36C25521R0002 Amendment 0005.pdf

5. PROJECT NUMBER (if applicable)

CODE7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER3. 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 CODECODE

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 3

0005 01-08-2021 N/A

36C255

Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048

36C255

Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048

To all Offerors/Bidders

36C25521R0002

11-27-2020

X

X X

Offers Due 1/21/2021, 4:30 PM CDT.

Wichita IR/DR Radiology Physician Services The solicitation is amended to:

1. Re-open the period for technical questions. The last day for offeror questions is 1/12/2021, 2:30 PM, CDT, and to extend the date offers are due, 1/21/2021, as shown in Block 11 above.

2. Readdress prior answered questions to clarify VA responses and provide additional information.

3. Replace Price Schedule page (page 2 of 8), adding a paragraph under "Pricing Instructions:" section.

4. Provides a mock-up sample of the monthly contractor productivity report and a sample of multi-CPT code procedures.

5. The Full Request for Proposal conformed to all changes made by Amendments 0001 through 0005 is provided. All prior versions should be discarded. The conformed copy should be used for proposal submission.

---Last Entry Amendment 0005--- (block 14 continued page 2)

Michael Cumins Contracting Officer

VA-VHA-2019-C1CA342A

SF30, Block 14 (continued)

SF 30, Block 14, Item No. 1 – the solicitation’s period for technical questions is re-opened to allow for final offeror questions. The last day and time for questions via electronic mail to michael.cumins@va.gov is 1/12/2021, 2:30 PM CDT.

The solicitation’s Offers Due Date, SF 1449, Block 8, is changed to 1/21/2021, 4:30 PM CDT.

SF 30, Block 14, Item No. 2 – Questions previously asked and answered by Amendment 0002, Questions 1, 5 and 6, and Amendment 0003, Questions 14, 21 and 22, are readdressed to clarify and provide additional response. See page 3.

SF 30, Block 14, Item No. 3 – The second page of the Price Schedule is replaced to add a third (3rd) paragraph under the “Pricing Instructions:” section.

SF 30, Block 14, Item No. 4 – A mock-up sample of the intended monthly contractor productivity report is provided as a sample of what the contractor would expect to receive from the VA on a monthly basis as identified in the Performance Work Statement section 6.2.2.1.

Examples of multiple-CPT code procedure types are provided for reference to clarify the application of wRVUs for a single procedure, as follows. These are only examples of possible CPT code combinations and shall not be construed to be actual CPT Code make-up as shown, common or repetitive procedures:

Example 1: Port placement: CPTs 99152+3561+76937 = 6.34 wRVUs Example 2: Nephrostomy tube: CPTs 50435+99152+50432 = 6.07 wRVUs Example 3: Liver embolization: CPTs 75774+75726+36248+36245+ 36247+99153+99152+76937+37243 = 26.75 wRVUs Example 4: Ct guided liver biopsy: CPTs 77012+47000 = 3.15 wRVUs Example 5: Fluoro guided myelogram: CPTs 77003+62284 = 2.14 wRVUs

SF 30, Block 14, Item No. 5 – a Fully Conformed-Copy of RFP 36C25521R0002 is provided, conformed to Amendments 0001 through 0005, with all previous updates incorporated.

Questions and Answers

Questions and Answers to Previously asked and answered question to provide additional clarity and response.

Amendment 0002, Q #1 originally asked the intent of section 6.2.2 and if the VA would provide monthly CPT code and wRVU information to the contractor for billing purposes.

- The question was answered to include revision of that section. In addition to the original answer and revision, the VA provides a mock-up of what the VA intends to send to the contractor showing the recorded of contractor radiological study production. VA further intends to provide this record of production in the format like the attached MS Excel spreadsheet entitled “Mock-up Sample” (fictitious example with exaggerated data entries). The available formatting available can be flexible and the MS Excel format may be adapted into a word-processing document format, such as MS Word, or Portable Document Format (PDF) if necessary.

Amendment 0002, Q #5 originally asked how the contractor would get access to completed wRVUs.

- The question was answered to reference Q #1. In addition to the original answer, the updated response above for that Q #1 applies.

Amendment 0002, Q #6 originally asked if the VA would provide wRVU formulas to use.

- The question was answered to indicate the offeror is responsible to develop its own pricing. In addition to the original answer, and the later-provided recent history of CPT codes/wRVUs during Fiscal Years 2019 and 2020, it is clarified that the VA recognizes that the term, “wRVU”, is a descriptive acronym utilized by the Centers for Medicare and Medicaid Services (CMS) to describe the “physician work to perform the service – technical skill, physical effort, mental effort and judgement, and psychological stress associated with the physician’s concern about the iatrogenic risk to the patient” as opposed to the practice expense or malpractice insurance expense that are the other two components of the overall, or total, RVU.

o CMS payment methodology, or components of RVU, have no bearing on the VA’s use of the term “wRVU”.

o The VA’s use of the term “wRVU” is the Unit of Measure for pricing and performance quantities.

o The request for proposal pricing for the Unit of Measure requests a price per 1.0 wRVU.

o The wRVUs (values) per CMS CPT Codes range from less than 1.0 wRVU (i.e.

0.00 wRVU to 0.99 wRVU) to multiples of 1.0 wRVU, reference CMS values for CPT codes.

o The offeror’s pricing should consider all costs to perform radiological studies/ interpretations, whether at 0.1 wRVU or higher.

Amendment 0003, Q #14 originally asked that since the price schedule does not include an RVU for practice expense or malpractice insurance expense (CMS’s terminology PE and MP) and what is VA’s expectation about those components of a total RVU.

- The question was answered to indicate that that price schedule does not request a cost breakdown. In addition to the original answer, and in reference to the above updated response for Amendment 0002 Q #6 to clarify VA’s use of the term wRVU, the Price Schedule is revised to add a paragraph to the “Pricing Instructions:” section.

o CMS’ PE and MP are not separately requested in the solicitation. This shall not be construed to mean that those factors should not be considered by the offeror when developing the wRVU unit prices as a “delivered price(s)” for the price schedule line items for diagnostic and interventional radiological services for each period, e.g. base year, and all four options.

Amendment 0003, Q #21 originally asked if the contractor would have access to VistA/CPRS specific reports that can be ran monthly to assist the contractor in creating their invoice, and if that access is not available to the contractor, how can the contractor use their own in-house billing/invoicing system considering HIPAA and VA Handbook 6500.

- The questions were answered to indicate that the VA will provide the productivity information to the contractor per the revised PWS section 6.2.2.1., and referenced Q #22 answer. In addition to the original answer, the attached spreadsheet, “Mock-up Sample” is an example of what would be provided to the contractor, monthly, to show the productivity by performed CPT codes, wRVU values, quantities and per contractor physician name.

- The method, as stated above, is intended to be in a spreadsheet format, or by word-processing if necessary. The information will not contain Personal Health Information (PHI) or Personally Identifiable Information (PII), except the identification of the performing physician. Each physician’s productivity will be listed in a separate “tab” within the spreadsheet, or similar word-processing document or PDF format, which will be transmitted by electronic mail to the contractor.

- The contractor is not prohibited from utilizing contractor-procured electronic mail encryption services if desired by the contractor for electronic mail security of the information, however, is not required since the transmittals will not include patient information. Any such encryption services, as contractor cost, must be compatible with VA’s PKI encryption.

Amendment 0003, Q #22 originally asked if the VA will grant non-provider (i.e. contractor physicians) back-office (administrative) personnel access to VistA/CPRS and remote access to accurately verify monthly billing information described in PWS section 6.2.2.1.

- The question was answered to indicate that the VA cannot grant remote access to VA systems and that the contractor physicians have the capability to take notes of radiological studies read in the Powerscribe system. In addition to the original answer, the VA provides that the contractor may, upon review of the initial information and require more specific productivity information, such as the specific dates an exam, or exams, was performed by a specific physician, the contractor may request the information case-by-case in sufficient time to ensure the invoice due date is met – by the 15th calendar day of the month following the month services were rendered.

- In conjunction with no ability to provide remote access, VA systems access for certain data or databases does not provide for “isolated” or limited access, so it is not possible for a contractor to have access to only contractor productivity, preventing the requested access.

---End of Questions and Answers---

36C25521R0002

Replacement Page 7 of 114

This is a Fixed Price Indefinite Delivery Indefinite Quantity contract. The period of performance for this contract will be a Base One (1) Year. Four (4) Option Years may be exercised at the sole discretion of the Government. There is no guarantee that any option year will be exercised.

The minimum value of services is applicable through the end of the base performance period stated in the award. The maximum value of services to be provided pertains to the life of the contract award and all four option periods, whether exercised or not.

Orders will be placed in accordance with FAR 52.216-18, Ordering.

In accordance with FAR Clause 52.216-22, Indefinite Quantity, the minimum contract amount is 1,350 wRVUs. The overall maximum amount established for this contract is 90,000 wRVUs.

Pricing Instructions:

The offeror is instructed to enter its proposed prices in the column entitled “Unit Price” for each SLIN for the Base Year of Performance and enter a total amount for each SLIN price according to the entered unit price and the quantities stated. The offeror is instructed to repeat the process for Option Years One, Two, Three and Four.

See Instructions to Offerors, FAR 52.212-1 and addendum, regarding additional information required with the offeror’s proposal. The offeror shall propose not less than two Interventional Radiologists and not less than two Diagnostic Radiologists. The total number of radiologists proposed shall not exceed 10. The offeror’s total proposed radiologists shall include at least one Fellowship-Trained Interventional Radiologist and at least one Fellowship-Trained Neuroradiologist.

The offeror shall provide a price offer for each period, base period and each option year. Proposed prices shall be all-inclusive, amounting to a “delivered price per wRVU”. The offeror’s price shall be considered as the offeror’s total price that has considered all costs or cost factors required to perform 1.0 wRVU of radiological services as described in the each SLIN for each period of performance. The price schedule utilizes CMS’ term “wRVU”, however offeror pricing is not required to be dependent on any CMS pricing or payment methodologies or RVU components breakdown, instead wRVU is the Unit of Measure for pricing and performance quantities for the purpose of this contract.

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