36C25623R0079 0005.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 4

4/16/2024

MSO-2024-COM-0004

36C598

Department of Veterans Affairs

Network Contracting Office 16

Central Arkansas Veterans HCS

2200 Fort Roots Drive, Bldg 41, Room 200

North Little Rock AR 72114 1706

36C598

Department of Veterans Affairs

Network Contracting Office 16

Central Arkansas Veterans HCS

2200 Fort Roots Drive, Bldg 41, Room 200

North Little Rock AR 72114 1706

To all Offerors/Bidders

36C25623R0079

X

X X

See CONTINUATION Page

The purpose of this amendment is to answer follow-up questions to Amendment 0003. Proposals are due as indicated in amendment 0004 by 15 May 2024 at 3PM Central Time Zone.

The answers to questions of this amendment revises the original solicitation as stated on pages 2-4 of this Amendment.

All other terms and conditions remain unchanged.

Thomas M. Kovarovic

Contracting Officer

Question 10 from Amendment 0003: Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award?

Answer from Amendment 0003: In order for the new Contract to count the vesting visit, the

Veteran would have to have a visit scheduled and attended with the new Contractor. Once an establishment of care appointment is completed, the new Contractor will inherit the patient and be allowed to bill.

Question: This answer is not a standard practice. From our experience the incumbent vendor is allowed to bill for all assigned veterans on day one. Can this be revised? This puts considerable risk on SDVOSBs.

Answer: In order for the new Contractor to count the vesting visit, the Veteran would have to have completed a visit within the past year. For Veterans who have not been seen within 12 months, in order for the new Contractor to count the vesting visit, those Veterans would need to have a visit scheduled and attended with the new Contractor. Once an establishment of care appointment is completed, the new Contractor will inherit the patient and be allowed to bill.

Question 5 from Amendment 0003 Pg. 23: Would the VA consider removing the requirement to provide proof of proposed lease with the landlord (page 223)? This requirement gives an advantage to the incumbent.

Due to the months-long proposal pendency period for CBOCs, landlords are generally unwilling to commit to lease terms so far in advance.

Answer from Amendment 0003: Anyone submitting a proposal should either own the property they are proposing or have some written agreement either in place or ready to put in place if the property is selected.

Question: "Ready to put in place" is not the same thing as being able to provide "proof of proposed lease". Can the government clarify if we need “proof of a lease” or “ready to put in place.”

Answer: Please provide documentation showing either proof or intent to lease or own the proposed property. This documentation may include, but are not limited to, written agreements, letters of intent, proposed leases, email agreements, communication logs (emails, texts, letters), witness statements, etc.

Question: Can the government please extend the submission deadline by 30 calendar days?

Answer: Amendment 0004 revised the due date for proposals. See Amendment 0004 for details.

Question: Will the Government provide a list of all medications that are to be provided by the

Contractor and the amounts that have been administered in the clinic? The Government's response was yes, but then didn't provide the information.

Answer: Vaccines are listed below and The VA does not have visibility of medications supplied by the contractor. The contractor is responsible for providing the medications necessary to treat patients. Reference 4.8.1 Prescription Fulfillment of the Performance Work Statement states that “The Contractor will provide all medications that are to be administered to patients in the clinic (including any necessary vaccines).. A list of medications will not be provided.”

ImmunizationName Count of Immunization s

COVID-19 (MODERNA), MRNA, LNP-S, BIVALENT, PF, 50 MCG/0.5

ML OR 25MCG/0.25 ML DOSE

COVID-19 (MODERNA), MRNA, LNP-S, PF, 50 MCG/0.5 ML (AGES

12+ YEARS)

HEP B, ADULT 8

INFLUENZA, HIGH-DOSE, QUADRIVALENT 194

INFLUENZA, INJECTABLE, QUADRIVALENT, PRESERVATIVE

FREE

PNEUMOCOCCAL CONJUGATE PCV20, POLYSACCHARIDE

CRM197 CONJUGATE, ADJUVANT, PF

PNEUMOCOCCAL POLYSACCHARIDE PPV23 4

RSV, BIVALENT, PROTEIN SUBUNIT RSVPREF, DILUENT

RECONSTITUTED, 0.5 ML, PF

RSV, RECOMBINANT, PROTEIN SUBUNIT RSVPREF, ADJUVANT

RECONSTITUTED, 0.5 ML, PF

TD (ADULT), 2 LF TETANUS TOXOID, PRESERVATIVE FREE,

ADSORBED

TD (ADULT), 5 LF TETANUS TOXOID, PRESERVATIVE FREE,

TDAP 135

ZOSTER RECOMBINANT 216

Grand Total 904

HAR immunizations FY23

ImmunizationName Count of Immunization s

COVID-19 (MODERNA), MRNA, LNP-S, BIVALENT, PF, 50 MCG/0.5

ML OR 25MCG/0.25 ML DOSE

COVID-19 (MODERNA), MRNA, LNP-S, PF, 100 MCG/0.5ML DOSE

OR 50 MCG/0.25ML DOSE

HEP A, ADULT 1

HEP B, ADULT 8

INFLUENZA VACCINE, QUADRIVALENT, ADJUVANTED 15

INFLUENZA, HIGH-DOSE, QUADRIVALENT 78

INFLUENZA, INJECTABLE, QUADRIVALENT 10

INFLUENZA, INJECTABLE, QUADRIVALENT, PRESERVATIVE

FREE

PNEUMOCOCCAL CONJUGATE PCV20, POLYSACCHARIDE

CRM197 CONJUGATE, ADJUVANT, PF

PNEUMOCOCCAL POLYSACCHARIDE PPV23 3

TD (ADULT), 2 LF TETANUS TOXOID, PRESERVATIVE FREE,

TD (ADULT), 5 LF TETANUS TOXOID, PRESERVATIVE FREE,

TDAP 83

ZOSTER RECOMBINANT 154

Grand Total 483

Question 10 from Amendment 0003: Will the new Contractor inherit the patients’ last vesting visit and be allowed to bill for one year from the date upon contract award? Answer: In order for the new contract to count the vesting visit, the Veteran would have to have a visit scheduled and attended with the new contractor. Once an establishment of care appointment is completed, the new contractor will inherit the patient and be allowed to bill.

Answer to Question 10 from Amendment 0003: indicates the new Contractor will not be able to bill the PMPM rate for any Veteran until they have a visit scheduled and attended with the new Contractor. Not being able to bill the PMPM rate until after the visit significantly impacts a small business, and not the norm utilized by all other VAMCs. Is it the VA’s intent to provide episodic care for Veterans at a different location while the new Contractor schedules and sees every enrolled patient prior to being able to bill for that patient?

Answer: In order for the new Contractor to count the vesting visit, the Veteran would have to have completed a visit within the past year. For Veterans who have not been seen within 12 months, in order for the new Contractor to count the vesting visit, those Veterans would need to have a visit scheduled and attended with the new Contractor. Once an establishment of care appointment is completed, the new Contractor will inherit the patient and be allowed to bill.