36C10G25R0022_amended_0004.pdf

This solicitation is for the National Dialysis Services Contract (NDSC). The Department of Veterans Affairs (VA) has a requirement to provide dialysis services for End-Stage Renal Disease (ESRD) and Acute Kidney Injury (AKI) from community-based dialysis service providers. The Contractor shall provide, supervise, and monitor outpatient chronic dialysis and AKI services to Veterans within the Contractor’s facilities, and provide home dialysis training to Veterans.

The intent of this program is to award contracts to multiple contractors to provide an expansive network of dialysis providers to serve thousands of Veterans throughout the United States and its territories.

Updates to this solicitation will be provided through the official U.S. Government System for Contracting on SAM.gov.

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C10G25R0022 06-30-2025

Gary T. Basile (gary.basile@va.gov) 916-472-1011 08-29-2025

5:00 PM EST

36C10X Strategic Acquisition Center Department of Veterans Affairs

10300 Spotsylvania Ave STE 400 Fredericksburg VA 22408

X

621492

$47 Million

N/A

X

36C10X

Strategic Acquisition Center Department of Veterans Affairs

10300 Spotsylvania Ave STE 400 Fredericksburg VA 22408

VAFSC

U.S. Department of Veterans Affairs Financial Services Center

PO BOX 149971

(see Section B.3 invoicing/payment) Austin TX 78714-8917

1-(877)-489-6135

See CONTINUATION Page

The purpose of this solicitation is to establish National (VA-Wide) Dialysis Services for the Department of Veterans Affairs.

This procurement effort is to establish Multiple Award Indefinite Delivery/Indefinite Quantity (IDIQ) contracts.

All initial questions must be in writing and sent to the Contracting Officer no later than July 9, 2025.

Contracting Officer: Gary T. Basile (gary.basile@va.gov) Contract Specialist: Sonia Sapla (sonia.sapla@va.gov)

See CONTINUATION Page

X X

X 1

36C10G25R0022

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 IT CONTRACT SECURITY

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

PERFORMANCE WORK STATEMENT

1. GENERAL INFORMATION

1.1 Title of Project

1.2 Scope of Work

1.3 Background

1.4 Definitions

2 PROJECT MANAGEMENT

2.1 Post Award and Contract Kickoff Meetings

2.2 Deployment and Implementation

2.3 Risk Management

2.4 Contract Performance Management

2.4.1 Quality Assurance Surveillance Plan

2.5 Transition Out (Optional CLIN)

2.6 Operational Quality Reporting Requirements

3 ANNUAL CLOSE OUT OF ADMINISTRATIVE FEES

4 QUALITY ASSURANCE PLAN (QAP) NETWORK REQUIREMENTS

4.1 Accreditation and Credentialing

4.2 Accreditation Requirements

4.2.1 Credentialing Requirements

5 CUSTOMER SERVICE

5.1 Contractor Contact Center Support to VA Staff

5.1.1 VA Provided Ticketing Tool

5.1.2 Contractor Use of VA-Provided Ticketing Tool

5.2 Contractor Maintained Records

6 REFERRALS AND SCHEDULING

6.1 Referral and Authorization Process

6.2 Scheduling

6.2.1 Scheduling Process

6.2.2 Expected and Unexpected Referral Disruption/Cancellation

7 MEDICAL DOCUMENTATION

7.1 Medical Documentation Submission

7.2 Medical Documentation Data Elements for Inclusion

7.3 Medical Documentation Submission Timeframes

7.4 Medical Documentation Compliance

7.5 Critical Findings

7.6 Medical Documentation and Audit

8 BILLING

8.1 Billing

8.1.1 Billing for Transient Dialysis Services

8.1.2 Billing for Incomplete Treatments

8.1.3 Billing for No Shows

8.1.4 Billing the Veteran

8.1.5 Billing for Each Active Veteran

8.2 Claims Processing

8.3 Claims Appeal Process

8.4 Administrative Invoices

9 ANTI-FRAUD CONTROLS FOR THE PREVENTION, DETECTION, AND

DETERRENCE OF FRAUD, WASTE, AND ABUSE

9.1 Program Integrity (PI) Responsibilities and Anti-Fraud Controls FWA Program .47

9.2 Anti-Fraud and Abuse Support

10 CLINICAL QUALITY AND MONITORING

10.1 Clinical Quality Monitoring Plan (CQMP)

10.2 Clinical Quality and Patient Safety Issues Identification

11 MISCELLANEOUS CONSIDERATIONS

12 TRAINING, DEVELOPMENT, DELIVERY & IMPLEMENTATION

12.1 Personal Health Information Training

13 DELIVERABLES

13.1 Method of Delivery

13.2 Government Acceptance

13.3 Schedule of Deliverables

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEMS (NOV 2021)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-7 OPTION FOR SEPARATELY PRICED LINE ITEM (MAR 1989)

C.7 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.8 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ...65

C.9 52.222-49 SERVICE CONTRACT LABOR STANDARDS—PLACE OF

PERFORMANCE UNKNOWN (MAY 2014)

C.10 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.11 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.12 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY

(FEB 2023)

C.13 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023)

C.14 852.222-71, Compliance with Executive Order 13899 (Deviation) (April 2025)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.16 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.17 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.18 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) ..79

C.19 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.20 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2025)

C.21 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.201-1 ACQUISITION 360: VOLUNTARY SURVEY (SEP 2023)

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT

ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023)

E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.6 52.216-1 TYPE OF CONTRACT (APR 1984)

E.7 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.8 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.9 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.10 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.11 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

E.12 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.13 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR: TBD

b. GOVERNMENT: Contracting Officer 36C10G Gary T. Basile

Strategic Acquisition Center

Department of Veterans Affairs

10300 Spotsylvania Ave STE 400

Fredericksburg VA 22408

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

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly upon VA Approval of the healthcare claim or invoice.

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

Department of Veterans Affairs Financial Services Center

7600 Metropolis Drive Bldg 5 Austin TX 78744

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

AMENDMENT NO DATE

0001 07/01/2025 0002 07/16/2025 0003 08/12/2025 0004 08/15/2025

B.2 IT CONTRACT SECURITY

VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY

VA INFORMATION CUSTODIAL LANGUAGE.

a. The Government shall receive unlimited rights to data/intellectual property first produced and delivered in the performance of this contract or order (hereinafter “contract”) unless expressly stated otherwise in this contract. This includes all rights to source code and all documentation created in support thereof. The primary clause used to define Government and Contractor data rights is FAR 52.227-14 Rights in Data – General. The primary clause used to define computer software license (not data/intellectual property first produced under this contractor or order) is FAR 52.227-19, Commercial Computer Software License.

b. Information made available to the contractor by VA for the performance or administration of this contract will be used only for the purposes specified in the service agreement, SOW, PWS, PD, and/or contract. The contractor shall not use VA information in any other manner without prior written approval from a VA Contracting Officer (CO). The primary clause used to define Government and Contractor data rights is FAR 52.227-14 Rights in Data – General.

c. VA information will not be co-mingled with any other data on the contractor’s information systems or media storage systems. The contractor shall ensure compliance with Federal and VA requirements related to data protection, data encryption, physical data segregation, logical data segregation, classification requirements and media sanitization.

d. VA reserves the right to conduct scheduled or unscheduled audits, assessments, or investigations of contractor Information Technology (IT) resources to ensure information security is compliant with Federal and VA requirements. The contractor shall provide all necessary access to records (including electronic and documentary materials related to the contracts and subcontracts) and support (including access to contractor and subcontractor staff associated with the contract) to VA, VA's Office Inspector General (OIG), and/or Government Accountability Office (GAO) staff during periodic control assessments, audits, or investigations.

e. The contractor may only use VA information within the terms of the contract and applicable Federal law, regulations, and VA policies. If new Federal information security laws, regulations or VA policies become applicable after execution of the contract, the parties agree to negotiate contract modification and adjustment necessary to implement the new laws, regulations, and/or policies.

f. The contractor shall not make copies of VA information except as specifically authorized and necessary to perform the terms of the contract. If copies are made for restoration purposes, after the restoration is complete, the copies shall be destroyed in accordance with VA Directive 6500, VA Cybersecurity Program and VA Information Security Knowledge Service.

g. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor may use and disclose VA information only in two situations: (i) in response to a qualifying order of a court of competent jurisdiction after notification to VA CO (ii) with written approval from the VA CO. The contractor shall refer all requests for, demands for production of or inquiries about, VA information and information systems to the VA CO for response.

h. Information made available to the contractor by VA for the performance or administration of this contract or information developed by the contractor in performance or administration of the contract will be protected and secured in accordance with VA Directive 6500 and Identity and Access Management (IAM) Security processes specified in the VA Information Security Knowledge Service.

i. Any data destruction done on behalf of VA by a contractor shall be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management, VA Handbook 6300.1, Records Management Procedures, and applicable VA Records Control Schedules.

j. The contractor shall provide its plan for destruction of all VA data in its possession according to VA Directive 6500 and NIST 800-88, Guidelines for Media Sanitization prior to termination or completion of this contract. If directed by the Contracting Officer’s Representative (COR) or the CO, the contractor shall return all Federal Records to VA for disposition.

TRAINING.

a. All contractors and subcontractors requiring access to VA information and VA information systems shall successfully complete the following before being granted access to VA information and its systems:

(1) VA Privacy and Information Security Awareness and Rules of Behavior course (Talent Management System (TMS) #10176) initially and annually thereafter.

(2) Sign and acknowledge (electronically through TMS #10176) understanding of and responsibilities for compliance with the Organizational Rules of Behavior, relating to access to VA information and information systems initially and annually thereafter; and

(3) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system or information access: [to be defined by the VA program official and provided to the VA CO for inclusion in the solicitation document – i.e., any role-based information security training]. Privacy & HIPAA Focused Training (Talent Management System (TMS) #10203) initially and annually thereafter.

b. The contractor shall provide to the COR a copy of the training certificates and certification of signing the Organizational Rules of Behavior for each applicable employee within five days of the initiation of the contract and annually thereafter, as required.

c. Failure to complete the mandatory annual training is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the required training is complete.

(End of Clause)

B.3 PRICE/COST SCHEDULE

The minimum guaranteed amount for this contract is $1,000.00. the applicable locality adjusted Medicare rate and the associated Active Per-Member Per-Month (PMPM) Administrative Fee after the VA approves payment of the healthcare claim or invoice. The estimated aggregate value of all contract awards and task orders under the National Dialysis Services Contract is $6,000,000,000.00. This ceiling is neither divided nor multiplied by the number of awardees.

The ceiling for each contract will be negotiated and set at the time of award.

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

TBD EA N/A N/A

Dialysis Services:

Dialysis Services, is inclusive of all authorized dialysis services for End-Stage Renal Disease (ESRD) and Acute Kidney Injury (AKI) from accredited community-based dialysis service providers. This includes providing, supervising, and monitoring outpatient chronic hemodialysis and peritoneal dialysis and AKI services to Veterans;

providing home-based hemodialysis services, training, and home visits to Veterans; and diagnostic testing.

This CLIN is priced and reimbursed at 100% of the applicable locality adjusted Medicare Rate.

Contract Period: Base POP Begin: 01-01-2026 04-01-2026 POP End: 12-31-2026 03-31-2027

TBD EA __________ N/A

Active Per-Member Per-Month (PMPM) Administrative Fee:

Administrative Services will reimburse the contractor for the administrative services required to manage and deliver the services purchased under this contract. This includes costs related to dialysis services, authorized through an Approved Referral, that occur to maintain availability and accessibility of an adequate number of CMS Medicare Program certified dialysis facilities, qualified healthcare providers, and necessary resources to meet the needs of Veterans requiring dialysis treatment.

This CLIN is reimbursed at the Active PMPM Administrative Fee based on each Active Veteran receiving dialysis services in a designated month.

Contract Period: Base POP Begin: 01-01-2026 04-01-2026 POP End: 12-31-2026 03-31-2027

1.00 JB __________ ________________

Implementation of services as outlined in the PWS:

Deployment and implementation of dialysis services within 90 calendar days of award.

Contract Period: Base POP Begin: 10-01-2025 POP End: 12-31-2025

Kidney Injury (AKI) from accredited community-based dialysis service providers. This includes providing, supervising, and monitoring outpatient chronic hemodialysis and peritoneal dialysis and AKI services to Veterans;

providing home-based hemodialysis services, training, and home visits to Veterans; and diagnostic testing.

This CLIN is priced and reimbursed at 100% of the applicable locality adjusted Medicare Rate.

Contract Period: Option 1 POP Begin: 01-01-2027 04-01-2027 POP End: 12-31-2027 03-31-2028 services purchased under this contract. This includes costs related to dialysis services, authorized through an Approved Referral, that occur to maintain availability and accessibility of an adequate number of CMS Medicare Program certified dialysis facilities, qualified healthcare providers, and necessary resources to meet the needs of Veterans requiring dialysis treatment.

This CLIN is reimbursed at the Active PMPM Administrative Fee based on each Active Veteran receiving dialysis services in a designated month. Only one Administrative Fee per Active Veteran per month is allowed.

Contract Period: Option 1 POP Begin: 01-01-2027 04-01-2027 POP End: 12-31-2027 03-31-2028

Kidney Injury (AKI) from accredited community-based dialysis service providers. This includes providing, supervising, and monitoring outpatient chronic hemodialysis and peritoneal dialysis and AKI services to Veterans;

providing home-based hemodialysis services, training, and home visits to Veterans; and diagnostic testing.

This CLIN is priced and reimbursed at 100% of the applicable locality adjusted Medicare Rate.

Contract Period: Option 2 POP Begin: 01-01-2028 04-01-2028 POP End: 12-31-2028 03-31-2029 services purchased under this contract. This includes costs related to dialysis services, authorized through an Approved Referral, that occur to maintain availability and accessibility of an adequate number of CMS Medicare Program certified dialysis facilities, qualified healthcare providers, and necessary resources to meet the needs of Veterans requiring dialysis treatment.

This CLIN is reimbursed at the Active PMPM Administrative Fee based on each Active Veteran receiving dialysis services in a designated month. Only one Administrative Fee per Active Veteran per month is allowed.

Contract Period: Option 2 POP Begin: 01-01-2028 04-01-2028 POP End: 12-31-2028 03-31-2029

Kidney Injury (AKI) from accredited community-based dialysis service providers. This includes providing, supervising, and monitoring outpatient chronic hemodialysis and peritoneal dialysis and AKI services to Veterans;

providing home-based hemodialysis services, training, and home visits to Veterans; and diagnostic testing.

This CLIN is priced and reimbursed at 100% of the applicable locality adjusted Medicare Rate.

Contract Period: Option 3 POP Begin: 01-01-2029 04-01-2029 POP End: 12-31-2029 03-31-2030 services purchased under this contract. This includes costs related to dialysis services, authorized through an Approved Referral, that occur to maintain availability and accessibility of an adequate number of CMS Medicare Program certified dialysis facilities, qualified healthcare providers, and necessary resources to meet the needs of Veterans requiring dialysis treatment.

This CLIN is reimbursed at the Active PMPM Administrative Fee based on each Active Veteran receiving dialysis services in a designated month. Only one Administrative Fee per Active Veteran per month is allowed.

Contract Period: Option 3 POP Begin: 01-01-2029 04-01-2029 POP End: 12-31-2029 03-31-2030

Kidney Injury (AKI) from accredited community-based dialysis service providers. This includes providing, supervising, and monitoring outpatient chronic hemodialysis and peritoneal dialysis and AKI services to Veterans;

providing home-based hemodialysis services, training, and home visits to Veterans; and diagnostic testing.

This CLIN is priced and reimbursed at 100% of the applicable locality adjusted Medicare Rate.

Contract Period: Option 4 POP Begin: 01-01-2030 04-01-2030 POP End: 12-31-2030 03-31-2031

Administrative Services will reimburse the contractor for the administrative services required to manage and deliver the services purchased under this contract. This includes costs related to dialysis services, authorized through an Approved Referral, that occur to maintain availability and accessibility of an adequate number of CMS Medicare Program certified dialysis facilities, qualified healthcare providers, and necessary resources to meet the needs of Veterans requiring dialysis treatment.

This CLIN is reimbursed at the Active PMPM Administrative Fee based on each Active Veteran receiving dialysis services in a designated month. Only one Administrative Fee per Active Veteran per month is allowed.

Contract Period: Option 4 POP Begin: 01-01-2030 04-01-2030 POP End: 12-31-2030 03-31-2031

Kidney Injury (AKI) from accredited community-based dialysis service providers. This includes providing, supervising, and monitoring outpatient chronic hemodialysis and peritoneal dialysis and AKI services to Veterans;

providing home-based hemodialysis services, training, and home visits to Veterans; and diagnostic testing.

This CLIN is priced and reimbursed at 100% of the applicable locality adjusted Medicare Rate.

Option to Extend Services IAW FAR Clause 52.217-8.

Contract Period: Option 5 POP Begin: 01-01-2031 04-01-2031 POP End: 06-30-2031 09-30-2031 services purchased under this contract. This includes costs related to dialysis services, authorized through an Approved Referral, that occur to maintain availability and accessibility of an adequate number of CMS Medicare Program certified dialysis facilities, qualified healthcare providers, and necessary resources to meet the needs of Veterans requiring dialysis treatment.

This CLIN is reimbursed at the Active PMPM Administrative Fee based on each Active Veteran receiving dialysis services in a designated month. Only one Administrative Fee per Active Veteran per month is allowed.

Option to Extend Services IAW FAR Clause 52.217-8.

Contract Period: Option 5 POP Begin: 01-01-2031 04-01-2031 POP End: 06-30-2031 09-30-2031

5003 1.00 JB __________

Transition Out (Optional CLIN)

Transition Out and Residual Services for up to 12 months after Contract Expiration Date. Please reference Section 2.5 Transition Out in the Performance Work Statement.

Option for Separately Priced Line Item IAW FAR Clause 52.217-7.

Contract Period: TBD POP Begin: TBD POP End: TBD

PERFORMANCE WORK STATEMENT

1. GENERAL INFORMATION

1.1 Title of Project

National Dialysis Services Contract (NDSC) purchased under the authority of 38 United States Code (U.S.C.) § 8153, “Sharing of Health-care Resources.”

1.2 Scope of Work

The Department of Veterans Affairs (VA) has a requirement to provide dialysis services for End-Stage Renal Disease (ESRD) and Acute Kidney Injury (AKI) from community-based dialysis service providers. The Contractor shall provide, supervise, and monitor outpatient chronic dialysis and AKI services to Veterans within the Contractor’s facilities, and provide home dialysis training to Veterans.

The Contractor shall meet all requirements outlined in this contract and follow Centers for Medicare and Medicaid Services (CMS) quality standards.

Outpatient-based dialysis services shall utilize Contractor resources, Contractor owned and maintained equipment, Contractor staff, and the Contractor equipment necessary or required for dialysis services.

All treatment modalities delivered must be in accordance with the CMS Medicare Program treatment guidelines to include CMS’ Phase III ESRD Clinical Performance Measures. All treatments must be requested and authorized by the VA Medical Center (VAMC) staff. The treatments to be provided include the following:

• Center-Based Hemodialysis (HD): Includes in-center dialysis.

• Home-Based HD: Care shall be provided using Method I as described by the CMS Medicare Benefit Policy Manual, Chapter 11 – End Stage Renal Disease. Method II is unallowable.

• Peritoneal Dialysis: This includes the types of Peritoneal Dialysis (CAPD, CCPD, etc.) described in CMS Medicare Benefit Policy Manual, Chapter 11 – End Stage Renal Disease.

• Training for Home-Based Modalities: Authorization and payment for home dialysis training will be in accordance with the CMS Medicare and Medicaid Programs; Medicare Benefit Policy Manual, Chapter 11 – End Stage Renal Disease, paragraph 30.2. A training authorization is required for all new home-based patients. Additional training must be preauthorized by the VAMC staff.

1.3 Background

VA is committed to providing Veterans with timely, accessible, and high-quality care. VA intends to honor this commitment by improving performance, promoting a positive culture of service, increasing operational effectiveness and accountability, advancing healthcare innovation through research, and training future VA clinicians.VA recognizes that while the healthcare landscape is constantly changing, VA’s unique population and broad geographic demands will continue to require community-based care for Veterans. A Veteran enrolled in the patient enrollment system of VA, established, and operated under 38 U.S.C. § 1705, may receive services under this contract. Healthcare services will be provided in each state as defined in 38 U.S.C. § 101(20).

This contract will not be used to acquire services for inherently governmental functions as defined by FAR 7.503 or personal services as defined by FAR

37.104. The Contractor will not perform work reserved for performance by Federal employees, and the Government will manage the Contractor consistent with its responsibility to perform all inherently governmental functions and maintain control of its mission and operations in accordance with requirements of Office of Federal Procurement Policy Letter 11-01.

1.4 Definitions

ACRONYMS/DEFINITIONS: The following terms, when used in this contract, will be interpreted as follows:

1. Abuse: Any practice that is inconsistent with accepted sound fiscal, business, or professional medical practice which results in services that are not medically necessary, have an unnecessary cost, or fail to meet professional standards for healthcare. The term “abuse” includes deception or misrepresentation by a provider, or any person or entity acting on behalf of a provider

2. Active Veteran: Those veterans who have availed of contractor services (i.e., received care) in a particular month. A veteran is counted as active (count=1) in a particular month if they have sought care at least once in that month.

PMPM is not paid for all enrolled Veterans but for only those veterans that have sought care one or more times in that month.

3. AKI: Acute Kidney Injury – also known as Acute Renal Failure

4. Authorization: An approved order to provide services related to the provision of dialysis care for the purpose of this contract and clauses contained herein

5. CAPD: Continuous Ambulatory Peritoneal Dialysis. A manual form of peritoneal dialysis, with no machine

6. CCPD: Continuous Cycling Peritoneal Dialysis, also known as Automated Peritoneal Dialysis, a form of peritoneal dialysis using a cycler at night

7. CHOW: Change in Ownership; describes the addition or loss of 51% majority ownership over an existing NDSC facility

8. Claim: A request for payment of dialysis services from the Contractor to VA.

As used in the PWS, this term does not include the meaning of the term “claim” as defined in FAR 2.101

9. CMS: Centers for Medicare and Medicaid Services

10. CO (Contracting Officer): A person with the authority to enter, administer, and/or terminate contracts and make related determinations and findings

11. COR (Contracting Officer’s Representative): An individual designated and authorized in writing by the Contracting Officer to perform specific technical or administrative functions. The COR is responsible for technical administration of the contract and will ensure proper Government surveillance of the Contractor’s performance. The COR will keep a quality assurance file. The COR is not empowered to make any contractual obligations or to authorize any contractual changes on the Government’s behalf.

12. CPT (Current Procedural Terminology): A coding system developed by the American Medical Association and a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. The purpose of the terminology is to provide a uniform language that will accurately describe medical, surgical, and diagnostic services, and will thereby provide an effective means for reliable nationwide communication among physicians, patients, and third parties.

13. Critical Findings: Those findings or results that require immediate evaluation by a healthcare provider such that failure to take immediate appropriate action might result in death, significant morbidity, or serious adverse consequences to the Veteran.

14. Days: All days within the PWS are calendar days unless otherwise noted.

When “business day” is noted, business day is defined as Monday through Friday, excluding standard Federal Holidays and any other day specifically declared to be a national holiday.

15. EDI: Electronic Data Interchange

16. EFT: Electronic Funds Transfer

17. EOB: Explanation of Benefits

18. ESRD: End Stage Renal Disease

19. FAR: Federal Acquisition Regulations

20. Fraud: Fraud is defined as a deception or misrepresentation by a provider, Veteran, or any person acting on behalf of a provider with the knowledge (or who had reason to know or should have known) that the deception or misrepresentation could result in some unauthorized benefit to self or some other person, or some unauthorized payment, or a claim that is false or fictitious.

21. FSC: Financial Services Center

22. Grievance: A written complaint of an actual or perceived issue.

23. HD: Hemodialysis

24. HHS: Department of Health and Human Services

25. HIPAA: Health Insurance Portability and Accountability Act

26. Inquiry Management and Oversight (IMO): Department for IVC Customer Service

27. Modify authorization: Create or adjust the parameters of an authorization following approval from VA

28. New Authorization: An authorization created to begin treatment for a Veteran who has not been seen by the Contractor before.

29. NDSC: National Dialysis Services Contract

30. NPI: National Provider Identifier

31. IVC: Integrated Veteran Care

32. PHI: Personal Health Information

33. Per Member Per Month (PMPM): The average cost or utilization per enrolled veteran per month for healthcare services provided through VA programs.

34. PPS: Prospective Payment System

35. Prior Authorization: A required process through which VA reviews and approves certain medical services to ensure the medical necessity and appropriateness of care prior to services being rendered within a specified timeframe from a non-VA provider or additional resources in the community.

36. Renewal Authorization: An authorization required to continue treatments once a current authorization expires.

37. Request for Service (RFS): A request and approval process that authorizes the Veteran to obtain specified care within a specified timeframe from additional resources in the community. Upon approval, a referral number is generated. The referral number must always be included on claims submitted by network providers for payment.

38. QASP: Quality Assurance Surveillance Plan

39. Transient Authorization: An authorization for short-term (less than 60-days) treatment at a facility other than the Veteran’s primary facility.

40. VA: Department of Veterans Affairs

41. VAMC: Veterans Affairs Medical Center

42. Vendorizing: The act of adding a Contractor’s facility into VA systems to provide payment.

43. Veteran: VA eligible dialysis patient

44. VHA: Veterans Health Administration

45. VHA Office of Integrated Veteran Care (IVC): The VHA office designated to support Dialysis services under the contract. IVC is a national program office that manages and advocates for Veterans' and beneficiaries' access to health care in both VA and community facilities.

46. VISN: Veterans Integrated Service Network

47. Warm transfer: VA staff speaking directly to a Veteran communicates with a Contractor Customer Service Representatives before transferring the Veteran and subsequently transfers the Veteran by introducing the Veteran and staying on the line until the call is completed with the Contractor Customer Service Representative.

48. Waste: Waste is defined as the overutilization or inappropriate utilization of services or other practices, that, directly or indirectly, result in unnecessary costs to the health care system. It is not generally considered to be caused by criminally negligent actions, but by the misuse of resources.

2 PROJECT MANAGEMENT

The Contractor shall be responsible for project management and delivery of the requirements of the contract.

2.1 Post Award and Contract Kickoff Meetings

Within two (2) weeks of contract award, the Contractor shall be available and participate in a virtual Post Award Meeting with VA stakeholders and Contractor representatives on a date to be mutually agreed upon by the Contractor and VA Contracting Officer (CO). The purpose of the Post Award Meeting is to do the following:

• Initiate the communication process between VA and Contractor including:

o Introduction of Contractor and VA personnel performing work related to this project o Identification of Contractor and VA stakeholder’s roles and responsibilities

• Provide a brief overview of project administration and reporting

• Establish action items/next steps and confirm dates, locations, and expectations and agenda for the Kickoff Meeting

The Contractor shall participate in a virtual Kickoff Meeting within 30 business days after contract award on a date mutually agreed upon by the Contractor and VA. The Contractor shall create and present a Kickoff Meeting Presentation describing the details of the approach for all deliverables and services under the contract and in accordance with Section 1213.3, “SCHEDULE OF DELIVERABLES.” The Contractor shall also provide the name of its transition team lead and a listing of its transition team members.

The Contractor shall describe and explain in detail the following:

• Resolution of assigned action items from Post Award Meeting

• Approach to all deliverables and services under this contract in accordance with the expectations defined in Section 1213.3, “SCHEDULE

OF DELIVERABLES”

• Approach to achieving go-live within the timelines specified

• Approach to communications required to manage the overall project to include:

o Key messages that shall be articulated to the VA stakeholders, as well as the timing associated with the delivery of those messages o Communication method, type, style, and channels it will use to reach VA stakeholders and Veterans, as well as the desired outcomes for the communication. VA stakeholders, by role and hierarchy, shall be communicated by VA.

o Action items and issues that require immediate response and coordination within the VA

The Contractor shall take meeting minutes, which shall be provided to VA. The meeting minutes shall include documentation of any major issues, agreements, or disagreements and agreed upon actions and timelines to resolve any major issues or disagreements discussed during the Kickoff Meeting.

Deliverables: (See Section 1213.3, “Schedule of Deliverables” for details.)

• Kickoff Meeting Presentation

• Kickoff Meeting Minutes and Action Items

2.2 Deployment and Implementation

The Contractor shall develop a Deployment and Implementation Strategy to detail the Contractor’s approach to implementing dialysis services. The Deployment and Implementation Strategy shall be submitted with the Contractor’s technical proposal and will be incorporated into the contract at contract award. The Contractor shall execute the Deployment and Implementation Strategy.

The Deployment and Implementation Strategy shall outline the implementation of all requirements in this PWS, including but not limited to: Deployment and Implementation; Customer Service; Referrals; Medical Documentation; Billing;

Fraud, Waste, and Abuse; and Clinical Quality and Patient Safety Monitoring.

The Deployment and Implementation Strategy shall also contain the Contractor’s Transition-in Plan that includes, but not limited to:

• Planned transition meetings and schedule

• Transition execution steps with associated milestones ensuring continuation of dialysis services delivery with minimal disruption to Veterans and VA

• Expected VA inputs to ensure effective transition

The Contractor shall achieve implementation no later than 90 days from contract award. Successful deployment of dialysis services shall ensure operational readiness and completed training. The Contractor shall:

• Prepare for deployment of dialysis services

Deliverables: (See Section 1213.3, “Schedule of Deliverables” for details.)

• Deployment and Implementation Strategy

2.3 Risk Management

The Contractor shall adhere to Attachment C, Project Risk Register which shall consist of self-reported (not facility level) risk and issues identified and reported by the Contractor at an organizational or contract-wide level, rather than risks/issues that are specific to an individual facility. management processes. For each risk identified, the Contractor shall include severity of risk, volumes, associated impacts (system, Veteran experience, provider experience, etc.) with timelines for reporting and mitigation to be completed.

The Contractor shall report risks and issues to VA for all dialysis services activities. In addition, the Project Risk Register must describe the impacts of these risks and issues and describe measures to either minimize or eliminate the potential impact on the provision of dialysis services.

The Contractor shall submit updated risk responses and actions, to include mitigation strategies in the Project Risk Register. The Contractor shall report risk(s) identified as extreme impact within 24 hours upon their identification(s) to the COR and CO.

Additionally, the Contractor shall participate in ad hoc CMS quality virtual Progress Report meetings, not to exceed 4 in a calendar year. Within 30 days of request by VA, the Contractor will report on risk responses and actions in Attachment D, Progress Report.

In addition, the Contractor shall collaborate with VA to establish the priority, scope, bounds, and resources for managing project risks and issues, and/or assess the courses of action related to them. The Contractor shall inform VA of relevant deliberations and recommendations to mitigate and resolve risks and issues as they are identified. VA shall have final approval of items in the quarterly Project Risk Register.

Deliverables: (See Section 1213.3, “Schedule of Deliverables” for details.)

• Attachment C, Project Risk Register

• Attachment D, Progress Report

2.4 Contract Performance Management

2.4.1 Quality Assurance Surveillance Plan

The Quality Assurance Surveillance Plan (QASP) will be finalized upon award and provided to the Contractor (reference Attachment A) for informational purposes. The QASP is a living document and may be updated by VA as necessary.

The Contractor shall meet the performance target established by the QASP (see Attachment BA) at the contract level. If established performance target is not met, VA may request development of Corrective Action Plans (CAP) through Attachment F - Contract Discrepancy Report. If problems have not been completely resolved, upon request by VA, the Contractor shall provide a CAP with an explanation, including its plan and timeframe for resolving the issue as part of an ad hoc virtual Progress Report meeting.

To provide for changing quality assurance and quality performance conditions, either VA or the Contractor may request changes to the components of QASP measurement and reporting. Non-administrative changes to the QASP shall be executed via bilateral agreement between VA and the Contractor.

Upon request and notification by the Contracting Officer, the Contractor shall participate in ad hoc project-related meetings with VA to address performance issues. The Contractor, as a result of failure to meet performance metrics, is subject to any or all punitive measures permitted by the Federal Acquisition Regulation (FAR) and VA Acquisition Regulation (VAAR), as determined by VA.

Performance issues will be recorded in Contractor Performance Assessment Reporting System (CPARS).

Deliverables: (See Section 1213.3 “Schedule of Deliverables” for details.)

• Attachment D, Progress Report

2.5 Transition Out (Optional CLIN)

The Contractor shall perform the Transition Out and residual service tasks below for this contract if required by the VA in accordance with FAR 52.217-7.

Transition Out activities require collaboration with a team comprised of VA and/or successor Contractor personnel. The term Transition Out is related to activities taking place during and after the last contract period exercised, in which the Contractor is transferring duties and responsibilities to a VA appointed designee, whether a government entity, another Contractor or a mix of both.

The Contractor shall provide residual services for 12 months after the Contractor no longer provides care, including continuing to process appeals, grievances, and support customer service for dialysis services that was delivered in the first

12 months of the last contract period of performance and in accordance with existing contract requirements. All parties involved in Transition Out services shall ensure minimal disruption of services to Veterans receiving care and providers delivering care.

Transition Out activities shall include the following:

• Delivery of a Transition Out Plan inclusive of a timeline of major events, key positions responsible for each of the functional areas involved in the Transition Out (e.g., claims, appeals, grievances), and staffing and other resources (e.g., transition project manager, transitions stakeholders) within 180 days of award

• Provide retroactive processing of referrals for authorized care

• Processing of all open healthcare claims invoices

• Providing a current inventory of all government-owned assets used by the Contractor over the life of the contract along with full support in the reconciliation of the inventory as needed

• Providing “shadowing” and other knowledge transfer meetings and opportunities to facilitate the transfer of information, processes, and data needed to continue the services being performed by the Contractor

• Providing current and accurate program management documents

• Removal and purging of all non-public or other protected GFI from any Contractor owned system, and certification of execution

• Update of the Transition Out Plan seven (7) calendar days after request from the Contracting Officer to accommodate updates and the successor/incoming Contractor’s Transition In Plan (included as part of successor/incoming Contractor’s Implementation Strategy)

The list above is not exhaustive. The Contracting Officer (CO) may discuss additional items or considerations related to phasing out services prior to the Transition period. The services required to Transition Out will only be exercised in the event of a need for an actual transition. The Transition Out Plan and Update (if requested by the CO) shall be delivered to VA. The Transition Out Plan and Update submitted by the Contractor shall be incorporated into the contract upon VA approval.

Deliverables: (See Section 1213.3, “Schedule of Deliverables” for details.)

• Transition Out Plan and Update

• Weekly Monthly Status Report of Claims Invoices and Phase-Out Activities

2.6 Operational Quality Reporting Requirements

The Contractor shall use the following to ensure effective management of the program:

1. The Contractor shall notify the Contracting Officer immediately of employee strikes at its Facilities. The Contractor shall also promptly give written notice to the Contracting Officer of the cessation of such occurrence.

2. The Contractor shall utilize Attachment B, Facilities Status Report, to provide information on facility demographics to VA (e.g. change in ownership (CHOW)). The Facilities Status Report shall be submitted to VA no more than five (5) business days following the scheduled kickoff meeting and monthly thereafter in accordance with Section 1213.3, Schedule of Deliverables. VA maintains the right to modify Attachment B, Facilities Status Report. Should changes occur, the Contractor will have 90 calendar days to implement changes to the format. The Contractor shall continue to submit facility updates via email or other means as directed by VA during the 90 calendar days until format changes are fully implemented. When submitting changes on Attachment B, Facilities Status Report, the Contractor shall not make changes to the template provided by the VA. The Contractor shall notify VA, using Attachment B, Facilities Status Report, for disqualifying or adverse administrative events.

3. The Contractor shall notify the authorizing VAMC personnel, COR, and Contracting Officer using Attachment B, Facilities Status Report, of all adverse administrative events by the CMS Medicare Program to include exclusion from participation from the Medicare program, Medicaid program, and other federal programs by the Contractor, its agents, employees, assigns or successors.

4. The Contractor shall notify the authorizing VAMC, COR, and Contracting Officer via e-mail and include information detailing the reasons for, and circumstances related to the loss or adverse impact in accordance with CMS Medicare Program reporting. Notification shall be provided if the below occurs, according to the cadence outlined in the Schedule of Deliverables:

• Any action affecting the status as a certified CMS Medicare Program provider of dialysis services to Veterans, or any other action affecting any of the dialysis facility’s federal or state licenses and CMS certification.

• Any investigations by the CMS Medicare Program into the business and/or billing practices of the dialysis facility that results in negative findings.

• Any other actual or pending legal or Governmental investigation, incident, claim, action, suit, or proceeding against the dialysis facility, which would impact the dialysis facility’s ability to carry out its duties and obligations under this contract.

• Exclusion from the CMS Medicare Program of any individuals employed by, or contracted with, the dialysis facility for the provision of ESRD services.

• Revocation of required federal or state licenses of any individuals employed by, or contracted with, the dialysis facility for the provision of ESRD services; and

• The lapse, for any reason, of the dialysis facility’s medical malpractice insurance coverage.

5. The Contractor shall establish and maintain a Quality Assurance Plan (QAP). The Contractor’s QAP shall demonstrate how the Contractor’s performance shall adhere to the QASP (see Attachment BA, QASP).

Deliverables: (See Section 1213.3 “Schedule of Deliverables” for details.)

• Attachment B, Facilities Status Report

• Quality Assurance Plan

3 ANNUAL CLOSE OUT OF ADMINISTRATIVE FEES

The Contractor shall submit electronic copies (in approved…