TATO) / AUTHORITY…