36C10B26R0006 - Questions and Answers.pdf

Ambient Scribe Enterprise Indefinite Delivery Indefinite Quantity (IDIQ) 36C10B26R0006

April 2, 2026

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

RFP/PWS

Reference

Questions / Comments Answers

1 RFP Sections B.2 and C.3

The projected ceiling listed in the solicitation is $775.7 million, though it is listed as $500 million on Acquisition Gateway so please confirm if Offerors should refer to the solicitation for the most up to date info? Also, confirm that funding has been secured for this or is that still subject to change?

The Maximum Overall Value of the Ambient Scribe IDIQ contracts is $775,720,000.00, as listed in Section B.2, Price Schedule, and Section C.3, 52.216-19 Order Limitations, of the solicitation.

Additionally, funding will be secured at the task order level, not at the IDIQ level.

2 RFP Section E.6

On page 90, the solicitation states that the Offeror’s proposal shall consist of seven (7) volumes. However, page 92 indicates that Volume I – Clinical Operational Deployment is due for Phase I evaluation under the Hard Down-Select (Go/No-Go), with subsequent volumes to be submitted only upon notification for Phase II. Can the Government please confirm whether only Volume I is required for the initial Phase I submission, or if all seven volumes must be submitted at this stage?

In Section E.6, Proposal Submission instructions, of the solicitation, it states “Volume I – Clinical Operational Deployment will be due in accordance with the Due Date included on the RFP’s cover page and will be evaluated as part of Phase I – Hard Down- Select on a Go/No-Go basis.

Offerors receiving a Go rating under Phase I will be notified by the Government and provided separate submission instructions and due dates for Phase II proposal volumes.” Therefore, only Volume I is due on Monday, April 6, 2026 at 3:00 p.m. EST. See updates made in Amendment A00001.

3 RFP Section

B.3, PWS

5.1.2.1

With reference to the Federal Risk and Authorization Management Program (FedRAMP) requirement, is this a strict requirement? Specifically, must the solution be FedRAMP authorized within the stated timelines, or is demonstrating the ability and commitment to achieve FedRAMP authorization sufficient?

The FedRAMP requirement is a mandatory requirement. The solution must be capable of achieving FedRAMP authorization at the Moderate impact level;

however, authorization is not required at proposal submission.

Refer to Performance Work Statement (PWS) 5.1.2.1 where it states, “The Contractor shall provide a cloud-hosted, Commercial Off-the-Shelf (COTS)

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

ambient dictation SaaS solution, on a Contractor-provided infrastructure that is complaint with FedRAMP. The solution will be authorized at the Moderate Impact Level in accordance with the Day 1 TO, and as mandated by Federal laws and policies, including making available any documentation, physical access, and logical access needed to support this requirement.”

4 General Given the complexity of the Request for Proposal (RFP), including the multi-phase evaluation process, extensive technical and compliance requirements, detailed documentation and reporting expectations, and the need to address performance metrics and security standards, it is requested if a two-week extension to the proposal submission deadline can be granted.

The Government will extend the proposal submission due date for Volume I – Clinical Operational Deployment under Phase I to April 6, 2026 at 3:00 p.m. EST.

Refer to answer to Question number 2 and see updates made in Amendment A00001.

5 General Is this a new effort or was there was a previous contractor that performed these requirements? If the latter, would the Government be able to inform me of the Contract number used for these services?

This is a new requirement. Prior efforts were limited to pilot activities conducted as part of an Artificial Intelligence (AI) Technical Sprint challenge and do not represent a previous contract for this requirement.

6 General Could the submission deadline be extended to allow sufficient time to prepare thorough and thoughtful responses?

Refer to answer to Question numbers 2 and 4 and see updates made in Amendment A00001.

7 RFP Section E.6(D)(2)(viii)

Regarding the Phase III Systems Functionality Test, Table VIII specifies a Word Error Rate (WER) threshold of ≤12% overall and ≤8% in routine/quiet scenarios, measured against "adjudicated ground truth transcripts using standard tooling." Please clarify what normalization rules will be applied prior to WER calculation — specifically, how will the following be handled:

The Government will not disclose the specific algorithms, normalization rules, or internal evaluation methods used during testing. All Offerors will be evaluated using the same standardized Government process to ensure fairness and consistency. The published acceptance criteria in the

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

punctuation differences, capitalization, medical abbreviations vs. their expanded forms (e.g., "mg" vs. "milligrams", "Dr."

vs. "doctor"), numeric representations (e.g., "10" vs. "ten"), filler words (e.g., "um", "uh"), and speaker attribution tags? Will the Government publish the specific tooling and normalization configuration used to compute WER?

Does any failure in any one of the scripts or tests mean an overall failure for the system functionality test?

solicitation remain the controlling requirements, and all Offerors will be held to those criteria uniformly.

8 RFP Section E.5(C)(2)(c)

In the Price Evaluation Approach, the IDIQ states that the Firm-Fixed-Price (FFP) per User-Month "shall include all enhancements, upgrades, improvements, travel, and additional capabilities that become part of the Contractor's generally available commercial Ambient Scribe solution."

Specifically, if a Contractor's Ambient Scribe solution is deployed for one specialty (e.g., primary care) and subsequently adapted or extended to support a different specialty (e.g., oncology), would the Government consider that specialty expansion an "enhancement" included in the existing per User-Month price, or a separately priced product?

As stated in Section B.2 and Section E.5 of the solicitation, the FFP per User-Month shall include all enhancements, upgrades, improvements, and additional capabilities that become part of the Contractor’s generally available commercial Ambient Scribe solution. Accordingly, expansion of the solution to support additional specialties, where such capability is incorporated into the Contractor’s generally available commercial offering, is considered part of the FFP per User-Month price and shall not be separately priced.

9 RFP Section B.2

How was the cap of 4,700,000 user-months derived? If more demand exists for the Ambient Scribe product, will the Government increase this cap?

The maximum quantity of 4,700,000 user-months represents the Government’s estimated ceiling for ordering under Contract Line Item Number (CLIN) 0001 over the life of the contract. This not-to-exceed quantity was based on anticipated enterprise-wide demand; however, detailed methodology will not be disclosed.

The Government does not intend to increase this cap.

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

10 General Based on the pending Veterans Integrated Service Network (VISN) reorganization, does VA anticipate that task orders will be issued at the VISN or VA Medical Center (VAMC) level or a combination of both?

In accordance with Section B.3, PWS 5.3.4.1 of the solicitation, it states “The Government anticipates issuing Request for Task Execution Plans (RTEP) to select one Contractor per VISN;

however, the Government reserves the right to structure competitions as appropriate to meet program requirements.”

11 RFP Section

B.3, PWS 5.1.1

In reference to PWS 5.1.1, it defines Ambient Scribe as clinical transcription and note generation. However, the "Advanced Functionalities" listed later in the same section — such as clinical decision support, automated referrals, and predictive analytics — represent capabilities that the industry would broadly consider distinct products well beyond transcription and note generation. How does the Government differentiate between a "functionality" included in the baseline Ambient Scribe solution and a separate product? Is the Government's expectation that all listed Advanced Functionalities must be included in the baseline per User-Month FFP price proposed under this solicitation, or will those capabilities be priced separately through future task orders?

Enhancements that become part of the Contractor’s generally available commercial Ambient Scribe product—such as routine accuracy improvements, User Interface refinements, new standard note formats, or expanded support for existing workflows like coding and orders are included in the CLIN 0001 per user month price.

Capabilities offered as separate modules (such as new product lines, add-on analytics engines, or capabilities not incorporated into the Contractor’s standard commercial offering) may be acquired under CLIN 0005 as Additional Capabilities.

12 RFP Section

B.3, PWS

6.1.11 and 6.6

In reference to PWS 6.1.11, it requires delivery of custom-developed code with unlimited rights under the SHARE IT Act, while Section 6.6 states that "models, weights, algorithms, and outputs generated using Government-furnished data or data first developed under this contract shall be the property of the Government." If a Contractor fine-tunes or adapts its commercially licensed AI model using VA data to improve clinical documentation performance (e.g., In accordance with PWS Section

6.6 “The Contractor may allow VA to fine-tune or conduct other forms of model customization (“Fine- Tuning Services” and any such resulting model, a “Fine-Tuned Model”), including using data provided by VA (“Fine-Tuning Materials”). Fine-Tuning Services use the Fine-Tuning Materials for the purpose of generating or validating Fine-Tuned Models.

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

specialty-specific optimization), does VA consider the resulting fine-tuned model weights to be Government property under Section 6.6, or are they considered a derivative of the Contractor's commercial product subject to the commercial software license terms in Section A.4? Please clarify where the boundary lies between custom-developed deliverables and adaptations to a Contractor's COTS solution.

Fine-Tuning Materials are VA Data. VA’s use of the Fine-Tuning Services does not constitute a violation of the prohibition on training in the Agreement; provided that the training conducted is solely for VA’s use of the Fine-Tuning Services

13 RFP Section B.2

Can the Government please provide an example of an enhancement it would consider baseline pricing vs. an update or new capability that would be priced separately?

Refer to answer to Question number 11.

14 RFP Section

B.3, PWS

5.3.3.1

In reference to PWS 5.3.3.1 (Monthly Reports), one of the deliverables is "Transcripts", which is defined as "textual transcripts with speaker attribution and timing information." A literal reading of this suggests that all clinical transcripts need to be part of the monthly reports. Can the Government please clarify this deliverable?

The transcripts must remain available in the application for 30 days in accordance with VA records management policies for intermediary records. Should a Freedom of Information Act request or other request require the transcript to be available longer a process must be in place to maintain the transcript until an all-clear notice is given or the government may request a hard copy.

15 General Can the Government please direct where the submission documents or forms are located within System for Award Management (SAM). Also, is submission of the proposal permitted using only an employer identification number (EIN), with the Unique Entity Identifier (UEI) to be provided after submission deadline? SAM.gov is delayed in processing at the moment.

Offerors must have an active SAM registration at time of proposal submission in accordance with Federal Acquisition Regulation (FAR) 52.204-7, as incorporated in Section E.1 of the solicitation. As SAM registration requires a UEI, Offerors are expected to have a UEI assigned at the time of submission. Submission using only an EIN is not permitted.

16 RFP Section B.2 and

How is the 4,700,000 user-months being calculated?

Refer to answer to Question number 9.

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

Attachment

17 j RFP Sections E.5 and E.6

How long does the Government anticipate between Phase I (Go/No-Go determination), Phase II (technical and price evaluation / IDIQ award), and Phase III (systems functionality testing), and will Phase III testing occur immediately following Phase II award or at a later point during the ordering period?

Refer to answer to Question number 2 on timeline for Phase I.

The Government does not establish a specific timeline between subsequent phases, as the duration of Phase II and Phase III will depend on the volume of proposals received and evaluation timelines. In accordance with Section E.6(D)(2)(viii) of the solicitation, only Offerors that successfully advance from Phase I

– Hard Down-Select and determined to be within the competitive range following Phase II evaluation will be invited to participate in the System Functionality Test (Phase III).

18 RFP Section E.5(A)(1)(a)

With respect to the Phase I Go/No-Go requirement stating that “solutions limited to pilot deployments…will not satisfy this requirement,” can the Government clarify the objective criteria it will use to distinguish an acceptable operational clinical deployment from a pilot deployment (e.g., duration of use, number of active clinicians, integration into standard clinical workflows, production support model, or inclusion in routine patient care)?

The Government will evaluate Phase I (Clinical Operational Deployment) in accordance with Section E.5, Factor 1 and the Volume I submission requirements. Offerors must clearly demonstrate that the proposed solution is currently deployed and in active operational use in real-world healthcare clinical environments supporting routine patient care, and is not limited to a pilot, demonstration, or proof-of-concept. The solicitation identifies the information required to support this determination, including deployment in healthcare clinical settings, use by clinicians as part of routine patient care, approximate duration of live clinical use, and supporting documentation. The Government

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

will assess whether the proposal demonstrates operational clinical use beyond a pilot based on the information provided. No additional objective criteria beyond those stated in the solicitation will be applied.

19 RFP Section E.5(A)(1)(a)

For Phase I, does the Government define a “healthcare clinical setting” as a distinct facility/location, a business unit, or a health system? How should Offerors treat multi-hospital systems or multi-clinic enterprises in meeting the “10 sites” requirement?

For purposes of Phase I – Clinical Operational Deployment, a “healthcare clinical setting” refers to a distinct physical clinical site where routine patient care is delivered (e.g., a hospital department, outpatient clinic, or similar care environment). Offerors may count sites within multi-hospital or multi-clinic health systems separately, provided each site represents a unique physical location where clinicians are actively using the solution as part of routine patient care.

20 RFP Section E.5(A)(1)(a)

For the “minimum of 10 clinicians per site” requirement, can the Government define the criteria it will use to count qualifying clinicians (e.g., licensed users with active accounts, clinicians who have completed encounters using the system)?

Clinicians who have routinely (daily/weekly) completed clinical encounters using the system.

21 RFP Section E.6(D)(2)(viii)

Beyond the acceptance criteria published in Table VIII, are there additional performance thresholds or evaluation criteria that will apply during the Phase III Systems Functionality Test?

No. The Government will evaluate Phase III (Systems Functionality) in accordance with the acceptance criteria and performance thresholds specified in Section E.6 (D)(2)(viii), Table VIII. No additional performance thresholds or evaluation criteria beyond those stated in the solicitation will be applied.

22 RFP Section E.6(D)(2)(viii)

What Electronic Health Record (EHR) environment will be used during the Phase III systems functionality test

The test will not be integrated with an EHR environment. Your

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

(Veterans Health Information Systems and Technology Architecture (VistA)/ Computerized Patient Record System (CPRS)), Oracle Health, or both)?

transcript and note will be saved as a raw text file.

23 RFP Section E.6(D)(2)(viii)

Will Offerors have access to a VA test environment to prepare for Phase III systems functionality testing, and if so, how far in advance of the scheduled test date?

No, Offerors will not have access to a VA test environment.

24 RFP Section E.6(D)(2)(viii)

The solicitation describes testing using pre-recorded encounters played in-room and captured by a laptop microphone.

Can the Government confirm whether alternative capture configurations (e.g., browser-based or device-native capture modes) are permissible during the test, or whether testing is strictly limited to room audio capture via the Government Furnished Equipment (GFE) microphone?

Testing will use a standard GFE laptop with in-room audio capture through the laptop’s built-in microphone, as described in the System Functionality Test procedures. Offerors only need to provide clear instructions for using their application on a GFE laptop under these conditions. How the solution is coded internally does not matter, but alternative capture methods or specialized hardware will not be used.

25 RFP Section E.6(D)(2)(viii)

For the Meaning Preservation criterion, the solicitation states that “any clinically significant meaning reversal that is detected is a failure.” Can the Government define what constitutes a clinically significant meaning reversal, whether Offerors have an opportunity to appeal or review flagged instances, and whether there is a remediation period before a final pass/fail determination is issued?

A clinically significant meaning reversal occurs when the generated note changes the clinical intent of what was said in the encounter in a way that could alter diagnosis, treatment, assessment, or patient risk.

Clinical Subject Matter Experts will determine whether any note contains unsafe or clinically significant errors. Because all scoring is performed by blinded clinical panels, the Government will not offer any additional appeal or reconsideration process.

26 RFP Section

B.3, PWS 5.1.4

Is Oracle Health / Cerner EHR integration required as a capability at contract award, or does the Government anticipate a phased EHR integration roadmap (e.g., VistA/CPRS for base

The Government will require the capability to integrate into CPRS VistA under the day 1 Task Order and reserves the right to request

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

period with Oracle Health addressed in subsequent task orders as the VA’s migration progresses)?

integration into Oracle Health/Cerner.

27 RFP Section

B.3, PWS 5.1.4

What specific Application Programming Interfaces (API) does VA expect vendors to use for EHR note insertion: Health Level Seven (HL7) Fast Healthcare Interoperability Resources (FHIR), VistA proprietary APIs, Oracle Health APIs, or a combination? Does VA have a preferred or required integration standard?

FHIR for CPRS VistA. Additional integrations may be required based on the capabilities and functionality of Vendors’ offerings.

As the VA Ambient AI Scribe program scales to enterprise, the VA may move toward a consolidated, VA-managed user interface for all ambient scribe workflows. To support this direction, scribe vendors should expect to expose their core capabilities via open, standards-based APIs so that the VA can consume these services within its own application environment.

28 RFP Section

B.3, PWS 5.1.4

Will VA provide a test environment for EHR integration development and validation prior to Authority to Operate (ATO) submission?

Refer to answer to Question number 23.

29 RFP Section

B.3, PWS 5.1.4

For the EHR integration requirement, can the Government clarify the expected scope of bidirectional integration, specifically which functional capabilities (e.g., note write-back, appointment context retrieval, structured data insertion) are required to satisfy the base integration requirement versus which may be addressed at the task order level?

All integration required to deliver the full product capabilities will be required under the day 1 TO for CPRS VistA.

30 RFP Section

B.3, PWS 5.1.4

What level of EHR write-back is expected for pre-charting, order capture, and care plan insertion, is structured data write-back into discrete fields required, or is free-text note insertion into the chart sufficient?

Capability for both free-text and structured data write-back into discrete fields is required through remote procedure calls.

31 RFP Section

B.3, PWS 5.1.4

and 6.1

Are there existing VA-approved integration patterns or middleware that contractors must use, or may contractors

Online documentation exists for common integration patterns (Lighthouse API for example).

Applicants will be expected to

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

propose their own integration architecture subject to VA approval?

propose their integration plan as a part of the submission process.

Integration plans must ultimately be reviewed and approved by the VA before adoption.

32 RFP Section

B.3, PWS

5.1.10

Are specific specialty care templates required at contract award, or will specialty coverage requirements be defined at the task order level based on the clinical needs of the applicable

VISN?

Specialty care will be a part of the day 1 task order.

33 RFP Section

B.3, PWS 5.1.1

and 5.1.2

Is nursing clinical documentation (e.g., nursing assessments, nursing patient management workflows) within scope of this contract, and if so, what are the EHR integration targets and documentation workflow expectations for nursing staff?

The ability to contribute to a note as a part of the outpatient care team is expected.

34 RFP Section

B.3, PWS

5.1.2.1 and 5.1.2.2

Can the Government clarify whether (a) a VA-issued agency ATO is required prior to Day One of the first task order, and (b) whether an Offeror with a FedRAMP Moderate authorization in process may receive IDIQ award provided full authorization and VA ATO are obtained within a defined period prior to task order performance?

An ATO is required prior to any integrations into VA systems. A conditional ATO may be issued at VA’s discretion pending FedRAMP Moderate authorization timelines are met.

35 RFP Section

B.3, PWS

5.1.2.2

What is VA’s expected timeline for completing agency ATO review following task order award?

This is dependent on the quality of documentation and response time of the Vendor. No timeline will be provided at this time.

36 RFP Section

B.3, PWS 6.1.4

For SaaS solutions delivered on FedRAMP-authorized cloud infrastructure, please clarify whether the IPv6-Only and dual-stack requirements in Section 6.1.4 are satisfied by the cloud service provider's network-level IPv6 support, or whether the SaaS application itself must be independently

In accordance with Section B.3, PWS 6.1.4, it requires that the solution, as delivered, support IPv6-only and dual-stack environments. Offerors shall ensure their SaaS solution is capable of operating in such environments in accordance with the solicitation requirements. The

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

certified to the USGv6 Profile (NIST SP 500-267B Rev. 1).

Government does not prescribe whether this capability is achieved through the cloud service provider’s infrastructure or the SaaS application itself, nor does the solicitation require independent certification to the USGv6 Profile.

37 RFP Section

B.3, PWS 4.2,

5.1.3, and 5.3.4.1

How many VISNs are anticipated to be in scope for task order competitions, and will all VISNs be competed at or near contract award or phased over the ordering period?

All VA VISNs are in scope for this contract. We anticipate VISNs will be competed at or near contract award.

38 RFP Section

B.3, PWS

5.3.4.1

Can a single RTEP cover multiple VISNs, or will each VISN be a separate competition?

Each VISN will be a separate competition.

39 RFP Section

B.3, PWS 5.1.1

What are the most prominent non- English languages spoken by the VA patient population the Government expects to be served under this contract, and are multi-language transcription and documentation capabilities required?

The languages required under the Veterans and Family Information Act: Spanish, Tagalog, Arabic, Chinese, Korean, Dari, Polish, Portuguese, Russian, Vietnamese, French, Haitian Creole.

40 RFP Section

B.3, PWS 5.1.4

and 5.3.4.1

Given VA’s ongoing Oracle Health/Cerner modernization under the Electronic Health Record Modernization (EHRM) program, can the Government clarify how the EHRM rollout schedule across VISNs will affect EHR integration requirements for task orders issued under this contract (specifically whether task orders will be sequenced to align with EHRM go-live dates at applicable sites)?

The EHRM rollout schedule will not change or sequence task orders.

All VISNs remain in scope at all times, and task orders will require integration based on the EHR environment active at that site when the order is issued. Task orders will not be timed or aligned to Oracle Health go-live dates.

41 RFP Section B.2

For CLIN 0001, are user-months calculated based on activated licenses or actual usage? How are partially used months counted (e.g., a clinician activated mid-month)?

On the activated license. VA will use the reporting provided by the vendor to track and discontinue inactive licenses. If a user has an active license in any month it is considered a user month.

42 RFP Section C.3

Are there minimum order quantities per VISN task order, or can individual task orders be issued for small site deployments?

There is no minimum order quantities. Task Order(s) will be issued at the VISN level.

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

43 RFP Section B.2

For CLINs designated as NSP (not separately priced), will VA require itemized cost breakdowns in the technical or price volume, or are these costs understood to be fully embedded within CLIN 0001?

CLINs designated as NSP represent required base deliverables under the contract.

Prices associated with these NSP CLINs shall be included within the priced CLINs, in accordance with Section B.2 of the solicitation. No additional itemized cost breakdowns are required.

44 RFP Section

B.3, PWS §

6.7.3 and Section B.2

Does the 30-day advance disclosure requirement for AI model changes apply to updates to underlying foundation models or third-party model components incorporated into the solution, or only to changes made at the vendor’s application layer?

Yes. The 30-day advance disclosure requirement applies to any material AI model change, including updates to underlying foundation models or third-party model components and not just changes made at the vendor’s application layer. Only routine, non-material maintenance updates are excluded.

45 RFP Section

B.3, PWS 6.7.3

What constitutes a “material” model change requiring formal 30-day disclosure versus a routine update, patch, or fine-tuning adjustment? Can the Government provide examples or a definition to guide contractor compliance?

A material change includes any update that could affect system behavior, accuracy, safety, bias, or compliance. Routine patches or minor maintenance updates that do not affect functionality are not considered material.

46 RFP Section

B.3, PWS 5.1.6

Does the Government expect (a) a single national help desk, (b) VISN-specific support structures, or (c) a hybrid model? What escalation coverage is expected outside standard business hours?

In accordance with PWS 5.1.6, the Contractor shall provide technical support (online and via phone) during normal duty hours: Monday through Friday, 7:00 a.m.-5:30 p.m. local time in accordance with the implementing facility’s respective time zone. Technical support shall troubleshoot and resolve technical, functional, and access issues. The Contractor shall provide a centralized support capability to address issues across all VISNs.. See updates made in Amendment A00001.

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final

47 RFP Section

B.3, PWS 5.1.6

For the ASA < 1 minute and abandonment rate < 5% KPIs, can the Government clarify whether these are measured monthly or on a rolling average basis, and whether they are assessed at the national contract level or per individual VISN task order?

KPIs such as ASA under 1 minute and abandonment rate under 5 percent will be measured monthly, at the national contract level, unless individual task order(s) specifies additional VISN-level tracking.

48 RFP Section E.5(A)(2)(d)

For Factor 5 Veterans Involvement credit for proposed SDVOSB/VOSB subcontractors, what specific documentation must be included in the proposal to demonstrate certification status at time of submission? Is a VetCert screenshot sufficient, or is additional documentation required?

Refer to Section E.6(D)(2)(b)(v), Volume V – Veterans Involvement Factor, of the solicitation.

SDVOSB/VOSB status will be verified based on certification in the SBA Veteran Small Business Certification Program database at time of proposal submission and award.

49 RFP Section E.5(A)(2)(d)

Beyond SDVOSB/VOSB certification of the prime or subcontractors, will the Government consider other forms of Veterans involvement in evaluating Factor 5 such as Veteran employment rates across the Offeror’s team? If so, what documentation or commitments are required to demonstrate this, and how will it be weighted relative to certified SDVOSB/VOSB participation?

The Government will evaluate Factor 5 – Veterans Involvement in accordance with Section E.5, Factor 5, of the solicitation. The Government will not consider additional forms of Veterans Involvement beyond those specified in the solicitation.

50 RFP Section B.2 and General Rollout

CLIN 0001 establishes a ceiling of 4,700,000 user-months but does not define a planning baseline. Can VA provide: a) an indicative target range for the number of clinicians expected to use ambient scribe at steady state, and b) an anticipated adoption ramp by ordering year (e.g., pilot vs national rollout)?

VA does not have a target clinician count to share. Adoption levels will vary by VISN and clinical need and will be determined through task order competitions.

51 General Since this is a Multiple Award Task Order (MATO) IDIQ, does VA anticipate:

a) awarding initial task orders to multiple vendors in parallel, and b) potentially operating more than one ambient scribe

Yes. The Government may award task orders to one or more contract holders in accordance with fair opportunity procedures. The Government reserves the right to

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

solution concurrently across different VISNs/sites?

issue task orders to multiple vendors and to support deployment of solutions across different VISNs, as appropriate to meet program needs.

52 General Will VA compete every task order among all awardees, or does VA anticipate any program-level standardization on a single primary ambient scribe solution over time?

All task orders will be competed among all awardees. VA does not plan to standardize on a single ambient scribe solution at the program level. Multiple solutions may operate in parallel across VISNs.

53 General Please confirm the EHRs in scope for this contract (e.g., VistA/CPRS, Oracle Health Cerner, Epic, other), and indicate approximately how many facilities or VISNs are expected to use each EHR over the 5-year ordering period.

Both VistA/CPRS and Oracle Health are in scope for use with Ambient Scribe. VA is only seeking to integrate with VistA/CPRS at this time. VA does not have a target clinician count to share.

Adoption levels will vary by VISN and clinical need and will be determined through task order competitions.

54 General For legacy VistA/CPRS sites, does VA expect deep, API-level integration (e.g., automatic patient/context launch and note injection) or is text-based insertion (e.g., via existing interfaces) acceptable as a first phase?

VA expects full API-level integration, including automatic patient/context launch and note insertion. Text-based insertion alone is not sufficient. The required integrations must support both freetext and structured data writeback through remote procedure calls, as specified in Section B.3, PWS 5.1.4, of the solicitation.

55 General Will VA provide standardized EHR integration patterns and governance (e.g., central integration services, shared APIs), or should each Offeror assume responsibility for designing and implementing those patterns per task order?

VA provides some established integration patterns, such as Lighthouse APIs, but contractors are expected to design and propose their own integration approach as part of each task order that include EHR integration.

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final

56 RFP Section

5.1.2.1

The solicitation states that the solution shall be FedRAMP-compliant at the Moderate impact level and obtain a VA-issued ATO. Does ‘authorized at Day 1 TO’ require existing authorization at award, or can authorization be obtained post-award prior to TO execution?

VA does not require an existing VA ATO at contract award. The contractor may obtain the VA ATO after award but before task order execution. The solution must hold a FedRAMP Moderate authorization at the time needed to support the task order. Refer to answers to Questions 3, 34, and 35.

57 RFP Section

5.1.2.2

Does VA expect the contractor to fund and execute all ATO-related assessment and documentation activities under this IDIQ, or will VA provide any shared security services or reusable control inheritance (e.g., from enterprise VA enclaves)?

VA will not be providing funds to execute ATO-related assessment and documentation activities under this IDIQ.

58 RFP Section

B.3, PWS 6.7.1

through 6.7.3

Sections 6.7.1-6.7.3 specify AI System/LLM documentation, compliance monitoring, corrective action plans, and change disclosures. Can VA clarify whether these deliverables are required:

a) once per contractor at the IDIQ level,

b) per solution (if a contractor offers multiple ambient scribe platforms), and/or c) per task order?

These deliverables apply to each ambient scribe AI solution an Offeror proposes. For every distinct model or platform, the contractor must provide the required AI documentation, monitoring approach, and change-notification materials so VA can evaluate that specific system’s compliance. These are not one-time, contractor-wide submissions; they are tied to each solution the contractor wants considered under the IDIQ.

At the Task Order level, the contractor updates and tailors these materials to reflect how that solution will be used for that TO.

This includes submitting monitoring and corrective-action information if issues arise, and

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

providing advance notice of material model changes before they are implemented. TO-specific reporting then folds into the regular contract reporting requirements.

59 RFP Section

B.3, PWS 6.7.1

through 6.7.3

Does VA require contractors to expose detailed model-level information (e.g., training data sources, architecture detail) or will high-level documentation of model behavior, guardrails, and controls be sufficient for AI governance deliverables?

VA does not require contractors to disclose sensitive or proprietary model internals such as detailed architectures, training data sources, or other protected IP. The AI governance sections (6.7.1– 6.7.3) focus on operational transparency, behavioral documentation, controls, risk monitoring, and change notifications, rather than exposing underlying model code or datasets.

60 RFP Section

B.3, PWS 5.1.3

The PWS calls for retaining intermediary data (audio, transcripts) for 30 days, with possible extensions for legal reasons.

Can VA confirm whether: a) VA expects the contractor to host all such data in the contractor's environment, or b) VA prefers those artifacts to be exported into VA-managed storage within the 30-day window?

The data will be kept in the vendor’s environment unless otherwise requested by VA.

61 General Does VA require any specific data residency constraints (e.g., all clinical and log data must reside in CONUS-based data centers) beyond FedRAMP Moderate requirements?

Yes. Beyond FedRAMP Moderate, VA requires that all VA data, including clinical data, transcripts, logs, and any derivative artifacts, be stored, processed, and transmitted only within the United States.

62 RFP Section B.2

CLIN 0001 states that the per-user-month price must include all future enhancements and additional capabilities that become part of the generally available commercial solution, with no additional charges. Please confirm that: a) new, separately branded

CLIN 0001 requires the per user-month price to include any enhancements or added capabilities that become part of the contractor’s generally available commercial ambient scribe product. This requirement does

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

products or modules are out of scope for this requirement, and b) 'included enhancements' are limited to features added to the licensed ambient scribe product SKU(s).

not apply to new, separately branded products or distinct modules that are not part of the licensed ambient scribe SKU.

Included enhancements are limited to features that become standard within the ambient scribe product itself.

63 RFP Section B.2

For CLIN 0001, can VA confirm that the billable unit is the number of named/active clinician users per month (not encounters or minutes), and clarify whether VA anticipates any minimum or maximum utilization thresholds per user?

The billable unit is the number of named/active clinician users per month.

64 RFP Section B.2

PWS 5.1.9 and CLIN 0005 reference 'Additional Capabilities.' Can VA provide examples of capabilities it anticipates using under this CLIN (e.g., AI-assisted order sets, coding support, summarization across multiple encounters) to better bound scope and pricing?

Refer to answer to Question number 11.

65 RFP Section B.2

Does VA intend CLIN 0005 to cover only ambient-scribe-related extensions, or could it also include broader AI assistant functionality (e.g., population-level analytics, admin automation) if built on the same platform?

CLIN 0005 is intended to cover additional capabilities that extend or enhance the ambient scribe solution. VA does not intend this CLIN to serve as a vehicle for unrelated or broader AI assistant products.

66 RFP Section E.5(A)(1)(a)

For the Phase I operational deployment requirement, can VA clarify whether prior implementations in non-VA health systems count equally, provided they meet the minimum of 10 sites x 10 clinicians, or whether VA/DoD deployments receive additional consideration?

Deployments that meet the criteria defined in the Sections E.5 and E.6 of the solicitation will be treated equally.

67 General Can vendors leverage evidence and evaluation results from the 2024 VHA AI Tech Sprint (e.g., clinical assessments, metrics) in lieu of re-performing similar

No.

Please be advised that any information contained herein is for informational purposes only, is offered in response to specific questions posed by prospective Offerors, and is subject to change throughout the question and answer process. Accordingly, in the event that there is any discrepancy between the information contained within this document, any subsequent Question and Answer document(s), and/or the Solicitation, Offerors are hereby advised that the terms and conditions contained within the final Solicitation control.

studies, and if so, how should such evidence be referenced in proposals?

68 General Does VA have any preference on whether the prime contractor is: a) the ambient scribe OEM, or b) a systems integrator teaming with one or more OEMs, provided all functional and security requirements are met?

The Government has no preference.

69 General If a prime proposes multiple COTS ambient scribe solutions (e.g., for different EHR environments), will VA evaluate each solution separately under Phase I/II/III, or evaluate the combined offering as a single technical solution?

The VA will only test one solution per Offeror; the test will not be in an integrated environment and will be EHR agnostic.

70 General Given the complexity of the RFP, including the multi-phase evaluation process, extensive technical and compliance requirements, detailed documentation and reporting expectations, and the need to address performance metrics and security standards, we respectfully request a two-week extension to the proposal submission deadline.

Refer to answer to Question numbers 2 and 4 and see updates made in Amendment A00001..

71 RFP Sections A.2 and A.4

The PWS section A.2 Combined Synopsis/Solicitation (p. 3) states that solutions will use “a Software as a Service (SaaS) delivery model” in “accordance with [FAR] part 12.”

Section (4) Disabling Software Code (p.

7) prohibits code that disables software.

This is contrary to the delivery of a subscription SaaS product that is enabled only through its licensed term.

We respectfully request that you please remove this requirement as it is incompatible with cloud based software delivery.

The Government will not remove Section A.4(4) (Disabling Software Code). This requirement remains applicable.