QA_Polypharmacy 36C10B26R0004_1.20.26 .pdf

Department of Veterans Affairs (VA) Reducing Inappropriate Polypharmacy at the

Department of Veterans Affairs Solicitation 36C10B26R0004

Date: January 20, 2026

The following questions have been submitted for Reducing Inappropriate Polypharmacy at the Department of Veterans Affairs, Solicitation 36C10B26R0004. Please see Question and Answer matrix below for further details.

Note: The answers provided below are for informational purposes, to assist potential Offerors in preparing proposals, and such answers do not themselves constitute an amendment to the Request for Proposal (RFP).

Where questions and answers necessitated such an amendment, such changes have been or will be incorporated into a formal amendment to the RFP. To the extent that any answers provided below conflict in any way with the RFP and any Amendments, the final RFP takes precedence.

Quote Due Date: Wednesday, January 28, 2026 at 4:00PM EST.

# Ref Questions Response

1. In a Government competitive best value solicitation with evaluation factors, it is common to include the evaluation ratings and definitions the Government will use in the evaluation of each factor. This could include color ratings, levels of confidence, etc. with definitions of each. We have also seen definitions for strengths, weaknesses, deficiencies, risks, etc.

Other than the “acceptable” rating description for the Technical and Small Business Factor, the solicitation mentions “performance risk assessment”, “low performance risk”, “unacceptable”, “rating no less than “Acceptable”” without defining these relative terms.

Will definitions for these terms be provided to potential offerors?

Adjectival rating definitions will not be provided in the solicitation.

Formal definitions for strengths, weaknesses, deficiencies, risks, etc.

will also not be provided in the solicitation. The Government will evaluate proposals in strict accordance with the stated evaluation criteria.

2. Section C, paragraph C.8

Requires the Contractor to submit a Small Business Participation Report on a quarterly basis.

Yes, this is in addition to the semi-annual Individual Subcontract Report and the annual Summary Subcontract Report required in

FAR 52.219-9.

Please confirm this is in addition to the semi-annual Individual Subcontract Report and the annual Summary Subcontract Report required in FAR 52.219-9

3. Section E, paragraph E.9 Basis for Award

States, “To receive consideration for award, a rating of no less than “Acceptable” must be achieved for the Technical Factor and the Small Business Factor”. There is a “Small Business Participation Commitment” factor identified in the same paragraph.

Please confirm E.9 Basis for Award is referring to the small business requirement of 17.5% (and only that) found under Small Business Participation Commitment subparagraph of E.8 (iii) Volume III - Small Business Participation Commitment

Yes. E.8 Basis for Award refers to the small business requirement found under Small Business Participation Commitment subparagraph of E.8 (iii) Volume III - Small Business Participation Commitment. Please note the percentage has been revised from 17.5% to 10%. Refer to Amendment 2.

** Please note that Section E of solicitation has been renumbered.

Section E.9 is now E.8. Refer to Amendment 2. **

4. Section B.4 CLINs 5001 and 6001 show the unit price as not to exceed (NTE). Will NTE be removed since the unit price is fixed and not an NTE

Yes, NTE be removed since the unit price is fixed.

5. Section 5.2.1, paragraph 3

States that "The Contractor shall provide Source Code (in its original, human readable form), Configuration Files, Build and Deployment Scripts, Database Schemas, API Specifications, Technical and User Documentation, and any other implementation artifacts necessary to operate, maintain or modify the software. The Contractor shall provide updated versions of these documents as applicable." Further, in Addendum B, B.2a, it is stated that "The Government shall receive unlimited rights to data/intellectual property first produced and delivered in the performance of this contract or order (hereinafter “contract”) unless expressly stated otherwise in this contract. This includes all rights to

Regarding Section 5.2.1, paragraph 3, and Addendum B, B.2a, "first produced" refers to the Source Code and other materials developed specifically for contract 36C10B26R0004. Please refer to RFO Clause 52.227-14-Rights in Data- General, which is incorporated by reference.

source code and all documentation created in support thereof.

Please confirm that the definition of first produced means the Source Code and other referenced material only developed specifically for the requirements in 36C10B26R0004

6. Section 5.4.1 Notes that "All deployed services shall be available and functional to serve user requests at no less than 99.9% availability". Further in this section on page 57, it is stated that "The Contractor shall: 1. Operate and maintain the solution hosted in the VAEC in accordance with the application and VAEC SLAs and operate the solution in its current environment in parallel as applicable.

A. Since the Offeror is dependent on

Government system availability to deliver its service, please confirm the Offeror will not be held to the 99.9% SLA in situations out of its control, such as during times of Government system outages.

B. Is the Offeror responsible for hosting a second full solution in its environment?

A. Yes, the Offeror will not be held to the 99.9% SLA in situations out of its control, such as during times of Government system outages.

B. No, the Offeror is not responsible for hosting a second full solution in its environment.

7. Section 5.2.14 Training We note that in CLIN/SLIN 0002AZ that the training materials are due one week prior to training.

a. Is use of the Contractor’s commercially available materials and templates acceptable or is customization to be anticipated? Will use of VA templates be required?

b. Will the COR be reviewing and approving the training and documentation materials prior to the submission which is due one week prior to training? Or will Contractor’s materials be accepted as is?

a. Yes, Contractor materials are acceptable if they are adequate to train VA staff. If customization of materials is needed to meet that requirement then that is allowable.

VA templates are not required.

b. Yes, COR will be reviewing and approving the training and documentation materials one week prior to the presentation to ensure they meet training needs.

Discussion should occur prior to this.

8. Section D, Contract Documents, Exhibits, or Attachments.

Is the spreadsheet provided as Attachment 2 intended to be both the “report” referenced in C.8 Small Business Participation Requirements, and the “commitment” spreadsheet required as part of the proposal referenced in paragraph E.8 Submissions Instructions, Volume III Small Business Participation Commitment?

No, the spreadsheet provided as Attachment 2 is not intended to be both the “report” referenced in C.8 Small Business Participation Requirements, and the “commitment” spreadsheet required as part of the proposal referenced in paragraph E.8 Submissions Instructions, Volume III Small Business Participation Commitment.

Refer to Attachment 2 – Small Business Participation Commitment and Attachment 3 – Small Business Participation Report.

9. Section E.8 Submissions Instructions, paragraph

(iii) Volume III Small Business Participation Commitment

States, “Please note that the overall small business requirement of 17.5% includes all small businesses under the NAICS code 513210. The NAICS code assigned to the solicitation does not necessarily apply to each subcontract.”

a. Since there are many requirements outside of NAICS code 513210 that could be subcontracted, could you please confirm that all small business categories (i.e.: SDB, WOSB, HUBZone, VOSB, VOSB) can be counted as small businesses for meeting the 17.5% requirement?

Or is this limiting small businesses under NAICS code 513210 designated subcontracts as the only type of subcontracts that can qualify under the 17.5% requirement and excludes small businesses on subcontracts with different NAICS codes?

In summary, the RFP refers to the NAICS code assigned to the contact when discussing subcontracting. It uses different terminology between the required 17.5 percent for SB, the various categories of small business (SDB, WOSB, HUBZone, VOSB,

a. Yes, all small businesses can be counted as small businesses for meeting the requirement. Please note the percentage has been revised from 17.5% to 10%.

b. Not all subcontracts have to be assigned NAICS code 513210.

Subcontracts assigned with different NAICS codes qualify assuming the subcontractors meet the size standard in the respective NAICS codes.

SDVOSB), and especially VOSB and SDVOSB. It implies, but it does not expressly state that the subcontracts must be assigned the same NAICS code that is assigned to the contract exclusively in order to get credit in the evaluation. In other words, it implies that subcontracts assigned different NAICS codes (ie: program management, training, custom computer programming services, etc) are excluded from getting credit. Yet, acknowledges that the NAICS code assigned to the solicitation does not necessarily apply to each subcontract.

Please explain intent.

b. Please clarify the next sentence: “The NAICS code assigned to the solicitation does not necessarily apply to each subcontract.” For instance, does it mean not all subcontracts have to be assigned NAICS code 513210 and subcontracts assigned with different NAICS codes qualify assuming the subcontractors meet the size standard in the respective NAICS codes?

10. E.12 Small Business Participation Commitment Evaluation Approach and E.13 Veterans Involvement Evaluation Approach

Are all subcontracts to SDB, WOSB, HUBZone, VOSB, and SDVOSB required to be assigned NAICS code 513210 in order to receive credit for the subcontracting goals under E.12 Small Business Participation Commitment Evaluation Approach?

Also, do all subcontracts to SDVOSB and VOSB have to be assigned NAICS code 513210 in order to receive credit under E.13 Veterans Involvement Evaluation Approach?

Refer to question 9.

11. Section C, Contract Clauses, paragraph C.1, and Section E, Solicitation Provisions, paragraph E.1

Cite several FAR clauses and provisions with deviations incorporated by reference. The same paragraphs state the full text of the referenced clauses may be accessed at acquisition.gov. We do not see these FAR clauses and provisions

Due to the recent overhaul of the Federal Acquisition Regulation, VA has issued deviations for each FAR part and associated clauses and provisions.

annotated as deviations at acquisition.gov. It is a common practice to include clause deviations in full text in RFPs/contracts. Will the full text of these FAR deviations be added to the RFP?

Refer to FAR Overhaul link for full text version:

https://www.acquisition.gov/far-overhaul

12. Section C, Contract Clauses, paragraph C.1 and Section E, Solicitation Provisions, paragraph E.1

These sections list FAR clauses and provisions incorporated by reference.

According to acquisition.gov, the most recent FAC (2025-06) is dated 10/1/25. Several clauses and provisions listed at C.1 and E.I cite versions with dates different than the clauses and provision versions in acquisition.gov. Several of the clauses and provisions listed in the RFP are as recent as November 2025, which is later than the most recent FAC of 10/1/25 in acquisition.gov. Is there a more recent FAC that has not been updated to acquisition.gov?

Refer to question 11.

13. Are offshore resources allowed if they are part of a US based approved prime contractor and if so, how are background checks completed?

Refer to PWS Section 6.2.2 Contractor Personnel Security Requirements. They will be required to obtain and maintain the appropriate Background Investigation (Tier 2 / Moderate Risk).

14. The assumption is the offeror is able to host the testing and staging environments. Can you confirm this is acceptable?

Yes, the testing and staging environments will be hosted by

VA.

15. FAR Part 19.704 states the practice of expressing subcontracting goals as a percentage of dollars to be subcontracted. VAAR 819.704-70 states, “Subcontracting goals should be expressed as a percentage of total dollars to be subcontracted unless otherwise stated in the solicitation.”

Paragraph E.12, Small Business Participation Commitment Evaluation Approach expresses the subcontracting requirement and goal as a percentage of “contract value”.

We note that a percentage of contract value (ex: 17.5%) is extremely higher

Offerors shall use percentage of the total contract value. The small business subcontracting goal has been revised from 17.5% to 10%.

Refer to Amendment 2.

https://www.acquisition.gov/far-overhaul https://www.acquisition.gov/far-overhaul than a percentage of dollars to be subcontracted. Please confirm the exact method to be used in our submission.

16. E.8, Submission Instructions

States “Offerors shall ensure that any and all costs associated with the Offeror’s proposed application(s), software products, software solution, and/or system, shall be included in the Offeror’s proposed firm-fixed price, and shall serve as the Offeror’s firm-fixed price for the life of any resulting contract. No additional costs or fees relative to the Offeror’s proposed application(s), software products, software solution, and/or system including, but not limited to, licensing costs…” Section B.3 Software License, Maintenance and Technical Support, States “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. Then, Paragraph 6.1.11 Software and Licensing Requirements, states, ”…provision of all software licenses and any associated licensing maintenance required…. for the life of any resulting contract.” Please confirm the software licenses are for the life of the contract rather than in perpetual.

The software licenses are for the period of the contract and not perpetual.

17. In multiple places, the RFP mentions FAR 52.227-14 — Rights in Data— General and FAR 52.227-19 — Commercial Computer Software License. These two clauses are not incorporated in full text or by reference at C.1 FAR 52.252-2 Clauses Incorporated by Reference.

Please confirm that these clauses are

FAR clause 52.227-14 will be included. FAR 52.227-19 will not be included.

not in the contract and that it is intentional.

18. Section 3.0 Scope of Work

It states that "This solution shall be hosted in the VAEC environment .

The Contractor shall coordinate with VA to determine the best Cloud Service Provider (CSP) for the solution. The Contractor shall not be responsible for providing or acquiring cloud capacity or server hosting infrastructure..." Would we be allowed to host our SaaS in our FedRamp certified Azure cloud or must it be hosted in the VAEC?

Solutions must be hosted in the

VAEC.

19. Section B.7 Information System Hosting, Operation, Maintenance or Use

(a) states "The contractor shall comply with all Federal laws, regulations and VA policies, for Information systems (cloud and non-cloud) that are..." We note the reference to cloud and non-cloud hosting. Does this mean that we could host the solution in our cloud?

No, you cannot host the solution in your cloud. Solutions must be hosted in the VAEC.

20. Section C.5.2.10, Software Recommendations/ Provider Clinical Support Decisions

Specifics of the required polypharmacy software solution that support decision making are stated and that recommendations must be aligned with existing VA policy, directives and tools. We understand that meeting this requirement means that the Contractor will be integrating into the VA's CDS system entirely (into all of the VA/DoD Evidence- Based Clinical Practice Guidelines published on the VA website). We want to confirm this assumption - or will the Contractor's solution be the full Clinical Decision Support system utilized?

The new software must be aligned with existing VA policy, directives and tools.

The intent was that the new software not be in conflict with VA policy, and that the scope of the software is limited to the requirements defined in the PWS.

21. Section C.5 VAAR 852.204-71 Information and Information Systems Security (Feb 2023), page 99, item (d).

We note the requirement to state in our proposal where all non-US services are provided and that at a minimum, "the Contractor/subcontractor must include a detailed Information Technology Security Plan..." Is this to be provided with the RFP response and if so, in which part? Or is this to be provided post award for review and approval by the Contracting Officer?

This is to be submitted as part of Volume VI - Solicitation, Offer and Award Documents and Certifications/ Representations.

22. Section 5.2.7 Veteran Polypharmacy Risk Score and Section 5.2.8 Medication Risk Score

Both of these sections require the development of a risk score; one for potential polypharmacy issues with the specific Veteran, and one for potential polypharmacy, side effects, fall risks, adverse reactions, etc. for each individual medication. Does the VA expect a numerical score (e.g. 1 –

10) to be generated for the risk scores when all factors are considered, or is a risk assessment of Mild, Moderate, Severe (or similar) acceptable?

Yes, a risk assessment of Mild, Moderate, Severe (or similar) is acceptable, but not preferred compared to a numerical risk score.

VA expects a numerical score to be generated. If offerors want to supplement with a risk assessment of mild, moderate, or severe then it will be considered, but only in addition to the numerical risk score.

23. Extension Will the Government issue an amendment extending the proposal submission deadline to fourteen (14) calendar days after issuance of the amendment containing the Government’s responses to Offeror questions?, Given that the Government’s responses may materially affect Offerors’ approach and content for Volumes I, III, IV, and V, additional time is needed to review and assess the Government responses and to submit a complete, compliant, and high-quality proposal

The proposal due date has been extended to January 28, 2026 via Amendment 0001 issued on 1/13/26.

24. 5.2.6 What data sources will be available for the offeror to construct and present the comprehensive medication list for medications prescribed in the community. For example, will the government provide a claims feed from the CCN providers, access to Surescripts data ?

The vendor must provide the comprehensive medication list for medications prescribed in the community.

25. RFP Section E.8; RFP header shows 36C10B26R0004

Section E.8 references a different solicitation number in the email subject line. Please confirm the correct solicitation number that must appear in the email subject line and on all file names for proposal submission.

The correct solicitation number is 36C10B26R0004. Refer to Amendment 2.

26. PWS 4.1; RFP Section

B.4; CLIN 0002

The Performance Work Statement states a 6‑month base period;

however, Section B.4 lists the Base Period PoP as 12 months while CLIN 0002 indicates the PoP is six months from date of award.

Please confirm the correct Base Period PoP and which duration governs.

Base period PoP is 6-months.

Section B.4 has been updated.

Refer to Amendment 2.

27. RFP Section B.4 CLIN 0001/0002 pattern

For the Base Period, CLIN 0001 (Program Management) is Not Separately Priced and states its price is included in priced CLIN 0002.

Please confirm that offerors must price only CLIN 0002 for the Base Period (and similarly for Program Management CLINs in the option periods), with all costs embedded in the priced solution CLINs.

Yes, offerors must price only CLIN 0002 for the Base Period (and similarly for Program Management CLINs in the option periods), with all costs embedded in the priced solution CLINs

28. RFP Section B.4 Optional Task Two

(CLIN 6001)

For Optional Task Two (CLIN 6001), the schedule references both a PoP of 12 months from date of exercise and an overall PoP of NTE 48 months.

Please clarify the intended period(s) of performance and how offerors should price CLIN 6001 accordingly.

The POP for CLIN 5001 and 6001 are dependent on when the contractor can execute the requirements of enterprise and full capability.

For pricing, quote out the per month cost for full enterprise deployments x 48months. If/When the optional CLIN is exercised, the pricing will be adjusted based on the number of months left in the overall contract period.

29. PWS 5.5.1/5.5.2 task lists; CLIN training SLIN references

Optional Task descriptions list “5.2.13 Training,” while CLIN deliverables reference training IAW

PWS 5.2.14.

The correct PWS paragraph for Training is 5.2.14. References in the PWS have been updated. Refer to Amendment 2.

Please confirm the correct PWS paragraph number(s) for training requirements and deliverables.

30. RFP Section E.8 submission instructions

Section E.8 states each email submission must be less than 5MB and allows multiple emails.

Please confirm whether the 5MB limit is per email (total attachments) and whether compressed (ZIP) files are permitted. If ZIP files are not permitted, please confirm whether multiple attachments totaling <5MB are allowed per email.

Yes, compressed (ZIP) files are permitted. 5MB per email.

31. RFP Section E.8; PWS requires evidence sources in recommendations

Section E.8 restricts use of hyperlinks (except the demo link).

Please clarify whether references to evidence (e.g., citations/DOIs) may be provided as plain text and whether active/clickable hyperlinks within the written volumes are prohibited.

No. The use of hyperlinks in proposals is prohibited and any information contained within those hyperlinks will not be evaluated.

Demo link is the only acceptable hyperlink.

32. RFP Section E.8 technical submission instructions; demo requirements

Please confirm whether the 60‑minute pre‑recorded online demonstration link must be included within the Technical Volume (counting toward the 30‑page limit), or if it may be provided on an unscored cover/administrative page.

The 60‑minute pre‑recorded online demonstration link must be included within the 30 page limit.

33. PWS 4.1 performance period language

The PWS requires pilot implementation at 10 VAMCs within 26 weeks of award and indicates Option Period One will be executed once the solution is proven functional.

Please clarify the Government’s intended decision criteria and process/timeline for determining ‘proven functional’ and exercising Option Period One.

VA will provide documentation post-award to establish criteria for determining pilot success. Criteria may include, but not be limited to, veteran outcomes reporting and clinical user access and engagement as described in the PWS.

34. PWS 5.2 (Pilot Phase;

CPRS + Federal EHR);

Section E.8 demo instructions (if applicable)

Pilot Phase (PWS 5.2) states VA will identify 10 VAMCs, at least one running the Federal EHR. Please confirm:

(a) when after award VA will provide the list of pilot sites, site points-of-

a) A list will be provided with all details needed at the Kickoff Meeting.

b) Section B. Technical – Software Solution Demonstration does not mention CPRS or Federal EHR contact, and any site-level onboarding/integration prerequisites (e.g., CPRS/Federal EHR access, test accounts, connectivity requirements);

and

(b) for the technical demo/evaluation, whether offerors are expected to demonstrate workflows in both CPRS and the Federal EHR context, or whether demonstrating one EHR context is sufficient for evaluation.

context because neither is required.

Demonstrating the Offeror’s existing solution with or without EHR context is adequate for this requirement, with an emphasis on demonstrating the requirements listed in this section.

35. PWS 5.3.1.3

Integration requirements

The PWS states bidirectional data exchange with CPRS and the Federal EHR and notes that JLV/VLER/VDIF‑EP integration may be required.

Please clarify which interfaces are mandatory for the pilot phase versus later phases and which VA-provided endpoints/services will be available in pilot environments.

Refer to PWS Section 5.2 for the base period tasks which are intended to describe a Minimum Viable Product (MVP).

Refer to PWS Section 5.3 where JLV, VLER, and VDIF‑EP are described and thus applicable to Option Period One. This option period is intended to bring more functionality to the MVP.

VA will make available all required endpoints as needed for each phase.

36. PWS 5.3.1.3

Integration requirements

The PWS references a secure, standards-based API (e.g., FHIR R4 or higher) and notes that meeting all requirements may require communications beyond FHIR R4.

Please clarify the minimum required FHIR version(s), profiles/implementation guides, and any non-FHIR integration mechanisms the Government anticipates (e.g., CDS Hooks, HL7 v2, custom APIs) including VA's existing deprescribing tools and web based solutions.

The minimum required FHIR version is FHIR R4. VA anticipates the use of SMART on FHIR, CDS Hooks, and may require additional standards-based or custom integration mechanisms (e.g., HL7 v2 or REST APIs) for certain workflows.

For deprescribing functionality, integration details will be finalized during design in coordination with VA subject matter experts. VA will provide applicable implementation guides and integration constraints post-award to ensure alignment with VA CDS workflows and interoperability standards.

37. PWS 5.3.1.3

Integration requirement #4

The PWS indicates decision support should be available ‘at the time of decision-making’ using CDS hooks or other triggers.

The highest and only priority of this solicitation is polypharmacy work to perform medical reconciliation and identification of risk.

Please identify the clinical workflows the Government considers highest priority for triggers during the pilot (e.g., medication reconciliation, order entry, discharge, outpatient prescribing).

38. PWS 5.3.1.3 write-back paragraph

The PWS states actions documented through the solution (e.g., progress notes, clinical actions, deprescribing) must be written back to the medical record and be easily queried.

Please clarify the minimum required write-back artifacts for pilot (e.g., note type, order changes, structured fields) and the expected query/reporting mechanism.

Refer to question 36.

39. PWS 5.2 base period pilot phase

The PWS requires automatic patient synchronization across the solution and the EHR.

Please clarify the expected technical pattern(s) for context passing and authentication (e.g., SMART on FHIR launch, SSO via VA identity provider) for CPRS and for the Federal EHR.

For CPRS Sites, CCOW synchronization / functionality or Support for SMART on FHIR launch. For Federal EHR sites SMART on FHIR launch.

40. PWS 5.3.1.2

Responsiveness

The PWS requires page/data load times under five seconds under normal operating conditions.

Please clarify the Government’s assumptions for ‘normal’ concurrency (e.g., number of concurrent users per site / enterprise) and how performance will be measured during acceptance.

The VA is unable to provide an estimate of concurrency. One way to frame this requirement is: how many users push your software over the required < 5 second loading time?

41. PWS 4.1 (24/7/2-hour response); PWS 5.4.1 (availability)

The PWS references service availability requirements and also states ‘24/7/2-hour response support.’

Please define the incident severity levels and the required response and resolution times for each severity (including after-hours coverage expectations).

Refer to PWS Section 5.4.1 for required incident acknowledgement/response timeline.

VHA will work with the vendor to define incident severity levels post-award. The required incident response regardless of incident severity level is two hours. VHA will work with the vendor to define incident resolution time based on severity level post-award.

42. PWS 5.5.1.1 Adverse Event Reporting

Optional Task One requires automatically filing adverse event reports to the Allergy/ADR package in CPRS or the Federal EHR, with subsequent submission to VA ADERS under VAMedSAFE (or to other systems as indicated).

Please clarify what ‘automatically filing’ entails (data elements, workflow, interfaces), and whether any direct integration to VA ADERS is required from the solution.

Direct integration with VA ADERS is not required.

Interface requirements for the allergy/ADR package will be provided after award.

43. PWS 5.5.1.2 Data Logging

Optional Task One requires that all software inputs/outputs be available for analysis using VA tools and captured in the VA Corporate Data Warehouse/National Data Systems, including continuous monitoring for algorithm drift.

Please clarify the expected data pipeline mechanism, required data elements, refresh frequency, and retention requirements.

Integration will leverage VA-approved secure data transfer methods (e.g., VAEC-native services or VA-managed ETL processes) to feed data into CDW.

All relevant input parameters, output results, and metadata necessary for algorithm performance monitoring and drift detection. Specific data elements will be confirmed during onboarding.

Data should be refreshed daily, consistent with existing CDW practices.

Retention will follow VA policy for clinical and operational data, in alignment with VA Handbook 6500 and applicable records management directives.

44. PWS 5.5.2.3 Veteran Communication

Optional Task Two references interfacing with VA Veteran digital health tools (e.g., My HealtheVet, VA Annie, VA Health and Benefits App).

Please clarify which of these integrations are in scope for Optional Task Two versus considered aspirational, and what APIs/technical

These are listed as examples.

Expect that two Veteran digital health tool integrations will be required with details driven by feedback from prior phases. The government will provide the required integration details once the digital health tools are selected after the enterprise deployment.

standards VA expects for these connections.

45. CLIN deliverables for ATO artifacts; PWS states deployment under VA CDS platform / VAEC

Multiple CLIN deliverables include ‘VA Authority to Operate artifacts.’

Please clarify whether the contractor is expected to obtain a new ATO, inherit an ATO through the VA Clinical Decision Support (CDS) platform boundary, or support an existing ATO.

Please also identify the expected RMF artifacts and Government-provided resources (e.g., templates, tools) to support ATO timelines.

We anticipate expanding the CDS platform ATO to include the new polypharmacy software, with support from the vendor. However, depending on the architecture of the contracted software, an independent ATO may be required.

The Vendor should be prepared to facilitate / assist with any documentation (RMF artifacts) necessary to ensure compliance with ATO.

46. Section E price evaluation / basis for award (as applicable)

Please confirm which line items will be included in the evaluated price for best-value tradeoff: base + all option periods only, or base + all option periods + optional tasks (CLIN 5001 and 6001).

See section C5. Price Evaluation Approach

For evaluation purposes only, and except when it is determined in accordance with FAR 17.204-1 not to be in the Government’s best interests, the Government will evaluate quotes for award purposes by adding the total price for all options to the total price for the basic requirement. This includes a six-month extension under FAR 52.217-8, Option to Extend Services, which applies to this solicitation. Evaluation of the option under FAR 52.217-8 will be accomplished by using the prices offered for the last option period to determine the price for a six-month option period, which will be added to the base and all option periods to arrive at the total price. Thus, the Offerors total price for the purpose of evaluation will include the base period, all option period, and one-half of the last option period.

Offerors are not required to enter a price for the six-month period.

Evaluation of options will not obligate the Government to exercise the option(s).

47. Solicitation contract clauses; price evaluation section

The solicitation includes FAR 52.217-8, Extension of Services (6 months).

Please clarify whether the Government will evaluate pricing for the 6‑month extension and, if so, how offerors should calculate/represent that pricing (e.g., at the last option period monthly rate).

Yes, the Government will evaluate pricing for the 6‑month extension.

See Question #46.

48. PWS VAEC/GFE

language; CLIN ‘includes all costs’ language

The PWS states VA will furnish VAEC capacity as Government Furnished Equipment and the contractor is not responsible for providing/acquiring cloud capacity.

Please confirm that VAEC infrastructure costs should be excluded from the offeror’s CLIN pricing, and clarify whether any non- VA cloud services (if proposed) are permissible and must be included in pricing.

VAEC infrastructure costs should be excluded from the offeror’s CLIN pricing. Any non-VA cloud services (if proposed) are permissible and must be identified and included in pricing.

49. PWS 5.2 base period pilot phase

Given the requirement to ensure consistency of alerts and recommendations with CPRS to avoid alert fatigue, please clarify the Government’s acceptance criteria for ‘consistency’ (e.g., matching severity tiers, matching interaction identifiers, configurable thresholds).

The solution must ensure that alerts and recommendations are not discordant with CPRS, including drug-drug interaction severity tiers, interaction identifiers, allergies, duplicates, dosing limits, PGx recommendations etc.

50. PWS 5.3.1.3 write-back paragraph

Because the PWS emphasizes writing actions back to the EHR in a way that enables simple reporting, please clarify whether the Government will consider stronger ‘closed-loop’ documentation (structured write-back, queryable fields, automated reporting dashboards) as a discriminating capability in evaluation.

Question does not provide enough information/ documentation to be able to give an adequate response.

51. PWS 5.5.1 Optional Task One – Enterprise Deployment; PWS

5.5.2 Optional Task

Two – Full Capability;

and OT1/OT2 Pricing

Please clarify the intended sequencing and pricing relationship between OT1 (Enterprise Deployment) and OT2 (Full Capability): (a) May OT2 be exercised before OT1, or is OT2 intended only after OT1 is

The intent is to execute OT1 either prior to or at the same time as OT2 if software is capable. Given the unknown timeline of OT1 and OT2, indicate the monthly cost x 48.

Then if executed the price will be

Schedule exercise language.

exercised/implemented; (b) if OT1 is exercised first and provides enterprise-wide access, should OT2 be priced/evaluated as incremental (delta) cost for the additional OT2 requirements (i.e., not duplicative of enterprise access/licensing already priced under OT1); and (c) if OT2 is exercised first, does OT2 include/replace OT1 scope, or would OT1 still be separately exercised/priced?

determined based on number of months left

52. Section B.4 (MO quantities; Optional Tasks 5001/6001 NTE 48 MO; NSP SLINs);

SF1449/FFP contract type

The Pricing Schedule uses MO (Month) quantities for FFP CLINs (e.g., Base 6 MO; options 12 MO) and lists Optional Tasks 5001/6001 as FFP with Qty/PoP shown as “NTE 48 MO,” while associated SLIN deliverables are marked NSP. For pricing comparability and invoicing clarity, please clarify:

(a) for CLINs with MO quantities, is pricing intended as a monthly unit price multiplied by the number of months, or as a single fixed total price for the entire period with monthly (or other) invoicing;

(b) for purposes of quantity/invoicing, is a “month” a calendar month or a fixed day-count period measured from award/option exercise, and how will partial months be treated (proration vs full month);

(c) for Optional Tasks 5001/6001, does “NTE 48 MO” function as a ceiling on the number of months the Government may order/invoice at the offered monthly unit price, or is the Government evaluating/paying a fixed total for the full 48 months;

(d) when/how will the Government establish the actual number of months to be ordered (at task exercise or via subsequent modification); and

a) For CLINs with a unit of “Month (MO), pricing is intended as a monthly unit price multiplied by the number of month resulting in the total price for the CLIN.

b) The 6-month base and 12-month optional periods are based on the award date. For purposes of pricing, MO is based on actual award date. For example, if awarded on 2/10, the monthly billing could be done each month on the 10th.

c) For CLINs 5001/6001, price out $X/mo x 48mo.

d) The actual award amount will be determined if/when the optional CLIN’s are executed based on how much time is allowable for the entire contract period.

e) SLIN’s are required as part of the parent CLIN, however if scope is modified pricing can be adjusted at that time.

(e) are NSP SLINs mandatory deliverables upon exercise of the parent CLIN, and if the Government adds/removes NSP scope, will pricing be adjusted via an equitable adjustment to the associated priced CLIN(s)?

53. Section C.8 “Small Business Participation Requirements” (p.

106); Volume III – Small Business Participation Commitment (p. 122);

Section D, Attachment 2 – SBPC Spreadsheet.

"Section E.12 states that the Government’s subcontracting goals and the overall Small Business Participation Requirement (17.5%) are evaluated as a percentage of the “total contract value.”

Please clarify how VA defines “total contract value” for purposes of (1) completing the Volume III Small Business Participation Commitment (SBPC) spreadsheet and (2) evaluating compliance with the 17.5% requirement and socioeconomic subcontracting goals.

Specifically, does “total contract value” mean the Base Period value at time of award only, or does it mean the sum of Base + all option years + optional tasks (OT1/OT2) that are priced but not guaranteed to be exercised?

Total Contract Value is the full value of the contract. Base + all option years + optional tasks (OT1/OT2) that are priced but not guaranteed to be exercised.

Please be advised the percentage has been revised from 17.5% to 10%. Refer to Amendment 2.

54. Section B.3; Section B.4 CLIN structure (0002/1002/2002/3002/ 4002; optional

5001/6001); PWS

6.1.11

Section B.3 states the software license is perpetual unless otherwise stated, and PWS 6.1.11 requires the Contractor to provide all software licenses and associated licensing maintenance for the life of the contract. However, Section B.4 does not include a discrete “software license” CLIN and cautions offerors not to alter line items. To ensure consistent pricing across offerors, please confirm:

(1) which priced CLIN(s) must include all software license fees and any associated license maintenance/support (including any third‑party content/knowledge base

1) CLINs 0002, 1002, 2002, 3002, 4002, 5001, and 6001 should include license and/or subscription fees for the relevant period.

Section B.3(2)(a) is struck.

2) The government does not have a preference for license or subscription models, but prefers cost structures that are predictable and do not require precise accounting of the number of beneficiaries, users, transactions, etc (shall use approximate numbers or ranges). As stated in the PWS, solutions must be hosted on the VA Enterprise Cloud, and no software as a service will be accepted.

licensing)—e.g., CLIN 0002 and the applicable option-year CLINs 1002/2002/3002/4002 and, if exercised, optional task CLINs 5001 and/or 6001;

(2) whether VA will accept a subscription/SaaS licensing model priced within the annual period CLINs so long as the Government’s use rights are perpetual per Section B.3, or whether VA intends offerors to price a one‑time perpetual license fee; and

(3) if perpetual rights are required, whether offerors should price the perpetual license cost one time (e.g., within the initial awarded period) with ongoing maintenance/support priced in later periods, or whether offerors should include license-related costs within each period’s priced CLIN amount.

3) Perpetual rights are not required or accepted.

55. Section E.8 “Submission Instructions” (Volume I

– Technical Factor), including the 30-page limit for Volume I and the instruction that annexes/attachments count against page limits unless otherwise indicated; and Section E.8(i) Volume I – Technical Factor, “Provide evidence …” for PWS 5.2.7, 5.2.8, 5.3.3.2, 5.3.1.2, and

5.2.10 (RFP pp. 117– 118).

"Section E.8(i) requires Offerors to “provide evidence” (e.g., peer-reviewed journal articles, white papers, quantitative analysis, or similar) demonstrating that the proposed software solution meets, or can be configured to meet, PWS 5.2.7, 5.2.8, 5.3.3.2, 5.3.1.2, and 5.2.10; however, Volume I is limited to 30 pages and the submission instructions indicate that annexes/attachments generally count against page limitations unless otherwise stated.

Please clarify what constitutes acceptable “evidence” for evaluation purposes within these constraints.

Providing a quote with a citation is sufficient evidence. For example, our formula uses data as outlined in the Harvard Journal of Medicine, titled “xxxxxx”, dated 1/1/2000, [quote from article].

56. PWS 3.0; PWS 5.4.1;

PWS 5.4.2; PWS 6.4;

PWS 6.6

Please confirm how the Government will assess and enforce application/service SLAs (e.g., availability, reachability, response time) when a performance degradation or outage is attributable

Performance issues related to VAEC will not negatively impact the contractor’s performance metrics.

to VA Enterprise Cloud (VAEC) Government-Furnished Equipment/capacity or other Government-controlled infrastructure.

57. PWS 5.4.1; PWS 5.4.2;

PWS 6.4

Please clarify what ticketing system(s) and interfaces the Contractor must use to 'log trouble tickets with the responsible party' for VAEC or other Government-managed services, and what constitutes a 'logged' ticket for SLA stop-clock purposes (e.g., creation time, acknowledgment time, assignment time).

VA uses ServiceNow as the Government ticketing system for VAEC and other VA-managed services. Contractors will coordinate with VA system stewards to ensure trouble tickets are logged appropriately.

58. PWS 5.4.1; PWS 5.4.2 If access to the Government ticketing system is unavailable during an incident, what alternate notification method (email/phone bridge/Service Desk) will the Government accept to establish the SLA attribution timestamp until system access is restored?

If access to the Government ticketing system is unavailable during an incident, the Contractor may use email notification to the designated VA points of contact to establish the SLA attribution timestamp until system access is restored.

59. PWS 5.4.1; PWS 5.4.3 PWS 5.4.1 references Government-published maintenance windows.

Please identify where these maintenance windows will be published, how far in advance updates will be issued, and how scheduled VAEC/upstream maintenance will be treated in SLA calculations (excluded vs. counted).

VAEC publishes an annual maintenance calendar. These maintenance windows generally do not impact end users, and if a maintenance event is expected to affect availability, adequate notification will be provided and coordinated in advance.

Scheduled VAEC or upstream maintenance activities will be excluded from SLA calculations, provided they are documented in accordance with PWS requirements.

60. PWS 5.4.1; PWS 5.4.2;

PWS 6.4

Please confirm the Government’s source-of-truth for measuring availability and reachability (e.g., VAEC monitoring, synthetic tests, APM) and how discrepancies between Contractor monitoring and Government monitoring will be reconciled for QASP/SLA determination.

Availability and reachability will be measured using VA-approved Application Performance Monitoring (APM) tools and synthetic tests, as defined in the approved Application Monitoring Plan.

Any discrepancies between Contractor monitoring and Government monitoring will be reconciled collaboratively between the Contractor, COR, and CO to ensure accurate QASP/SLA determination.

61. PWS 3.0; PWS

5.2.2(17); PWS 6.6;

PWS 5.4.1

VA will furnish VAEC capacity as

GFE.

Please provide (or identify) the applicable VAEC platform SLAs (compute, storage, network, managed services) and clarify how VAEC SLA breaches will be handled when they impact the Contractor’s application SLAs.

VAEC platform SLAs (compute, storage, network, and managed services) are managed by VA. Any VAEC SLA breaches that impact the Contractor’s application performance will be excluded from Contractor SLA calculations, provided the Contractor documents the event in accordance with PWS requirements.

62. PWS 5.3.1.2; PWS

5.3.1.3; PWS 6.4

For the responsiveness requirement ('under five seconds under normal operating conditions'), please define 'normal operating conditions' in VAEC (expected concurrent users, dataset sizes, latency to VA systems/data sources) and confirm whether VAEC resource constraints are excluded from responsiveness performance findings.

For enterprise deployment:

• Concurrent user estimate =

10% of 180k = 18k

• Dataset estimate = largest

VISN (VISN 8) = 1.4M

Veterans

For pilot, concurrent users will be much fewer.

Any VAEC resource constraints are excluded from responsiveness performance findings.

63. PWS 5.4.2; PWS 6.6;

PWS 5.4.1

Please confirm what VAEC/CSP monitoring tools are available to the Contractor (e.g., logs/metrics/APM) and what access levels, data retention, and export capabilities will be provided to support the required Application Dashboard and SLA reporting.

Typical AWS-native monitoring tools (e.g., CloudWatch logs, metrics, and dashboards) will be available at the level of access necessary to meet PWS requirements for the Application Dashboard and SLA reporting.

In addition, VA utilizes Dynatrace and Datadog on other VAEC projects for application performance monitoring (APM) and observability. Access levels, data retention, and export capabilities will be provisioned to support contractual reporting requirements and will be coordinated during onboarding.

64. PWS 5.4.1; PWS 5.4.2;

PWS 6.1.5

PWS 5.4.1 requires automated tests executed at least every 300 seconds.

Please clarify where these synthetic monitoring tests must be executed from (inside VAEC, VA network, external vantage points) and how test failures caused by VA network controls (e.g., proxies/TIC) will be attributed.

The location and configuration of synthetic monitoring tests will be defined in the Application Monitoring Plan submitted by the contractor post-award, in accordance with the PWS.

Government approval of the plan is required prior to proceeding with testing.

Automated tests should be designed to monitor system performance effectively.

Any test failures attributable to VA-controlled network components (e.g., proxies, TIC gateways) will be documented and excluded from contractor performance metrics, provided the contractor includes a record of the trouble ticket issued to the party responsible.

Per section 5.4.2 of the PWS: “The Contractor shall provide an Application Monitoring Plan that defines how metrics will be monitored throughout the performance of the requirements, including the automated testing tools and automated SLA testing scripts that shall be used. The Contractor shall provide the Application Monitoring Plan to the VA PM/COR for review and approval.”

65. PWS 5.4.2; PWS 5.4.1 When an outage is attributable to VAEC or another Government-managed dependency, will the Government provide incident details (e.g., VAEC incident ticket/RCAs) necessary for the Contractor’s Postmortem Report requirements, and what is the expected division of responsibility for root cause analysis?

Yes, when an outage is attributable to VAEC or another Government-managed dependency, the Government will provide incident details (e.g., VAEC incident ticket/RCAs) necessary for the Contractor’s Postmortem Report requirements. Expected division of the responsibility will depend on the incident, but regardless the root cause analysis will be completed collectively.

66. PWS 5.2.2(17); PWS

5.2.3; PWS 3.0; PWS

6.4

Please describe the process and typical timelines for requesting additional VAEC compute, storage, or network capacity (including approvals), and confirm that delays in Government provisioning will be excluded from Contractor schedule/SLA performance findings.

Necessary resources will be requested and provisioned in accordance with VAEC timelines.

Delays in Government provisioning will be excluded from Contractor schedule/SLA performance findings.

67. PWS 5.4.2; PWS 6.4 Quarterly Resource Utilization Optimization Plans require Contractor recommendations.

Please clarify whether implementing any optimization changes that require VAEC configuration changes will be contingent on Government approval and timelines, and how delays in Government execution will be treated under QASP.

Yes, VAEC configuration changes will be contingent on government approval timelines using a standardized process. Delays due to Government VAEC configuration will not be treated as a violation of performance metrics as outlined in the QASP.

68. PWS 5.3.1.3; PWS

5.4.1; PWS 6.4

Please identify the specific VA-managed upstream/downstream systems and external data sources that are required for the solution (e.g., CPRS/Federal EHR APIs, JLV/VLER/VDIF-EP), and confirm that outages/latency from those services will be handled as external dependencies for SLA/QASP purposes.

Refer to PWS Section 5.3.1.3 Integration.

Outages/latency from external services will be handled as external dependencies for SLA/QASP purposes.

69. PWS 6.4; PWS 5.4.1;

PWS 5.4.2

PWS 6.4 states the Government may alter or change QASP surveillance methods.

Please confirm how such changes will be communicated (e.g., advance notice, contract modification), and whether new…