36C26125Q0147.docx
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- R612--Insurance Discovery for the San Francisco Veterans Affairs Health Care System (SFVAHCS)
- Solicitation number
- 36C26125Q0147
About this file
This is a Request for Quote (RFQ) issued by the VA Pacific Islands Health Care System seeking Insurance Discovery Services for the San Francisco VA Health Care System (SFVAHCS). The solicitation requires a contractor to provide insurance discovery software and one part-time employee (20 hours/week) to identify active, inactive, and potentially eligible insurance coverage for VA beneficiaries through Medicaid, Medicare, and other health insurance programs. The contract includes a base period from February 1, 2025 to January 31, 2026, with four one-year option periods through January 31, 2030.
The solicitation is a 100% set-aside for small businesses under NAICS code 524298 (All Other Insurance Related Activities) with a size standard of $30.5 million. Responses are due by January 15, 2025 at 10:00 AM PST. The contractor must provide on-site services Tuesday through Friday from 9:00 AM to 2:30 PM at the San Francisco VA Medical Center, with ad hoc telework capability. Key requirements include conducting beneficiary screening, researching coverage options, assisting with application processes, providing weekly status updates, and maintaining HIPAA compliance through a Business Associate Agreement. The contractor is prohibited from billing insurance companies or taking billing actions on behalf of VA.
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Other files
| File | Type | Posted |
|---|---|---|
| Insurance Discovery Workflow.pdf | ||
| WD 2015-5637 Rev 27 dated 7-22-2024.pdf | ||
| SOP Insurance Discovery.docx | DOCX document |
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36C26125Q0147
PAGE 1 OF
1. REQUISITION NO.
2. CONTRACT NO.
3. AWARD/EFFECTIVE DATE
4. ORDER NO.
5. SOLICITATION NUMBER
6. SOLICITATION ISSUE DATE
a. NAME
b. TELEPHONE NO. (No Collect Calls)
8. OFFER DUE
DATE/LOCAL
TIME
9. ISSUED BY
CODE
10. THIS ACQUISITION IS
UNRESTRICTED OR
SET ASIDE:
% FOR:
SMALL BUSINESS
HUBZONE SMALL
BUSINESS
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
WOMEN-OWNED SMALL BUSINESS
(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED
SMALL BUSINESS PROGRAM
EDWOSB
8(A)
NAICS:
SIZE STANDARD:
11. DELIVERY FOR FOB DESTINA-
TION UNLESS BLOCK IS
MARKED
SEE SCHEDULE
12. DISCOUNT TERMS
13a. THIS CONTRACT IS A
RATED ORDER UNDER
DPAS (15 CFR 700)
13b. RATING
14. METHOD OF SOLICITATION
RFQ
IFB
RFP
15. DELIVER TO
CODE
16. ADMINISTERED BY
CODE
17a. CONTRACTOR/OFFEROR
CODE
FACILITY CODE
18a.
PAYMENT WILL BE MADE BY
CODE
TELEPHONE NO.
UEI:
EFT:
PHONE:
FAX:
17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED
SEE
ADDENDUM
19.
20.
21.
22.
23.
24.
ITEM NO.
SCHEDULE OF SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
(Use Reverse and/or Attach Additional Sheets as Necessary)
25. ACCOUNTING AND APPROPRIATION DATA
26.
TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA
ARE
ARE NOT ATTACHED.
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA
ARE
ARE NOT ATTACHED
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________
29. AWARD OF CONTRACT: REF. ___________________________________ OFFER
COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND
DATED ________________________________. YOUR OFFER ON SOLICITATION
DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY
(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE
ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED
SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:
30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED
AUTHORIZED FOR LOCAL REPRODUCTION
(REV. NOV 2021)
PREVIOUS EDITION IS NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.212
7. FOR SOLICITATION
INFORMATION CALL:
STANDARD FORM 1449
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL
PRODUCTS AND COMMERCIAL SERVICES
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
662-25-2-5075-0004 36C26125Q0147 12-30-2024 Angela Gerlitzki 808-539-1307 01-15-2025
10:00 AM
PST
Department of Veterans Affairs Network Contracting Office 21 (NCO 21) VA Pacific Islands Health Care System 711 Kapiolani Blvd Suite 200 Honolulu HI 96813 X X 524298 $30.5 Million N/A X "See Performance Work Statement"
Department of Veterans Affairs Network Contracting Office 21 (NCO 21) VA Pacific Islands Health Care System Kapiolani Blvd Suite 200 Honolulu HI 96813
Department of Veterans Affairs FMS VA-9(101) Financial Services Center PO Box 149971 Austin TX 78714-9971 866-372-1141 See CONTINUATION Page Insurance Discovery Services for the San Francisco Veterans Affairs Health Care System (SFVAHCS) in accordance with the Performance Work Statement (PWS).
Offerors shall follow the submission instructions specified in FAR Provisions 52.212-1 and 52.212-2, and any addendums included in this solicitation. Failure to follow the instructions will result in an unfavorable evaluation and may not be considered for award.
See CONTINUATION Page X Angela Gerlitzki Contracting Officer Table of Contents
| SECTION A | 1 |
| A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES | 1 |
| SECTION B - CONTINUATION OF SF 1449 BLOCKS | 4 |
| B.1 CONTRACT ADMINISTRATION DATA | 4 |
| B.2 IT CONTRACT SECURITY | 5 |
| B.3 PRICE/COST SCHEDULE | 15 |
| ITEM INFORMATION | 15 |
| B.4 Performance Work Statement | 19 |
| SECTION C - CONTRACT CLAUSES | 27 |
| C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2023) | 27 |
| C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 32 |
| C.3 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS (NOV 2021) | 33 |
| C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) | 35 |
| C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) | 35 |
| C.6 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997) | 35 |
| C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS | 36 |
| C.8 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022) | 36 |
| C.9 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018) | 36 |
| C.10 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY (FEB 2023) | 37 |
| C.11 VAAR 852.211-76 LIQUIDATED DAMAGES – REIMBURSEMENT FOR DATA BREACH COSTS (FEB 2023) ALTERNATE I (FEB 2023) | 46 |
| C.12 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-OWNED SMALL BUSINESS EVALUATION FACTORS (JAN 2023) (DEVIATION) | 47 |
| C.13 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019) | 47 |
| C.14 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018) | 48 |
| C.15 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) | 49 |
| C.16 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2024) | 49 |
| SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS | 58 |
| SECTION E - SOLICITATION PROVISIONS | 59 |
| E.1 52.201-1 ACQUISITION 360: VOLUNTARY SURVEY (SEP 2023) | 59 |
| E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) | 59 |
| E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021) | 62 |
| E.4 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT ORDERS—REPRESENTATION AND DISCLOSURES (DEC 2023) | 65 |
| E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018) | 66 |
| E.6 52.216-1 TYPE OF CONTRACT (APR 1984) | 67 |
| E.7 52.233-2 SERVICE OF PROTEST (SEP 2006) | 67 |
| E.8 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION (OCT 2018) | 68 |
| E.9 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018) | 68 |
| E.10 VAAR 852.239-75 INFORMATION AND COMMUNICATION TECHNOLOGY ACCESSIBILITY NOTICE (FEB 2023) | 68 |
| E.11 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021) | 69 |
| E.12 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2024) | 71 |
36C26125Q0147
Page 1 of Page 1 of
SECTION B - CONTINUATION OF SF 1449 BLOCKS
B.1 CONTRACT ADMINISTRATION DATA
1. Contract Administration: All contract administration matters will be handled by the following individuals:
a. CONTRACTOR:
b. GOVERNMENT:
Department of Veterans Affairs Network Contracting Office (NCO) 21
2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:
| [X] |
| 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or |
| [] |
| 52.232-36, Payment by Third Party |
3. INVOICES: Invoices shall be submitted in arrears:
| a. Quarterly | [] |
| b. Semi-Annually | [] |
| c. Other | [X] Monthly in Arrears |
4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.
ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:
| AMENDMENT NO |
| DATE |
B.2 IT CONTRACT SECURITY
VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY
1. GENERAL
Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.
2. ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS
a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.
b. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.
c. Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness.
d. Custom software development and outsourced operations must be located in the U.S. to the maximum extent practical. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandates, the contractor/subcontractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by VA, specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor.
e. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor's employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination.
3. VA INFORMATION CUSTODIAL LANGUAGE
a. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).
b. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor's information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA's information is returned to the VA or destroyed in accordance with VA's sanitization requirements. VA reserves the right to conduct on site inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.
c. Prior to termination or completion of this contract, contractor/ subcontractor must not destroy information received from VA, or gathered/ created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300, Records and Information Management and its Handbook 6300.1 Records Management Procedures, applicable VA Records Control Schedules, and VA Handbook 6500.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.
d. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.
e. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.
f. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.
g. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.
h. The contractor/subcontractor must store, transport, or transmit VA sensitive information in an encrypted form, using VA-approved encryption tools that are, at a minimum, FIPS 140-2 validated.
i. The contractor/subcontractor's firewall and Web services security controls, if applicable, shall meet or exceed VA's minimum requirements. VA Configuration Guidelines are available upon request.
j. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA's prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.
k. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor is in receipt of a court order or other requests for the above mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response.
l. For service that involves the storage, generating, transmitting, or exchanging of VA sensitive information but does not require C&A or an MOU-ISA for system interconnection, the contractor/subcontractor must complete a Contractor Security Control Assessment (CSCA) on a yearly basis and provide it to the COR.
4. INFORMATION SYSTEM DESIGN AND DEVELOPMENT
a. Information systems that are designed or developed for or on behalf of VA at non-VA facilities shall comply with all VA directives developed in accordance with FISMA, HIPAA, NIST, and related VA security and privacy control requirements for Federal information systems. This includes standards for the protection of electronic PHI, outlined in 45 C.F.R. Part 164, Subpart C, information and system security categorization level designations in accordance with FIPS 199 and FIPS 200 with implementation of all baseline security controls commensurate with the FIPS 199 system security categorization (reference Appendix D of VA Handbook 6500, VA Information Security Program). During the development cycle a Privacy Impact Assessment (PIA) must be completed, provided to the COR, and approved by the VA Privacy Service in accordance with Directive 6507, VA Privacy Impact Assessment.
b. The contractor/subcontractor shall certify to the COR that applications are fully functional and operate correctly as intended on systems using the VA Federal Desktop Core Configuration (FDCC), and the common security configuration guidelines provided by NIST or the VA. This includes Internet Explorer 7 configured to operate on Windows XP and Vista (in Protected Mode on Vista) and future versions, as required.
c. The standard installation, operation, maintenance, updating, and patching of software shall not alter the configuration settings from the VA approved and FDCC configuration. Information technology staff must also use the Windows Installer Service for installation to the default "program files" directory and silently install and uninstall.
d. Applications designed for normal end users shall run in the standard user context without elevated system administration privileges.
e. The security controls must be designed, developed, approved by VA, and implemented in accordance with the provisions of VA security system development life cycle as outlined in NIST Special Publication 800-37, Guide for Applying the Risk Management Framework to Federal Information Systems, VA Handbook 6500, Information Security Program and VA Handbook 6500.5, Incorporating Security and Privacy in System Development Lifecycle.
f. The contractor/subcontractor is required to design, develop, or operate a System of Records Notice (SOR) on individuals to accomplish an agency function subject to the Privacy Act of 1974, (as amended), Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations. Violation of the Privacy Act may involve the imposition of criminal and civil penalties.
g. The contractor/subcontractor agrees to:
(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies:
(a) The Systems of Records (SOR); and
(b) The design, development, or operation work that the contractor/ subcontractor is to perform;
(1) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the proposed subcontract requires the redesign, development, or operation of a SOR on individuals that is subject to the Privacy Act; and
(2) Include this Privacy Act clause, including this subparagraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a SOR.
h. In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a SOR on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a SOR on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a SOR on individuals to accomplish an agency function, the contractor/subcontractor is considered to be an employee of the agency.
(1) "Operation of a System of Records" means performance of any of the activities associated with maintaining the SOR, including the collection, use, maintenance, and dissemination of records.
(2) "Record" means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and contains the person's name, or identifying number, symbol, or any other identifying particular assigned to the individual, such as a fingerprint or voiceprint, or a photograph.
(3) "System of Records" means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual.
i. The vendor shall ensure the security of all procured or developed systems and technologies, including their subcomponents (hereinafter referred to as "Systems"), throughout the life of this contract and any extension, warranty, or maintenance periods. This includes, but is not limited to workarounds, patches, hotfixes, upgrades, and any physical components (hereafter referred to as Security Fixes) which may be necessary to fix all security vulnerabilities published or known to the vendor anywhere in the Systems, including Operating Systems and firmware. The vendor shall ensure that Security Fixes shall not negatively impact the Systems.
j. The vendor shall notify VA within 24 hours of the discovery or disclosure of successful exploits of the vulnerability which can compromise the security of the Systems (including the confidentiality or integrity of its data and operations, or the availability of the system). Such issues shall be remediated as quickly as is practical, but in no event longer than days.
k. When the Security Fixes involve installing third party patches (such as Microsoft OS patches or Adobe Acrobat), the vendor will provide written notice to the VA that the patch has been validated as not affecting the Systems within 10 working days. When the vendor is responsible for operations or maintenance of the Systems, they shall apply the Security Fixes within days.
l. All other vulnerabilities shall be remediated as specified in this paragraph in a timely manner based on risk, but within 60 days of discovery or disclosure. Exceptions to this paragraph (e.g. for the convenience of VA) shall only be granted with approval of the contracting officer and the VA Assistant Secretary for Office of Information and Technology.
5. INFORMATION SYSTEM HOSTING, OPERATION, MAINTENANCE, OR USE
a. For information systems that are hosted, operated, maintained, or used on behalf of VA at non-VA facilities, contractors/subcontractors are fully responsible and accountable for ensuring compliance with all HIPAA, Privacy Act, FISMA, NIST, FIPS, and VA security and privacy directives and handbooks. This includes conducting compliant risk assessments, routine vulnerablity scanning, system patching and change management procedures, and the completion of an acceptable contingency plan for each system. The contractor's security control procedures must be equivalent, to those procedures used to secure VA systems. A Privacy Impact Assessment (PIA) must also be provided to the COR and approved by VA Privacy Service prior to operational approval. All external Internet connections to VA's network involving VA information must be reviewed and approved by VA prior to implementation.
b. Adequate security controls for collecting, processing, transmitting, and storing of Personally Identifiable Information (PII), as determined by the VA Privacy Service, must be in place, tested, and approved by VA prior to hosting, operation, maintenance, or use of the information system, or systems by or on behalf of VA. These security controls are to be assessed and stated within the PIA and if these controls are determined not to be in place, or inadequate, a Plan of Action and Milestones (POA&M) must be submitted and approved prior to the collection of PII.
c. Outsourcing (contractor facility, contractor equipment or contractor staff) of systems or network operations, telecommunications services, or other managed services requires certification and accreditation (authorization) (C&A) of the contractor's systems in accordance with VA Handbook 6500.3, Certification and Accreditation and/or the VA OCS Certification Program Office. Government- owned (government facility or government equipment) contractor-operated systems, third party or business partner networks require memorandums of understanding and interconnection agreements (MOU-ISA) which detail what data types are shared, who has access, and the appropriate level of security controls for all systems connected to VA networks.
d. The contractor/subcontractor's system must adhere to all FISMA, FIPS, and NIST standards related to the annual FISMA security controls assessment and review and update the PIA. Any deficiencies noted during this assessment must be provided to the VA contracting officer and the ISO for entry into VA's POA&M management process. The contractor/subcontractor must use VA's POA&M process to document planned remedial actions to address any deficiencies in information security policies, procedures, and practices, and the completion of those activities. Security deficiencies must be corrected within the timeframes approved by the government. Contractor/subcontractor procedures are subject to periodic, unannounced assessments by VA officials, including the VA Office of Inspector General. The physical security aspects associated with contractor/ subcontractor activities must also be subject to such assessments. If major changes to the system occur that may affect the privacy or security of the data or the system, the C&A of the system may need to be reviewed, retested and re- authorized per VA Handbook 6500.3. This may require reviewing and updating all of the documentation (PIA, System Security Plan, Contingency Plan). The Certification Program Office can provide guidance on whether a new C&A would be necessary.
e. The contractor/subcontractor must conduct an annual self assessment on all systems and outsourced services as required. Both hard copy and electronic copies of the assessment must be provided to the COR. The government reserves the right to conduct such an assessment using government personnel or another contractor/subcontractor. The contractor/subcontractor must take appropriate and timely action (this can be specified in the contract) to correct or mitigate any weaknesses discovered during such testing, generally at no additional cost.
f. VA prohibits the installation and use of personally-owned or contractor/ subcontractor-owned equipment or software on VA's network. If non-VA owned equipment must be used to fulfill the requirements of a contract, it must be stated in the service agreement, SOW or contract. All of the security controls required for government furnished equipment (GFE) must be utilized in approved other equipment (OE) and must be funded by the owner of the equipment. All remote systems must be equipped with, and use, a VA-approved antivirus (AV) software and a personal (host-based or enclave based) firewall that is configured with a VA-approved configuration. Software must be kept current, including all critical updates and patches. Owners of approved OE are responsible for providing and maintaining the anti-viral software and the firewall on the non-VA owned OE.
g. All electronic storage media used on non-VA leased or non-VA owned IT equipment that is used to store, process, or access VA information must be handled in adherence with VA Handbook 6500.1, Electronic Media Sanitization upon: (i) completion or termination of the contract or (ii) disposal or return of the IT equipment by the contractor/subcontractor or any person acting on behalf of the contractor/subcontractor, whichever is earlier. Media (hard drives, optical disks, CDs, back-up tapes, etc.) used by the contractors/ subcontractors that contain VA information must be returned to the VA for sanitization or destruction or the contractor/subcontractor must self-certify that the media has been disposed of per 6500.1 requirements. This must be completed within 30 days of termination of the contract.
h. Bio-Medical devices and other equipment or systems containing media (hard drives, optical disks, etc.) with VA sensitive information must not be returned to the vendor at the end of lease, for trade-in, or other purposes. The options are:
(1) Vendor must accept the system without the drive;
(2) VA's initial medical device purchase includes a spare drive which must be installed in place of the original drive at time of turn-in; or
(3) VA must reimburse the company for media at a reasonable open market replacement cost at time of purchase.
(4) Due to the highly specialized and sometimes proprietary hardware and software associated with medical equipment/systems, if it is not possible for the VA to retain the hard drive, then;
(a) The equipment vendor must have an existing BAA if the device being traded in has sensitive information stored on it and hard drive(s) from the system are being returned physically intact; and
(b) Any fixed hard drive on the device must be non-destructively sanitized to the greatest extent possible without negatively impacting system operation. Selective clearing down to patient data folder level is recommended using VA approved and validated overwriting technologies/methods/tools. Applicable media sanitization specifications need to be pre-approved and described in the purchase order or contract.
(c) A statement needs to be signed by the Director (System Owner) that states that the drive could not be removed and that (a) and (b) controls above are in place and completed. The ISO needs to maintain the documentation.
6. SECURITY INCIDENT INVESTIGATION
a. The term "security incident" means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/ subcontractor shall immediately notify the COR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/ subcontractor has access.
b. To the extent known by the contractor/subcontractor, the contractor/ subcontractor's notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant.
c. With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement.
d. In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident.
7. LIQUIDATED DAMAGES FOR DATA BREACH
a. Consistent with the requirements of 38 U.S.C. 5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/subcontractor processes or maintains under this contract.
b. The contractor/subcontractor shall provide notice to VA of a "security incident" as set forth in the Security Incident Investigation section above. Upon such notification, VA must secure from a non-Department entity or the VA Office of Inspector General an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of any sensitive personal information involved in the data breach. The term 'data breach' means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Contractor shall fully cooperate with the entity performing the risk analysis. Failure to cooperate may be deemed a material breach and grounds for contract termination.
c. Each risk analysis shall address all relevant information concerning the data breach, including the following:
(1) Nature of the event (loss, theft, unauthorized access);
(2) Description of the event, including:
(a) date of occurrence;
(b) data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code;
(3) Number of individuals affected or potentially affected;
(4) Names of individuals or groups affected or potentially affected;
(5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text;
(6) Amount of time the data has been out of VA control;
(7) The likelihood that the sensitive personal information will or has been compromised (made accessible to and usable by unauthorized persons);
(8) Known misuses of data containing sensitive personal information, if any;
(9) Assessment of the potential harm to the affected individuals;
(10) Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and
(11) Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised.
d. Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following:
(1) Notification;
(2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports;
(3) Data breach analysis;
(4) Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution;
(5) One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and
(6) Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs.
8. SECURITY CONTROLS COMPLIANCE TESTING
On a periodic basis, VA, including the Office of Inspector General, reserves the right to evaluate any or all of the security controls and privacy practices implemented by the contractor under the clauses contained within the contract. With 10 working-day's notice, at the request of the government, the contractor must fully cooperate and assist in a government-sponsored security controls assessment at each location wherein VA information is processed or stored, or information systems are developed, operated, maintained, or used on behalf of VA, including those initiated by the Office of Inspector General. The government may conduct a security control assessment on shorter notice (to include unannounced assessments) as determined by VA in the event of a security incident or at any other time.
9. TRAINING
a. All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:
(1) Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information and information systems;
(2) Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training;
(3) Successfully complete the appropriate VA privacy training and annually complete required privacy training; and
(4) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the contracting officer for inclusion in the solicitation document - e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements.]
b. The contractor shall provide to the contracting officer and/or the COR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required.
c. Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete.
(End of Clause)
B.3 PRICE/COST SCHEDULE
ITEM INFORMATION
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 80.00 |
| HR |
| __________________ |
| __________________ |
One Part-Time Equivalent (PTE) - Conduct screening and/or research to identify and/or engage beneficiaries who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
Contract Period: Base POP Begin: 02-01-2025 POP End: 01-31-2026 PRINCIPAL NAICS CODE: 524298 - All Other Insurance Related Activities PRODUCT/SERVICE CODE: R612 - Support - Administrative: Information Retrieval
| 12.00 |
| MO |
| __________________ |
| __________________ |
Insurance Discovery - Contractor shall provide insurance discovery software to identify active, inactive and/or potentially eligible insurance coverage for beneficiaries. Provide information obtained on accounts found to have existing health insurance coverage, to include period of coverage, name of insurance plan, and member ID information.
Contract Period: Base POP Begin: 02-01-2025 POP End: 01-31-2026
| 80.00 |
| HR |
| __________________ |
| __________________ |
One Part-Time Equivalent (PTE) - Conduct screening and/or research to identify and/or engage beneficiaries who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
Contract Period: Option 1 POP Begin: 02-01-2026 POP End: 01-31-2027
| 12.00 |
| MO |
| __________________ |
| __________________ |
Insurance Discovery - Contractor shall provide insurance discovery software to identify active, inactive and/or potentially eligible insurance coverage for beneficiaries. Provide information obtained on accounts found to have existing health insurance coverage, to include period of coverage, name of insurance plan, and member ID information.
Contract Period: Option 1 POP Begin: 02-01-2026 POP End: 01-31-2027
| 80.00 |
| HR |
| __________________ |
| __________________ |
One Part-Time Equivalent (PTE) - Conduct screening and/or research to identify and/or engage beneficiaries who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
Contract Period: Option 2 POP Begin: 02-01-2027 POP End: 01-31-2028
| 12.00 |
| MO |
| __________________ |
| __________________ |
Insurance Discovery - Contractor shall provide insurance discovery software to identify active, inactive and/or potentially eligible insurance coverage for beneficiaries. Provide information obtained on accounts found to have existing health insurance coverage, to include period of coverage, name of insurance plan, and member ID information.
Contract Period: Option 2 POP Begin: 02-01-2027 POP End: 01-31-2028
| 80.00 |
| HR |
| __________________ |
| __________________ |
One Part-Time Equivalent (PTE) - Conduct screening and/or research to identify and/or engage beneficiaries who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
Contract Period: Option 3 POP Begin: 02-01-2028 POP End: 01-31-2029
| 12.00 |
| MO |
| __________________ |
| __________________ |
Insurance Discovery - Contractor shall provide insurance discovery software to identify active, inactive and/or potentially eligible insurance coverage for beneficiaries. Provide information obtained on accounts found to have existing health insurance coverage, to include period of coverage, name of insurance plan, and member ID information.
Contract Period: Option 3 POP Begin: 02-01-2028 POP End: 01-31-2029
| 80.00 |
| HR |
| __________________ |
| __________________ |
One Part-Time Equivalent (PTE) - Conduct screening and/or research to identify and/or engage beneficiaries who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
Contract Period: Option 4 POP Begin: 02-01-2029 POP End: 01-31-2030
| 12.00 |
| MO |
| __________________ |
| __________________ |
Insurance Discovery - Contractor shall provide insurance discovery software to identify active, inactive and/or potentially eligible insurance coverage for beneficiaries. Provide information obtained on accounts found to have existing health insurance coverage, to include period of coverage, name of insurance plan, and member ID information.
Contract Period: Option 4 POP Begin: 02-01-2029 POP End: 01-31-2030
| GRAND TOTAL |
| __________________ |
Summary:
| Period of Performance |
| Monthly Price |
| Yearly Total Amount |
| Base Year – 2/1/2025 – 1/31/2026 |
| $ |
| $ |
| Option Year 1 –2/1/2026 – 1/31/2027 |
| $ |
| $ |
| Option Year 2 – 2/1/2027 – 1/31/2028 |
| $ |
| $ |
| Option Year 3 – 2/1/2028 – 1/31/2029 |
| $ |
| $ |
| Option Year 4 – 2/1/2029 – 1/31/2030 |
| $ |
| $ |
Aggregate Amount
Page 1 of
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B.4 Performance Work Statement Insurance Discovery for the San Francisco Veterans Affairs Health Care System (SFVAHCS)
1. General Specifications
a. Purpose: The contractor will provide insurance discovery services for beneficiaries of the San Francisco Veterans Affairs Health Care System (SFVAHCS). Insurance discovery is a process that investigates a patient’s current or potentially eligible insurance coverage. Insurance discovery locates any existing policies and analyzes them in full. These services are to identify current or potentially viable alternate payer sources for beneficiaries. The contractor will provide insurance discovery software, staff to research alternate payer sources, assist and facilitate the completion of required paperwork through the application process.
2. Place of Performance and Hours:
a. San Francisco VA Medical Center Bldg. 203, 1A-6 4150 Clement Street San Francisco, CA 94121
b. One Part-time, 20 hours/week; Weekdays only, no Holidays. Primarily on-site with ad hoc telework capability. Hours will be from: Tuesday to Friday 9 am-2:30 pm. Contractor/subcontractor work hours and work schedule is subject to change depending on the need of the facility. Any changes must be approved by the Contracting Officer Representative (COR) or designee prior to implementation.
3. Federal Holidays:
| New Year’s Day | Labor Day | |
| M.L. King’s Birthday | Columbus Day | |
| President’s Day | Veterans Day | |
| Memorial Day | Thanksgiving Day | |
| Independence Day | Christmas Day |
Juneteenth
Note: Any other day that is specifically declared by the President of the United States to be a National Holiday, will be observed.
4. Performance Criteria
a. The contractor shall provide insurance discovery software and a part time equivalent employee (PTE) that meet the following criteria:
i. Insurance discovery software to identify active, inactive and/or potentially eligible insurance coverage for beneficiaries.
ii. Identification of insured, uninsured, or under-insured beneficiaries.
iii. Conduct screening and/or research to identify and/or engage beneficiaries who are eligible or potentially eligible for coverage through Medicaid, Medicare, other health insurance, or other medical assistance funding programs.
iv. Provide information obtained on accounts found to have existing health insurance coverage, to include period of coverage, name of insurance plan, and member ID information.
v. Meet in-person/bedside and/or virtually with beneficiaries and/or VA staff to prepare necessary paperwork to apply for coverage: including completing applications and gathering required supportive documentation. Completed applications shall be submitted to assigned Social Worker. The Contractor is prohibited from submitting documents as a VA representative.
vi. Contractor is prohibited from taking any action toward insurance billing, billing decision process or billing identified insurances for beneficiary services authorized/rendered, on behalf of VA.
b. Response time:
i. Response with findings within 1 business day, identifying insured, uninsured and/or under insured beneficiaries.
ii. Provide potentially eligible coverage plans within 2 business days from receipt of findings in paragraph 4bi.
iii. Provide weekly updates on application status for uninsured and under insured beneficiaries.
iv. One part-time equivalent employee: Contractor must provide the following PTE available and ready:
v. PTE will assist and facilitate with application process for uninsured and under insured beneficiaries with potentially eligible coverage plans. Contractor will meet bedside with beneficiary and meet with clinical team members onsite or virtually.
vi. Provide the necessary fieldwork, administrative work, and any other assistance required to assist the patient in applying for Medicaid or other medical assistance funding benefits.
vii. Long-term Care Applications. Assist with preparation of medical assistance applications necessary to discharge patients to a more appropriate care setting (e.g. Nursing Home, Long Term Care Facility, Residential Care Facility for the Elderly, etc.).
viii. Medicaid Secondary Certification (including Qualified Medicare Beneficiary (QMB)). For accounts with no secondary coverage, will assist the patient with completing an application for Medicaid secondary benefits (including QMB), schedule interviews, and gather supporting documentation.
ix. Disability Advocacy. If state Medicaid rules require submission of an application to Social Security Administration (SSA) as a condition to Medicaid approval, will assist the patient with the Supplemental Security Income (SSI)/Social Security Disability Insurance (SSDI) process, including all appeals.
5. Contractor Personnel Qualifications
a. Contractor Employees shall conduct in a business-like manner at all times while on VA premises.
b. Attire: The Contractor shall wear an identifying badge with name, function, and a photograph of the employee. The Contractor will wear an appropriate and professional uniform. Contractor personnel performing contract services shall meet at all times the qualifications specified in this scope of work.
c. Contractors shall have and be vaccinated prior to performance of work:
d. Health examinations including annual Tuberculosis (TB) skin test result, also known as PPD;
e. Either received the Hepatitis B vaccine series, or is immune as a result of acquired infection, or have been offered and refused the vaccinations;
f. Received measles-mumps-rubella (MMR) vaccine. Combined vaccine (MMR) is the vaccine of choice if individuals are likely to be susceptible to more than one of the three diseases and is required for all persons born after 1956;
g. A negative PPD within the last (6) months, or if a known reactor, a negative chest X-ray within the past year;
h. A history of varicella (chicken pox) or, if unknown, results of a varicella antibody test. If non-immune, must be vaccinated with varivax (chicken pox);
i. Contractors shall be able to obtain a security clearance within 60 days of contract award. Security clearances and fingerprinting are conducted by the San Francisco VA Medical Center (SFVAMC) at no cost to the contractor.
6. Infection control requirements.
a. Health tests. Contractor attests that assigned personnel have fulfilled all testing and screening requirements as described below prior to first duty shift. Evaluations and tests shall be current within the past year, except as noted. At the VA’s request, Contractor shall provide proof that all requirements are current and fully met as described within 2 business days of request.
b. Tuberculosis Screening and Testing.
i. For those with previous documented positive Purified Protein Derivative (PPD) test results: All Contractor personnel shall provide a note from their physician, dated within the past three months stating they are free of any signs and symptoms of tuberculosis. This evaluation will be renewed annually.
ii. For those with previously negative PPD skin test results: All Contractor personnel shall provide proof of a negative reaction to PPD testing, performed in accordance with the latest CDC standards…
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