36C10G18R0208-1-0015001.pdf

Question number OFFEROR QUESTIONS TO AMENDMENT A0013 CONTRACTING OFFICER RESPONSE

The submission instructions require that the Offeror submit the CCN Region 4 FPR-2 in two versions, in an email to CCN4@va.gov and in two CD ROMs per changed Volume (one clean and one line-in/line-out). Please confirm that these are the instructions you wish for us to follow, given that L.4 of the Conformed RFP 36C10G18R0208-1 Amendment 0013 provides conflicting instructions.

Yes, The FPR-2 request letter provides additional instructions we wish you to follow. Amendment A0015 provides an updated Section L.4.1 specific to FPR-2 .

The FPR-2 instructions require that an Offeror make a written statement for any Volume that will not require a change. Is it your intention that this statement(s) be included as a separate Tab in Volume V? And, should the SF33 also be included in Volume V if no changes are being made to Volume I?

Yes, The offeror may comply with the requirement by acknowledging the amendment via including the signed SF30 as a separate tab in Volume V and provide the signed Amendment SF33 in Volume V if no changes are being made. If there are no changes to the VOL V then offeror may submit the documents in the envelope with the CDs.

Does FPR-2 Submission of Final Proposal Revisions take precedence over submission instructions in Section L when a conflict exists?

Yes, Amendment A0015 provides an updated Section L.4.1 specific to FPR-2 .

Are we only required to submit via email and CD ROM, and will not submit an FPR-2 version via the AcquServe Vendor Portal.?

Yes, the Offeror is only required to submit via email and CD ROM. Amendment A0015 provides an updated Section L.4.1 specific to FPR-2 .

For CLIN 0008, Table 24 shows as Priced AND Weighted, but Table 30 does not include a weighting. Please clarify for us if this CLIN is weighted or not?

Yes CLIN is weighted, Table 30 is corrected in Amendment 0014 dated 4/6/19.

Why is the Government now requesting offerors to contradict the reimbursement requirement defined by Section B.1 by allowing offerors to propose reimbursement of Section 4.1 and

4.2 defined Healthcare Services at below the Medicare Rates for Highly Rural Care Areas and Scarce Medical Resources?

CLIN X002 (All Periods of Performance) description was changed in Amendment A0015 to: ““Price Required. This CLIN is to be priced as a percentage of Medicare. The contractor may propose a percentage rate equal to or greater than the Medicare rate. See Attachment L, “Region 4 Authorizations & Unique Counts by Rurality FY15-FY18”.

The Contracting Officer will only authorize pricing to be paid for this CLIN when Contractor submits documentation for the rate proposed in a Highly Rural Area or for Scarce Medical Services

We request that the Government please clarify which CLIN defines the reimbursement of services covered by PWS 4.1 and 4.2. The requested pricing included in the tables on pages 9-49 of the Amendment 13 conformed RFP for CLIN X002 contradicts the stated reimbursement requirements defined by Section B.1.

CLIN X002 (All Periods of Performance) description was changed in Amendment A0015 to: ““Price Required. This CLIN is to be priced as a percentage of Medicare. The contractor may propose a percentage rate equal to or greater than the Medicare rate. See Attachment L, “Region 4 Authorizations & Unique Counts by Rurality FY15-FY18”.

The Contracting Officer will only authorize pricing to be paid for this CLIN when Contractor submits documentation for the rate proposed in a Highly Rural Area or for Scarce Medical Services

Would the Government provide clarification that for purposes of CLIN X002, that only proposed rates in excess of the applicable Medicare rates should be proposed by each offeror to the extent applicable. No rates below the applicable Medicare Rates should be proposed.

No rates below medicare rate should be proposed.

In the tables on pgs. 9 - 49 of the Amendment 13 conformed RFP, the CLIN/Option x002 CLIN Description was revised to state that offerors “may propose a rate less than, equal to or greater than the Medicare rate.” However, on pg. 52 of the Amendment 13 conformed RFP, in Section B.1, the RFP states that CLIN x002 “only applies if the Contractor must execute a specific agreement in a Highly Rural Care Area at a rate that exceeds Medicare as required to maintain Network Adequacy” [emphasis added]. If CLIN x002 only applies when a contractor needs to execute an agreement at a rate that exceeds the Medicare rate, then why is the Government requesting offerors to propose a rate that is less than or equal to the Medicare rate?

"Less than" is removed from CLIN description in Amendment 0015.

The information being requested in the tables on pages 9-49, contradict the defined applicability for CLIN X002 on page 52.

How can the Government evaluate a proposed rate that is less than the Medicare rate as “fair and reasonable” when this CLIN is defined to only be applicable for reimbursement rates that exceeds Medicare Rates?

"Less than" is removed from CLIN description in Amendment 0015.

Could the Government please confirm that CLIN X002 is only applicable for proposed reimbursement rates that exceed Medicare Rates and revise the tables on pages 9-49 accordingly to remove the language “may propose a rate less than, equal to or”?

No." Less than to be removed in Amendment 0015. Equal or above. See 9 and 10.

Can the Government please provide an example of a scenario in which they would trade-off a higher cumulative weighted score (presumably correlated with a lower aggregated proposed price) for a higher aggregated proposed price?

It is possible for a higher total aggregate price to correspond to a more favorable cumulative weighted score. Section M.4.3.4 states: “The Contracting Officer may determine the proposed prices fair and reasonable based solely on an analysis of the cumulative weighted score in accordance with this section.” and “The Government reserves the right to trade-off in the award decision the total aggregate proposed price against the cumulative weighted score. The Government may award to a higher aggregate proposed price.”

What is the purpose of the objective weighting of CLIN Group C if the Government will ultimately be applying subjective discretion in the contract award decision between the aggregate proposed price and the cumulative weighted score?

The purpose of the weighting is to ensure the procurement reflects VA objectives and services are procured at a Fair and Reasonable price. Please see Question 12 for additional detail.

Is the Government’s intention in this revision simply to reserve the right to perform a best value tradeoff (between price - using Cumulative Weighted Score as the Total Evaluated Price -versus other evaluation criteria) even if it results in an award to a higher aggregate proposed price? Or did the Government intend to refer to making a tradeoff between proposed price and the weighted score for that price, in which case the manner in which such a tradeoff would be made is entirely unclear, and we request that further clarification be provided

The Government refers to making a tradeoff between Cumulative Weighted Score against total aggregate price to determine which is in the best interest of the government.

Amendment 13 conformed RFP uses the following terms interchangeably throughout the RFP: “Aggregate Proposed Price,” “Total Evaluated Price (TEP)”, and “Cumulative Weighted Score.” Can the Government please clarify the definitions of each of these items? In all cases, will the Cumulative Weighted Score be used as the Total Evaluated Price?

• The Total Evaluated Price of each CLIN is calculated by applying unit price proposals to volume data.

• The Score of each CLIN is the difference between the IGCE and the Total Evaluated Price of each CLIN multiplied by the applicable weight.

• The Cumulative Weighted Score is the sum of the CLIN-specific scores; this serves as the Offeror’s Total Evaluated Price across all CLINs.

• The Total Aggregate Proposed Price is the sum of the Total Evaluated Price of each CLIN (i.e., non-weighted).

Amendment 13 RFP Table 30 does not have a weight assigned to CLIN x008, which is in CLIN Group C. What weighting does the Government intend to apply to CLIN x008?

Please see Amendment A0014 posted 4/6/19 for correct Table 30.

17 Did the Government intend to assign a weight of 0% to CLIN x008?

No, Please see Amendment A0014 posted 4/6/19 for correct Table 30.

If a weighting greater than 0% is applied, how the weightings be adjusted for the other CLINs listed on Table 30 because the weightings listed for the other CLINs on Table 30 currently totals to 100%?

Please see Amendment A0014 posted 4/6/19 for correct Table 30.

Can the Government please confirm that Attachment Y excludes the Home Infusion billed charges and Home Infusion total amounts paid for the Choice program, which it is our understanding is significantly larger than the PC3 or any other current VA program, which we assume is what is currently stated in the Attachment Y amounts?

Yes, Attachment Y is based on all non-VA care, excluding Choice program.

20 Can the Government provide the total Home Infusion amounts paid for the Choice program?

The Government does not intend to provide total Home Infusion amounts paid for the Choice program.

Does the Government expect the total Home Infusion charges under CLIN x008 for the VA Region 4 CCN contract to be comparable to the $32,765 in total amounts paid in the 27-month period (i.e., $1,200 per month)?

No. The table does not say it is a projection of future spending. The Government is providing the historical information for the CPT codes that are being utilized for the evaluation. This data displays all CPT codes where there was no VA Fee Schedule and CMS Schedule, and the total bill frequency , total unique, and billed charges for the period stated.

If no, can the Government provide an estimate of the annual amount of billed charges that will occur during the Region 4 CCN contract?

The Government does not intend to provide a projection of billed charge expenditures at this time.

For all of the CLINs where the Government provided volume amounts in Amendment 13, can the Government confirm whether these are annual or monthly volume estimates?

The volume estimates provided in Amendment A0013, which are used in the IGCE and will support proposal evaluation are all annual, with the following exceptions:

SubCLINs X011Ax, X011Bx, and X011CA are monthly Active Veteran estimates, as the applicable unit for these SubCLINs is a "price for each Active Veteran per month".

24 Would the Government please confirm that all volume amounts are correct as stated or whether any updates are necessary.

All volumes in Amendment A0013 are correct for use in the pricing evaluation and represent the most up to date information available.

Why are the volumes included in Figures 2 and 3 significantly higher than the volumes in RFP Attachment AB - Pharmacy 14 Day Fills v2 (e.g., 3,500 prescriptions per year in Attach AB vs.

150,000 to 600,000 depending on the year in Figure 3)?

The volume assumptions in the amendment are informed by data in the attachments, but also include additional assumptions to best estimate future demand.

26 Are the amounts in Figures 2 & 3 the number of prescriptions filled or the cost of the medications? They are the number of projected prescriptions to be filled.

Can the Government please confirm that the CDT volumes provided in this table will be used to evaluate the pricing for each of the annual periods included in the contract PoP?

Yes, the CDT volumes provided in this table will be used to evaluate the pricing for each of the annual periods included in the contract PoP

Can the Government please confirm that the volumes provided in the table are intended to represent the estimated monthly volumes and NOT intended to represent annual volumes?

The volume estimates provided in Amendment A0013, which are used in the IGCE and will support proposal evaluation are all annual, with the following exceptions:

SubCLINs X011Ax, X011Bx, and X011CA are monthly Active Veteran estimates, as the applicable unit for these SubCLINs is a "price for each Active Veteran per month".

The 5 April 2019 letter with the Submission of Final Proposal Revisions (FPR-2) references an Attachment I that contains the page limitation requirements for this FPR-2 submission.

However, Attachment I was not provided. Can the Government please provide the attachment this letter is referring to?

No FPR-2 attachment is provided, Please see revised submission instructions in Amendment A0015.

Can the Government clarify if the line-in/line-out text submission should indicate all edits (i.e., both FPR-1 and FPR- 2 edits) from the original proposal submission OR if the line-in/line-out text submission should only indicate all edits from the FPR-1 “clean” proposal submission to FPR-2 proposal submission?

Yes, the line-in/line-out text submission should only indicate all edits from the FPR-1 “clean” proposal submission to FPR-2 proposal submission.

31 Will you extend the time and date for receipt of Offers Yes, the submission date and time is extended to 12 April 2019 at 10:00 EDT.

Please clarify and confirm that offerors need not complete and submit a new “CCN Reg4 Pricing Template v8 04032019” unless an offer submits a FPR-2

A complete CCN Reg4 Pricing Template v8 04032019 is required. If the VOL V Volume is not changed from FPR it requires a statement is required as with other volumes.

Please clarify and confirm that, if an offeror decides to not make any changes to its original proposal or FPR-1, the offeror must only submit via email the required statements indicating no further revisions are warranted (i.e., confirming no FPR-2 is being submitted), along with emailed copies of the required SFs.

If the FPR-1 submission is unchanged then the Offeror need only submit via email the required statements indicating no further revisions are warranted (i.e., confirming no FPR-2 is being submitted), along with emailed copies of the required SFs. A completed CCN Reg4 Pricing Template v8 04032019 is required, even if pricing is unchanged.

With regard to the SF submissions themselves, please confirm that signed SF-30s for Amendments 13 and 14 must be submitted, but that offerors are not required to re-submit the SF-33 unless submitting a revised proposal.

The SF-33 is required. The SF-33 may be included with a revised VOL V or sent in the CD envelope.

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