CCN Region 5 Alaska Consolidated Responses to Questions from Industry for A0002.pdf

ITEM RFP SECTION RFP SUBSECTION RFP PAGE NUMBER (Number Identified at the bottom page of

PDF)

RFP CATEGORY COMMENT/RECOMMENDATION/FEEDBACK GOVERNMENT RESPONSE

1 E.1 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO

OFFERORS—COMMERCIAL ITEMS

4.2 1 SECTION E - SOLICITATION PROVISIONS SF1449 states that the response to RFP 36C10G20R0014-001 is due June 1, 2020.

Due to the changes in requirements since Region 5's last solicitation and the amount of information subject to review, interpret, and produce within a response, will the VA consider extending the deadline for response to mid- June?

Yes, the new closing date is now June 8, 2020. Please see Amendment 0002, Block 11 and 14 of the SF 30.

2 PWS Section 1.1 Section B, C, D, and E - All Subsections

14 1.0 GENERAL INFORMATION Since the last solicitation, there appears to be various changes to RFP 36C10G20R0014-001.

To review, compare, and assess material changes that have occurred and respond within the timeline noted by the VA, will the VA consider providing an attachment that summarizes all changes made between the last solicitation requirements and RFP 36C10G20R0014-001 requirements?

No - this is a new solicitation.

3 E.8 ADDENDUM 52.212-2 EVALUATION FACTORS Basis for Award 187 SECTION E - SOLICITATION PROVISIONS RFP 36C10G20R0014-001 will result in a single-award, Indefinite Delivery Indefinite Quantity (IDIQ) contract. The requirements of the RFP require labor-driven outputs (including kick-off meeting, development of multiple deliverables, and design of training programs, etc.) as part of the IDIQ administration effort and separate from direct billing of fixed price deliverables.

How will the awarded contractor be reimbursed associated with these efforts under the IDIQ - will these be reimbursed under the performance based milestones within the implementation plan?

In accordance with B.5 Price/Cost Schedule, 2 CLIN Specific Descriptions, NSP CLIN XY12, Upon satisfactory completion of the start-up/implementation milestones identified and accepted in the contractor’s implementation plan the Contractor shall invoice in accordance with the firm fixed price performance-based milestones. The Contractor may not invoice the entire lump sum amount if it fails to meet the implementation milestones in the accepted implementation plan. These implementation services shall be excluded from other Contractor administrative service fees.

4 PWS Section 12.13 Procedural Codes and Regulations

87 12.0 CLAIMS PROCESSING AND ADJUDICATION FOR CCN

HEALTHCARE SERVICES RENDERED

Article 12.13 states "The Contractor shall ensure the claims processing system and any associated business rules and processes incorporate and maintain VA statutory and regulatory authorities, including any subsequent changes thereto."

Which statutory and regulatory authorities are the VA referring to?

38 United States Code (U.S.C.) § 1703, "Veterans Community Care Program", 38 United States Code (U.S.C.) § 1725 "Mill Bill/Emergency Non-Service Connected Care" and 38 United States Code (U.S.C.) § 8153, “Sharing of Health-care Resources." 38 U.S.C. § 8153 refers to a number of statutes regarding reimbursement.

5 PWS Section 12.1 12.1.1 Claims Adjudication and Payment Rules

74 12.0 CLAIMS PROCESSING AND ADJUDICATION FOR CCN

HEALTHCARE SERVICES RENDERED

Article 12.1.1. states "The Contractor's claims processing system shall be capable of adding rules and edits based on information from VA, to include the application of Alaska VA fee schedules and Maximum Allowable Charges Schedule (Attachment 12).

When the VA states "Alaska VA fee schedules" are they being inclusive of adding rules and edits to include the application of VA Tribal Sharing Agreement rates and reimbursement methodologies?

Yes. The Contractor's system must be capable of adding rules and edits to include the Alaska Fee Schedules (CLIN XY06), Tribal Health Payment Methodologies (XY22) and Maximum Allowable Charges Schedules.

6 PWS Section 3.1 3.2 Provider Networks 32 3.0 HIGH PERFORMING NETWORK Subsection 3.2 states "The Contractor shall meet the following minimum network adequacy standards for urgent care. 90% of enrolled Veterans are within 30 minutes of an Urgent Care clinic with CMS. POS codes 17, 20, 22, 81, or an approved POS 11 Urgent Care location in Region 5."

This network adequacy standard is not feasible in some highly rural areas of Alaska. Will telemedicine capabilities to meet urgent care adequacy for areas where criteria cannot be met be accepted by the VA?

VA has modified the language for PWS Section 3.2. The requirement now reads:

• 70% of enrolled Veterans are within a 30 minute commute/drive time of an Urgent Care clinic with CMS at the start of HCD for the base year and through the end of Option Year 1.

• For Option Periods 2- through 7 the Contractor shall meet 90% of enrolled Veterans access to an Urgent Care clinic within a 30 minute commute/drive time.

VA will evaluate the Contractor's ability to build an Urgent Care Network for PWS Section 3.2 for the base year through Option Year 1 only, specifically, 70% of enrolled Veterans are within a 30 minute commute/drive times of an Urgent Care clinic with CMS at the start of HCD. See PWS Section 3.2, E.4.2.1.1 and E.8, Subfactor 2 of Amendment 0002.

7 PWS Section 7.4 7.5.4 Network 60 1.0 GENERAL INFORMATION Subsection 7.5.4 states "The Contractor shall operate a Veteran and Provider call center that will address immediate needs to triage/troubleshoot issues real-time. Any general questions regarding the UC benefit, eligibility, copayment information, or other general information will be routed via an IVR system to the VA’s Veterans’ Experience Office. The Contractor shall provide an escalation pathway in the event issues are not resolved for the provider or the Veteran. The Contractor shall provide services between the hours of 7AM and 12AM in the time zone of urgent care provider. In accordance with Section 18.2, the Contractor must always provide System Availability 99.9 percent of the time, measured monthly. The contractor must always create and provide customer service technology availability statistics to VA monthly as part of the deliverable referenced in Section 6.8, “Call Center Operations and Customer Service Technology Performance Requirements and Metrics.” The Customer Service Availability statistics must always calculate the service’s unavailability for each calendar month. Calculation of service unavailability is the number of available minutes in a calendar month vs. the number of unavailable minutes and will not include any time the service is unavailable due to scheduled maintenance. The Contractor must always notify the CO and COR of scheduled system maintenance at least two (2) weeks in advance. The system maintenance notification must always include the system(s) affected, changes that will occur, and the date/time the changes will be in effect. The Contractor must always schedule system maintenance during the standard maintenance windows provided by VA. For unscheduled system maintenance, unscheduled downtime, unexpected interruption to web/online services, and call center functionality, the Contractor must always notify VA immediately (within one [1] hour of being alerted of an issue). Such notification must always be electronic via an agreed upon process with VA."

This entire subsection is a new addition/requirement to the solicitation - will the VA please explain the reasoning for this change? The addition of the Contractor operating a call center for not only providers, but also the Veterans poses the need for increased resources, workflows, and processes.

The purpose of adding Veterans is to provide Veterans with access to information regarding Urgent Care benefit, eligibility, copayment information or other general information that is routed via an IVR system to the VA's Veteran Experience Office.

8 PWS Section 7.5 7.5.5 62 1.0 GENERAL INFORMATION Within subsection 7.5.5 Education, the RFP states that "The contractor will collaborate with VA on proposed educational materials that will be sent to Veterans, UC providers, or UC pharmacies and will submit to VA for review and approval prior to publishing content."

Since the last solicitation, the VA added the word "Veterans" to this subsection. Will the VA please explain the reasoning for this change? The addition of Veteran educational materials poses the need for increased resources and development.

The requirements for Urgent Care within VA has been expanded and revised to include educating Veterans.

9 PWS Section 3.7 3.7.1 Credentialing Requirements

40 3.0 HIGH PERFORMING NETWORK Subsection 3.7.1 states that "The THPs have established accreditation and credentialing standards established by the Indian Health Service (HIS) which are acceptable within the scope of this contract for CCN participation and Veteran care. The Contractor is encouraged to include providers employed by THPs."

This paragraph previously stated that THPs provide significant healthcare to Veterans in AK, especially in the highly rural, lower population density areas. Will the VA provide clarification as to why this sentence was removed and will the VA explain how a Contractor facilitating the CCN would be able to perform the scope of work within the PWS without full THP participation to ensure access, adequacy, and a streamlined ability to receive healthcare services is achieved for veterans in rural and highly rural Alaska which comprises the majority of the Alaska healthcare landscape?

Contractors can and are encouraged to use THPs to provide healthcare services to Veterans in Alaska. However, if the contractor is offering and counting the THPs as part of their network then the THPs must comply with the terms and conditions of the CCN contract.

10 PWS Section 7.1 7.1 Referrals 55 7.0 REFERRALS In subsection 7.1 Referrals, the RFP states, "All services require an Approved Referral from VA. There are very limited exceptions which an Approved Referral is issued retroactively as outlined below. For any care provided under this contract, Contractor shall not invoice VA unless an Approved Referral has been issued by VA."

What would the VA prefer a Contractor to do in the event that a claim is received with no approved referral - hold the payment to providers until there is an approved referral in place and/or deny if no approved referral is generated or something else? Will the VA please clarify the referral process for urgent and emergent medical services?

a. Please read PWS Section 7.0 in its entirety.

b. Please see the requirements of PWS Section 7.1 for Notification of Emergent Healthcare and PWS Section 7.5 for Urgent Care. For Invoicing, please see Section B.8.

11 SECTION E Solicitation Provisions 10 SECTION E - SOLICITATION PROVISIONS In section A. Term of Contract, the RFP states "The Contracting Officer will revise the base period of performance based on actual date of award. Base Period: October 12, 2020 - October 11, 2021."

How does the nine month implementation time frame factor into the base period?

The 9-month implementation time frame is included within the 12-month base period.

12 PWS Section 3.1 3.1 Network Adequacy 28 1.0 GENERAL INFORMATION The footnote on page 28 indicates that the commute/drive time definition is available within Attachment 1 - we are unable to locate the definition in attachment 1.

Will the VA clarify where in attachment 1 this definition exists or provide the definition if it's not currently in attachment 1?

Drive/Commute Time is the time between the Veteran’s official residence (as determined in the eligibility and enrollment system) and the rendering provider’s physical address without factoring in allocations for traffic conditions (based on claims information). Drive/Commute time is not limited by mode of transportation because of the geographic landscape of Alaska.

Please see Amendment 0002 for updated Attachment 1 PWS Terms and Definitions 0001.

13 C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE

CONTRACT (MAR 2000)

Option to extend the term of the contract

161 SECTION C - CONTRACT CLAUSES The option to extend the term of the contract states "The Government may extend the term of this contract by written notice to the Contractor within 15 days of Contract expiration." In the last solicitation, the option to extend the term of the contract stated within 30 days of Contract expiration.

What was the VA's purpose for changing the government's ability to extend the term of this contract from 30 days to 15 days?

Revised Clause 52.217-9 to read as: (a) The Government may extend the term of this contract by written notice to the Contractor within 30 days of Contract expiration; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension.

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

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed eight (8) years and 6 months. Please see Amendment 0002

14 PWS Section 3.2 3.2.1 CCN Healthcare Services Network

34 3.0 HIGH PERFORMING NETWORK In subsection 3.2.1 the RFP states "The Contractor shall make every reasonable attempt to enroll Alaska THPs to ensure adequate access to community care for AK Veterans."

THPs are the only healthcare providers in most rural and highly rural Alaska - THPs currently are reimbursed by the VA under the VA Tribal Sharing Agreements - to maintain the integrity of those agreements and ensure all Alaska Veterans receive care, will the VA allow tribal providers to operate with the CCN under the contract provisions, terms, and rates established within the standing VA Tribal Sharing Agreement? This will allow for a streamlined process and will ensure THPs are participating in the CCN, THPs, as the only healthcare provider option in rural and highly rural areas, No. Under the CCN contract all care provided must follow the terms and conditions stated in the CCN Performance Work Statement, to include the provider being in the CCN network.

Please review the entire RFP for all requirements, specifically section 7.0 Referrals and B.5 Schedule of Services. The VA Tribal Health Sharing Agreements (THSA) will be recognized in the same manner as they are recognized now after the implementation of Region 5 Community Care Network (CCN).

The 26 existing reimbursement agreements with Alaska Tribal Health Programs (THPs) will remain standalone agreements.

The terms in those agreements do not apply to the CCN Region 5 RFP and resulting contract. The CCN contract is a separate contract vehicle for VA to acquire care in the community (for all Veterans) and will not/does not supersede or overlay the existing requirements outlined in those agreements.

Reimbursement to THPs under CCN will be at the same rate that THPs receive under the THSAs (see CLIN XY22).

15 E.8 ADDENDUM 52.212-2 EVALUATION FACTORS Factor 3 Price: D 193 SECTION E - SOLICITATION PROVISIONS In Section E.8 Addendum 52.212-2 Evaluation Factors Factor 3 - Price D. CLIN XY11 (Administrative Services) the VA provides a table 6 with projected active veterans volume by contract year.

Was this table provided as an example of how the CLIN is calculated or are these the projections that the VA will utilize to pay for administrative services? Are the projected active veterans in Table 6 example volumes? Will the Contractor be paid based on projected active veterans (as listed in Table 6) or actual active veteran volume experienced each month of HCD?

Table 6 was provided as an example of how the CLIN is calculated. Yes, projected active veterans in Table 6 are example volumes. The contractor will be paid based on actual active veteran volume experienced each month of HCD.

All estimates provided in the tables and attachments are estimates only and there is no guarantee that they will be purchased. The solicitation states as follows:

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

(a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule and are estimates only and are not purchased by this contract.

16 C.18 VAAR 852.271-70 NONDISCRIMINATION IN SERVICES

PROVIDED TO BENEFICIARIES (JAN 2008)

C. 18 Guaranteed Contract Minimum and Contract Maximum

167 SECTION C - CONTRACT CLAUSES The RFP states "The guaranteed minimum for each period of performance is below. The guaranteed minimum will only be satisfied through payments to CLIN XY11 with the exception of the base period in which the guaranteed minimum through payments to CLIN XY12." From there, the period of performance minimum for the base period is $2,000,000.

Will the VA please provide explanation on what would constitute a minimum in a given performance period? Please explain how the minimum threshold of $2,000,000 was determined and what would have to occur for a Contractor to only receive a minimum payment for a particular performance period or base period. Further explanation regarding the determination of the minimum threshold and a situation that would warrant a Contractor to only be paid the contract minimum under a healthcare delivery IDIQ contract is necessary to understand the VA's approach.

IAW Section C.18 Guaranteed Contract Minimum and Contact Maximum, the minimum guarantee for the base period is $2,000,000.00 and option periods is $690,000. IAW FAR 16.504(a)(2), to ensure that a contract is binding, the minimum quantity must be more than an nominal amount, but should not exceed the amount the agency is fairly certain to order. The Government will not disclose how this amount was determined.

The Government intends to pay per line items in accordance with paragraph C.18 Guaranteed Contract Minimum and Contract Maximum (CLIN XY11 and XY12) in the solicitation.

The minimum would only be paid in circumstances in which amount invoices for that period of performance is less than minimum amount (up to the guaranteed minimum amount). The Government anticipates on achieving the $2M during the base period of performance and $690k during option periods through Task Orders.

17 PWS Section 3.1 3.1 Network Access Standards

27 3.0 HIGH PERFORMING NETWORK PWS Section 3.1 specifies referral drive times will be calculated using Bing Maps. Please confirm that equivalent mapping tools other than Bing Maps will be acceptable for calculating drive times?

No. For evaluating network adequacy, VA will utilize Bing Maps.

18 PWS Section 3.1 3.1.4 Invalid Rationales 31 3.0 HIGH PERFORMING NETWORK PSW Section 3.1.4 states that an inability to come to financial terms is not the basis for a waiver. It appears this language and approach comes from Medicare Advantage. When a provider will not accept Medicare, it is an indication that the market has a shortfall or that providers in that geography are paid a greater rate for their services.

It is suggested that providers declining to accept VA set rates be considered a valid basis for a waiver.

The Waiver requirements defined in PWS Section 3.1.4 explicitly states "VA expects the Contractor to only submit a Waiver Request when the current CCN Access Standards cannot be met based on provider/facility supply". Not being able to come to financial terms is not a valid basis for a waiver.

19 PWS Section 3.2 PWS Section 7.5

3.2 Provider Networks

7.5.3 Claims

Processing

33 3.0 HIGH PERFORMING NETWORK

7.5 REFERRALS

The covered services in Sections 3.2 and 7.5.3 of the RFP calls out POS 17, 20, 11, 22 and 81 as Urgent Care services. To be consistent with other CCN contracts that allow POS 17, 19, 20, 11, 22 and 81, please confirm that POS 19 will be added to the list of Urgent Care options in the Region 5 RFP.

POS 19 is not intended to be added to Region 5 at this time.

20 PWS Section 3.3 3.3 Out-of-Network Providers

36 3.0 HIGH PERFORMING NETWORK PWS Section 3.3 requires the following for non-network reimbursement: "The Contractor shall invoice the VA the lesser of the amount billed by the out of network provider or the rate identified in CLIN XY06 regardless of the amount paid by the contractor to the out of network provider"?

It is our recommendation that VA require the contractor to use the hierarchy to improve consistency in payment and not create differences in how out-of-network providers are paid.

Regarding payment and invoicing for out of network providers, please see PWS Section 3.3 for Out of Network Providers and B.5 Price/Cost Schedules and B.8 Invoicing.

21 PWS Section 7.1 PWS Section 7.5.1 PWS Section 7.5.2

7.1 Notification of

Emergent Healthcare

7.5.1 Eligibility

7.5.2 Covered Services

7.0 REFERRALS Please clarify the following conflicting language in the RFP related to Urgent Care:

1) PWS 7.1 states "For any care provided under this contract, Contractor shall not invoice VA unless an Approved Referral has been issued by the VA". Later language on pages 58-60 seems to alternatively suggest VA or the Contractor will generate the approved referral. Urgent Care is an example of when the Contractor would generate the authorization versus receive an approved referral. Please clarify that the Contractor is responsible for generating Urgent Care approved referrals.

2) PWS Section 7.1 states "Contractor shall ensure that its in-network urgent care providers confirm the Veteran is eligible to use the urgent care benefit prior to providing the urgent care. The provider must submit a Referral Request to VA. Contractor shall not invoice VA unless an Approved Referral has been issued by VA for this care". However, PWS Section 7.5.1 of the RFP indicates:

"The Contractor shall provide a unique Contractor-generated UC approval number to all claims associated with each Veteran Urgent Care episode of care" and "The contractor generated urgent care approval number begins in UC and ends in R5". Please clarify in Sections 7.1, 7.5.1 and 7.5.2 that VA expects to consistently apply the CCN contract requirements across regions and thus the Contractor should implement a process where the referral is generated by the Contractor, and the Provider is not responsible to contact VA directly for a referral.

1) The PWS Section 7.1 clearly states, "The Contractor shall educate its emergency care providers to notify VA within 72 hours of the Veteran’s self-presenting to an in-network emergency department or CCN provider, in order for VA to issue an Approved Referral. The Contractor shall instruct providers to notify VA through direct messaging, secure email, secure fax, telephone, or preferably and once available, EDI 278".

2) PWS Section 7.5.1 states, "VA will provide a daily Urgent Care eligibility file to the Contractor containing a “U” code for eligible Veterans produced by the Enrollment System through the DAS system". In PWS Section 7.5.2 it states, "Per Section

7.3 the Provider shall request a referral from VA once care is rendered to the Veteran".

3) The referral process is identified in PWS Section 7.0.

4) Requirement that the Contractor shall provide a unique Contractor generated UC approval number to all claims is removed from the RFP. See Amendment 0002 B.3, PWS Section 3.2, PWS Section, 7.5.2 and PWS Section 7.5.3.

22 PWS Section 7.1 7.1 Notification of Emergent Healthcare

56 7.0 REFERRALS PWS Section 7.1 states "The Contractor shall notify VA within seven (7) calendar days of admitting a Veteran to a hospital for routine care, treatment, or procedure, within the course of the SEOC, in order for VA to issue an Approved Referral". Does this apply to SEOC's that already include coverage for an inpatient stay? Is a separate referral from VA required for this type of inpatient claim?

1) This scenario is not referring to already approved inpatient care. If there is a current approval referral (authorization) for inpatient care, then there is no need to request a new one from VA, unless the level of Veteran’s care has changed or new treatments, care or procedures are needed that were not previously authorized.

2) If a Veteran has an approved referral for care and a result of that care is that he or she must be admitted for an inpatient stay or additional levels of care are needed that were not previously authorized, then the Contractor must notify VA for approval.

23 PWS Section 15.1 15.1 Urgent/Emergent Prescriptions

95 15.0 PHARMACY Section 15 identifies that "A prescription written by a VA provider constitutes an approved referral." How is this type of Approved Referral issued to the Contractor?

The VA provider Prescription shall be recognized by the CCN pharmacy as an approved referral to fill the Veteran's prescription. The Veteran will present the prescription to the CCN pharmacy. See Section B.8 Invoicing.

24 PWS Section 15.3 15.3 Routine Maintenance Prescriptions

100 15.0 PHARMACY PWS Section 15.3 states that the "Contractor shall request an approved referral from VA for this care prior to invoicing VA".

Please confirm that that flu vaccinations in the Region 5 contract, like other CCN contracts, will not require an approved referral or prior authorization, but will require that the Contractor only dispense flu vaccinations from the VA approved list.

Yes, your assumption is correct. There is no approved referral or prior authorization required for the standard flu vaccine.

25 B.4 Schedule of Deliverables B.4 Schedule of Deliverables

117 N/A The Contractor Security Control Assessment (CSCA) is not listed in the Deliverables table. However, it is required under section B.2.3. Please confirm whether the CSCA is required.

The CSCA is no longer required. See Amendment 0002, Section B.2.3.

26 B.5 Price/Cost Schedule B.5 Price/Cost Schedule

134 N/A Section B.5 identifies: "Informational CLIN XY01, Medicare (rates) for General Health Services. For these services, use CLIN XY06 to invoice VA." Please confirm that this means no claims will be paid under XY01.

Yes, your assumption is correct.

27 Section D Attachment A - VA Medical Center Catchment Area by CCN Region

168 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR

ATTACHMENTS

Attachment A (VAMC Catchment Area) includes 29 distinct boroughs, but only 8 are assigned to Anchorage VA Medical Center.

Please confirm the Anchorage VAMC catchment area covers the entire state of Alaska for purposes of this contract.

Yes, your assumption is correct. Alaska VAMC is responsible for all boroughs and the Unorganized Areas of Alaska (the entire state).

28 Section D Attachment 12 - Maximum Allowable Charges

169 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR

ATTACHMENTS

How are the rates used in the Maximum Allowable Charges attachment derived? How frequently are they updated? Maximum Allowable Charges were derived from Industry data.

The Maximum Allowable Charges Schedule will be updated on an annual basis. See Amendment 0002 B.3, PWS Section 12.1.1.

29 Section D Attachment 12 - Maximum Allowable Charges

169 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR

ATTACHMENTS

Please clarify if the procedure is not payable under Alaska VA Fee Schedules and is not present on Attachment 12, does the Contractor pay Billed Charges?

No. All charges should be covered under the Alaska Fee Schedules (CLIN XY06), Tribal Health method of payment (CLIN XY22) or The Maximum Allowable Charges Schedule (Attachment 12). However, CLIN XY08 states, "In absence of an associated/established Alaska VA fee, HIT services will be paid at the Contractor’s percentage of billed charges and VA will not reimburse in excess of proposed percentage (%) of billed charges for HIT services".

30 E.1 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO

OFFERORS—COMMERCIAL ITEMS

Table 1. File Name, Page Limitations

172 SECTION E - SOLICITATION PROVISIONS Section E 3.6.2 and Table 1 indicate the Volume IV narrative BOE should be submitted as PDF, but paragraph 4.4.1 indicates submission in Microsoft Word. Please confirm PDF is the intended submission format?

The BOE should be submitted in PDF. See revised Amendment 0002 section 4.4.1 for details.

31 E.1 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO

OFFERORS—COMMERCIAL ITEMS

4.1.1 174 SECTION E - SOLICITATION PROVISIONS Section E 4.1.1 requires that signed original documents be included with Volume I. Please confirm that since the submission is purely electronic per Section E 3.4 and electronic scans of physically signed documents will be acceptable.

The proposal submission is electronic. The only form of electronic signature that is acceptable is a digital signature. A scanned copy of a document with your wet signature, although not considered a digital signature, remains acceptable. See Amendment 0002 Section 4.1.9 and 4.1.9.1.

32 PWS Section 1.2 2.3.1 18 2.0 PROJECT MANAGEMENT Veterans' in Alaska are currently receiving community care through the Patient Centered Community Care Program and other contracts utilized by VA to refer care to community providers. Will issuance of referrals from these existing programs be discontinued at start of Health Care Delivery for VA CCN? Will the period covered under the referrals for the other programs end at the VA CCN Health Care Delivery date or will there be an overlap where care is being rendered using both VA CCN and other program referrals? If there will be overlap, how long will period of care on referrals from other programs extend after VA CCN Health Care Delivery?

The referrals from existing programs will not be discontinued at the start of HCD for CCN. Referrals will continue to be in effect until they expire based on the end date of the referral.

33 2.0 Project Management 2.3 Project Management Plan (Project Plan)

2.3.1 Implementation

Strategy

18 Testing/Validation w/VA Please detail the testing/validation required by the VA prior to the start of healthcare delivery. Are there requirements for End to End testing with the VA? If so, what is the volume of test cases?

It is for the Contractor to propose the testing/validation as part of its Implementation Strategy. This is a performance work statement and the VA is not dictating how implementation will be achieved.

End of Questions and Answers for A0002

DRAFT RFP RESPONSES