36C25623R0018 0002.pdf

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 6

MSO-2023-COM-0002

Department of Veterans Affairs

NCO 16

Central Arkansas Veterans HCS

2200 Fort Roots Drive, Bldg 41, Room 200

North Little Rock AR 72114 1706

Department of Veterans Affairs

NCO 16

Central Arkansas Veterans HCS

2200 Fort Roots Drive, Bldg 41, Room 200

North Little Rock AR 72114 1706

To all Offerors/Bidders

36C25623R0018

X

X

X 1

The purpose of this amendment is to answer all questions that were submitted before the due date of 16 November 2022.

This amendment also revises 2.7 of the Performance Work Statement on page 18 of the solicitation as stated in the attached pages.

All other terms and conditions remain unchanged.

Billy Morris

Contracting Officer

Questions for Pulmonologist Requirement

1. Are they requiring 2 Pulmonologists, one for nights and one for days? Will they work 7 on / 7 off? Yes

2. How many beds are in the ICU? 10 ICU, 10 Stepdown. It’s a closed and combined Med-Surg ICU

3. What support staff is available? One mid-level in day-time weekdays, Fee-basis hospitalist on weekends, Tele-ICU 24/7

4. Do you have residents? Nurse Practitioners / PA’s? NPs

5. Is there a hospitalist attending as Primary in ICU or closed ICU unit with ICU attending covering ICU? Closed Unit with ICU attending in charge

6. What is the average daily census? 8 ICU 4 Step down

7. What are the average admissions and discharges per day? 3

8. How far in advance are the schedules confirmed? 1 month-6 months

9. Is this a new requirement or an existing requirement? This is an existing requirement.

10. How many incumbents are there performing this work? Ghost RX is the current contractor providing the two Pulmonologists.

11. What are the incumbent names, contract #s, and revenues received under the incumbent contract? The contractor is Ghost RX and the Contract Number is V797D40232 36C25621F0164. We will not reveal the contractor’s revenues.

12. How many FTEs were on the previous contract? Has the PWS Changed? There were 2 FTE and the requirement/PWS has not changed

13. What did you like about the previous contract? Dislikes? We do not provide that information to competing contractors.

14. What are your KPIs? The medical service stated that PKIs are not relevant to this requirement and that they do not provide that information for solicitations.

15. If we have a teaming agreement with a subcontractor, does the subcontractor's experience count as experience for the prime? The past performance of the prime contractor will be looked at as more important than the past performance of a sub-contractor, but we will take their past performance into consideration.

16. Does the Pulmonologist also need to be Board Certified or Eligible in Critical Care as well? Yes. Is the schedule 7 on/off ? Yes

17. Will one Pulmonologist be working 7 day shifts while the other simultaneously works 7 nights? Yes, if possible or can do shifts at different weeks.

18. How many patients per day on average during the day shift? 10 bed ICU, 10 bed SD, 3-

4 new admits/day Night shift? Same but 1-2 admits

19. How many other Pulmonologists will they be working with during the day shift? 0-1 Night shift? 0

20. What other support staff is available during the day shift? Mid-level Night shift? Tele-

ICU

21. Do you accept physicians who are board certified only in pulmonary or only in critical care OR are you looking for both Pulmonary and Critical care double board-certified physicians? Board eligible or Board certified but in both

22. Work schedule is confusing in SOW. Do they work 12 hours (7a-7p) per day in a week on and off model? Will there be any night shift or call responsibilities? 12-hour shifts;

Both in day and nights; can be worked in blocs for example 7 day shifts or 7 night shifts. Can’t do 24-hour shifts.

23. Do they work only in ICU and In-patient? Are there any clinic responsibilities? ICU, Stepdown, ED consults, Inpatient pulmonary and critical care consults. No clinic.

24. How many contracted physicians are working currently? Two

25. How many patients per day are seen by each provider in ICU / Clinic / Floors? ICU is a

10 bed unit; Stepdown is 10 beds as well. No patient responsibility on floors.

26. I request to change the NAICS code back to originally published 621111 - offices of physicians which is more appropriate. GSA schedule for physicians is also named as

621 schedule (derived from 621 NAICS code) We will be keeping 561320 as the

NAICS Code as it will open the requirement up for more competition due to the small business size standard.

27. From the Statement of work: “Services shall be provided for the period from 1 January

2023 through 31 December 2027 with 14 days of coverage per month in 12-hour blocks from Sunday – Saturday, 7:00 a.m. to 7:00 p.m. and 7:00 p.m. to 7:00 a.m.” Can you clarify is this 14-day blocks of 24 hours of coverage and then 14 days of no coverage?

Or will the coverage be changing as needed? We need 14 days covered every month. They can be in shorter time blocks of say 7 shifts in one go or 10 or any other number thereof. Every month we need 28 twelve-hour shifts covered.

28. Technical Proposal Format

1. Is there a page limit for the technical proposal? No page limits. Ensure that you follow the instructions in E.2 ADDENDUM TO 52.212-1

INSTRUCTIONS TO OFFERORS—COMMERCIAL SERVICES starting on page 81.

2. Does the Technical Proposal page limit include the following:

a. Candidate resumes/evidence/proof of experience No page limits.

Ensure that you follow the instructions in E.2 ADDENDUM TO

52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

SERVICES starting on page 81.

b. Certifications/licensure documents No page limits. Ensure that you follow the instructions in E.2 ADDENDUM TO 52.212-1

INSTRUCTIONS TO OFFERORS—COMMERCIAL SERVICES

starting on page 81.

c. Evidence/documentation of full and unrestricted licenses to practice medicine in the United States No page limits. Ensure that you follow the instructions in E.2 ADDENDUM TO 52.212-1 INSTRUCTIONS TO

OFFERORS—COMMERCIAL SERVICES starting on page 81.

d. Copies of insurance certificate - professional liability No page limits.

Ensure that you follow the instructions in E.2 ADDENDUM TO

52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

SERVICES starting on page 81.

3. What is Font and Font size requirement for the technical proposal? There is no specified font size. Ensure that you follow the instructions in E.2

ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

SERVICES starting on page 81.

4. Is there a specific font size for proposal graphics? There is no specified font size. Ensure that you follow the instructions in E.2 ADDENDUM TO

52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL SERVICES

starting on page 81.

5. Will the Table of Contents be counted in the page limit for the technical proposal? No page limits. Ensure that you follow the instructions in E.2

ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

SERVICES starting on page 81.

6. What are the margin requirements for the Technical Proposal? There is no margin requirement. Ensure that you follow the instructions in E.2

ADDENDUM TO 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

SERVICES starting on page 81.

Past Performance:

1. If a contractor has past performance placing and managing ER physicians, will this type of past performance qualify as a similar Contract requirement as listed in the solicitation? It could be considered similar if the complexity, dollar value, and period of performance are also similar but past performance placing and managing Board Certified or Board Eligible Pulmonologists may receive a higher confidence rating.

2. Must all past performance be from the Prime contractor, or can some of the past performance be from the subcontractor? Past performance from a sub-contractor may be submitted but the past performance of the prime contractor will be looked at as more relevant and will have more influence on the confidence rating.

3. Will the past performance from a subcontractor be evaluated the same as past performance provided by the prime? The past performance of the prime contractor will be looked at as more relevant and will have more influence on the confidence rating.

Incumbent Information

1. What is the name of the incumbent company? Ghost RX, Inc.

2. What is the current contract value for the incumbent contract? $2,574,720.00

3. Is the incumbent eligible to submit an offer for this requirement? Yes

4. If there are incumbent providers, is it the government’s intent to retain the providers currently providing services: The award goes to the contractor. Not the providers. We will award based on the evaluation factors of Past

Performance, Technical Capability/Experience, and Price.

Candidate Qualifications

1. Will the government accept a trade-off from Board Eligible/Board Certified

Pulmonologist to Board Eligible/Board Certified Internal Medicine Physician with Critical Care/Pulmonary experience? It is not in the veterans’ best interest to compromise on the requested qualifications. We want Board eligibility in Pulmonary and Critical care to be the minimum standard.

In section 2.7. No Employee status: The contractor shall be responsible for protecting the contract physician(s) furnishing services. To carry out this responsibility, the contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation: QUESTION: If provider is 1099 and/or corp-to-corp and carries their workers compensation, will that suffice? Yes. The intent is to ensure that it is understood that the Veterans Administration will not be responsible for these items and that it is the contractor’s responsibility to ensure that the provider is covered. The Contractor is responsible for complying with all applicable federal and state employment laws.

2.7.3 Health examinations: QUESTION: If the provider is 1099 and/or corp-to-corp and carries and takes care of their own health examinations will the agency accept their own health report/immunization records? Yes. The intent is to ensure that it is understood that the Veterans Administration will not be responsible for these items and that it is the contractor’s responsibility to ensure that the provider is covered. The Contractor is responsible for complying with all applicable federal and state employment laws.

2.7.4 Income tax withholding: QUESTION: If provider is 1099 and/or corp-to-corp will the agency accept self-certification from providers on tax withholdings and social security payments? Yes. The intent is to ensure that it is understood that the

Veterans Administration will not be responsible for these items and that it is the contractor’s responsibility to ensure that the provider is covered. The Contractor is responsible for complying with all applicable federal and state employment laws.

2.7.5 Social security payments: QUESTION: If the provider is 1099 and/or corp-to-corp will the agency accept self-certification from providers on tax withholding and social security payments? Yes. The intent is to ensure that it is understood that the

Veterans Administration will not be responsible for these items and that it is the contractor’s responsibility to ensure that the provider is covered. The Contractor is responsible for complying with all applicable federal and state employment laws.

QUESTION: For pay structure is their premium pay for excess hours over 40 hours worked? There isn’t any Premium pay

Section 4.4.3.2 QUESTION: Are mandatory meetings/training paid at the hourly rate? Yes

Section C.11 Supplemental Insurance Requirements

Workers’ compensation and employers’ liability: Contractors are required to comply with applicable Federal and State workers compensation and occupational disease statutes. If occupational diseases are not compensable under those statues, they shall be covered under the employer’s liability section of the insurance policy, except when contract operations are so commingled with a contractor’ commercial operations that it would not be practical to require this coverage. Employer’s liability coverage of at least

$100,000 is required, except in states with exclusive or monopolistic funds that do not permit workers’ compensation to be written by private carriers. QUESTION: If provider is 1099 and/or corp-to-corp will the agency accept self-certification from providers?

The intent is to ensure that it is understood that the Veterans Administration will not be responsible for these items and that it is the contractor’s responsibility to ensure that the provider is covered. The Contractor is responsible for complying with all applicable federal and state employment laws.

C.12 52.232-19 Availability of funds for the next fiscal year (APR 1984)

Funds are not presently available for performance under this contract beyond

September 30th of any year. The Government’s obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the

Government for any payment may arise for performance under this contract beyond

September 30th, until funds are made available to the contracting officer for performance and until the contractor receives notice of availability, to be confirmed in writing by the contracting officer. QUESTION: Will the contractor be notified prior to scheduling/PO’s if there are no funds? How much notice will the contractor receive, if any at all? As soon as we know we will inform the contractor. It is very rare that these medical service contracts do not get funded.

This Amendment also changes the verbiage at 2.7 on page 18 of the Performance Work

Statement from:

“No Employee status: The Contractor shall be responsible for protecting Contractor’s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:”

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

To:

“No Employee status: The Contractor shall be responsible for protecting Contractor’s physician(s) furnishing services. Contractor is responsible for complying with all applicable federal and state employment laws and regulations including but not limited to”

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.