CCN Next Gen Medical TOPR WEST 0002-04 Amendment.pdf

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1 23

Medical TOPR West 0002 04 02-20-2026

36C10G

U.S. Department of Veterans Affairs

OPAL | Strategic Acquisition Center

10300 Spotsylvania Ave | STE 400

Fredericksburg VA 22408-2697

36C10G

U.S. Department of Veterans Affairs

OPAL | Strategic Acquisition Center

10300 Spotsylvania Ave | STE 400

Fredericksburg VA 22408-2697

To all Offerors/Bidders

36C10G26R0003

12-15-2025

X

X X x

The purpose of this TOPR Amendment (Medical TOPR West 0002 04) is to make the following changes:

1. Update language throughout the RFP in Section B and Section E.

2. Update Attachment 3: Price Schedule

See Continuation Page for further details.

All other terms and conditions remain unchanged.

Jessica Portillo

Contracting Officer

CONTINUATION PAGE MEDICAL TOPR WEST 0002-04

Note: The words in red font in the “To” sections of each change denote the new language to be added in each version.

1. CHANGE 1:

The following language in Section B.2.1 TASK ORDER PROCEDURES is hereby changed as follows:

FROM:

Contractors under CCN Next Gen - Medical shall provide services as requirements are identified throughout the ordering period. Each requirement will specify details as they relate to deliverables, performance, and other technical items. The Government anticipates the task orders to have a Period of Performance (PoP) consisting of one (1) a three (3) year base period and two (2), 12 month option periods.

TO:

Contractors under CCN Next Gen - Medical shall provide services as requirements are identified throughout the ordering period. Each requirement will specify details as they relate to deliverables, performance, and other technical items. The Government anticipates the task orders to have a Period of Performance (PoP) consisting of one (1) three (3) year base period and two (2), 12 month option periods.

2. CHANGE 2:

The following language in Section B.4 MEDICAL CLIN STRUCTURE, is hereby changed as follows:

FROM:

CLIN X001, Healthcare Services subCLIN X001AA, Standard Medicare Rate Healthcare Services, VA will pay the Contractor authorized medical services at the locality-adjusted Medicare Rates.

(Government-provided rate) subCLIN X001AB, PPS Exempt Healthcare Services, VA will pay the Contractor for authorized medical services that are excluded from IPPS and OPPS based on CMS-issued payment rules. This includes services delivered at All Payer Model Agreement Hospitals that are included in rate orders and unit rates approved by the State, unless there is a VA CO approved rate that sets an alternate rate for such services. (Government-provided rate)

Medical TOPR West 0002- 04

CLIN X002, Waivers of Payment Rates

CLIN X003, Seasonal Vaccinations

CLIN X004, Fee Schedules subCLIN X004AA, VA Fee Schedule, covers all authorized non-Medicare medical services. VA will pay the Contractor the VA Fee Schedule rate when a given medical procedure is not payable under Medicare rules or is payable under Medicare rules but does not have established pricing at the local level.

(Government-provided rate) subCLIN X004AB, Alaska Fee Schedule, covers all authorized non-Medicare medical services in the state of Alaska. VA will pay the Alaska Fee Schedule rate for services furnished in Alaksa using the Alaska Fee Schedule and the Alaska Professional Fee Schedule, unless there is a VA CO approved rate that sets an alternate rate for such services. (Government-provided rate)

CLIN X005, Non-Medicare, Non-Fee Schedule Healthcare Services

CLIN X006, Urgent and Emergent Medication subCLIN X006AA, Brand Name Medication, VA will reimburse the Contractor for Brand Name medication at the awarded prices based on a percentage of Average Sale Price (ASP).

subCLIN X006AB, Generic Medication, VA will reimburse the Contractor for Generic medication at the awarded prices based on a percentage of Average Sale Price (ASP).

subCLIN X006AC, Dispensing Fee, The Contractor shall invoice the Dispensing fee at the awarded price for each dispensing activity.

CLIN X007, Disaster Response - Urgent and Emergent Medication subCLIN X007AA, Brand Name Medication, VA will reimburse the Contractor for Brand Name medication at the awarded prices based on a percentage of Average Sale Price (ASP).

subCLIN X007AB, Generic Medication, VA will reimburse the Contractor for Generic medication at the awarded prices based on a percentage of Average Sale Price (ASP).

subCLIN X007AC, Dispensing Fee, The Contractor shall invoice the Dispensing fee at the awarded price for each dispensing activity.

CLIN X008, Administrative Services subCLIN X008AA Administrative Services for Healthcare Services, VA will pay the Contractor for administrative services required to manage and deliver the healthcare services purchased under this contract.

subCLIN X008AB, Administrative Services for Pharmacy Benefits Management (PBM), VA will pay the Contractor for administrative services required to manage and deliver the pharmacy services purchased under this contract.

CLIN X009, Organ Acquisition Cost

CLIN X010, Incentive/Disincentives subCLIN X016AA Administrative Services Performance Incentives, VA will pay the Contractor for net incentive fees earned (less any disincentive fees assessed), during the period of performance of this Sub CLIN, in accordance with the Performance Requirement Summary (PRS). Disincentive fees assessed to the Contractor that exceed the amount of incentive fees earned during the period of performance under which the performance occurred will be billed to the Contractor via Credit Memo (in Tungsten Network).

subCLIN X016AB Value Based Care Lower Extremity Joint Replacement (LEJR) Performance Incentive, VA will pay the Contractor for incentive fees earned during the period of performance of this CLIN, in accordance with “Attachment C

- Performance Requirement Summary (PRS)”.

CLIN X011, Implementation

VA will make a lump sum payment to the Contractor upon satisfactory completion of all start-up/implementation milestones identified in the contractor’s implementation plan and accepted by the CO. The contractor shall invoice in accordance with the firm fixed price performance-based milestones. The Contractor shall not invoice for implementation before full HCD is achieved across the region. CLIN X011 reflects the total lump sum costs of transition, implementation, and administrative services prior to full HCD. Implementation services shall be excluded from CLIN X008, Administrative Services.

CLIN X012, Transition Out:

VA will pay the Contractor for transition out and residual service tasks, including retroactive processing of referrals and claims adjudication, providing claims, transition open referrals, providing an inventory of assets, facilitating knowledge transfer, removal of government furnished information, and customer service transition. This CLIN will be paid as a fixed price upon VA initiation of the transition out period. Transition out services shall be excluded from CLIN X008, Administrative Services.

OPTIONAL CLIN X013, Implementation – Optional Task

OPTIONAL subCLIN X013AA, Implementation of Healthcare Appointment Scheduling and Comprehensive Care Coordination at the VA Facility, VA will pay the Contractor for completion of the implementation of appointment scheduling and care coordination at a VA facility. VA will pay the awarded price for each VA Facility that orders appointment scheduling and comprehensive care coordination. Implementation of Optional Task services shall be excluded from CLIN X008, Administrative Services and CLIN X010, Implementation. The Contractor is only eligible to invoice for one implementation payment per VA Facility during the Period of Performance of the contract.

OPTIONAL subCLIN X013AB, Implementation for Appointment Scheduling and Comprehensive Care Coordination at the Contractor's Site, VA will pay the Contractor for completion of the implementation of appointment scheduling and care coordination at the Contractor’s site. VA will pay the awarded price for appointment scheduling and comprehensive care coordination at the Contractor's site. Implementation services shall be excluded from CLIN X008, Administrative Services and CLIN X011, Implementation. The Contractor is only eligible to invoice for one implementation payment during the period of performance of the contract.

OPTIONAL CLIN X014, Appointment Scheduling and Comprehensive Care Coordination Administration

The tiers are as follows:

Tiers Number of Unique VA Approved Referrals by Period of Performance

Tier 1 0 – 200,000

Tier 2 200,001 – 300,000

Tier 3 300,001 – 400,000

Tier 4 400,001 – 500,000

Tier 5 500,001 +

OPTIONAL CLIN X015, Care Coordination Follow-Up

OPTIONAL CLIN X016, Software, Process, and Proof of Concept Development

Optional subCLIN X016AA Extra-Small (XS), Small modifications to existing functionality. Architecturally insignificant, only involves one team, similar to work done in the past by team, no new technologies involved. An extra small task consists of 1 Sprint, over a 1–4-week period.

Optional subCLIN X016AB Small (S), Small modifications to existing functionality.

Architecturally insignificant, few dependencies but only involves one team, similar to work done in the past by team, no new technologies involved. A small task consists of 2 Sprints, over a 1–2-month period.

Optional subCLIN X016AC Medium (M), More significant modifications to existing functionality. Minor architectural changes, few dependencies across 1-2 teams, precedents exist for the work but teams are inexperienced in doing it, may involve new technologies. A medium task consists of 4 Sprints, over a 3–6-month period.

Optional subCLIN X016AD Large (L), No existing functionality to leverage. Major architectural changes required, multiple dependencies across multiple teams, no precedents for the work, no experience on the teams, involves new technologies.

A large task consists of 7 Sprints, over a 7–18-month period.

Optional subCLIN X016AE Extra Large (XL), No existing functionality to leverage. Major architectural changes required, multiple dependencies across multiple teams, no precedents for the work, no experience on the teams, involves new technologies. An extra-large task consists of 10 Sprints, over an 18+ month period.

TO:

CLIN X001, Healthcare Services:

CLIN X001, Healthcare Services, VA will pay the Contractor for all authorized medical services provided under this contract. The Contractor shall reimburse network providers at the lessor of the billed charges or the maximum allowable rate specified by Medicare.

The lesser of the billed charges means that if the amount billed by the network provider is lower than the maximum allowable Medicare rate, the Contractor shall reimburse the provider based on the billed amount rather than the Medicare rate.

Sub CLIN X001AA, Standard Medicare Rate Healthcare Services:

Sub CLIN X001AA, Standard Medicare Rate Healthcare Services: VA will pay the

Contractor for authorized medical services at the locality adjusted Medicare

Rates.

Sub CLIN X001AB, PPS Exempt Healthcare Services:

Sub CLIN X001AB, PPS Exempt Healthcare Services, VA will pay the Contractor for authorized medical services that are excluded from IPPS and OPPS based on

CMS issued payment rules. This includes services delivered at All Payer Model

Agreement Hospitals that are included in rate orders and unit rates approved by the State, unless there is a VA CO approved rate that sets an alternate rate for such services.

CLIN X002, Waivers of Payment Rates:

CLIN X002, Waiver of Payment Rates, VA will pay the Contractor for authorized services in highly rural areas and/or regions with scarce medical resources by allowing payment at a percentage above the locality-adjusted Medicare rate, the VA Fee

Schedule rate, or the Alaska Fee Schedule rate. Upon VA approval and execution of a waiver request, the Contractor shall reimburse providers at the lesser of the approved rate or the billed charges for the specified services. The lesser of the billed charges means that if the provider's billed amount is lower than the rate approved through the waiver request, the Contractor will reimburse the provider based on the billed amount rather than the higher approved waiver rate.

CLIN X003, Seasonal Vaccinations:

CLIN X003, Seasonal Vaccinations, VA will pay the Contractor for administrating the influenza (trivalent, quadrivalent and high dosage), COVID-19 vaccines at retail pharmacies. Pricing for this CLIN is determined by the awarded price for each vaccination. CLIN X003 includes the administration and product fee.

CLIN X004, Fee Schedules:

CLIN X004, VA Fee Schedule, covers all authorized non-Medicare medical services. VA will pay the Contractor the Fee Schedule rates when a given medical procedure is not payable under Medicare rules or is payable under Medicare rules but does not have established pricing at the local level.

Sub CLIN X004AA, VA Fee Schedule:

Sub CLIN X004AA, VA Fee Schedule, VA will pay the Contractor the VA Fee

Schedule rate when a given medical procedure is not payable under Medicare rules or is payable under Medicare rules but does not have established pricing at the local level and there is an established VA Fee Schedule rate.

Sub CLIN X004AB, Alaska Fee Schedule:

Sub CLIN X004AB, Alaska Fee Schedule, covers all authorized non-Medicare medical services in the state of Alaska. VA will pay the Alaska Fee Schedule rate for services furnished in Alaksa using the Alaska Fee Schedule and the Alaska

Professional Fee Schedule, unless there is a VA CO approved rate that sets an alternate rate for such services.

CLIN X005, Non-Medicare, Non-VA, Non-Alaska Fee Schedule Healthcare

Services:

CLIN X005, Non-Medicare, Non-VA, Non-Alaska Fee Schedule Healthcare Services, VA will pay the Contractor for authorized healthcare services when a given medical service or procedure is not payable under Medicare rules, or is payable under Medicare rules but does not have established pricing at the local level, and is not included in the VA

Fee Schedule. When there is not a Medicare rate or VA Fee Schedule rate for the authorized service(s), the VA shall reimburse the Contractor at 50% of the provider’s billed charges.

CLIN X006, Urgent and Emergent Medication:

CLIN X006, Urgent and Emergent Medication, VA will pay the Contractor for urgent and emergent medications dispensed by pharmacies in the Contractor's network without direct charges to the Veteran. VA will reimburse the Contractor for Brand Name (Sub

CLIN X006AA) and Generic (Sub CLIN X006AB) medication at the awarded prices based on a percentage of Average Sale Price (ASP). The Contractor shall invoice the

Dispensing fee (Sub CLIN X006AC) at the awarded price for each dispensing activity.

Sub CLIN X006AA Brand Name Medication

Sub CLIN X006AB Generic Medication

Sub CLIN X006AC Dispensing Fee

CLIN X007, Disaster Response ONLY – Urgent and Emergent Medication:

OPTIONAL CLIN X007, Disaster Response ONLY – Urgent and Emergent Medication, VA will pay the Contractor for urgent and emergent medications dispensed by pharmacies in the Contractor's network without direct charges to the Veteran during a specified and approved “Disaster Response” scenario. CLIN X007 will only be exercised in the case of a disaster that prevents VA’s mail order pharmacy from delivering medications to Veterans. Prescription fills may be for 30-days under this CLIN. VA will reimburse the Contractor for Brand Name (Sub CLIN X007AA) and Generic (Sub CLIN

X007AB) medication at the awarded prices based on a percent of ASP. The Contractor shall invoice the Dispensing fee (Sub CLIN X007AC) at the awarded price for each dispensing activity.

Sub CLIN X007AA Brand Name Medication

Sub CLIN X007AB Generic Medication

Sub CLIN X007AC Dispensing Fee

CLIN X008, Administrative Services:

CLIN X008, Administrative Services, VA will pay the Contractor for the administrative services required to manage and deliver the services purchased under this contract.

These costs are separate from the costs of providing medical services and implementation. Administrative services and activities include, but are not limited to, the following items:

• Claims Appeals

• Claims Processing

• Clinical Quality and Patient Safety Monitoring

• Alternative Payment Models

• Utilization Management

• Contractor Administrative Costs

• Contact Center

• Contractor Profits

• Credentialing

• Customer Service

• Data Analytics and Reporting

• Fee Schedule Updates

• Invoicing and Billing

• Medical Documentation Procedures

• Network Development and Management

• Program Integrity

• Project Management

• Referrals Management

• Training

This CLIN is paid following achievement of full healthcare delivery (HCD) based on the monthly Enrolled Veteran population in the Task Order's geographic jurisdiction/region.

Sub CLIN X008AA Administrative Services for Healthcare Services:

Sub CLIN X008AA, Administrative Services for Healthcare Services, VA will pay the Contractor for administrative services required to manage and deliver the healthcare services purchased under this contract.

Sub CLIN X008AB, Administrative Services for Pharmacy Benefits

Management (PBM):

Sub CLIN X008AB, Administrative Services for Pharmacy Benefits Management

(PBM), will pay the Contractor for administrative services required to manage and deliver the pharmacy services purchased under this contract.

CLIN X009, Organ Acquisition Cost:

CLIN X009, Organ Acquisition Cost, VA will pay the Contractor an equitable payment for reasonable organ acquisition services/costs required to support quality transplant programs in agreement with certified transplant centers (CTC). Medicare Standard

Acquisition Charges (SACs) shall be used for reimbursement of the reasonable and necessary costs associated with solid organ acquisition.

The Contractor shall include provisions in agreement with CTCs that allows reimbursement for organ acquisition according to the most current Medicare Cost

Report Data, under the D-4 Worksheet.

CLIN X010, Incentives/Disincentives:

VA will pay for incentives and disincentives related to performance metrics, quality of service, and other criteria as specified by the PWS; incentives encourage exceeding baseline performance requirements and disincentives address underperformance.

Sub CLIN X010AA, Adverse Credit Reporting Incentives:

Sub CLIN X010AA, Adverse Credit Reporting Incentives, VA will pay the

Contractor for net incentive fees earned (less any disincentive fees assessed) for

PO2.7 during the period of performance in accordance with “Attachment C -

Performance Requirement Summary (PRS)”.

Sub CLIN X010AB, Value Based Care Lower Extremity Joint Replacement

(LEJR) Performance Incentive:

Sub CLIN X010AB, Value Based Care Lower Extremity Joint Replacement

(LEJR) Performance Incentive, VA will pay the Contractor for net incentive fees earned (less any disincentive fees assessed) for PO5.1 during the period of performance in accordance with “Attachment C - Performance Requirement

Summary (PRS)”.

CLIN X011, Implementation:

CLIN X011, Implementation, VA will make a lump sum payment to the Contractor upon satisfactory completion of all start-up/implementation milestones identified in the contractor’s implementation plan and accepted by the CO. “Satisfactory completion” would mean the Contractor has completed all start-up/implementation milestones identified in the Contractor’s implementation plan and those milestones have been accepted by the CO. It also requires that the Contractor not invoice for implementation until full HCD is achieved across the region, with invoicing aligned to the firm fixed price performance-based milestones and covering the lump-sum transition/ implementation/ administrative services prior to full HCD (with implementation services excluded from

CLIN X008, Administrative Services).

CLIN X012, Transition Out:

CLIN X012, Transition Out, VA will pay the Contractor for transition out and residual service tasks, including retroactive processing of referrals and claims adjudication, providing claims, transition open referrals, providing an inventory of assets, facilitating knowledge transfer, removal of government furnished information, and customer service transition. This CLIN will be paid as a fixed price upon VA initiation of the transition out period. Transition out services shall be excluded from CLIN X008, Administrative

Services.

OPTIONAL CLIN X013, Task Implementation:

OPTIONAL Sub CLIN X013AA, Implementation of Appointment Scheduling and Comprehensive Care Coordination at the VA Facility:

OPTIONAL Sub CLIN X013AA, Implementation of Appointment Scheduling and

Comprehensive Care Coordination at the VA Facility, VA will pay the Contractor for completion of the implementation of appointment scheduling and care coordination at a VA facility. VA will pay the awarded price for each VA Facility that orders appointment scheduling and comprehensive care coordination.

Implementation services shall be excluded from CLIN X008, Administrative

Services and CLIN X011, Implementation. The Contractor is only eligible to invoice for one implementation payment per VA Facility during the Period of

Performance of the contract.

OPTIONAL Sub CLIN X013AB, Implementation for Appointment Scheduling and Comprehensive Care Coordination at the Contractor's Site:

OPTIONAL Sub CLIN X013AB, Implementation for Appointment Scheduling and

Comprehensive Care Coordination at the Contractor's Site, VA will pay the

Contractor for completion of the implementation of appointment scheduling and care coordination at the Contractor’s site. VA will pay the awarded price for appointment scheduling and comprehensive care coordination at the Contractor's site. Implementation services shall be excluded from CLIN X008, Administrative

Services and CLIN X011, Implementation. The Contractor is only eligible to invoice for one implementation payment during the period of performance of the contract.

OPTIONAL CLIN X014, Healthcare Appointment Scheduling and Comprehensive

Care Coordination:

OPTIONAL Sub CLIN X014, Appointment Scheduling and Comprehensive Care

Coordination, VA will pay the Contractor for appointment scheduling and care coordination at the awarded monthly price for the number of unique VA Approved

Referrals for the tier ordered. If the Contractor receives unique referrals over the annual tiered volumes, the Contractor shall return those referrals to VA.

When the quantity of unique VA Approved Referrals exceeds a tier, the subsequent tier may be ordered.

The tiers are as follows:

CLIN X014

Number of Unique VA Approved

Referrals by Period of Performance

Sub CLIN X014AA (Tier 1) 0 – 200,000

Sub CLIN X014AB (Tier 2) 200,001 – 300,000

Sub CLIN X014AC (Tier 3) 300,001 – 400,000

Sub CLIN X014AD (Tier 4) 400,001 – 500,000

Sub CLIN X014AE (Tier 5) 500,001 +

OPTIONAL CLIN X015, Care Coordination Follow-Up:

OPTIONAL CLIN X015, Care Coordination Follow-Up, VA will pay the Contractor for care coordination follow-up services at the awarded monthly price for the number of unique VA Approved Referrals, including implementing the care coordination follow-up process. Payments are limited to one payment per Veteran per month.

OPTIONAL CLIN X016, Software, Process, and Proof of Concept Development:

OPTIONAL CLIN X016, Software, Process, and Proof of Concept Development, VA will pay the Contractor for software design, customization, development, configuration, interface development, programming changes, and modifications to include system update services and process and proof of concepts changes in accordance with current software development methodologies associated with software solutions, as needed.

This CLIN is paid based on a fixed price for each instance of a software development, process, or proof of concept task aligned to the following task sizes:

OPTIONAL Sub CLIN X016AA Extra-Small (XS):

OPTIONAL SUBCLIN X016AA Extra-Small (XS), Small modifications to existing functionality. Architecturally insignificant, only involves one team, similar to work done in the past by team, no new technologies involved. An extra small task consists of 1 Sprint, over a 1–4-week period.

OPTIONAL Sub CLIN X016AB Small (S):

OPTIONAL SUBCLIN X016AB Small (S), Small modifications to existing functionality. Architecturally insignificant, few dependencies but only involves one team, similar to work done in the past by team, no new technologies involved. A small task consists of 2 Sprints, over a 1–2-month period.

Optional Sub CLIN X016AC Medium (M):

OPTIONAL SUBCLIN X016AC Medium (M), More significant modifications to existing functionality. Minor architectural changes, few dependencies across 1-2 teams, precedents exist for the work but teams are inexperienced in doing it, may involve new technologies. A medium task consists of 4 Sprints, over a 3–6-month period.

OPTIONAL Sub CLIN X016AD Large (L):

OPTIONAL SUBCLIN X016AD Large (L), No existing functionality to leverage.

Major architectural changes required, multiple dependencies across multiple teams, no precedents for the work, no experience on the teams, involves new technologies. A large task consists of 7 Sprints, over a 7–18-month period.

OPTIONAL Sub CLIN X016AE Extra Large (XL):

OPTIONAL SUBCLIN X016AE Extra Large (XL), No existing functionality to leverage. Major architectural changes required, multiple dependencies across multiple teams, no precedents for the work, no experience on the teams, involves new technologies. An extra-large task consists of 10 Sprints, over an 18+ month period.

3. CHANGE 3:

The following language in Section, E.1 ADDENDUM TO FAR 52.212-1 INSTRUCTIONS

TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES,

FACTOR 1: Technical Evaluation Phase II, Subfactor 1.2: Medical Network Adequacy Plan, bullet 1, is hereby changed as follows:

1. Approach to building and maintaining a network with sizing and capacity to meet the network adequacy standards stated in Table 1 Network Adequacy Standards in each VAMC catchment area as outlined in Attachment C “Performance

Requirement Summary”. This shall include details on the numbers and types of providers entering the CCN Next Generation Medical – West (including those from other Offeror, Federally Qualified Healthcare Centers (FQHCs), and VA-identified preferred providers)

1. Approach to building and maintaining a network with sizing and capacity to meet the network adequacy standards stated in Table 1 Network Adequacy Standards in each VAMC catchment area as outlined in Attachment C “Performance

Requirement Summary”. This shall include details on the numbers and types of providers entering the CCN Next Generation Medical – West (including those from other contracts, Federally Qualified Healthcare Centers (FQHCs), and VA-identified preferred providers)

4. CHANGE 4:

The following language in Section E.1 ADDENDUM TO FAR 52.212-1 INSTRUCTIONS

TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES,

FACTOR 4: Price, is hereby changed as follows:

FROM:

All proposals must include a Price Volume to be considered for award. The Pricing Template in “Attachment 3 – CCN Next Gen Medical – West TOPR Price Schedule”, contains CLINs with varying pricing methodologies. The following CLINs and their corresponding Sub CLINs are pre-priced by VA: CLIN X001; CLIN X004; CLIN X005;

X010 and CLIN X017. The Offeror must propose pricing for all non-pre-priced CLINs (i.e., populate all cells within the Price Schedule), including all CLINs identified as optional. Offerors must provide pricing for the base year and all option periods for all non-pre-priced CLINs. Failure to price the base and all option periods shall cause the offer to be rejected from further consideration. Offerors shall submit their prices using “Attachment 3 – CCN Next Gen Medical – West TOPR Price Schedule,” and provide an explanatory narrative that the Offeror provides as the basis for their proposed price.

The Offeror’s completed Price Schedule constitutes its price proposal to the Government. VA requires the Offeror to propose pricing for all non-pre-priced CLINs (X002, X003, CLIN X006; X007, X008, X009, X011, X012, X013, X014, and X015), for each applicable year of the period of performance. Green colored cells require Offeror input. Gray colored cells are not priced by Offerors. Do not add or change gray cells.

TO:

All proposals must include a Price Volume to be considered for award. The Pricing Template in “Attachment 3 – CCN Next Gen Medical – West TOPR Price Schedule”, contains CLINs with varying pricing methodologies. The following CLINs and their corresponding Sub CLINs are pre-priced by VA: CLIN X001; CLIN X004; CLIN X005;

CLIN X009 and CLIN X010. The Offeror must propose pricing for all non-pre-priced

CLINs (i.e., populate all cells within the Price Schedule), including all CLINs identified as optional. Offerors must provide pricing for the base year and all option periods for all non-pre-priced CLINs. Failure to price the base and all option periods shall cause the offer to be rejected from further consideration. Offerors shall submit their prices using

“Attachment 3 – CCN Next Gen Medical – West TOPR Price Schedule,” and provide an explanatory narrative that the Offeror provides as the basis for their proposed price.

The Offeror’s completed Price Schedule constitutes its price proposal to the Government. VA requires the Offeror to propose pricing for all non-pre-priced CLINs (X002; X003; CLIN X006; X007; X008; X011; X012; X013; X014; X015; and X016), for each applicable year of the period of performance. Green colored cells require Offeror input. Gray colored cells are not priced by Offerors. Do not add or change gray cells.

5. CHANGE 5:

The following language in Section E.1 ADDENDUM TO FAR 52.212-1 INSTRUCTIONS

TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES,

FACTOR 3: VETERAN INVOLVEMENT/ SUBCONTRACTING PLAN, is hereby changed as follows:

FROM:

The Prime Contracting goals listed above shall be calculated based on the percentage of total subcontracted dollars for percentage of subcontracted service dollars, excluding subcontracted supplies (as defined in FAR 2.101).

The Subcontracting goals listed above shall be calculated based on the percentage of total subcontracted dollars for percentage of subcontracted service dollars, excluding subcontracted supplies (as defined in FAR 2.101).

TO:

The Prime Contracting goals listed above shall be calculated based on the percentage of subcontracted service dollars, excluding subcontracted supplies (as defined in FAR 2.101).

The Prime Contracting goals listed above shall be calculated based on the percentage of subcontracted service dollars, excluding subcontracted supplies (as defined in FAR 2.101).

6. CHANGE 6:

The following language in Section E.1 ADDENDUM TO FAR 52.212-1 INSTRUCTIONS

TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES,

FACTOR 4: Price, Price Schedule, is hereby changed as follows:

Price Schedule

The Price Schedule contains CLINs with varying pricing methodologies. VA requires the

Offeror to propose pricing for all non-pre-priced CLINs, for each applicable year of the

Period of Performance. The X in the CLIN number stands for the year of the contract, with zero being the base year (e.g., CLIN X001 in the base year is CLIN 0001). Refer to

Section B.4, Medical CLIN Structure, for a description of each CLIN/subCLIN.

Calculations supporting the percentages may be submitted in the applicable tab in

“Attachment 3 – CCN Next Gen Medical – West TOPR Price Schedule”.

Directions for Pricing CLINs

The Offeror shall input their proposed prices/rates in the green colored cells. Proposed prices for Option Year 9 will be used to determine the price for the optional extension period for evaluation purposes.

CLIN X001, Healthcare Services

Government-provided rate - Not priced.

CLIN X002, Waivers of Payment Rates

Offerors shall propose a maximum percentage above locality-adjusted Medicare Rate, in percentages, for each year of the Period of Performance.

CLIN X003, Seasonal Vaccinations

Offerors shall propose a unit price, in dollars, to administer and dispense a single seasonal vaccine. The cost of the vaccination medications shall be captured under

CLIN X001.

CLIN X004, Fee Schedule:

Government-provided rate - Not priced.

CLIN X005, Non-Medicare, Non-Fee Schedule Healthcare Services:

Government-provided rate - Not priced.

CLIN X006, Urgent and Emergent Medication subCLIN X006AA, Brand Name Medication

Offerors shall propose a unit price for brand name medications, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of

Performance.

subCLIN X006AB, Generic Medication

Offerors shall propose a unit price, for generic medications, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of Performance.

subCLIN X006AC, Dispensing Fee

Offerors shall propose a unit price, in dollars, for each medication that is dispensed for each year of the Period of Performance.

CLIN X007, Disaster Response ONLY - Urgent and Emergent Medication:

subCLIN X007AA, Brand Name Medication

Offerors shall propose a unit price, for brand name mediations, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of

Performance.

subCLIN X007AB, Generic Medication

Offerors shall propose a unit price, for generic mediations, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of

Performance.

subCLIN X007AC, Dispensing Fee

Offerors shall propose a unit price, in dollars, for each medication that is dispensed, for each year of the Period of Performance.

CLIN X008, Administrative Services

SubCLIN X008AA Administrative Services for Healthcare Services:

Offerors shall propose a unit price, in dollars, that applies to the monthly enrolled

Veteran population for each year of the Period of Performance.

SubCLIN X008AB, Administrative Services for Pharmacy Benefits Management

(PBM):

Offerors shall propose a unit price, in dollars, that applies to the monthly enrolled

Veteran population for each year of the Period of Performance.

CLIN X009, Organ Acquisition Cost:

Government-provided rate - Not priced.

CLIN X010, Incentives/Disincentives

Government-provided rate - Not priced.

CLIN X011, Implementation:

Offerors shall propose a lump sum price, in dollars, to be paid following completion of implementation. The Offeror’s BOE shall include milestones associated with meeting concrete implementation goals, such as completion of the network build, system readiness, and achievement of proposed staffing goals.

CLIN X012, Transition Out:

Offerors shall propose a lump sum price, in dollars, for each year of the Period of

Performance to be paid when CLIN X012 is exercised.

OPTIONAL CLIN X013, Optional Task Implementation

OPTIONAL subCLIN X013AA, Implementation of Appointment Scheduling and

Comprehensive Care Coordination at the VA Facility

Offerors shall propose a lump sum per VA facility price, in dollars, to be paid following completion of implementation at each VA facility where CLIN X013 is exercised, for each year of the Period of Performance.

OPTIONAL Sub CLIN X013AB, Implementation for Appointment Scheduling and

Comprehensive Care Coordination at the Contractor's Site

Offerors shall propose a lump sum, in dollars, to be paid following completion of implementation at the Contractor’s site when CLIN X013 is exercised, for each year of the Period of Performance.

OPTIONAL CLIN X014, Appointment Scheduling and Comprehensive Care

Coordination Administration

Offerors shall propose a unit price, in dollars, that applies to each Approved Referral for appointment scheduling, by quantity tier, for each year of the Period of Performance.

OPTIONAL CLIN X015, Care Coordination Follow-Up

Offerors shall propose a unit price, in dollars, that applies to each Approved Referral for care coordination follow-up each year of the Period of Performance.

OPTIONAL CLIN X016, Software, Process, and Proof of Concept Development

Offerors shall propose a unit price, in dollars, for each instance of a software, process, and proof of concept development task aligned to the task sizes below, for each year of the Period of Performance.

OPTIONAL subCLIN X016AA, Extra-Small (XS) Software, Process, and Proof of

Concept Development Task Size

OPTIONAL subCLIN X016AB, Small (S) Software, Process, and Proof of Concept

Development Task Size

OPTIONAL subCLIN X016AC, Medium (M) Software, Process, and Proof of Concept

OPTIONAL subCLIN X016AD, Large (L) Software, Process, and Proof of Concept

OPTIONAL subCLIN X016AE, Extra-Large (XL) Software, Process, and Proof of

Price Schedule

The Price Schedule contains CLINs with varying pricing methodologies. VA requires the

Offeror to propose pricing for all non-pre-priced CLINs, for each applicable year of the

Period of Performance. The X in the CLIN number stands for the year of the contract, with zero being the base year (e.g., CLIN X001 in the base year is CLIN 0001). Refer to

Section B.4, Medical CLIN Structure, for a description of each CLIN/subCLIN.

Calculations supporting the percentages may be submitted in the applicable tab in the

“Attachment 3 – CCN Next Gen Medical – West TOPR Price Schedule”.

Directions for Pricing CLINs

The Offeror shall input their proposed prices/rates in the green colored cells. Proposed prices for Option Year 9 will be used to determine the price for the optional extension period for evaluation purposes.

CLIN X001, Healthcare Services:

SubCLIN X001AA, Standard Medicare Rate Healthcare Services

Government-provided rate - Not priced.

SubCLIN X001AB, PPS Exempt Healthcare Services

Government-provided rate - Not priced.

CLIN X002, Waivers of Payment Rates:

Priced. Offerors shall propose a maximum percentage above locality-adjusted Medicare

Rate, in percentages, for each year of the Period of Performance.

X003, Seasonal Vaccinations:

Priced. Offerors shall propose a unit price, in dollars, to administer and dispense a single seasonal vaccine. The cost of the vaccination medications shall be captured under CLIN X001.

CLIN X004, Fee Schedules:

SubCLIN X004AA, VA Fee Schedule

Government-provided rate - Not priced.

SubCLIN X004AB, Alaska Fee Schedule

Government-provided rate - Not priced.

CLIN X005, Non-Medicare, Non-Fee Schedule Healthcare Services:

Government-provided rate - Not priced.

CLIN X006, Urgent and Emergent Medication:

SubCLIN X006AA, Brand Name Medication

Priced. Offerors shall propose a unit price for brand name medications, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of

Performance.

SubCLIN X006AB, Generic Medication

Priced. Offerors shall propose a unit price, for generic medications, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of

Performance.

SubCLIN X006AC, Dispensing Fee

Priced. Offerors shall propose a unit price, in dollars, for each medication that is dispensed for each year of the Period of Performance.

CLIN X007, Disaster Response ONLY - Urgent and Emergent Medication:

SubCLIN X007AA, Brand Name Medication

Priced. Offerors shall propose a unit price, for brand name mediations, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of

Performance.

SubCLIN X007AB, Generic Medication

Priced. Offerors shall propose a unit price, for generic mediations, excluding dispensing fees, as a percentage of the ASP price, for each year of the Period of Performance.

SubCLIN X007AC, Dispensing Fee

Priced. Offerors shall propose a unit price, in dollars, for each medication that is dispensed, for each year of the Period of Performance.

CLIN X008, Administrative Services:

SubCLIN X008AA Administrative Services for Healthcare Services:

Priced. Offerors shall propose a unit price, in dollars, that applies to the monthly enrolled Veteran population for each year of the Period of Performance.

SubCLIN X008AB, Administrative Services for Pharmacy Benefits Management

(PBM):

Priced. Offerors shall propose a unit price, in dollars, that applies to the monthly enrolled Veteran population for each year of the Period of Performance.

CLIN X009, Organ Acquisition Cost:

Government-provided rate - Not priced.

CLIN X010, Incentives/Disincentives:

SubCLIN X010AA, Adverse Credit Reporting Incentives

Government-provided rate - Not priced.

SubCLIN X010AB, Value Based Care Lower Extremity Joint Replacement (LEJR)

Performance Incentive

Government-provided rate - Not priced.

CLIN X011, Implementation:

Priced. Offerors shall propose a lump sum price, in dollars, to be paid following completion of implementation. The Offeror’s BOE shall include milestones associated with meeting concrete implementation goals, such as completion of the network build, system readiness, and achievement of proposed staffing goals.

CLIN X012, Transition Out:

Priced. Offerors shall propose a lump sum price, in dollars, for each year of the Period of Performance to be paid when CLIN X012 is exercised.

OPTIONAL CLIN X013, Optional Task Implementation:

OPTIONAL SubCLIN X013AA, Implementation of Appointment Scheduling and

Comprehensive Care Coordination at the VA Facility

Priced Offerors shall propose a lump sum per VA facility price, in dollars, to be paid following completion of implementation at each VA facility where CLIN X013 is exercised, for each year of the Period of Performance.

OPTIONAL SubCLIN X013AB, Implementation for Appointment Scheduling and

Comprehensive Care Coordination at the Contractor's Site

Priced. Offerors shall propose a lump sum, in dollars, to be paid following completion of implementation at the Contractor’s site when CLIN X013 is exercised, for each year of the Period of Performance.

OPTIONAL CLIN X014, Appointment Scheduling and Comprehensive Care

Coordination Administration

Offerors shall propose a unit price, in dollars, that applies to each Approved Referral for appointment scheduling, by quantity tier, for each year of the Period of Performance.

OPTIONAL SubCLIN X014AA, Appointment Scheduling Administration and

Comprehensive Care Coordination Tier 1

Priced. Offerors shall propose a unit price by quantity tier.

OPTIONAL SubCLIN X014AB, Appointment Scheduling Administration and

Comprehensive Care Coordination Tier 2

Priced. Offerors shall propose a unit price by quantity tier.

OPTIONAL SubCLIN X014AC, Appointment Scheduling Administration and

Comprehensive Care Coordination Tier 3

Priced. Offerors shall propose a unit price by quantity tier.

OPTIONAL SubCLIN X014AD, Appointment Scheduling Administration and

Comprehensive Care Coordination Tier 4

Priced. Offerors shall propose a unit price by quantity tier.

OPTIONAL SubCLIN X014AE, Appointment Scheduling Administration and

Comprehensive Care Coordination Tier 5

Priced. Offerors shall propose a unit price by quantity tier.

OPTIONAL CLIN X015, Care Coordination Follow-Up:

Priced. Offerors shall propose a unit price, in dollars, that applies to each Approved

Referral for care coordination follow-up each year of the Period of Performance.

OPTIONAL CLIN X016, Software, Process, and Proof of Concept Development:

Offerors shall propose a unit price, in dollars, for each instance of a software, process, and proof of concept development task aligned to the task sizes below, for each year of the Period of Performance.

OPTIONAL SubCLIN X016AA, Extra-Small (XS) Software, Process, and Proof of

Priced. Offerors shall propose a unit price aligned to the XS task size.

OPTIONAL SubCLIN X016AB, Small (S) Software, Process, and Proof of Concept

Development Task Size

Priced. Offerors shall propose a unit price aligned to the S task size.

OPTIONAL SubCLIN X016AC, Medium (M) Software, Process, and Proof of Concept

Development Task Size

Priced. Offerors shall propose a unit price aligned to the M task size.

OPTIONAL SubCLIN X016AD, Large (L) Software, Process, and Proof of Concept

Development Task Size

Priced. Offerors shall propose a unit price aligned to the L task size.

OPTIONAL SubCLIN X016AE, Extra-Large (XL) Software, Process, and Proof of

Priced. Offerors shall propose a unit price aligned to the XL task size.

7. CHANGE 7:

The following language in Section E.2 ADDENDUM TO FAR 52.212-2 EVALUATION— COMMERICAL ITEMS, Feasibility of Approach, is hereby changed as follows:

FROM:

An evaluation rating of “Unacceptable” will result in VA’s determination that the Offeror’s proposal is not awardable and will result in the Offeror’s elimination from further consideration. In such cases, the Offeror will not participate in Phase III of the Technical evaluation, all other volumes of the proposal will not be evaluated, and the Offeror will be removed from the competition.

TO:

An evaluation rating of “Unacceptable” will result in VA’s determination that the Offeror’s proposal is not awardable and will result in the Offeror’s elimination from further consideration. In such cases, the Offeror will not participate in Phase II of the Technical evaluation, all other volumes of the proposal will not be evaluated, and the Offeror will be removed from the competition.

8. CHANGE 8:

The following language in section E. 3 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS — COMMERICAL ITEMS, C. Instructions, Conditions, and Notice to Offerors, bullet d, is hereby changed as followed:

FROM:

a. All files will be submitted as an Acrobat (PDF) file, or a compatible file as indicated in other sections. The top, bottom, left and right margins shall be a minimum of one inch (1”) each. Font size shall be no smaller than 12-point; Arial or Times New Roman fonts are required. Character style shall be set at no less than single spacing and 100% scale. Tables and illustrations may use a reduced font size not less than 8-point and may be landscape. Line spacing shall be set at no less than single space. Each paragraph shall be separated by at least one blank line. Page numbers, company logos, headers and footers may be within the page margins ONLY and are not bound by the 12-point font requirement. All proprietary information shall be clearly and properly marked. Footnotes to text shall not be used. Additionally, Offerors shall not use hyperlinks or embedded files of any kind in any proposal Volume. If included, these will not be reviewed or evaluated.

TO:

a. All files will be submitted as an Acrobat (PDF) file, or a compatible file as indicated in other sections. The page size shall be standard US Letter size (8.5" x 11"). The top, bottom, left and right margins shall be a minimum of one inch (1”) each. Font size shall be no smaller than 12-point; Arial or Times New Roman fonts are required. Character style shall be set at no less than single spacing and 100% scale. Tables and illustrations may use a reduced font size not less than 8-point and may be landscape. Line spacing shall be set at no less than single space. Each paragraph shall be separated by at least one blank line. Page numbers, company logos, headers and footers may be within the page margins ONLY and are not bound by the 12-point font requirement. All proprietary information shall be clearly and properly marked. Footnotes to text shall not be used.

Additionally, Offerors shall not use hyperlinks or embedded files of any kind in any proposal Volume. If included, these will not be reviewed or evaluated

9. The following attachments are hereby revised:

“Attachment 3 CCN Next Generation Medical West…