Postconference QA_0004.pdf

NDSC

Post-Conference Questions

1. If we have facilities that have passed their certification survey, but are pending receiving the CMS approval letter with the PTAN, should these facilities be listed on our facility listing for the RFP or should they be left off until we have the PTAN number?

VA: The solicitation requires that all dialysis facilities proposed by the offeror to be utilized in the resulting contract are Medicare-certified. The “Attachment 2 – Attestation Statement” must certify that all facilities listed are Medicare-certified. Facilities pending CMS approval and PTAN do not meet this requirement at the time of proposal submission and should not be listed until certification is complete. (Ref: Section E.2, Volume II – Facility Certification; PWS 4.1, 4.2)

2. PWS Section 5.1 Contractor Contact Center Support to VA Staff (p. 31) “The Contractor shall establish and maintain the Contractor Contact Center to support…”

a. Is there a requirement for how quickly the contractor needs to respond to calls from VA?

For example, if lines are at capacity during a call, will VA accept a call back at a later time?

If so, what is the SLA for a call back?

VA: The requirement is for a warm transfer, defined in the PWS in Section 1.4 as “staying on the line until the call is completed.” There is not a requirement for response time or Service Level Agreements for callbacks if lines are at capacity. The PWS specifies that the Contractor Contact Center must operate from 8AM to 6PM, Monday through Friday, excluding Federal holidays, in all local time zones. (Ref: PWS 5.1)

b. If the contractor has a question regarding the patient’s account, can the contractor ask questions to the VA representative on the line?

VA: The PWS does not prohibit the contractor from asking questions to the VA representative on the line regarding a patient’s account. The Contractor Contact Center is established to support VA staff inquiries, and communication is expected to be two-way for resolving issues. (Ref: PWS 5.1)

c. Will the contractor be able to apply standard call center guidelines and procedures not specified in the RFP (ex. only 3 member inquires per call)?

VA: The PWS does not specify restrictions on the contractor’s internal call center guidelines and procedures, except that the contractor must meet the requirements outlined in the PWS, including providing a direct line for VA staff and supporting inquiries as described. Any additional internal procedures are not prohibited unless they conflict with contract requirements. (Ref: PWS 5.1)

3. PWS Section 5.1.1 VA Provided Ticketing Tool (p. 31-32) “The Contractor shall track and address inquiries from VA staff…”

a. Since contractors must bypass warm transfers, will the contractor be allowed to call back with a response or resolution to VA’s question or request? If so, what is the SLA for a call back?

VA: The PWS requires that the contractor provide an escalation process and a direct line to a customer service representative to facilitate warm transfers, bypassing IVR or queues. It does not specify a Service Level Agreement for callbacks if a response cannot be provided immediately. (Ref: PWS 5.1.1)

4. PWS Section 5.1.2 Contractor Use of VA-Provided Ticketing Tool (p. 32)“VA will provide the Contractor with access to the VA-provided ticketing tool…”

a. Regarding the VA-provided ticketing tool, is it VA’s intent to call in to the contractor provided customer service center with an issue and then have the contractor create a ticket related to the issue? Will VA provide greater clarity regarding ticket submission roles and responsibilities between the contractor and VA?

VA: No, this is not referring to a Contractor ticketing tool. The PWS states that the contractor shall use the VA-provided ticketing tool to track, respond to, and resolve issues identified by VA staff or by the contractor when an inquiry requires escalation to VA. The contractor is responsible for providing a resolution in the ticketing system, including a full written response. (Ref: PWS 5.1.2)

5. PWS Section 8.1.2 Billing: Vendor Onboarding (p.39-40) “Vendor Onboarding: VA requires all vendors to submit…”

a. Please confirm that neither a UEI nor a full SAM registration is required for vendors and each clinic location to participate as service providers under this contract. Form 10091 indicates that UEI/SAM registration is optional and UEI/SAM registrations are not required for Medicare participation.

VA: The PWS does not state that a UEI or full SAM registration is required for each clinic location, only that vendorization via Form 10091 is required. (Ref: PWS 8.1)

6. Section C.11.c.2 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY (FEB 2023) (p. 63) “All Contractors, subcontractors, third parties, and business associates working with VA information are subject to the same investigative requirements…”

a. Regarding background security investigations detailed in VA Directive and Handbook 0710, what level of sensitivity level or Tier does the VA intend to require for contractor employees that access VA information?

VA: Please reference VAAR 852.204-71(2). The specific Tier or sensitivity level is not specified in the PWS. All Contractors, subcontractors, third parties, and business associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors to access VA information and VA information systems shall be in accordance with VA Directive and Handbook 0710, Personnel Security and Suitability Program.

b. Does VA have a comprehensive list of specific screening checks tied to each Tier that can be provided for contractor review?

VA: Please reference VAAR 852.204-71 (b). The PWS does not provide a comprehensive list of specific screening checks tied to each Tier. However, the VA follows federal guidelines (primarily from the Office of Personnel Management [OPM] and the National Background Investigations Bureau [NBIB]) that define the required checks for each investigation tier. VA’s own policies (such as VA Handbook 0710, Personnel Security and Suitability Program) outline these requirements.

7. Section C.11 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY (FEB 2023)

(p. 64) “Contractor operations required to be in United States…”

a. Please confirm that any Information Technology Security Plans for proposed outsourced services under C.11 are not required until after award.

VA: Please reference VAAR 852.204-71 (d). The Contractor/subcontractor must state in its proposal where all non-U.S. services are provided. At a minimum, the Contractor/subcontractor must include a detailed Information Technology Security Plan, for review and approval by the Contracting Officer, specifically to address mitigation of the resulting problems of communication, control, and data protection.

b. Please identify any non-US locations VA deems acceptable without an Information Technology Security Plan for call center services, revenue operations, billing, information technology service tickets for applications, troubleshooting for applications, or other data management or storage?

VA: Please reference VAAR 852.204-71(d). The PWS does not identify any non-U.S.

locations that are acceptable without an Information Technology Security Plan.

c. What information must an offeror provide with its proposal if an offeror is proposing support services outside of the continental United States?

VA: Please reference VAAR 852.204-71 (d). The Contractor/subcontractor must state in its proposal where all non-U.S. services are provided. At a minimum, the Contractor/subcontractor must include a detailed Information Technology Security Plan, for review and approval by the Contracting Officer, specifically to address mitigation of the resulting problems of communication, control, and data protection.

d. Is the requirement to perform “custom software development and outsourced operations” in the continental United States specific to information technology development and services activities? If not, what activities and services are expected to be located in the United States?

VA: Please reference VAAR 852.204-71(d). This reference in the clause is specific to information technology development and services activities.

8. Section C.8 FAR 52.222-49 (p. 60)

a. Please identify any required wage determinations associated with the contract if any action with regard to wage determinations is required as part of proposals.

VA: Per FAR 52.222-49 and Section E.2 Addendum to 52.212-1, Volume I (iv), has requested that Offerors provide the following with their proposal:

• Identify all known places of performance in order for wage determinations to be incorporated into any resultant contract.

• If an offeror believes any labor category is exempt from the Service Contract Labor Standards, they shall provide the rationale for exemption.

A final determination of Service Contract Labor Standards applicability for each labor category will be made prior to award and any wage determinations required will be included in the resultant contract.

9. July 15, 2025 Presentation (Slide 12)

a. Please clarify what the Government requires when it states on Slide 12 that Volume I

Requirements include “Wage Determinations IAW FAR 52.222-49”.

VA: Per FAR 52.222-49 and Section E.2 Addendum to 52.212-1, Volume I (iv), has requested that Offerors provide the following with their proposal:

• Identify all known places of performance in order for wage determinations to be incorporated into any resultant contract.

• If an offeror believes any labor category is exempt from the Service Contract Labor Standards, they shall provide the rationale for exemption.

A final determination of Service Contract Labor Standards applicability for each labor category will be made prior to award and any wage determinations required will be included in the resultant contract.

10. Attachment C (Project Risk Register)

a. Please provide additional context for Risk Register Columns F, X, and Y, per below:

b. Column F requires “A more detailed description of the risk that includes context from interviews” please clarify the interviews the Government expects to be conducted?

VA: The requirement is for a more detailed description of the risk, which may include context from interviews conducted by the contractor as part of their risk identification and management process. (Ref: PWS 2.3)

c. Please clarify the strategic objectives for column X, which asks “What strategic objectives is this risk associated to?”

VA: The contractor should align identified risks to the strategic objectives of the project or organization as relevant. (Ref: PWS 2.3)

d. Please clarify other priorities and other means in column Y and the question “Does this risk align to a mission that is separate from strategic objectives but has been identified as a priority through other means (i.e. GAO, OIG, etc.)?”

VA: “Other means” and “Other priorities” both refer to priorities identified by external oversight or audit entities such as GAO or OIG, separate from the project’s strategic objectives. (Ref: PWS 2.3)

11. Is the use of an electronic health care clearinghouse required? (p. 40; para 5A); (p. 39; para8.1.1)

Does VA currently use an electronic healthcare clearinghouse for the current contracts? Can the offeror propose one?

VA: The PWS requires that health care claims be submitted via HIPAA-compliant Electronic Data Interchange (EDI) transactions sent through the Financial Services Center (FSC). The PWS does not specify a required clearinghouse, nor does it prohibit the offeror from proposing one, as long as claims are submitted in the required format. (Ref: PWS 8.1)

12. "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." (p.16; para.1.4.2) Please confirm that all services received as part of Training for Home based Modalities are among the services covered by this contract, if authorized.

VA: Yes, training for home-based modalities is among the services covered by this contract, if authorized. (Ref: PWS 1.2, PWS 1.4)

13. Who is responsible for retrieval of private medical records? Does VA have a contractor for this process that can be used?

VA: The contractor providing the dialysis services is responsible for retrieving and submitting the required medical documentation directly to VA.

14. "(e) Multiple offers. Offerors are encouraged to submit multiple offers presenting alternative terms and conditions, including alternative line items (provided that the alternative line items are consistent with FAR subpart 4.10), or alternative commercial products or commercial services for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately"

(p. 86; para. (e))

"Multiple offers from one Offeror will not be accepted in response to this solicitation." (p. 89;

para. 1.b).

These statements seem to contradict each other. Please clarify.

VA: Section E.2 52.212-1 (e) will be tailored in accordance with FAR 12.302 to the following:

(e) Multiple offers. Offerors are encouraged to submit multiple offers. Each offer submitted will be evaluated separately.

The following in Section E.2 Addendum to 52.212-1, 1(a) will be deleted:

“Multiple Offers from one Offeror will not be accepted in response to this solicitation”.

15. "(f) Late submissions, modifications, revisions, and withdrawals of offers" (p. 86-87). We believe this is superseded by VAAR 852.273-70, Late Offers. Please clarify.

VA: VAAR 852.273-70 will be incorporated into the RFP via amendment.

16. "Evaluation Factor 2, 3, and 4 are considered technical factors and are of equal importance. They will be evaluated separately as standalone factors. They are not considered subfactors." ...

Evaluation Factor 2, Evaluation Factor 3, Evaluation Factor 4, and Evaluation Factor 5 are equally weighted". (p. 109) If Factors 2, 3 and 4 are of "equal importance", how can Factors 2, 3, 4, and 5 also be "equally weighted" at the same time? The two sections, when taken together, seem ambiguous. Please clarify.

VA: Please reference Section E.12, subsection (i) in the revised RFP. This section has been revised to the following:

Evaluation Factors 2 through 5 are equally weighted and when combined, are significantly more important than the price factor. There is no technical factor that is more important than another technical factor. Each technical evaluation factor is equally important; additionally, in the best value tradeoff analysis, all non-priced evaluation factors will be given equal weight. Ultimately, the price must be determined fair and reasonable to be eligible for award. Since the government does not anticipate in engaging in discussions, offerors should submit their best priced offer with the proposal submission.

The following Evaluation Methodology for Technical Capability Factors section has been deleted:

Evaluation Methodology for Technical Capability Factors

Evaluation Factor 2, 3, and 4 are considered technical factors. and are of equal importance. They will be evaluated separately as standalone factors. They are not considered subfactors.

17. "The Government shall review available past performance data in the Past Performance Information Retrieval System found in the Contractor Performance Assessment Reporting System (CPARS)." Does that mean that evaluators can consider a CPAR from a contract other than one of the three submitted by the contractor for evaluation?

VA: Yes. In Section E.12 52.212-2, Evaluation Factor 5: Past Performance, the Government has indicated: The Government reserves the right to obtain past performance information from any available source and may contact customers other than those identified by the Offeror when evaluating past performance.

18. "Proposals will be evaluated on the written information submitted by Offeror. Offerors shall submit a well-written proposal with adequately detailed information which clearly demonstrates compliance with the solicitation requirements and allows for a meaningful evaluation by the agency. Clarity and completeness are essential. Data not submitted with the proposal but submitted previously or presumed to be known (i.e., previous projects performed for the United States Government) will not be considered as part of the proposal" (89), however: "The government reserves the right to obtain past performance information from any available source and may contact customers other than those identified by the Offeror when evaluating past performance. (p. 110) Please clarify this ambiguity.

VA: Proposals will be evaluated on the written information submitted by Offeror; however, the Contracting Officer will adhere to FAR 15.305(a)(2)(ii):

The solicitation shall describe the approach for evaluating past performance, including evaluating offerors with no relevant performance history, and shall provide offerors an opportunity to identify past or current contracts (including Federal, State, and local government and private) for efforts similar to the Government requirement. The solicitation shall also authorize offerors to provide information on problems encountered on the identified contracts and the offeror’s corrective actions. The Government shall consider this information, as well as information obtained from any other sources, when evaluating the offeror’s past performance. The source selection authority shall determine the relevance of similar past performance information.

19. Pg 6: FAR “52.232-33” & “52.232-36”; The actual FAR does not indicate the required time for the VA to approve and ensure payment is issued for claims, how long will it take for the VA to approve and pay claims under the new NDSC? Can you please redirect to another payment section of FAR if time to pay claims is otherwise published?

VA: FAR 52.232-33 is checked in Section B.1 and is associated with “Method of Payment”. FAR 52.212-4 (Contract Terms and Conditions—Commercial Products and Commercial Services), which states in section (g)(2): “Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.”

The Prompt Payment Act and its implementing regulations (5 CFR part 1315) generally require federal agencies to pay contractors within 30 days after receipt of a proper invoice or after receipt of goods/services, whichever is later, unless otherwise specified in the contract.

20. Pg 8: According to “The ceiling for each contract will be negotiated and set at the time of award."

What will the ceiling for each contract be based on?

VA: The ceiling for each contract will be negotiated and set at the time of the award after receipt of proposals and evaluations.

21. Pg 9: To avoid a delayed reimbursement for CLIN 0003, will the VA release in the next Amendment to the solicitation its expected required “data” items in anticipation that there will be such data requests after BOE is submitted by offeror? “CLIN 0003: Implementation The offeror shall propose a lump sum price, in dollars, to complete implementation. The Offeror shall provide a Basis of Estimate (BOE) for implementation within the price proposal narrative that describes the duration, work activities, and methodology required to support the proposed price. The Government may request data other than certified cost or pricing data from the offeror to the extent necessary to determine a fair and reasonable price IAW FAR 15.403-3.”

VA: The Government may request data other than certified cost or pricing data from the offeror to the extent necessary to determine a fair and reasonable price IAW FAR 15.403-3 after review of the BOE.

22. Pg 16: " 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." Per the conference, can please confirm "sought care" means one single visit during the month and does it matter if the visit was for a dialysis treatment and/or what if visit was only for a related service, such as lab work?

VA: “Sought care” means a veteran has availed of contractor services (i.e., received care) at least once in that month. The PWS does not specify that the visit must be for dialysis treatment only; therefore, any authorized service under the contract, including related services such as lab work, would count. (Ref: PWS 1.4)

23. Pg 15: Shouldn’t this statement be modified to indicate requests may come from VAMC and/or Contractor? “All treatments must be requested and authorized by the VA Medical Center (VAMC) staff.”

VA: The PWS states: “All treatments must be requested and authorized by the VA Medical Center (VAMC) staff.” (Ref: PWS 1.2) Requests cannot come from a contractor.

24. Pg 22: "The Contractor shall adhere to Attachment C, Project Risk Register which shall consist of self-reported (not facility level) risk and issue management processes." (p. 22) Can you please clarify: "self-reported (not facility level)" ?

VA: “Self-reported (not facility level)” means the Project Risk Register should include risks and issues identified and reported by the contractor at the organizational or project level, not at the individual facility level. (Ref: PWS 2.3, p. 22)

25. Pg 22: "Contractor shall participate in ad hoc virtual Progress Report meetings.”; How many meetings should contractor expect? What will be the agenda for these meetings?

VA: The PWS has been revised to state that the contractor shall participate in ad hoc Virtual Progress report meetings, not to exceed four (4) in a calendar year. (Ref: PWS Section 2.3, 7.4, 13.3)

26. Pg 23: “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” . In advance of the award of the NDSC, will the VA consider and agree to use Contractor’s CMS quality metrics already established and made publicly available by CMS?

VA: The VA may consider using Contractor’s CMS quality metrics as part of the Quality Assurance Surveillance Plan (QASP) for the NDSC contract, but it is not obligated to automatically accept them in full. The VA typically reserves the right to define its own quality metrics and may supplement or modify CMS metrics to meet VA-specific requirements. Any adoption of contractor-proposed metrics would require VA review and explicit bilateral agreement prior to contract award or as a contract modification.

27. Pg 23: Will the VA prepare a CPAR for each of the Contractor's facilities used in the performance period or is it based on aggregating all facilities?

VA: VA will follow the guidance outlined in FAR 42.1502(a):

(a) General. Past performance evaluations shall be prepared at least annually and at the time the work under a contract or order is completed. Past performance evaluations are required for contracts and orders as specified in paragraphs (b) through (f) of this section, including contracts and orders performed outside the United States. These evaluations are generally for the entity, division, or unit that performed the contract or order.

28. Pg 23 all of Transition Out: How will contractor be reimbursed for the various requirements “after the last contract period exercised”?

VA: An Optional CLIN was added to Section B.3 for Transition Out services if needed in accordance with Section 2.5.

29. Pg 29: How many total ESRD VA beneficiaries are there in the United States and District of Columbia? “Dialysis services are required in the United States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands”

VA: Please reference Attachment 4 – Non-VA Dialysis Care Data for FY24.

30. Pg 32: Is a dedicated line required for just VA staff or can the Contractor’s existing customer service line be used? “Direct telephone line for VA staff to contact contractor staff”; Does the VA also have a dedicated line for Contractor to utilize in contacting VA about claims, appeals, etc?

VA: Vendors should utilize the VA FSC (Financial Services Center) Vendor Support line.

31. Pg 33: “The contractor’s inability to access authorizations through the established HSRM Portal shall not be a reason to refuse care to the Veteran." What is the protocol for the contractor to follow at this point?

VA: If the contractor is unable to access authorizations through the established HSRM Portal, the protocol specified in the PWS is as follows:

• The contractor shall contact the VAMC within 10 business days from the authorization expiration date and inquire as to the status of the authorization. If the authorization has been input into HSRM, the contractor shall contact the authorizing VAMC or C4 Help Desk at 1-877-881-7618. The contractor’s inability to access authorizations through the established HSRM Portal shall not be a reason to refuse care to the Veteran.

32. Pg 40, 5b: What is the protocol for Contractor to follow after this first step: “Denied invoices will first be addressed by the VA FSC Customer Service”

VA: C. Resubmissions: The Contractor shall resubmit claims within 90 calendar days of receipt from the Financial Service Center (FSC). (Ref. PWS Section 8.1(5)(C))

33. Pg 41: Is there something missing after section 8.3? It seems like there should be more to the claims appeal process than what is currently shown. What happens if the questions cannot be answered satisfactorily by the FSC?

VA: The Contractor is required to direct questions to FSC. There is no additional protocol or escalation after this step.

34. I have a couple of questions regarding the effective date column of the Facility List attachment.

a. Is this something we need to fill out on the Facility List or leave blank?

VA: The effective date column does not need to be completed.

b. If we need to list an effective date, what effective date is VA looking for? Is this the effective date the facility was added to our current existing VA agreement?

VA: The effective date column does not need to be completed.