Amend_0003_to_RFP_36C25521R0002.pdf

36C25521R0002 Amendment 0003

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 8

0003 12-31-2020

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

01/14/2021, 4:30 PM Central Time Zone

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

1. SF1449 Block 8, as amended, is changed to 1/14/2021, 4:30 PM Central Time, extending the offer due date and time.

2. Technical Questions and Answers, #7 through #25, are provided. Amendment Pages 2-4.

3. Solicitation Pages 85 and 87 are replaced to clarify how and where to submit offers. Amendment Pages 5-6.

4. Quality Assurance Surveillance Plan pages 5 and 6 are replaced to clarify item 17 Acceptable Quality Level Column, page 5, from 80% to 90% to match the PWS, and update the CPARS internet link on page 6. Amendment Pages 7-8.

5. This amendment provides historical radiological data for Fiscal Years 2019 and 2020 in PDF and spreadsheet formats, but are not attached to this Amendment. Data is available electronically in www.beta.sam.gov for this amendment.

6. The Full RFP, conformed to all changes made by Amendments 0001 through 0003, is provided electronically.

Michael Cumins Contracting Officer

VA-VHA-2019-C1CA342A

http://www.beta.sam.gov/

CONTINUATION PAGE

Questions and Answers:

The following questions (Q. #) have been asked.

Government responses (A. #) are provided under each question.

** Questions Q. #1 through Q. #6 were answered in previously issued Amendment 0002.

Q. #7: Will the VA provide VistA/CPRS training during the contract start-up period?

A. #7: Yes. Per RFP section 2.1.7, table item 6, VistA/CPRS is a hands-on training provided by the VA and will be provided immediately upon issuance of the Second (2nd) Notice to Proceed issued. Training will be provided by the radiology department.

Q. #8: How many VA employed radiology physicians are on staff? What is their primary function?

A. #8: The VA has two (2) full-time radiology physicians. Both perform diagnostic radiological duties.

Q. #9: Would NAICS code 621512 for Diagnostic Imaging Centers be more accurate for this acquisition versus the assigned NAICS 621111?

A. #9: No. The NAICS 621111, with a current size standard of $12 million as published by the Small Business Administration and effective 8/19/2019, remains applicable to this acquisition as shown on the SF1449, Block 10 with $12 million size standard.

Q. #10: 2 Can VA provide recent history of Diagnostic Interpretations by modality (CT, MRI, X-ray/film), and provide recent history of the top 10 CPT codes volumes for Interventional Radiological procedures?

A. #10: Yes, the VA provides summary quantif ied data for previous Fiscal Years 2019 and 2020 data by CPT code. Breakdown by modality cannot be provided. See History Summary Page PDF and spreadsheet versions. The data does not differentiate between performance by Wichita VAMC, contractor, or other Government resources and shall not be construed to alter, change or supplement the estimated quantities stated in the solicitation Price Schedule, and shall not be construed to alter, change or supplement the stated contract or order minimum or maximum quantities stated in the solicitation.

Q. #11: Does the current contract include reimbursement based on wRVUs?

A. #11: This (wRVU-based) is a new requirement not previously procured.

Q. #12: Are the requirements to provide at least one fellowship-trained Interventional radiologist and one fellowship-trained neuroradiologist in the current/existing contract?

A. #12: This (wRVU-based) is a new requirement not previously procured.

Q. #13: Can VA provide a breakdown of the annual historical wRVUs - Diagnostic and Interventional?

A. #13: See response provided for A #10 above.

Q. #14: The price schedule does not include an RVU for practice expense or insurance. What is VA's expectation about how those components of a total RVU are to be addressed.

A. #14: The price schedule requests a price per wRVU for diagnostic procedures and a price per wRVU for interventional procedures per period of performance, e.g. Base Year, each option period. The price schedule does not request cost breakdown other than the requested unit price(s).

Q. #15: What types of certifications/skillsets does the VA desire in a contractor program manager?

A. #15: The offeror’s designation of a Program Manager is an option the offeror may choose, however is not a mandatory requirement. A contractor’s point of contact (POC), e.g. Program Manager, or other, would be the contractor’s POC for contract related communications, management and physician and contract performance oversight.

Q. #16: What is the title for the Contracting Officer's Representative overseeing this type of radiology contract? What credentials do they possess?

A. #16: Refer to the RFP section 1.5.13.; B.3 (PWS) section 5.3; and FAR 1.604 and VAAR 801.603-70 & 801.603-71. The Contracting Officer oversees the contract. The Contracting Officer’s Representative (COR) will be a person delegated by the Contracting Officer to monitor the contractor’s performance of the contract, subject to specific limited authority and other limitations. The title will be “COR” in that capacity.

Q. #17: How many days after contract award will the successful contractor have for start-up activities before the first day of providing services?

A. #17: At the time of award, a Notice to Proceed will be issued to the contractor to commence providing physician information submitted to the Contracting Officer for security and credentialing/ privileging, later followed with a second Notice to Proceed to be issued for physician services to begin. The security and credentialing/privileging could take up to three (3) months. See the next question and answer.

Q. #18: Approximately how many days does the VA require to complete privileging for contract physicians?

A. #18: Credentialing/privileging typically take from one to two months to complete. Security processes could take up to three months. Both processes are initiated concurrently. Both processes require diligent and swift document submissions, actions and responses by the contractor and the individual physicians to complete both processes. The level of swiftness on the part of contractor could lessen the amount of time or delay the processing.

Q. #19: One area of section 2.10.2.1. states, ", but the contractor shall schedule an interventional radiologist for onsite coverage for at least f ive times per month." Which differs from, in the same paragraph, stating, "but require an appropriately credentialled interventional radiologist onsite at least twice a week." Please clarify which frequency the VA wants an interventional radiologist?

A. #19: This amendment provides a replacement page and language for section 2.10.2.1 to clarify.

Q. #20: Can VA further define the supporting documentation required by section 6.2.1. when submitting monthly invoices?

A. #20: As stated in sections 6.2.1.1 through 6.2.1.8. See also answer A #22 for Q #22 below.

Q. #21: Once contract providers record this information (section 6.2.2), will the contractor have access to VistA/CPRS specific reports that can be run monthly to assist the contractor in creating their invoice? If VistA/CPRS is unable to fulf ill these tasks, how can the contractor use their own in-house billing/ invoicing system considering HIPAA and VA Handbook 6500?

A. #21: Per section 6.2.2.1., the VA will provide information to contractor. See also answer A #22 for Q #22 below.

Q. #22: Will VA grant non-provider back office contract personnel access to VistA/CPRS and remote access to accurately verify monthly billing information described in PWS 6.2.2.1?

A. #22: Remote access to VA systems cannot be provided. However, contractor physicians will have the capability to take notes of radiological studies read in the Powerscribe log which may be provided as supporting information

Q. #23: How should proposals be submitted – electronically or by mail?

A. #23: This amendment provides two (2) replacement pages and language to clarify – original pages 85 and 87 to clarify proposal submission.

1) Page 85 – paragraph (d), added third (3rd) through seventh (7th) sentences beginning with “Proposals shall be submitted”, and

2) Page 85 – Section “Proposal Submittal”, second paragraph, added fifth (5th) through ninth (9th) sentences beginning with “Proposals shall be submitted”.

Q. #24: The QASP indicates, "at least 80% of interventional radiology exams will have final interpretations within 48 hours. The PWS section 4.4.3.18 on pages 34 and 35 indicates "at least 90%". Which percentage is correct?

A. #24: QASP page 5 is replaced to replace 80% with the correct 90% for item 17 Acceptable Quality Level definition.

Q. #25: The CPARS link is broken on page 6. Is there an updated link to the referenced document?

A. #25: QASP page 6 is replaced to update the CPARS internet link.

(c) Multiple offers. Offerors are encouraged to submit multiple offers presenting alternative terms and conditions, including alternative line items (provided that the alternative line items are consistent with subpart 4.10 of the Federal Acquisition Regulation), or alternative commercial items for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately. In order to evaluate multiple offers, each must be submitted separate from the other and clearly marked to differentiate between them, e.g. “Proposal 1 of x”, and so on.

(d) Offers are due Not Later Than 01/14/2021, 4:30 P.M. Central Time. FAR 52.212-1 (c) is tailored to replace “The offeror agrees to hold the prices in its offer f irm for 30 calendar days from the date specified for receipt of offers,” with “The offeror agrees to hold the prices in its offer f irm for 90 calendar days from the date specified for receipt of offers,”. Proposals shall be submitted either electronically by e-mail to michael.cumins@va.gov, or hard copy by U.S. Postal Service or private delivery service to Dept. of Veterans Affairs, Network Contracting Office 15, Healthcare Branch, Attention Michael Cumins, 3450 S. 4th Street Trafficway, Leavenworth, Kansas 66048. Due to limitations of COVID19 Pandemic, Hand-carried submission may be utilized, but requires at least 2-hours notif ication by phone to Michael Cumins, (913) 946-1122 to arrange for hand-carry delivery at an agreed time to the address above. Facsimile submittal shall not be accepted. Internet hyperlinked versions shall not be accepted or accessed. Offeror signatures must be “wet-ink” fashion as VA does not recognize non-Government electronic/digital signatures.

(e) Documents, including laws, regulations, standards and VA, VHA or Robert J. Dole specific directives, handbooks or policies may be referenced, cited or internet web site hyperlinked in lieu of included as documents, exhibits or attachments. Those referenced, cited or hyperlinked items will be provided to the offeror upon request if otherwise unavailable or inaccessible to the offeror.

2. Provisions that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

3. Basis for Contract Award

(a) This is a best value source selection. The Government will select the best overall offer, based upon evaluation of all technical and past performance factors and subfactors stated in this section.

Contract may be awarded to the offeror who is deemed responsible in accordance with the FAR, whose offer conforms to the solicitation’s requirements (to include all stated terms, conditions, representations, certifications, and all other information required by the Performance Work Statement) and is judged by an overall assessment of the evaluation factors that represent the best value to the Government.

THE GOVERNMENT RESERVES THE RIGHT TO AWARD TO OTHER THAN THE LOWEST

PROPOSED PRICE. However, the degree of importance of price as a factor in determining award could become greater depending upon the equality of the offers evaluated in the non-price factors.

The greater the equality of offers within the non-price factors, the more important price becomes in selecting the best value to the Government.

(b) Award for All of the Work. The Government intends to award one IDIQ contract as a result of this solicitation.

(c) Offers will be evaluated in accordance with the following factors:

Factor 1 – Technical, non-price factor/subfactors:

Board Certif ied / Board Eligible Interventional and Diagnostic Radiologists

Subfactor A – Training and Board Certif ication

Second (2nd) Replacement of Page 85 of 114 mailto:michael.cumins@va.gov

So that the Government may respond to all questions timely and in an appropriate format, questions must be submitted no later than December 11, 2020, 4:30 p.m. Central Time Zone and will be answered by amendment to the solicitation. Telephonic inquiries will not be accepted. All technical questions shall be submitted via email to Michael.Cumins@va.gov. Questions received after this date will not be answered.

Proposal Submittal

This requirement is being solicited using the procedures in FAR Parts 12 and 15.

Offers are to be submitted in two parts: 1) a non-price response consisting of the offeror’s technical proposal response and the offeror’s past performance proposal responses, and 2) a price response. Both responses are to be submitted together; however, the non-price and price responses shall be separated, by the offeror, into two severable parts. The pricing response shall consist of the signed Standard Form (SF) 1449 and completion of the Price Schedule and documents required by the solicitation. The non-price response shall address all non-price evaluation criteria. Proposals shall be submitted either electronically by e-mail to michael.cumins@va.gov, or hard copy by U.S. Postal Service or private delivery service to Dept. of Veterans Affairs, Network Contracting Office 15, Healthcare Branch, Attention Michael Cumins, 3450 S. 4th Street Trafficway, Leavenworth, Kansas 66048. Due to limitations of COVID19 Pandemic, Hand-carried submission may but utilized, but requires at least 2-hours notif ication by phone to Michael Cumins, (913) 946-1122 to arrange for hand-carry delivery at an agreed time to the address above. Facsimile submittal shall not be accepted. Internet hyperlinked versions shall not be accepted or accessed. Offeror signatures must be “wet-ink” fashion as VA does not recognize non-Government electronic/digital signatures.

• The offer shall include the name and address of the organization submitting the proposal(s), point(s) of contact to include e-mail address and phone number. The named point of contact shall have the authority to bind and make representations and certif ications on behalf of the offeror.

• The non-price response to the solicitation shall not have any reference to price. Price information must be limited to the price response which includes the SF 1449 and the price schedule.

• In order that each proposal be properly evaluated, it is required that each offeror respond to all items in the order as they appear in the evaluation criteria above. Proposals shall be organized with each section appropriately identified.

• As part of the offer package, the offeror shall state their current insurance status that meets the requirements of the solicitation’s requirements at C.10 - FAR 52.228-5 – Work on a Government Installation; C.11 – Supplemental Insurance Requirements; C.19 – VAAR 852.237-70 Indemnification and Medical Liability Insurance; and Section 2.7 requirement to provide for Workers’ compensation, 2) Professional Liability Insurance, status as –

(Check as applicable) Offeror:

___ Currently Holds insurance with coverage in the amounts meeting or exceeding the requirements of the clause, provided by: (include insurer’s statement of insurability, or ___ Have held the types of insurance and could acquire it again: (include an insurer’s statement of insurability), or ___ Has never held the types of insurance but am insurable for this type of insurance:

(include an insurer’s statement of insurability)

• The VA will not pay or reimburse for any cost(s) incurred in preparation and submission of a proposal.

The Government intends to award a single FP-IDIQ Contract award as a result of this solicitation.

Every precaution will be taken to safeguard non-price responses against disclosure to unauthorized persons. Any reference to price or cost within the non-price response shall be removed. The non-price response will be informally evaluated for completeness to ensure that all solicitation requirements are addressed.

Second (2nd) Replacement of Page 87 of 114 mailto:%20Michael.Cumins@va.gov

Replacement QASP Page 5 Page 7 of 8

14 Report preparation B.3 – 3.3., 4.3., 4.4.

Timeliness of reporting non-routine cases

STAT/emergency department diagnostic studies shall have final interpretations within one (1) hour from the time these diagnostic studies are made available to the contract radiologist for interpretation during normal weekday duty hours {8:00 AM-4:30 PM Monday-Friday).

At least 95% STAT/ emergency department diagnostic studies shall have final interpretations within one (1) hour from the time these diagnostic studies are made available to the contract radiologist for interpretation during normal weekday duty hours {8:00 AM-4:30 PM Monday-Friday).

Periodic Inspection Validated User/Customer Complaints

Intermittently

15 Report preparation B.3 – 3.3., 4.3., 4.4.

Timeliness of reporting in-patient cases

Routine inpatient exams shall be given priority over outpatient exams and shall have final interpretations within four (4) hours from the time these diagnostic studies are made available to the contract radiologist for interpretation during normal weekday duty hours {8:00 AM-4:30 PM Monday-Friday).

At least 95% of routine inpatient exams shall have final interpretations within four (4) hours from the time these diagnostic studies are made available to the contract radiologist for interpretation during normal weekday duty hours {8:00 AM-4:30 PM Monday- Friday).

Periodic Inspection Validated User/Customer Complaints

Intermittently

16 Report preparation B.3 – 3.3., 4.3., 4.4., 6.1.

Timeliness of reporting routine cases It is expected that most routine outpatient diagnostic exams obtained during weekday duty hours will have final interpretations by midnight the same day.

At least 90% of routine outpatient diagnostic exams obtained during weekday duty hours will have final interpretations by midnight the same day and 100% of exams will have final interpretations within 48 hours (excluding weekends/holidays).

Periodic Inspection Intermittently

17 Report preparation B.3 – 4.3., 4.4., 6.1.

Timeliness of reporting interventional radiology cases

It is expected that most interventional radiology cases obtained at any time will have final interpretations within 48 hours of the exam.

At least 90% of interventional radiology exams obtained at any time will have final interpretations within 48 hours of the exam.

Periodic Inspection Intermittently

18 Electronic Health Record (EHR)

B.3 – 1.5., 4.3., 4.4., 6.1.

Adequacy of reporting in EHR Patients requiring hospitalization for an interventional radiology complication require an initial EHR note detailing the procedure, any complications, hand-off, and plan;

as well as daily notes (excluding weekends/holidays) until the complication is successfully managed.

100% of patients requiring hospitalization for an interventional radiology complication require an initial EHR note detailing the procedure, complication, hand-off, and plan; as well as daily notes (excluding weekends/holidays) until the complication is successfully managed.

Validated User/Customer Complaints

Intermittently

19 Electronic Health Record (EHR)

B.3 – 1.5., 4.3., 4.4., 6.1.

EHR alert management It is expected that each contractor physician review EHR alerts, each time they work at the RJD VA. No alerts shall be over 30 days old.

Furthermore, they must maintain access to the EHR by logging in at least once every 30 days.

At least 95% compliance with no alerts greater than 30 days, and at least 95% compliance with maintaining EHR access.

Periodic Inspection Validated User/Customer Complaints

Intermittently

Quality Assurance Surveillance Plan (QASP)

CPAR RATINGS ASSIGNED TO QASP ITEMS:

Metrics and methods are designed to determine rating for a given standard and acceptable quality level.

The following ratings shall be used (Reference: CPARS User Manual https://www.cpars.gov/help.htm Guides option):

EXCEPTIONAL: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified.

VERY GOOD:

Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also there should have been NO significant weaknesses identified.

SATISFACTORY:

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also there should have been NO significant weaknesses identified.

MARGINAL:

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g. Management, Quality, Safety or Environmental Deficiency Report or letter).

UNSATISFACTORY:

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Note: To justify an Unsatisfactory rating, you should identify multiple significant events in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT.

However, a singular problem could be of such serious magnitude that it alone constitutes an unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the contractor of the contractual deficiencies (e.g. Management, Quality, Safety or Environmental Deficiency Reports, or letters).

Replacement QASP Page 6 https://www.cpars.gov/help.htm