Record of Questions and Answers 0022 4.24.26 Final (002).pdf

Questions and Answers 36C10G26R0003 0022

Ques tion

Industry Questions VA Answers

CLIN X008, the VA revised table 5 to be an average annual Veteran population. For an annual PMPM, the offeror would need to multiply the estimated population included in the revised Table 5 by 12 months. The TEP methodology refers to table 5 as the monthly average, which would be correct. This makes the revisions to the Table 5 title seem like a typo.

Does VA wish offerors to price a “Per Member Per Month” cost in CLIN X008 or a “Per Member Per Year

According to Sections E.1 and E. 2 of the TOPR of the TOPR, CLIN X008, 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. For example, if the Offeror proposes $5 PMPM and the hypothetical average monthly enrollment is 1,000,000 Veterans, the monthly cost is $5,000,000.

For evaluation, VA will multiply this monthly amount by 12 to calculate the annual cost for each performance year for the CLIN. Although actual monthly enrollment may vary slightly, the annual average provided in Table 5 represents VA’s best estimate and provides a reasonable basis for evaluating yearly costs. Refer to Section 2.9, Administrative Invoice, of the PWS (Attachment 1) for additional detail.

CLIN X0013 appears to have a discrepancy. Both sub-CLIN X013AA and X013AB require offerors to identify the total cost of implementation per site (i.e., the VA Facilities for X013AA and the contractor-owned sites for X013AB) for each year of the base and option periods of performance (i.e., for five years). The new TEP methodology for calculating the price for CLIN X013AB does not include the estimated number of implementations (as the TOPR now does for CLIN X013AA ), and is not clear regarding how the price for sub-CLIN X013AB will be calculated.

Will the VA please clarify this discrepancy?

For SubCLIN X013AB, Offerors must propose a single lump-sum price for contractor-side implementation for each applicable year. Unlike SubCLIN X013AA, VA is not paying for implementation PER site, therefore VA is not providing an estimated number of contractor-owned site implementations. X013AB is not priced on a per-site or volume basis.

For CLIN X003 (Seasonal Vaccinations and Adult Immunizations), please confirm whether the volumes provided represent the total annual volume or monthly volumes that should be annualized (multiplied by 12). Additionally, these volumes differ from those provided in Amendment 14 (Attachment_Pa__CCN_Legacy_Vaccination_Medication_Volumes.xlsx)— please confirm which data set Offerors should rely upon.

The volumes provided for CLIN X003 are annual estimates and should not be multiplied by 12. If any discrepancy exists between these volumes and Amendment 14, Offerors must rely on the Amendment 21 CLIN X003 volumes in the current solicitation and pricing schedule, as Amendment 14 reflects legacy reference data rather than the pricing data for this CLIN.

VA has clarified that CLIN X003 covers vaccine administration/dispensing only and that vaccine ingredient costs must be included under CLIN X001, and that Medicare methodology applies only to the administration component. Absorbing vaccine ingredient costs into CLIN X001 presents pricing and evaluation risk, as ingredient costs vary significantly by NDC, manufacturer, formulation, and dose. Additionally, Medicare and CMS-defined pricing methodologies for vaccine ingredients are limited, vaccine specific, and not consistently available across all products. To promote pricing clarity and alignment, we recommend consideration of a separate CLIN (e.g., CLIN X003AA) for vaccine ingredient costs.

Thank you for the recommendation. At this time, the VA is not establishing a separate CLIN for vaccine ingredient costs. No further changes will apply to this CLIN.

For CLIN X006 (Urgent and Emergent Medications) and CLIN X007 (Disaster Response:

Urgent and Emergent Medications), please clarify the definitions of “cost base” (e.g., AWP, total amount paid by the VA, or another basis) and “dispensing fee (volume)” (e.g., total claims processed or total paid prescriptions). The volumes provided differ materially from those in Attachment_P_- Health_Care_Historical_Volumes_and_Estimated_Enrollment_and_Eligibility(1).xlsx, and clarification would support consistent pricing assumptions.

For CLIN X006 and CLIN X007, “cost base” refers to the VA-provided estimated allowable medication cost amount to be used for pricing and evaluation purposes.

Dispensing fee (volume) refers to the VA-provided estimated prescription/claim volume to which the dispensing fee applies. These figures are evaluation assumptions established by the VA, for the purpose of evaluation only, and are not intended to require Offerors to derive or substitute another benchmark such as AWP unless expressly stated elsewhere in the solicitation.

Attachment P reflects historical reference information only.

To further support accurate and competitive pricing, it would be helpful for Offerors to see regional historical prescription and vaccine volumes with actual NDCs dispensed, as well as the Urgent/Emergent Formulary, similar to the VA National Drug File with NDC extract provided on the VA National Formulary website. The VA previously released regional NDC data during market research phase; updating this information by region would help industry better align pricing to historical utilization.

The VA does not intend to provide additional regional historical prescription or vaccine volume data, including actual NDC-level utilization, beyond the information already included in the solicitation and related attachments. Offerors should base their pricing on the assumptions and data provided in the current solicitation materials in Sections E.1 and E. 2. To the extent applicable, formulary information is available through the VA National Formulary resources already identified in the

PWS.

For CLIN X008 (Administrative Services), please explain why the number of monthly enrolled Veterans differs between SubCLIN X008AA and X008AB. If both SubCLINs are based on monthly enrolled Veterans, should these volumes be the same? If either SubCLIN is intended to be based on unique utilizers, please confirm and update the regional pricing schedules accordingly. Additionally, please confirm whether the volumes provided represent the total annual volume or monthly volumes that should be annualized (multiplied by 12).

This was resolved in Amendment 21, please refer to amendment 21 for details. According to Sections E.1 and E. 2 of the TOPR, CLIN 008, 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. For example, if the offeror proposes $5 PMPM and the hypothetical average monthly enrollment is 1,000,000 Veterans, the monthly cost is $5,000,000.

For evaluation, VA will multiply this monthly amount by 12 to calculate the annual cost for each performance year for the CLIN. Although actual monthly enrollment may vary slightly, the projected average monthly enrolled Veteran provided in Table 5 represents VA’s best estimate and provides a reasonable basis for evaluating yearly costs. Refer to Section 2.9, Administrative Invoice, of the PWS (Attachment 1) for additional detail.

Finally, it would benefit both the VA and industry if the regional pricing schedules explicitly included the unit volumes that will be used to evaluate total price.

Providing this clarity supports consistent pricing assumptions across Offerors, improves price comparability, and reduces the risk of misalignment during evaluation—ultimately supporting a clearer, fairer, and more efficient procurement process.

Thank you for the recommendation. At this time, the VA does not intend to revise the pricing schedule.