Record of Questions and Answers 0021 4.23.26.pdf

Question and Answers 36C10G26R0003 0021

Question

Industry Questions VA Answers

1 In this section, volumes are provided for purposes of TEP extended value calculations. In reviewing the healthcare CLINs (e.g. Waivers of Payment Rates), the Base Period Year 1 values are all ~74% of the Base Period Yar 2 values which aligns with the stated assumption of a January 2027 award date. However, the Base Period Year 1 volumes for the administrative CLINs (e.g.

Administrative Services for Healthcare Services) appear to be 98%+ of the Base Period Year 2 values. Please clarify.

VA Response: The percentages shown represent VA’s estimated volume for the two separate CLINs. There is no error in the figures.

2 CLIN 5 description was updated to Non-Medicare, Non- VA, Non- Alaska Fee Schedule Healthcare Services, however, Attachment 3

- CCN Next Gen Medical - West TOPR Price Schedule v5 was not similarly updated. Please clarify.

VA Response: CLIN 5 description is correct. Refer to continuation page of Amendment 21 for revised information.

3 In Amendment 20, VA has now provided volumes for Offerors to use in order to calculate an extended price. For CLIN X008AA Administrative Services for Healthcare Services, VA has noted the values (TOPR West) as 306,046 for Base Period Year 1 with slight escalations for subsequent years.

The description of the CLIN in the TOPR Directions for Pricing CLINs is “Offerors shall propose a unit price, in dollars, that applies to the average monthly enrolled Veteran population for each year of the Period of Performance.” In the CCN Next Gen Medical - West TOPR 0002 Conformed Copy 04172026, the description of the CLIN is “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.”

These values are inconsistent with data provided in Attachment P Health Care Historical Volumes and Estimated Enrollment and Eligibility.xlsx. Specifically, an evaluation of tab Enrolled Vets would illustrate that for FY28, the West would have Enrolled Veterans of 3,613,571. These Veterans are presumably enrolled each day of the year with modest increases and decreases occurring naturally. As a result, the expected monthly average or daily average would be 3,613,571. If an Offeror uses the 306,046 as the units, the calculated price per unit will be substantially greater than using the 3,613,571. Please clarify the unit value to be used.

VA Response: Refer to continuation page of Amendment 21 for revised information.

4 In Amendment 20, VA has now provided volumes for Vendors to use in order to calculate an extended price. For CLIN X008AA Administrative Services for Healthcare Services, VA has noted the values (TOPR West) as 306,046 for Base Period Year 1 with slight escalations for subsequent years. For CLIN X008AB Administrative Services for Pharmacy Benefits Management (PBM) VA has provided values as 5,620 for the same period.

In the CCN Next Gen Medical - West TOPR 0002 Conformed Copy 04172026, the description of CLIN X008, Administrative Services is “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.” There is no separate definition provided for CLIN X008AA Administrative Services for Healthcare Services and CLIN X008AB Administrative Services for Pharmacy Benefits Management (PBM). If both sub- CLINs use “the monthly Enrolled Veteran population” please explain why there would be a difference as a Veteran does not enroll separately in the pharmacy benefit and no such distinction exists in the language provided.

5 In Amendment 20, VA has now provided volumes for Offerors to use in order to calculate an extended price. For CLIN X0014AX Approve Referrals for Appointment Scheduling VA has provided a single value. For Base Period Year 1 that value is 330,338. At pg.

70 VA states for each sub-CLIN (X0014AA-Z0014AE) "The Offeror’s proposed Tier X unit price for each year of the Period of Performance will be multiplied by the projected number of Approved Referrals for appointment scheduling per year provided in E.1 FACTOR 4: PRICE, Table 7." However, CLIN X0014AA (Tier 1) is 0-200,000, therefore, 330,338 is not possible under this tier.

Please consider clarifying that the TEP will be based on the 0- 200,000 for Tier 1, the 200,001-300,000 for Tier 2, and the remaining 30,338 using Tier 3 pricing with Tier 4 and Tier 5 not utilized in the TEP. This method would also provide clarity to offerors with respect to the utilization of the tier structure.

VA Response: Vendors are still required to propose pricing for each tier/ each sub-CLIN under this CLIN. The estimated volume provided by the VA is for informational purposes only and is intended to assist vendors in analyzing and structuring their pricing. The VA will amend the solicitation language to clarify that the estimated volume associated with this CLIN is for informational purposes only. Refer to continuation page of Amendment 21 for revised information.

The VA intends to evaluate CLIN X014 using a true tiered structure where projected volumes are distributed across applicable thresholds rather than applying the total volume to every tier. The Total Evaluated Price (TEP) will be the weighted sum of these calculated values, ensuring that optional CLINs are not mathematically over-weighted and that the evaluation reflects reasonable costs. Final evaluation criteria and CLIN definitions for these tiered services are established at the Task Order Proposal Request (TOPR) level.

Provide this clarifying language: Tier 1 is the proposed fixed price for appointment scheduling for the first 200,000 approved referrals. Tier 2 is the proposed fixed price for appointment scheduling for approved referrals 200,001 through 300,000. Tier 3 is the proposed fixed price for appointment scheduling for approved referrals 300,001 through 400,000. Tier 4 is the proposed fixed price for appointment scheduling for approved referrals 400,001 through 500,000. Tier 5 is the proposed fixed price for appointment scheduling for approved referrals of 500,001 or more. A price must be provided for every tier for each year of the PoP.

For example, for evaluation purposes if the anticipated annual volume was 339,000, the first 200,000 will be multiplied by your Tier 1 proposed price per approved referral for Tier 1 (e.g., $10). So, 200,000 times $10. The next 100,000, within Tier 2, would be multiplied by your proposed price per approved referral for Tier 2 (e.g., $8). The remaining 39,000 will be multiplied by your Tier 3 proposed price (e.g., $6).

6 In the descriptions of the Sub-CLINs for X0016AA Software, Process, and Proof of Concept Development, VA identifies a number of sprints associated with each size. For example, a Medium task is noted as 4 sprints over a 3-6 month period. It is widely considered an industry norm that a "sprint" consists of two weeks of activity. As a result, pricing for this task would consist of 4 sprints x 2 weeks per sprint or 8 weeks of activity to occur over 3- 6 months. Please confirm this is consistent with VA's expectations or provide a specific number of weeks or hours per sprint.

VA Response: Yes, those are VA's expectations.

7 The IDIQ states the IDIQ award date is August 2026. The TOPR states the IDIQ award date is January 2027. Please confirm the date listed in the TOPR is intended to be the TOPR award date. If not, please clarify what is meant by the two different dates and how they relate to the batch evaluation approach in IDIQ E.4(A).

VA Response: The anticipated IDIQ award date of August 2026 is correct. The anticipated TOPR award date is January 2027.

8 CCN IDIQ Amendment 20 (Document 3610G26R0003+0020+CCN+Next+Gen+Medical+Amendment.pd

f) and CCN Medical East and West TOPR documents.

CCN IDIQ Amendment 20 (Document 3610G26R0003+0020+CCN+Next+Gen+Medical+Amendment.pd

f) states, "The Government anticipates that the IDIQ award date will commence on or about August 2026..."

CCN Medical East and West TOPR documents states, "The Government anticipates that the IDIQ award date will commence on or about January 2027..." please clarify.

VA Response: The anticipated IDIQ award date is August 2026. The anticipated TOPR award date is January 2027.

9 Conformed TOPR East and West (APR 17, 2026) In the last conformed RFP, in the Directions for Pricing CLINs, the language instructs that “Offerors shall use the VA estimated data below when pricing CLIN[s]” in several sections, the RFP instructions contradict with the pricing template “unit” column.

For example:

a. In the CLIN x003 Seasonal Vaccinations and Adult Immunizations, if Offerors were to apply the Table 2-Projected Vaccination Administration Volumes by Contract Year, then it would contradict the pricing template unit of $ per vaccination/immunization. Please clarify.

VA Response: Vendors are to input their proposed seasonal vaccination/adult immunization unit prices -- $ per vaccination/immunization, as the pricing template reflects for this CLIN – for each year of the period of performance. For evaluation purposes only, the proposed unit prices will be multiplied by the projected volumes provided, resulting in the TEP for each year of the period of performance. The sum of these values across the period of performance will represent the TEP for CLIN X003.

9b For the brand name and generic pricing, if bidders were to apply their AWP discounts to the Table 3 /4 Cost Base, offerors will identify their savings and the subsequent cost base to VA. The pricing template is requesting % of AWP per medication. How should offerors populate the spreadsheet?

VA Response: Please refer to the Evaluation Criteria section of the TOPR for CLIN-specific methodologies related to the TEP calculations. For example, in CLIN X006AA, if the vendor wished to propose 80% of the AWP, the vendor would enter 80% in the pricing template, and VA would apply that percentage to the applicable cost base to calculate the resulting evaluated cost and savings.

9c For the software development CLIN, the pricing template is requesting $ per software development task, whereas the TOPR is informing “Offerors shall use the VA estimated data below when pricing CLIN X014. Table 7-Projected Number of Approved Referrals for Appointment Scheduling by Contract Year. Please clarify.

VA Response: Vendor is conflating Optional CLIN X0016, Software, Process, and Proof of Concept Development with Optional CLIN X0014, Healthcare Appointment Scheduling and Comprehensive Care Coordination. Please refer to the Evaluation Criteria section of the TOPR for CLIN-specific methodologies related to the TEP calculations.

10 Conformed TOPR East and West (APR 17, 2026) Can VA confirm the volumes for CLIN x008AA Administrative Services for Healthcare Services in table 5? In Attachment P, East Region in year 2 there are ~ 5.4M monthly enrolled veterans. The offeror’s year 2 price will represent 12 months of effort for the 5.4M monthly enrolled veterans. To calculate a monthly enrolled veteran population price, should offeror’s divide their year 2 total price over ~64M enrolled Veteran member months (5.4M x 12 months)? As page 14 indicates “This CLIN is paid following achievement of full healthcare delivery (HCD) based on the average monthly Enrolled Veteran population in the Task Order's geographic jurisdiction/region” and since there is on average 5.4M monthly enrolled, bidders will be invoicing on the 5.4M monthly enrolled (versus the 447,901).

VA Response: Refer to continuation page of Amendment 21 for revised information.

11 Conformed TOPR East and West (APR 17, 2026) Amendment 13 updated the pricing evaluation criteria to state VA will review the first-year pricing . Given an offeror’s first-year pricing may include both implementation (CLIN x012) and administrative price (CLIN x008), please clarify how the government will determine reasonableness in accordance with

FAR 15.404-1.

VA Response: The Government will determine price fairness and reasonableness by applying the requirements of FAR 15.404 1 together with the additional pricing considerations required for multiyear acquisitions under FAR Part 17. The first year price will be evaluated for fairness and reasonableness using standard price analysis principles, while also accounting for multiyear specific elements."

12 Conformed TOPR East and West (APR 17, 2026) When populating CLIN x002 Waivers of Payment Rates, how should offerors populate the cells for the annual payment waiver?

For example, if an Offeror is bidding a 50% rate, should they populate the cell with 50% or 150%? Please clarify.

VA Response: To ensure the Vendor's proposal are evaluated correctly, the Vendor should populate the cell with the 100% Medicare rate, plus the percentage above Medicare that they are proposing. In your example, if your proposal is 50% above the Medicare rate, then it should be put in the spreadsheet as 150% (100% plus 50%).

13 Conformed TOPR East (APR 17, 2026) It appears the conformed TOPR contains a material inconsistency: CLIN X009, Organ Acquisition Cost, and corresponding Sub CLINS are noted as both pre-priced (pg. 47) and non-pre-priced (pg. 48). Please clarify.

VA Response: CLIN X009 is pre-priced. Refer to continuation page of Amendment 21 for revised information.

14 The IDIQ award date identified in RFP 36C10G26R0003 conflicts with the IDIQ award date identified in 36C10G26R0003 0001.

Will you please clarify the anticipated award dates for IDIQ and TOPRs East and West?

a. IDIQ 36C10G26R0003 : The Government anticipates that the IDIQ award date will commence on or about August 2026.

b. TOPR East 36C10G26R0003 0001-13: The Government anticipates that the IDIQ award date will commence on or about January 2027.

VA Response: The anticipated IDIQ award date of August 2026 is correct. The anticipated TOPR award date is January 2027.

15 VA’s revised Instructions to Offerors state “Offerors shall use the VA estimated data below when pricing CLIN X008” and adds Table 5 “Table 5-Projected Average Monthly Enrolled Veteran Population Volumes by Contract Year “ to CLINs X008AA &

X008AB.

o It appears that the member months now equal what was a single month average in attachment P, and perhaps VA inadvertently divided the annual year end enrollments by 12 instead of multiplying by 12 to calculate the total member months. To demonstrate, we’ve added calculations based upon Attachment P in the Table below to how member months are typically calculated within the industry.

o Additionally, we believe the basis months should be the same for CLIN X008AA and X008AB o If our calculations are verified, we request VA also verify the volumes in CLIN X002, X003, X006, and X007.

16 The TOPR East RFP outlines a tiered pricing structure for CLIN X014. However, A0020’s described TEP methodology indicates that each sub-CLIN tiered price will be multiplied by the projected volume in E.1 FACTOR 4: PRICE, Table 7. For example, Evaluation Criteria item n. CLIN X014, Optional: Healthcare Appointment Scheduling and Comprehensive Care Coordination, sub bullet a. states, “The sum of these values represents the TEP for CLIN X014AA.”

• As written, this approach does not appear to account for the application of volume-based tiers. Instead, it suggests that each tier price would be evaluated against the same total volume, regardless of where the projected volume would fall within the defined tiers. Can the VA please clarify whether the intent is:

o To apply the full volumes to each tier price for evaluation purposes, or o To evaluate the pricing based on a true tiered structure, where volume is distributed across applicable tiers based on thresholds?

• As written, this method seems to over weight the optional CLINs substantially, leading to a potentially unfair representation of price. To correct this, we suggest VA clarify they will use a single tier versus adding the tiers.

VA Response: Vendors are still required to propose pricing for each tier/ each sub-CLIN under this CLIN. The estimated volume provided by the VA is for informational purposes only and is intended to assist vendors in analyzing and structuring their pricing. The VA will amend the solicitation language to clarify that the estimated volume associated with this CLIN is for informational purposes only. Refer to continuation page of Amendment 21 for revised information.

The VA intends to evaluate CLIN X014 using a true tiered structure where projected volumes are distributed across applicable thresholds rather than applying the total volume to every tier. The Total Evaluated Price (TEP) will be the weighted sum of these calculated values, ensuring that optional CLINs are not mathematically over-weighted and that the evaluation reflects reasonable costs. Final evaluation criteria and CLIN definitions for these tiered services are established at the Task Order Proposal Request (TOPR) level.

Provide this clarifying language: Tier 1 is the proposed fixed price for appointment scheduling for the first 200,000 approved referrals. Tier 2 is the proposed fixed price for appointment scheduling for approved referrals 200,001 through 300,000. Tier 3 is the proposed fixed price for appointment scheduling for approved referrals 300,001 through 400,000. Tier 4 is the proposed fixed price for appointment scheduling for approved referrals 400,001 through 500,000. Tier 5 is the proposed fixed price for appointment scheduling for approved referrals of 500,001 or more. A price must be provided for every tier for each year of the PoP.

For example, for evaluation purposes if the anticipated annual volume was 339,000, the first 200,000 will be multiplied by your Tier 1 proposed price per approved referral for Tier 1 (e.g., $10). So, 200,000 times $10. The next 100,000, within Tier 2, would be multiplied by your proposed price per approved referral for Tier 2 (e.g., $8). The remaining 39,000 will be multiplied by your Tier 3 proposed price (e.g., $6).

17 Can VA clarify how CLIN X002 waiver payment detail as detailed in A0020 aligns to the waiver data volume provided in A0019?

While we understand the figures provided in A020 reference to claims dollars versus the total waiver’s included in A019, we remain unclear if A0020 dollars indicated are dollars above the Medicare rate or a different figure.

VA Response: A0020 CLIN X002 Table 1 values reflects the anticipated base allowable Medicare rate based on historical actuals, against which the proposed percentage above Medicare rate will be applied.

The vendor shall use this table for CLIN X002 pricing. Attachment 8 (Medical Network Waiver Data) in Amendment 0019 reflects historical data that was provided for informational purposes only.

To ensure the Vendor's proposal is evaluated correctly, the Vendor should populate the cell with the 100% Medicare rate, plus the percentage above Medicare that they are proposing. In your example, if your proposal is 50% above the Medicare rate, then it should be put in the spreadsheet as 150% (100% plus 50%).

18 Will the Government provide the projected month and year for offeror notifications and scheduling of oral presentations, given the window of August 2026 (IDIQ award) through January 2027 (TOPR award)?

VA Response: No. Refer to E.1 ADDENDUM TO FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES for all relevant information.

19 Based on the current CLIN definitions and Attachment P values for the West region, the monthly average enrolled members should be approximately 3.6 million for both CLINs X008AA and X008AB, but Table 5 shows Year 1 monthly average enrolled members of 306,046 for X008AA and 5,620 for X008AB. The enrolled member population should be the same whether referenced monthly or annually, and therefore the Table 5 figures are significantly understated unless the VA is using a different basis such as active members or utilizers instead of enrolled members. Will the VA please confirm whether Table 5 is in error and provide the corrected data to match the approximate 3.6 million enrolled members for both CLINs? If not in error, will the VA please provide the corrected CLIN definitions (active members, utilizers, etc.)

and example calculations with sample numbers to derive total evaluated price for CLINs X008AA and X008AB?

20 Will the government clarify the award date for the TOPR? The TOPR amendment and conformed copy currently refers to the IDIQ instead of the TOPR.

VA Response: The anticipated IDIQ award date is August 2026. The anticipated TOPR award date is January 2027.