CCN NG Medical Record of Questions Amendment 0011.pdf

Questions # Vendor Questions VA Answers

Could you kindly confirm whether the effort is still in the pre-RFP stage? If so, is there an anticipated timeline for the RFP release? Additionally, have there been any determinations made regarding the contract vehicle or potential set-asides?

We are no longer in the pre-RFP stage known as the RFI. The RFP was released to SAM.gov on 12/15/2025 to the public. Please review the RFP and combined synopsis posted for the vehicle type and set-aside. Additionally, the Government hereby replaces the original attachment "Next Gen Medical Combined synopsis_solicitation_Final_12.15.2025.docx" in full with " Next Gen Medical Combined synopsis_solicitation_Revised_12.23.2025.docx ."

We would like to know if this is a brand new contract OR if there is (was) an incumbent performing these services. If not brand new, could you please provide the current / previous contract number?

This requirement is a recompete. The services were previously performed under the following existing contracts 36C10G19D0038, 36C10G21D0001, 36C79119D0004, 36C79119D0005, 36C79119D0006.

I am interested in learning more about the Contract Opportunity below that was released yesterday. Is there anything scheduled for general understanding and questions regarding this contract?

All information pertaining to question submissions and the pre-proposal conference are provided in the RFP and TOPRs.

There appears to be a few files missing from the sam.gov posting. The TOPR West is missing the following attachments:

The East attachments are there, but not the West.

Can the Government please post these files?

The following attachments are included through this amendment and are associated with 36C10G26R0003 - Medical TOPR West: • ATTACHMENT C - Performance Requirement Summary

Does a notice of No-bid statement constitute a compliant response? Or will the VHA consider multiple no-bid responses (which are submitted timely in accordance with B.5.1 (3)) as a repeated failure to respond?

A timely submitted Notice of No-Bid, provided in accordance with Section B.5.1, constitutes a compliant response to a Task Order Proposal Request (TOPR). Timely No-Bid submissions will not be considered a failure to respond. The Government reserves the right to consider the overall level of participation at the task order level when evaluating past performance, exercising options, or making off-ramping determinations in accordance with the solicitation.

Is it the government’s intent to limit prospective offerors to only those who have experience as large commercial insurance carriers with a regional/national footprint or is the intent to encourage single-state or community affiliated Medicaid health plans to bid on the IDIQ contract.

This solicitation is being competed full and open to align with the Government’s intent to promote maximum competition. VA will not limit prospective offerors to those who have experience as large commercial insurance carriers with a regional/national footprint. However, Government will evaluate corporate experience in implementing services across multiple states in accordance with Section E.4 of the RFP.

Please confirm that it is VHA’s intent to consider offerors for award who may qualify across all, or only subset of the IDIQ’s PWS tasks.

Offerors do not have to demonstrate corporate experience in all task areas defined in Section 1.2 of the IDIQ PWS. Offerors who demonstrate adequate corporate experience, as described in Section E of the IDIQ RFP, for relevant services in one or more of the task areas described in Section

1.2 of the IDIQ PWS will be evaluated and considered for IDIQ contract award.

The Government will evaluate and award task order / TOPR proposals in accordance with Section E of the TOPR.

Please confirm that “full requirements of the solicitation” is defined as the submission-specific instructions to the offeror (i.e., volumes, formats, page counts, etc.), and that “full requirement” does not include each and every task identified in the IDIQ PWS.

VA confirms that “full requirement”, as stated in RFP Section E.3, is referring to the submission-specific instructions to the offeror (i.e., volumes, formats, page counts, etc.). VA intends to amend the RFP Section E.3 to clarify this language.

Are you able to direct me to the registration link for the CCN pre-proposal conference on 1/22 in DC? To register for the Pre-Proposal Conference provide the required information as required by section E.3 (D) of the RFP.

I would like to know if there will be an info session for this opportunity that we might be able to attend. Additionally, is there a Scope of Work and eligibility list that we might be able to access?

Reference Section D of the Medical RFP and TOPRs for information regarding the pre-proposal conference and the published attachments for more details on the requirement.

I didn’t see where to register for the pre-proposal meeting. Is there a link you can share? To register for the Pre-Proposal Conference provide the required information as required by section E.3 (D) of the RFP.

I wanted to request clarification on whether Audiology for hearing disabilities will be covered as part of this scope of this recently released RFP? If it is not, will there be a separate RFP process where Audiology will be covered?

Audiology is not covered under the scope of the Community Care Network Next Generation Medical Multiple Award IDIQ.

I was hoping you could please share any information or a link for registration to the industry day pertaining to the VA CCN NextGen Medical requirement: Solicitation number 36C10G26R0003.

To register for the Pre-Proposal Conference provide the required information as required by section E.3 (D) of the RFP.

I have a psychiatric and obesity medicine practice in Naperville IL. I am interested in becoming part of your network. I was unable to find the appropriate form to fill out under your RFP. Could u please send me the forms required to be considered?

Under the current Community Care Network (CCN) contract, Naperville, IL falls under CCN Region 2, which is managed by Optum. In order to join CCN, contact Optum by phone at 1-844-839-6108 or online at https://vacommunitycare.com/provider. Additional information can also be found at https://www.va.gov/COMMUNITYCARE/providers/Community-Care-Network.asp. Future awardees under CCN Next Generation will establish a process for providers interested in joining the network and this process will be posted to the VA Community Care page.

Hi – We were hoping you could provide some clarification;

The pre-proposal dates in the CCN documents: it says January 21 on the first page, but January 22 on page 100.

We are thinking that you are doing the Dental Pre-Proposal Conference on the 21st, and the Medical Pre-Proposal Conference on the 22nd.

Is that a correct assumption?

The Dental Pre-Proposal conference is 1/21/2025. The Medical Preproposal conference is 1/22/2025. Block 20 of the Dental RFP is amended to reflect this correction.

1. How many awards are going to be granted?

2. There is mention in the solicitation document that there would be a pre proposal conference for this award in person in DC but I was wondering if we can stream this online, live for those that cannot make that time?

3. How open are the solutions about using Agentic AI for Metabolic Syndrome since there seems to be no mention of that use case in the documents on sam.gov

1. VA has not established a maximum number of IDIQ contract awards; awards will be based on the quality number of responses received. Each TOPR states the number of awards possible for each.

2. VA does not intend to provide a live stream of the preproposal conference, nor does VA expect to allow for a “dial-in” option. Attendance at the preproposal conference is not mandatory and does not preclude an Offeror from submitting a proposal in response to the RFP. VA may make a recording of the preproposal conference publicly available via an amendment published on SAM.gov.

3. Offerors are free to use various solutions to meet PWS requirements as long as they align with the requirements and constraints established in the PWS. Proposals will be evaluated in accordance with Section E of the associated RFP/TOPR.

Can you help locate the Statement of Work for Notice ID 36C10G26R0003? Refer to Attachment 1 for the PWS associated with this requirement.

For the Past Performance factor, does VA want complete contract documents for each reference, or will narrative descriptions using the Past Performance Reference Template, supplemented by only the most relevant contract sections or excerpts, be sufficient?

The latter is expected. In accordance with Factor 2 of the TOPR, "The Offeror shall complete and submit the Past Performance References attachment in its entirety." Utilization of the attached documents are expected.

Is the 25 page limit for the Past Performance narrative volume intended to cover all reference narratives combined, or is the 25 page limit applied per individual reference (ie a total of 75 pages)?

In accordance with Table 2 – TOPR Proposal Volume Requirements, the Past Performance page limitations are: 3 PPQs; plus No more than a 3-page narrative for all PPQs.

Will VA allow a CCN Next Gen Medical contractor to serve non contiguous states within a region (for example, through task orders that group states or service areas that are not geographically adjacent), or does VA intend that task orders within a region will generally correspond to contiguous geographic groupings?

The Performance Work Statements (PWS) for Task Order (TO) 0001 (East) and TO 0002 (West) posted to SAM.gov as part of this solicitation list the states included in the current regional alignment (East and West). The VA will identify regional states at the TOPR level. The expectation is that offerors will propose in accordance with the TOPR.

What specific purposes will a SAM registration and UEI serve under this procurement (e.g., responsibility determination, payment, exclusion checks), given that proposals are submitted by email to the identified contacts? Is this needed now if a plan is only applying to the IDIQ portion of the procurement?

The Government must ensure all Offerors are eligible to submit a proposal. In accordance with FAR 4.1102 (a) Policy, Offerors and quoters are required to be registered in SAM at the time an offer or quotation is submitted in order to comply with the annual representations and certifications requirements.

What happens if an entity changes between time of IDIQ award and TOPR award later? Refer to FAR Subpart 42.12 - Novation and Change-of-Name Agreements.

Are the listings of socioeconomic category in priority order? The socioeconomic categories for subcontracting are not listed in any specific order.

Do planned subcontractors and other team members need to have active Unique Entity Identifiers (UEIs) at the time of IDIQ proposal submission, or is it sufficient for only the prime offeror to have an active UEI at submission with subcontractor UEIs provided prior to award?

The prime contractor is the only entity required to have an active UEI at the time of proposal as the Government only has privity of contract with the prime contractor.

Please confirm that there will be no option for Offerors to have additional virtual attendees for the Pre-Proposal Conference.

VA does not intend to have a virtual option available for the pre-proposal conferences. A recording of the pre-proposal conference will be posted on SAM.gov.

Please confirm that the East and/or West Price Schedules (Attachment 3) are the required pricing format for the TOPR proposals and must be proposed simultaneous to the IDIQ prime contracts as noted in the solicitation synopsis and that no instructions to this effect are provided in the solicitation for the IDIQ (SF 1449) itself.

Correct.

For the VA CCN-NG Medical Pre-Proposal Conference that is scheduled for Thursday, 22JAN26, can you please clarify how many attendees a company can send to this conference. The original RFP section about this conference indicates that only 2 are allowed, but the amendment about this conference says, “all attendees.” If we are permitted to send more than 2, then we would like to send 4 attendees. Can you please clarify the number of attendees that a company can send to this conference? Also, for the attestation of citizenship required to attend the Pre-Proposal Conference, do you have a templated attestation letter that you want attendees to complete, sign, and submit? If not, then what details are you looking for in the attestation letter. We want to ensure that we provide you with the appropriate attestation letter.

Lastly, when will you be able to provide the location of the Pre-Proposal Conference?

As stated in the RFP, each interested Offeror is allowed 2 attendees per conference. Refer to Amendment 0001 posted on 12/23 for all pre-proposal conference submission instructions.

Will VA consider single state plans that manage multiple service regions/GSAs and cross border care on shared platforms—as described in their Past Performance narratives—as meeting the “covering multiple states” relevancy criteria, when they explain the operational similarity to coordinating multiple states?

To clarify, VA is not evaluating past performance at the IDIQ level. At the IDIQ level, VA is evaluating three factors: 1) Corporate Experience, 2) Veteran Involvement/Subcontracting Plan, and 3) Price. In accordance with Section E of the RFP, VA will evaluate whether the offeror’s collective contract references demonstrate corporate experience covering multiple states.

Please see IDIQ RFP section E.3 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS — COMMERICAL ITEMS for more information on the IDIQ evaluation criteria.

For the Medical TOPR evaluation, past performance is one factor, as outlined in TOPR section E.1 ADDENDUM TO FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES. In accordance with Section E of the RFP, VA will evaluate whether the offeror’s collective contract references demonstrate corporate experience covering multiple states. In this factor, relevance is outlined as the following:

“Relevant” is defined as a contract that is of similar scope, magnitude, and complexity to the current requirements.

• Scope: References will be determined similar in scope if the Offeror’s references include maintaining a healthcare and pharmacy network while also adjudicating resulting healthcare and pharmacy claims.

• Magnitude: References will be determined similar in magnitude if the reference meets or exceeds $200,000,000 in healthcare and/or pharmacy claims paid within a 12-month period or if the geographic coverage area of the healthcare and/or pharmacy network includes a minimum of nine (9) U.S. States.

• Complexity: References will be determined similar in complexity if the reference includes payment of healthcare claims in accordance with Medicare payment rules, transmission of healthcare claims using a clearinghouse, return of medical documentation and appointment scheduling services.

Please confirm that a local Medicaid plan offeror is not required to hold a current multi state Medicaid contract (or contracts with multiple states) to be eligible for award of the CCN Next Gen Medical IDIQ, provided that the offeror’s proposal and collective Past Performance references (prime plus affiliates and/or subcontractors) demonstrate multi state capabilities consistent with the stated relevancy criteria.

In accordance with Section E of the RFP, Offerors are not required to hold a current multi-state Medicaid contract to be eligible for award at the IDIQ level. To clarify, VA is not evaluating past performance at the IDIQ level. At the IDIQ level, VA is evaluating three factors: 1) Corporate Experience, 2) Veteran Involvement/Subcontracting Plan, and 3) Price. Please see IDIQ RFP section E.3 ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS

— COMMERICAL ITEMS for more information on the IDIQ evaluation criteria.

For the Medical TOPR evaluation, past performance is one factor, as outlined in TOPR section E.1 ADDENDUM TO FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES. In this factor, relevance is outlined as the following:

“Relevant” is defined as a contract that is of similar scope, magnitude, and complexity to the current requirements.

• Scope: References will be determined similar in scope if the Offeror’s references include maintaining a healthcare and pharmacy network while also adjudicating resulting healthcare and pharmacy claims.

• Magnitude: References will be determined similar in magnitude if the reference meets or exceeds $200,000,000 in healthcare and/or pharmacy claims paid within a 12-month period or if the geographic coverage area of the healthcare and/or pharmacy network includes a minimum of nine (9) U.S. States.

• Complexity: References will be determined similar in complexity if the reference includes payment of healthcare claims in accordance with Medicare payment rules, transmission of healthcare claims using a clearinghouse, return of medical documentation and appointment scheduling services.

Offerors should include a narrative in their past performance submission at the TOPR level to demonstrate the relevancy of their submission. VA will consider this narrative during the evaluation process.

Please confirm that VA’s intent is to allow award to plans that can grow into multi state capabilities over the life of the CCN Next Gen Medical IDIQ—through expansion, teaming, or corporate/affiliate arrangements—rather than limiting awards only to offerors that already operate multi state networks at the time of initial IDIQ award.

VA will evaluate offerors based on the corporate experience demonstrated at the time of proposal submission, in accordance with Section E of the RFP. VA will not base IDIQ award decisions on prospective future growth, expansion, or post-award teaming arrangements that are not supported by demonstrated corporate experience in implementing relevant services across multiple states.

"Please confirm that the VA Socioeconomic Subcontracting Goals identified as “Prime Contracting” are applicable to the Offeror and those identified as “Subcontracting” are applicable to the large business subcontractors proposed under the Offeror. If this assumption is incorrect, please define the difference between the “Prime Contracting” and “Subcontracting” goals."

Per Section E of the RFPs, all large business Offerors shall submit a Small Business Subcontracting Plan. As stated in Factor 2, “The Subcontracting Plan shall meet the minimum VA subcontracting goals set forth below,” and references Table 2 - VA Socioeconomic Subcontracting Goals. The targets in Table 2 are divided into VA Prime Contracting (direct contracts) goals and subcontracting (awards from Prime Contractors). The Offeror’s Subcontracting Plan shall meet the targets established in the “Subcontracting” column of Table 2.

See Amendment 0003 for further details.

Readiness acceptance criteria: What are the specific artifacts and test/validation steps VA will require and accept before initiating HCD at a station (checklists, exit criteria, end-to-end interface testing)?

Prior to initiating full Health Care Delivery activities at a VA medical center, the Department of Veteran Affairs (VA) will require the completion, review, and acceptance of defined artifacts and validation activities to ensure clinical readiness, patient safety, system reliability, cybersecurity compliance, and operational alignment. VA will require vendors to adhere to deployment and implementation expectations as detailed in the PWS section 2.3.

• VA will require that all hardware/software components are installed and operational prior to Health Care Delivery as detailed in the PWS section 16.3.

• VA will require the vendor to validate data flow and interoperability across all integrated systems and VA enterprise systems, as outlined in PWS Sections 16 and 16.3.1. This validation will serve as official sign-off confirming compliance with the ICD and EDI Companion Guides.

• VA will require the vendor to confirm completion of the readiness checklist and exit criteria before initiation of station level activities. All documentation is to be reviewed and approved by VA stakeholders, ensuring no critical defects as detailed in the PWS section 2.3.

• In addition, VA will require the vendor to provide test plans, test results, and validation sign-off as detailed in the PWS section 16.2 and 16.3.

Could you point me to information on the allocation for the RPM?

https://sam.gov/workspace/contract/opp/7b2734002e4048bfa2ac4cc5b0479930/view

Are there specific line items for IT to run the IDIQ structure?

No.

Please clarify what Prime contracting means in the context of this procurement. As defined by the FAR 3.502-1. Prime Contractor means a person who has entered into a prime contract with the United States. Prime contract means a contract or contractual action entered into by the United States for the purpose of obtaining supplies, materials, equipment, or services of any kind.

Please confirm that Dental services are not being requested under this solicitation and references to “Dental” will be removed from the solicitation and supporting documentation.

Solicitation 36C10G26R0003 is for Medical and 36C10G26R0004 is for Dental. Any reference to "dental" on Solicitation 36C10G26R0003 and supporting documentation will be removed.

Under the VA Socioeconomic Subcontracting Goals it is noted that the calculation is based on the percentage of subcontracted dollars for distribution services only. Please define “distribution services.”

See revised RFP language to replace the term “distribution services” with “percentage of subcontracted service dollars, excluding subcontracted supplies (as defined in FAR 2.101)

See amendment 0008 for further details.

"Under the VA Socioeconomic Subcontracting Goals it is noted that the calculation should exclude supplies. Please define “supplies.”

For the purposes of subcontracting goal calculations, supplies are defined in accordance with FAR 2.101.

"Please confirm that, although Implementation and Transition Out are included in the price schedules for the TOPRs, there will be no funding associated with the Implementation or Transition Out of the IDIQ contract itself."

IDIQ will not have any funding associated. All funding for this requirement will be provided via a Task Order as applicable.

"Please confirm that there will be no funding associated with the IDIQ contract itself, and that, any and all administration and management of the IDIQ contract will be at the sole cost of the awardee."

The IDIQ will have no funding obligations. All funding associated will be obligated through the award of Task Orders, as applicable. The the second part of the question is unclear and couldn't be answered.

Please confirm that for the East and/or West TOPRs Health Care Delivery (HCD) is to begin after 90 days of task order award and be fully capable within 12 months of awarding – meaning that Offerors should have in place, within 90 days of award, the capacity and systems to begin providing HCD to some portion of eligible Veterans on Day 91 post task order award.

In accordance with Section 2.3 of the PWS for each TOPR, "The Contractor shall not provide HCD at any site sooner than 90 days from contract award but shall achieve full HCD no later than 12 months from contract award. This requirement does not dictate when HCD must start, except that it shall not start sooner than 90 days from contract award and that full HCD must be completed no later than 12 months from contract award.

Both the IDIQ and TOPR RFPs have provisions for Cancellation Under Multiyear Contracts in accordance with FAR 52.217-2. Please confirm whether FAR 52.249-2, Termination for Convenience of the Government (Fixed-Price) and/or FAR 52.249-2, Termination for Convenience of the Government (Services) should be in the RFPs.

No. For this acquisition, Termination for Convenience is governed by the clause at FAR 52.212 4(l)."

Warriors Heart Virginia (EIN 88-4199251) and Warriors Heart Texas (EIN 37-1742449) are currently participating providers under the CCN Legacy program.

As the VA transitions to CCN Next Generation, we would like to request information regarding the process required to be included in CCN Next Gen. Specifically, we are seeking guidance on any enrollment or re-contracting requirements, applicable timelines, and any forms or documentation that may be necessary to ensure continuity of services for the Veteran population.

Please advise on the appropriate next steps or direct us to the correct point of contact or resources for this transition.

Awardees of each TOPR will be responsible for establishing a process for community providers interested in providing services under CCN Next Gen.

I hope that you will be able to confirm whether the VA will allow an Offeror to satisfy this requirement through the use of a functionally equivalent geo-mapping solution, provided that the alternative solution:

• Produces results that are substantially similar in accuracy, reliability, and output to those produced by Microsoft Azure Maps; and

• Provides VA with full access to the geo-mapping solution and underlying outputs for oversight, validation, and audit purposes.Please advise whether Offerors may propose alternative geo-mapping solutions that meet the functional and oversight requirements described above, or whether use of Microsoft Azure Maps is mandatory with no acceptable substitutes. Please advise whether Offerors may propose alternative geo-mapping solutions that meet the functional and oversight requirements described above, or whether use of Microsoft Azure Maps is mandatory with no acceptable substitutes.

Per Section 3.1 of the Performance Work Statements (PWS) for both TO 0001 (East) and TO 0002 (West), Microsoft Azure Maps is required as the geo-mapping solution. VA will not allow alternative geo-mapping solutions.

How are services priced when Medicare has no equivalent (new codes, rare services, certain therapies, pediatrics, etc.)

and what is the dispute process for those priced services?

Rates may be established in the VA Fee Schedule, but not always. Please see CCN NG Medical Network Contractor Manual Sections 11.2.1 Waiver of Payment Rates and B.5.2 VA Payment Hierarchy, and Next Gen Medical TOPR Sections B.3 and B.4 for more information.

If direct contracts are required, will VA provide a standard provider agreement template and identify non-negotiable terms (audit, termination, overpayment recovery, dispute resolution, prompt pay, etc.)?

Awardees of each TOPR will be responsible for establishing a process for community providers interested in providing services under CCN Next Gen.

HCD start expectations: The PWS states HCD cannot start sooner than 90 days after award and full HCD must be achieved within 12 months. Does VA intend to direct initial HCD to begin near the 90-day minimum, or may offerors propose a later initial HCD start date (e.g., 150–180 days) provided full HCD is achieved within 12 months?

VA does not direct initial HCD to begin at or near the 90-day minimum. In accordance with Section 2.3 of the Performance Work Statement (PWS) for Task Order Request for Proposals (TOPR) 0001 and 0002, "The Contractor shall not provide HCD at any site sooner than 90 days from contract award but shall achieve full HCD in the CCN Next Generation Medical Network – East [West] no later than 12 months from contract award." This requirement does not dictate when HCD must start, except that it shall not start sooner than 90 days from contract award and that full HCD must be completed no later than 12 months from contract award.

Evaluation impact: If an offeror proposes a later initial HCD start (while meeting the 12-month full HCD requirement), will that be considered acceptable and how (if at all) will it affect technical evaluation / best value tradeoff?

VA will evaluate Offerors’ proposed approaches and schedules in accordance with the applicable evaluation factors set forth in Section E of the TOPRs and the underlying IDIQ, as applicable.

In accordance with Section 2.3 of the Performance Work Statement (PWS) for Task Order Request for Proposals (TOPR) 0001 and 0002, "The Contractor shall not provide HCD at any site sooner than 90 days from contract award but shall achieve full HCD in the CCN Next Generation Medical Network - East [West] no later than 12 months from contract award." This requirement does not dictate when HCD must start, except that it shall not start sooner than 90 days from contract award and that full HCD must be completed no later than 12 months from contract award. VA will evaluate proposals in accordance with Section E of the TOPRs.

Station rollout sequencing: What is VA’s planned/target schedule for the first stations/catchments to initiate HCD in Medical East, and what is the earliest date VA anticipates issuing HCD initiation to the contractor?

The Contractor must submit a Deployment and Implementation Plan and then bi weekly Deployment and Implementation Status Reports. The CO will review and approve the Deployment and Implementation Status Reports and, “Upon approval, the CO will notify the Contractor that they shall initiate HCD activities. HCD at each Station will be achieved upon CO acceptance.” (PWS Section 2.3) This requirement does not dictate when HCD must start, except that it shall not start sooner than 90 days from contract award and that full HCD must be completed no later than 12 months from contract award.

Retroactive changes: Beyond retroactive CMS/Medicare pricing changes, are there other retroactive policy or benefit changes that require claims reprocessing? If so, what are the performance timelines and financial accountability expectations?

Yes, there will be other claims reprocessing and adjustment scenarios. Please see CCN Next Gen – Medical East/West TOPR PWS, Section 11.4 for more information about claims reprocessing and Section 12 of the PWS and CCN Next Gen Medical Network Manual for reimbursement submission, timelines, and processes.

Prompt pay requirements and interest/penalties: Please confirm clean claim definitions, required adjudication/payment timeframes, EFT/ERA requirements, and any interest/penalty obligations.

Please refer to CCN Next Gen – Medical East/West TOPR PWS Section 11.1 for claims submission and processing timeframes, Section 11.2 for claims processing, adjudication, and remittance guidance, Section 11.4 for claims reprocessing and adjustment timeframes, Section 11.5 for provider appeals and reconsideration timeframes, and Section 12 for claim invoice reimbursement submissions to VA. The definition table in PWS contains the Clean Claim definition. Please also review the same sections in the CCN Next Gen Medical Network Contractor Manual for additional information as available. For interest/penalty obligations, all federal and state laws and regulations are applicable.

Provider/member dispute and appeals volumes: Can VA provide historical volumes and SLAs for provider payment disputes and member appeals/grievances related to CCN (Medical East) to inform staffing and tooling?

Due to the new VISN/state alignment, current CCN Regions 1-3 may not fully align with the CCN next generation Medical East region. Moreover, current CCN Regions 4-5 may not fully align with the CCN next generation Medical West region. For a listing of the current CCN Regional breakdown, visit https://www.va.gov/COMMUNITYCARE/providers/Community-Care-Network.asp.

During Fiscal Year (FY) 2025, current CCN Regions 1-3 had a combined dispute, complaints, grievance, and appeals (DCGA) volume of 1,141, with 1,048 DCGAs from Veterans (who are considered the ‘member’ for this question) and 93 from providers. Conversely, current CCN Regions 4-5 had a combined DCGA volume of 1,304, with 1,249 DCGAs from Veterans and 55 from providers.

For FY 2026, as of January 6, 2026, current CCN Regions 1-3 have a combined DCGA volume of 275, with 255 DGCAs from Veterans and 20 from providers. During the same period, the current CCN Regions 4-5 have a combined DCGA volume of 260, with 260 DCGAs from Veterans and 11 from providers. Finally, the current CCN Third Party Administrators (TPAs) have developed internal guidance on handling DCGAs, but it is proprietary information.

Process Clarification: Please confirm whether responses to submitted questions will be addressed exclusively during the live pre-proposal conference, or whether written responses (e.g., published Q&A) should be expected.

All written questions and answers will continue to be published to SAM.gov via RFP amendments. Additionally, the VA intends to conduct a Questions and Answers live session during the Pre-proposal conference. The Pre-Proposal conference recording will be published to SAM.gov.

Bullet 5 says "The Contractor shall have at minimum one FTE dedicated to the VA for every 100,000 enrolled Veterans or fraction thereof" Does this mean Veterans enrolled in VA healthcare or Veterans enrolled in VA healthcare and residing in the East region or some other type of enrollment? (Refrence Attachment 1 CCN Next Gen TOPR East PWS)

In reference to the requirement listed in Medical East TOPR PWS, Section 14.1, “enrolled Veterans” refers to Veterans enrolled in VA health care who are eligible for services within the geographic scope of the applicable Task Order (East region), as defined in the Performance Work Statement. The requirement applies to the population served under the task order, not to the total national VA-enrolled Veteran population.

Confirm if proposal responses may be submitted electronically via email instead of paper media to the 10300 Spotsylvania Ave office. (Proposal Submission & Structure)

Proposals shall be submitted in accordance with the Instructions listed in Section E.3 "Addendum to FAR 52.212-1 Instructions to Offerors - Commercial Items", subpart E.2 "Proposal Submissions".

Our understanding of the RFP process is:

*IDIQ award establishes the eligibility to participate in the CCN program.

*IDIQ contractors will be awarded based on this RFP scope to become approved vendors.

*An approved vendor would be eligible to compete for TOPRs, and that is what defines our scope, geographic coverage, etc.

*Based on task award HCD (Health Care Delivery), this would determine effective date.

Can you please provide a more detailed description with anticipated scope and key milestones/date for individual TOPRs (Benefits, Membership & Plan Details)

The scope and schedule for each Task Order Proposal Request (TOPR), including any applicable Benefits, Membership, or Plan Details, will be defined only within the individual TOPR at the time it is issued. VA will not release task order–specific scope, schedule, or plan details prior to award.

For the two TOPRs currently issued, Offerors are advised that all information made available prior to award is limited to what is expressly set forth in the applicable TOPR, including the Performance Work Statement (PWS) and Section E (Evaluation Criteria).

Is Dental included in this RFP? If yes, what products? Are dental claims embedded with medical or separate?

Additionally, within 36C10G26R0003 Next Gen Medical vFINAL 12.14.25_JP.pdf, section E.1.3 asks carriers to include the RFP number and "CCN Next Gen - Dental Network" in the subject line of all question submission emails. Please confirm that questions regarding this section should reference CCN Next Gen - Medical Network" instead. (Proposal Submission & Structure)

Dental services are not included in this requirement.

See Amendment 0006 for further details regarding this correction.

Confirm if this IDIQ solicitation requires three separate submissions: (1) IDIQ Proposal with three volumes, (2) Medical East Proposal with four volumes, (3) Medical West Proposal with four volumes. (Proposal Submission & Structure)

This IDIQ solicitation requires (1) IDIQ Proposal with three volumes. See Section E.3.C of the RFP, Table 1 - IDIQ Proposal Volume Requirements.

Offerors may also submit a proposal in response to the TOPRs for Medical East, Medical West, or both. Each TOPR for Medical East and Medical West requires the proposals to submit four volumes. See Section E.1.3 of the TOPRs, Table 2 - TOPR Proposal Volume Requirements of the TOPRs."

Clarify which volumes should be included in the East and West proposals (some documents reference Volumes I–III, others Volumes I–IV). (Proposal Submission & Structure)

For the East and West TOPRs, please refer to "Table 2 - TOPR Proposal Volume Requirements" found in Section E.1.

What are the specific target dollar or percentages amounts for VA subcontracting goals for SDVOSB/VOSB/and other small business categories? (Vendor & Compliance Requirements)

VA's subcontracting goals are listed on page 104 of the Solicitation in Table 2 (Section E.2).

Throughout the RFP, references to NEMT, Fiscal Intermediary, and Electronic Visit Verification appear—can VA provide a comprehensive summary of requirements/SLAs? (Network & Credentialing)

VA is unable to provide a response due the lack of clarity and the intent of the inquiry cannot be determined. VA requests clarity from the submitter.

The PWS requires SCA establishment within 72 hours. We request clarification on what constitutes "established".

(Network & Credentialing)

Language has been added; please see updated version of the TOPR PWS Section 3.3.2 for both East and West. "An SCA is considered “established” when the Contractor has executed a one-time contractual agreement with an out-of-network provider for a specific Veteran and episode of care. This includes completion of the SCA Request Form, documentation of the SCA contract established date and time, and approval of the provider to render care and receive payment at VA-designated rates."

Network Adequacy: Will the VA provide additional guidance as to what specialties they would like us to include when running network adequacy (i.e. what specialties would we include for Primary Care/Mental Health Care/Specialty Care)? Necessary to understand exact specialties to be included in each bucket. (Network & Credentialing)

For historical reference only, see the data below for informational purposes and be advised that VA may change this alignment https://dvagov-my.sharepoint.com/:x:/g/personal/makayla_bindel_va_gov/IQDEYvAukh-hQafUvqIBK1PMAUainlxl1vok6hnl-vJQtuk?e=J4oer9

Would VA consider modifying the pricing CLIN cap (100% of Medicare fee schedule) to “current contracted rate”? Any additional insight the VA can share on how you envision migrating to more VBC would be helpful. (Pricing & Financials)

The ceiling for the pricing CLIN, set at 100% of the Medicare fee schedule, will remain as stated for the purposes of this solicitation and any resultant contract. For additional information regarding value-based care (VBC), please refer to Section 15.9 of the TOPR PWS.

Would we be expected to match existing plan benefits? If so, please share details on current plan design. (Benefits, Membership & Plan Details)

See PWS Section 4, “CCN HEALTH BENEFIT PACKAGE,” and specifically Section 4.1, “CCN Medical Network Health Care Services,” for the required benefit scope. The Contractor shall build and maintain a network and operational capabilities that support the VA-defined Health Benefit Package and related special programs (urgent care, nursing home care, home health, dialysis, transplants, DME, pharmacy, etc.) as described in Sections 3, 4, 5, 7, 8, 9, 10, and 11.

Who is responsible for ID card production (contractor, third-party vendor, or self-produced)? (Administrative Details) This question is too vague for VA to develop a response.

What is the VA's expectation around performance metrics? Please explain how you want reports to represent cost, trends and utilization. (Program Terms )

See Attachment C Performance Requirement Summary for VA required contract performance metrics.

The second question is unclear as to which reports are being referenced in the question. The requirements for the content and structure of all required deliverables, including reports, are defined in Attachment 1 TOPR PWS, Section 19, “Schedule of Deliverables,” along with report formatting. The following are TOPR PWS sections addressing requirements for cost and utilization reports:

TOPR PWS Section 8.1.5, “UM Reporting Data, Trends, and Risks”

PWS Section 8.1.6, “Utilization Management Data and Performance Requirements”

Per Section 19, “Schedule of Deliverables,” the format of the Monthly TCOC Report and UM Monthly Report are contractor-determined, subject to VA review and approval.

There are multi aspects of the IDIQ, PWS, and TOPR that contemplate that the VA can make unilateral changes to the contractual obligations during performance, such as:

According to the RFP and TOPR documents, these changes will be negotiated or equitably adjusted on the basis of the contractor’s costs. Can the VA explain whether FAR Part 31 applies to the VA-caused changes? What are the VA’s expectations for how contractors must document, present, and support these costs? (Program Terms)

FAR 31 is applicable if the conditions listed in FAR 31.000 are present. These are: (a) the pricing of contracts, subcontracts, and modifications to contracts and subcontracts whenever cost analysis is performed; and (b) the determination, negotiation, or allowance of costs when required by a contract clause. (FAR 31.000)

All changes will be handled in accordance with FAR 52.212-4(c), Changes.

Section B.7.2 states that the required Non Disclosure Agreement (NDA) for execution is provided as “Attachment A.”

However, the document labeled Attachment A contains only the CCN Stakeholders List, and no NDA appears to be included elsewhere in the RFP materials. Could the department please confirm whether the NDA was omitted and, if so, provide the correct NDA attachment?

The NDA is now removed from the attachment list. Please see Amendment 0011.

Section D refers to "Attachment A - CCN Next Gen Medical Non-Disclosure". However, the document labeled Attachment A contains only the CCN Stakeholders List, and no NDA appears to be included elsewhere in the RFP materials. Could the department please confirm whether the NDA was omitted and, if so, provide the correct NDA attachment?

The NDA is now removed from the attachment list. Please see Amendment 0011.

Section 18 discusses that the VA may order these tasks in accordance with "Ordering Procedures in Section X.X of the contract." Notably, the contract does not contain a Section X.X and there is only one reference to ordering procedures in the context of FAR 16.507. Could you please provide clarity surrounding this item?

Optional Tasks described in this section may be ordered by VA in accordance with FAR 16.507, as outlined in the Ordering Procedures in Section B.5.1 of the IDIQ. VA will issue amended language in the TORPs to reflect this.

Section 7.1 states that "Duplicate RFS. If an RFS is submitted for services already approved by VA and a valid VA Approved Referral exists, a response must be sent to the provider with the VA Approved Referral number.". Please clarify whether this requirement is intended to be fulfilled by the VA or by the Contractor, as the responsible party is unclear.

This requirement is intended to be performed by the Contractor. When a duplicate Request for Services (RFS) is submitted for services that have already been approved by VA and a valid VA Approved Referral exists, the Contractor is responsible for responding to the provider with the applicable VA Approved Referral number, in accordance with Section 7.1 of the Performance Work Statement.

Section 7.2.1 states that "As soon as available, submit clinical documentation in association with a notification to include:

1. Emergency Room Notes

2. Physician Progress Notes

3. History and Physical

4. Discharge Summary" Please clarify whether this requirement is intended to be fulfilled by the Community Hospital or by the Contractor, as the responsible party is unclear.

This requirement is intended to be fulfilled by the Contractor. The Contractor is responsible for obtaining and submitting the identified clinical documentation to VA, as soon as available, in accordance with Section 7.2.1 of the Performance Work Statement.

Section 11.2.3 states "The Contractor will, at a minimum, apply rules identified in Table 44 for Point of Service (POS) National Council for Prescription Drug Programs (NCPDP) transactions." Could you please provide clarity? As Table 44 in the document relates to conditions for determining duplicate pharmacy claims. The referenced table does not appear to be included within the Attachment.

Table numbers have been revised, and the reference now points to Table 45. Please see updated Attachment 2 CCN Next Gen Medical Network Contractor Manual, posted on 12/23/2025. This Manual version is applicable to both East and West.

See Amendment 0001 for further details regarding this correction.

Section D.2 refers to "ATTACHMENT T – Non-Disclosure Agreement". Could the department please confirm whether the NDA was omitted and, if so, provide the correct NDA attachment?

The NDA is now removed from the attachment list. Please see Amendment 0011.

Section D.2 refers to "ATTACHMENT C - Performance Requirement Summary". However, the "Attachment C Performance Requirement Summary_Medical East_IDF.xlsx" Included in the solicitation refers only to East. Please confirm if this file also applies to West and IDIQ as well or if separate files will be released.

Please see Amendment 0001 posted on Dec 23, 2025 that includes Attachment C _ Performance Requirement Summary_Medical West

Please confirm if Attachment Q is for reference only or if the contractor is being asked to complete this form. Attachment Q is for reference only.

Section D.2 refers to an "ATTACHMENT R - Network Adequacy Rate Waiver Form". Please confirm if the file labeled "Attachment R Network Adequacy Rate Waiver Form_MedicalEast.pdf also applies to the West and IDIQ parts of this solicitation.

Attachment R – Network Adequacy Rate Waiver Form is applicable at the TOPR level for both the West and East.

Section D.2 refers to an "ATTACHMENT U – Incentive Disincentive Plan West". The file received in this solicitation is labeled "Attachment U- Incentive Disincentive Plan East.docx". Could the department please confirm whether the West file was omitted and, if so, provide the correct West attachment?

Please see Amendment 0001 posted on Dec 23, 2025 that includes Attachment U - Incentive Disincentive Plan_Medical West

In Attachment G Medical Network Waiver Request Form.pdf, the instructions ask that the contractor complete Parts I- VII. However, parts V-VI are appear to be for the VA to complete and Part VIII is not included in the file. Please confirm that the carrier should complete Parts I-IV only.

See Amendment 0006 for the corrected Attachment G Medical Network Waiver Request Form .

Will the VA provide additional guidance as to what constitutes "routine" in this section? VA is unable to provide a response because the question is unclear and the intent of the inquiry cannot be determined.

Location Restrictions: Are there any restrictions regarding agent work location for call, claim, and chat services (e.g., on-site versus remote/work-from-home)?

VA does not intend to restrict work agent locations as related to this question.

Dedicated Support Team:1. Will the solution require a dedicated team for call, chat, and claims support? 2. Will this include dedicated claim support functions such as Recoveries, CG&A, Rework, etc.?

The Contractor shall establish and maintain a Contractor Contact Center that includes toll-free telephone lines and access to customer service through electronic messaging. The contractor contact center shall provide services, including, but not limited to, referral/claim status, claim issues (including reprocessing), complaints, and provider enrollment. Please see CCN Next Gen – Medical East/West TOPR PWS, Section 6.1.3 for more information.

Artificial Intelligence Usage- Are there any limitations or restrictions on the use of AI within the contact center? Outside of the modes of AI/Self-Service identified in the PWS, including IVR self-service, chat self-service, and portal self-service, any other modes of AI shall require preapproval by VA before implementation.

What is meant by "IT Support" in the statement "Contractor shall provide IT support as part of the Contractor Contact Center". Is this a dedicated IT help desk (vs. customer service contact center)?

The Contractor shall provide IT support as part of the Contractor Contact Center to assist users with issues or questions concerning Contractor systems, data, access, and information exchange. Please see CCN Next Gen – Medical East/West TOPR PWS, Section 6.4 for more information.

Which foreign languages would require translation services? Under federal civil rights laws, including the Vietnam Era Veterans' Readjustment Assistance Act (VEVRAA) and the Americans with Disabilities Act (ADA), contractors are required to provide language assistance and translation services to veterans. This includes: Providing translation services in all languages likely to be encountered in the United States and ensuring effective communication with individuals who are limited in English proficiency (LEP).

What is CQ monitoring and what is the CQ Process? TOPR PWS Section 2.6 defines CQ as “Continuous Query (CQ”). As referenced in TOPR PWS Section 3.6, Credentialing: “The Contractor shall implement continuous monitoring of each network provider through the National…