36C24423R0132 0001.pdf
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- Solicitation number
- 36C24423R0132
About this file
This document is a solicitation amendment modifying the price schedule for a community based outpatient clinic opportunity with the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4. The amendment changes the line item numbering in the price schedule and includes estimated quantities. The solicitation seeks proposals to provide primary care services to veterans through a community based outpatient clinic located in Pottsville, Pennsylvania, with a minimum contract value of $2,000,000 and maximum of $32,000,000 over five base years and five option years. Pricing is to be proposed as a capitation rate per member per month. Estimated enrollment quantities are provided for each contract period.
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5. PROJECT NUMBER (if applicable)
CODE 7. ADMINISTERED BY
2. AMENDMENT/MODIFICATION NUMBER
CODE
6. ISSUED BY
8. NAME AND ADDRESS OF CONTRACTOR
4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE
9A. AMENDMENT OF SOLICITATION NUMBER
9B. DATED
PAGE OF PAGES
10A. MODIFICATION OF CONTRACT/ORDER NUMBER
10B. DATED
BPA NO. 1. CONTRACT ID CODE
FACILITY CODE CODE
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers
E. IMPORTANT:
is extended,
(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.
12. ACCOUNTING AND APPROPRIATION DATA
(REV. 11/2016)
is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.
15C. DATE SIGNED
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER
Contractor
16C. DATE SIGNED
14. DESCRIPTION OF AMENDMENT/MODIFICATION
16B. UNITED STATES OF AMERICA
Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER
15B. CONTRACTOR/OFFEROR
STANDARD FORM 30 PREVIOUS EDITION NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.243
(Type or print) (Type or print)
(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
(Number, street, county, State and ZIP Code)
(If other than Item 6)
(Specify type of modification and authority)
(such as changes in paying office, appropriation date, etc.)
(If required)
(SEE ITEM 11)
(SEE ITEM 13)
(X)
CHECK
ONE
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
(Signature of person authorized to sign) (Signature of Contracting Officer)
1 4
0001 MSO-2023-COM-0030
00244
Department of Veterans Affairs Network Contracting Office 4
00244
Department of Veterans Affairs Network Contracting Office 4
To all Offerors/Bidders 36C24423R0132
11-08-2023 X
X X
See CONTINUATION Page
The purpose of this solicitation amendment is to change the line item numbering, and to include estimated quantities, in the Price Schedule at Section B.2 of RFP 36C24423R0132.
The conformed Price Schedule is included in the continuation pages.
Kevin M. Balser Contracting Officer
36C24423R0132 0001
CONTINUATION PAGE
B.2 PRICE SCHEDULE
The quantities listed in the Price Schedule below for CBOC services located within the city limits of Pottsville PA 17901 are estimates only and are not to be considered a minimum or maximum.
The Government will order the below specified minimum contract value of services and may order up to and including the below specified maximum contract value of services through task orders under this basic Indefinite Delivery Indefinite Quantity (IDIQ) contract during the duration of the contract inclusive of all option periods. The maximum amount under this contract is not guaranteed. PMPM includes cost of unassigned patient visits, contractor shall not bill separately or propose an additional LIN or bill separately for these costs. All quantities are estimated, the government will pay for services performed as certified by the COR.
Ordering Procedures: VA has the sole authority to assign Veterans treated by the contractor into the Primary Care Management Manual (PCMM) software program used to track primary care clinic veteran rosters. Specific billable processes for issuing task orders under the resultant contract are included in section 6. Refer to section 6.2.1 for billable roster information and refer to section 6.2.2 invoicing and payments for payment processing.
*Contract minimum and maximum values were developed in consideration of the Independent Government Cost Estimate. Actual minimum and maximum values may be adjusted in a contract resulting from this solicitation in consideration of the successful price proposal.
*Contract Minimum $2,000,000.00 *Contract Maximum $32,000,000.00
Base Year 1– 08/01/2024 – 07/31/2025
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
AA
Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2200
Total for Base Year 1 $________________________
Base Year 2– 08/01/2025 – 07/31/2026
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
AB
Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2175
Total for Base Year 2 $________________________
Base Year 3– 08/01/2026 – 07/31/2027
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
AC
Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2153
Total for Base Year 3 $________________________
Base Year 4– 08/01/2027 – 07/31/2028
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
AD
Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2132
Total for Base Year 4 $________________________
Base Year 5– 08/01/2029 – 07/31/2030
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
AE
Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2111
Total for Base Year 5 $________________________
Option Year 1– 08/01/2030 – 07/31/2031
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
1001 Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2090
Total for Option Year 1 $________________________
Option Year 2– 08/01/2031 – 07/31/2032
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
2001 Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2069
Total for Option Year 2 $________________________
Option Year 3– 08/01/2032 – 07/31/2033
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
3001 Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2049
Total for Option Year 3 $________________________
Option Year 4– 08/01/2033 – 07/31/2034
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
4001 Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2028
Total for Option Year 4 $________________________
Option Year 5– 08/01/2034 – 07/31/2035
Line Item
Services Unit Estimated
Quantity Price per Unit
Total Estimated Cost per month
Total Estimated Cost per year
5001 Primary Care Services at capitation rates per member per month (PMPM)
PMPM 2008
Total for Option Year 5 $________________________
TOTAL FOR BASE AND OPTION YEARS $___________________________
End of Document
B.2 PRICE SCHEDULE
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