36C26126Q0379.docx

36C26126Q0379

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

36C261-26-AP-1725

36C26126Q0379 02-19-2026 Jill Williams 702-001-5380 03-17-2026 11:00am

PDT

00261 Department of Veterans Affairs Network Contracting Office 21

X X Y 561440 $19.5 Million N/A X See Delivery Schedule

00261 Department of Veterans Affairs Network Contracting Office 21 Southern Nevada Healthcare System 6900 N. Pecos Road, Building 6 North Las Vegas NV 89086

Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin TX 78714-9971 See CONTINUATION Page Service required is to ID Workers Compensation cases and perform associated collection activities on behalf of the VISN 21 and VISN 22 Offices of General Counsel.

Offerors shall adhere to the instructions of FAR 52.212-1, on "how-to" submit its quote. Offerors shall also provide evidence to answer the Evaluation Criteria as stated in FAR 52.212-2.

Period of Performance is to begin on April 01 2026 to March 30 2027, plus 4 Option Years.

All submissions must be received by 03-16-2026 at 11:00am PST See CONTINUATION Page X X Jill Williams Contracting Officer Table of Contents

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: Contracting Officer 36C261 Department of Veterans Affairs Network Contracting Office 21

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted 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.

N/A

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

Section B.2 – Price and Delivery Schedule –

The Contractor and the Department of Veterans Affairs will enter into an agreement to provide California Worker’s Compensation Case Identification and collection activities on behalf of the Office of General Counsel for Veterans Integrated System Networks of 21 and 22. Refer to the Statement of Work for full scope of the work.

Contract period of performance are identified in the below chart.

The following prices are hypothetical for the purposes of bid evaluation. See Section B, Price Proposal Evaluation Worksheet, which will be used by all offerors to provide hypothetical pricing based on offered collection percentages.

The VA does not guarantee a minimum or maximum amount of collections under this contract.

Total Amount

Offerors shall not alter, edit or change any CLIN items without expressed approval from the Contracting Officer. Changing this Price Schedule may be deemed as NON-RESPONSIVE to the solicitation. This is a Firm Fixed Price contract. Per hour rate shall include all costs associated with the performance of this contract.

Price Proposal Evaluation Worksheet

Offeror’s Company Name: _________________________________

Contractor will receive a percentage of total monthly collections as follows. Enter a percentage For:

a. $0 to $100,000:________ %

b. $100,000 to $200,000:_________ %

c. $200,000 to $300,000:_________ %

d. $300,000 and above:_________%

For purposes of evaluation, the price will be determined by completing the following using the percentage above:

Item a:_______ % x $100,000 = $___________ Item b:_______ % x $99,999 = $___________ Item c:_______ % x $99,999 = $__________ Item d:_______ % x $99,999 = $__________

Total: $ _________

There are no restrictions on commissions/ percentages.

Offerors shall submit its price proposal with their bid/proposal.

Print Full Name Signature

STATEMENT OF WORK

DESCRIPTIONS/SPECIFICATIONS

1.1 PURPOSE: The Department of Veterans Affairs requires the services of a contractor to identify California workers' compensation cases in which VA, as a self-procured medical lien claimant under the California Labor Code, may obtain reimbursement for medical care provided to an injured worker. The Contractor shall identify such cases and take all necessary steps under California Labor Code and the Workers' Compensation Appeals Board (WCAB) Rules of Practice and Procedure to affect recovery on behalf of VA.

1.2 LIMITATION: This contract applies only to VA claims arising under the workers' compensation laws of California.

1.3 BACKGROUND: The Department of Veterans Affairs provides medical care and treatment to eligible veterans. On occasion, VA also pays for treatment by private health care providers. 38 U.S.C. § 1729 - Recovery by the United States of the cost of certain care and services authorizes VA to recover the reasonable cost of treatment incurred incident to a veteran's employment that is covered by a workers' compensation law or plan providing for payment of health care costs. The VA Revenue Law Group has responsibility to assert medical care cost recovery claims arising from medical care rendered by VA hospitals and clinics, or paid for by VA, in cases arising within its jurisdiction.

1.4 SCOPE OF WORK: The Contractor shall maintain computerized access to a database which provides filing information on California workers' compensation claims and will utilize this information to identify claims involving medical treatment by VA. When patient data is provided by VA, the Contractor shall compare such data with this database in an effort to further identify claims in cases where VA has provided care. It will notify VA of all cases so that VA employees may produce bills for medical care related to the claimed industrial injury. In Contractor-identified cases and in any cases identified independently by VA and referred to the Contractor at VA's discretion, the Contractor shall: perform all tasks required to prepare, file, and assert liens as provided by California law, including negotiation with workers' compensation insurers and appearance at Workers' Compensation Appeals Board conferences and hearings; collect on said liens; and remit all collections to VA through the VA Revenue Law Group. In addition, to the extent authorized by the VA Revenue Law Group, the Contractor shall prepare and answer Petitions for Reconsideration before the Workers' Compensation Appeals Boards and prepare and respond to requests for Writs of Review by the California Court of Appeals, when necessary to perfect and recover a workers' compensation lien or award. This contract does not include services in any civil action.

2.1 MANAGEMENT: The Contractor shall attempt to discover any and all California workers' compensation claims by individuals receiving care from VA. The Contractor shall notify each appropriate California VA facility, by creating a new case in the case management system, that its patient has made a claim regarding an industrial injury or occupational disease, enabling the facility to generate workers' compensation billing. This notice shall include a list of injuries and dates of related treatment. The Contractor shall utilize the current VA electronic systems to the greatest extent as possible to provide this notice. Upon receipt of VA bills, the Contractor shall pursue reimbursement from the injured worker's employer or its workers' compensation insurer.

2.1.1 The Contractor shall identify workers' compensation cases filed by VA patients by means of the case filings at the California Workers' Compensation Appeals Board (WCAB) and patient data provided by VA, as well as by any other sources of information available to it. The Contractor shall employ a computerized system for matching Social Security numbers ("SSN") of WCAB applicants to the unique identifiers of VA patients.

2.1.2 The Contractor shall provide each appropriate VA facility the name and SSN of the patient/injured worker, the date of injury, a description of the injury (specifying injured body parts), and all relevant WCAB case numbers.

2.1.3 If requested by an individual VA facility, the Contractor shall send its employees to that facility periodically to assist in identifying and printing the records of treatment for which VA employees will generate billing according to the Department of Veterans Affairs schedule of charges. (This service may also be performed via remote access to the VA electronic chart. Contractor employees shall be subject to a background investigation and shall complete all required VA training prior to being given access to the VA computer system.)

2.1.4 Upon receipt of VA bills and medical records, the Contractor shall establish a case file that will contain all documentation pertaining to the collection case, including but not limited to: VA bills and medical reports; correspondence with VA and with other parties to the WCAB case; memos or records of telephone contacts; pleadings generated, filed, and served by the Contractor, including but not limited to the Notice of Lien; pleadings, settlement documents, medical reports, and hearing notices received from other parties; and all notices, orders, and other documents received from the WCAB. The case file shall contain the names and addresses of all parties to the WCAB case and the WCAB numbers of any related cases filed by the VA patient.

2.1.5 The Contractor shall document all case actions as they transpire and maintain this documentation chronologically by date in the file as a "Case File History." The Contractor shall also gather and maintain employer information within the "Case File History." This includes at least the employer's name and address, the employer's compensation carrier's name and address, and the policy number.

2.1.6 The Contractor shall file an initial standard WCAB form Notice and Request for Allowance of Lien on behalf of VA with the WCAB within 10 working days of receiving VA's bills and records and shall timely serve all parties as they are identified. The Notice of Lien shall be accompanied by all documentation required by the WCAB Rules of Practice and Procedure to perfect the lien, including but not limited to, VA's bills and medical records. Upon receipt of supplemental VA billing and records, the Contractor shall file and serve amended Notice(s) of Lien, with accompanying documentation within 10 working days. (To the extent required by the WCAB, liens shall be filed electronically.)

2.1.7 The Contractor shall provide VA Revenue Law Group with a copy of each Notice of Lien filed, with its transmittal cover letter and service sheet, at the time of filing. At the same time, the Contractor shall send VA Revenue Law Group a list itemizing each VA bill submitted with the Notice of Lien, including each bill's amount, date(s) of service, and diagnosis code with its description, and a summary total of those bills.

2.1.8 The Contractor shall attend hearings, settlement conferences, and lien trials at the WCAB as necessary to vigorously assert VA's claim for reimbursement.

2.1.8.1 In advance of scheduled hearings, settlement conferences, and lien trials, and periodically otherwise, the Contractor shall request supplemental billing from VA.

2.1.8.2 The Contractor shall inform VA if it learns the patient/injured worker has ongoing care and/or the patient/injured worker raises additional alleged injuries.

2.1.9 The Contractor may negotiate a proposed compromise of VA's claim with the employer and/or its insurer, but no final agreement may be entered into without prior VA Revenue Law Group authorization. If the Contractor's employee receives a proposal while attending a hearing or conference at the WCAB, he or she shall attempt to contact VA Revenue Law Group for authority at that time. VA's decision to compromise or waive a claim shall be final, binding on the Contractor, and not subject to dispute by the Contractor. In settling cases whose dollar amount exceeds Revenue Law Group authority, Contractor shall prepare a worksheet for the U.S. Department of Justice to be forwarded by Revenue Law Group along with its recommendation to the U.S. Department of Justice for approval.

2.1.10 With the advance concurrence of VA Revenue Law Group, the Contractor may pursue recovery through the appellate levels of the California workers' compensation system. In suitable cases, this may include filing a Request for Reconsideration with the WCAB, responding to another party's Request for Reconsideration, or filing or responding to a Petition for a Writ of Review by the California Court of Appeal.

2.1.10.1 The Contractor must forward to VA Revenue Law Group in a timely manner any WCAB order which, if not objected to, would result in a diminution or denial of VA's lien claim.

2.1.10.2 The Contractor may not litigate on behalf of the Department of Veterans Affairs any non-workers' compensation matter nor appear in any forum outside the California workers' compensation system.

2.2 RECOVERY FROM OTHER SOURCES: The Contractor shall not attempt to recover payment of VA charges from non-workers' compensation sources.

2.2.1 If, while pursuing a workers' compensation recovery, the Contractor becomes aware of other sources of VA recovery, it shall refer this information to VA Revenue Law Group immediately.

2.3 CASE COLLECTION CONSTRAINTS: The Contractor shall initiate collection activity no later than 10 business days after receiving VA's initial bills and medical records. Collection action may include, but is not limited to, filing a Notice of Lien with the WCAB and serving the parties, demanding payment, developing case data, and filing objections or petitions with the WCAB.

2.3.1 If a case is uncollectible after reasonable collection attempts have been made, the Contractor may return the file to VA Revenue Law Group. No fee will be paid to the Contractor in these cases. VA may pursue further collection in such cases without incurring a fee obligation to the Contractor.

2.3.2 The Contractor shall demand of the employer or its workers' compensation insurer payment of the entire outstanding balance. The Contractor must obtain advance approval from VA Revenue Law Group prior to accepting a compromise offer or any other disposition short of full recovery.

2.3.3 The Contractor's failure to take collection action within 30 days of discovering a claim or receiving the bills from VA, resulting in lost revenue to VA, will entitle VA to damages against the Contractor to the extent of the claim.

2.4 COLLECTION STANDARDS: The Contractor shall ensure that all attempts to recover on VA claims are fair and reasonable and do not involve harassment, intimidation, or misleading representations. The Contractor shall avoid unnecessary communication concerning VA claims with persons other than the employer or its workers' compensation insurer. It shall not release information other than as required by the California WCAB Rules of Practice and Procedure and as permitted by Federal privacy statutes. Other requests for information concerning a VA patient shall be referred to VA Revenue Law Group. In addition to these specific requirements, the Contractor shall also ensure compliance with all applicable Federal and State laws pertaining to VA’s right of recovery.

CONTRACTOR RESPONSIBILITIES

3.1 DELIVERABLES: The Contractor shall deliver the following in accordance with the schedule set forth below:

3.1.1 Remittances: Monies collected shall be remitted on a regular basis in accordance with Executive Order 14247. Exact schedules will depend upon the volume and nature of workloads. Under no circumstances will this period exceed 21 days, except by prior arrangement with VA Revenue Law Group.

3.1.2 Interest: Interest accrued on any escrow account will be remitted monthly by certified check with a copy of the bank statement for each escrow account.

3.1.3 Reports: The Contractor shall provide a monthly list of WCAB hearings attended in the prior month (or since the report was last sent to VA). The Contractor shall also provide a monthly list of WCAB hearings scheduled for the next month (or until the next report will be sent). The Contractor shall provide a separate quarterly list of pending cases for each VA facility, alphabetized by patient's name, and including: each patient's name and SSN, the date the Contractor received the case, the dollar amount outstanding, and an annotation regarding current case status. The Contractor shall also provide a quarterly report of cases closed with recovery, including: patient's name and SSN, the VA facility from which the case originated, the dates the case was opened and closed, VA’s total claim, the amount collected, the amount of the Contractor's fee, the net amount to VA, and the reason for any compromise. The Contractor shall provide a separate quarterly list of cases closed without recovery, including: patient's name and SSN, the VA facility from which the case originated, the dates the case was opened and closed, VA’s total claim, and the reason these charges were uncollectible. Each of the three quarterly reports shall also include a cumulative total of the dollar amounts listed under the individual cases. The Contractor shall provide an annual report at the end of the Government Fiscal Year (September 30) which includes the fourth quarter information and a cumulative report.

3.1.4 Pending Bill Lists: As requested, the Contractor shall provide a quarterly list of all pending bills by medical center showing the name of the patient, last 4 of the SSN, and total billing amount. This data shall be provided in Microsoft Excel format or in a format that can be readily loaded into a Microsoft Excel spreadsheet

3.2 PERFORMANCE

3.2.1 Quality Program: The Contractor shall perform its services under this contract in accordance with the best commercial practices of' the collection agency profession.

3.2.2 Quality Control: Upon discovery of any errors by the Contractor, the Contractor will notify VA and take immediate corrective action. Errors may include, but are not limited to, interpretation or application of appropriate codes, policy, or arithmetic, or omissions. The Contractor holds the Government harmless for any loss resulting from such errors. The error must be corrected to the satisfaction of VA within 30 days from the date of discovery or notification. Notice of correction is to include, but is not limited to, the date and nature of the error, the date it was discovered, the date it was corrected, projected impact on VA caused by the error, and the Contractor's calculation of any assessable damages. This data is subject to verification by VA. The Contractor must correct the error retroactively if possible. Any damages incurred as a result of error shall be the responsibility of the Contractor. If the damage is related to a matter for which the Contractor has received a fee for services, that amount of damages shall be remitted to the Government within 15 workdays of the reimbursement notification.

3.2.3 Physical Security: The Contractor shall be responsible for safeguarding all VA records in its work area. At the close of each work period, facilities and equipment shall be secured. The Contractor, upon delivery to it of any Government-furnished records, assumes the risk of, and shall be responsible for, any loss thereof or damage thereto.

3.3 PERSONNEL

3.3.1 Personnel: The Contractor shall maintain sufficient offices in Northern and Southern California to enable its employees to attend hearings at all California WCABs and to send employees to any VA facility to assist the billing staff, as described at 3.6.3.

3.3.2 Project Manager: The Contractor shall provide a project manager who shall be responsible for the competent performance of the work. The project manager shall have full authority to act for the collection agency in all matters relating to performance. The project manager is considered the key to successful initiation of the collection in that his/her identification of a potential VA case begins the collection process. The project manager, at all times during performance and until the case is completed and accepted, shall give his/her personal attention to same. The project manager or alternate representative shall meet with Government personnel designated by the Contracting Officer to discuss immediate problems within 24 hours. The Contractor shall provide the telephone number of the person(s) to call should the need arise. The project manager shall be able to read, write, speak, and understand English.

3.3.3 Employees: Services are to be performed by competent personnel, experienced and highly qualified to provide the required services in accordance with the best commercial practices, without unnecessary delays. The Contractors shall employ such California-licensed attorneys as are required to perform work under this contract. Contractor shall not subcontract without prior approval by Revenue Law Group.

3.4 TRAINING OF EMPLOYEES: The Contractor shall establish procedures within which its employees shall operate while performing the level of collection activity specified in the agreement. These procedures shall include the required training of employees by the Contractor. Specifically, all employees shall receive training on the, allowing subjects:

3.4.1 The Privacy Act of 1974.

3.4.2 The Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and Department of Health and Human Services regulations implementing it.

3.4.3 The confidentiality of certain medical records under 38 U.S.C. § 7332.

3.4.4 Other applicable Federal and State laws and regulations pertaining to VA’s right of recovery

3.4.5 Specific collection practices and procedures to be followed in the performance of' this agreement. All of the contractor’s employees having access to VA confidential patient information shall receive annual VA-mandated privacy training. Contractor’s employees having access to the VA electronic chart shall receive all required VA training, including annual VA Cyber Security Training.

3.5 DATA SYSTEMS: The Contractor shall establish and maintain data systems which are capable of performing the data comparisons and providing the reports required by the contract.

3.6 CONFIDENTIALITY: The Contractor shall insure that access to data regarding any VA account shall be restricted solely to persons who are employed in the specific collection activity within the Contractor's organization which is responsible for the VA accounts.

3.6.1 The Contractor shall establish procedures to insure the privacy and confidentiality of the VA beneficiary records in accordance with the Privacy Act of 1974 and HIPAA.

3.6.2 With respect to any identifiable information concerning a VA patient under this agreement that is obtained by the Contractor, the Contractor: (1) is covered by and must conform to 5 U.S.C. § 552a(m), 38 U.S.C. § 5701, and 38 U.S.C. §7332; (2) shall not use any such information for any purpose other than carrying out the express terms of this agreement; (3) shall not disclose, except as otherwise specifically permitted by this agreement or authorized by the patient, any such information to any entity other than the patient's workers' compensation attorney, the employer(s), the employer's insurer(s), or the WCAB without the VA Revenue Law Group's prior written authorization specifying that the information is releasable. Any disclosure shall be made only in accordance with 38 U.S.C. § 3301, the Privacy Act of 1974, and HIPAA. The Contractor shall, for any such disclosure, maintain a disclosure accounting as required by 5 U.S.C. § 552a(c), which accounting shall include the name and address of each person or agency to whom disclosure was made, and the date, nature, and purpose of each disclosure. It shall be the responsibility of VA to ensure that records whose release is barred under 38 U.S.C. § 7332 are not transmitted to the Contractor. If the Contractor inadvertently receives such records, it shall not disclose them under any circumstances, but shall return them to VA Revenue Law Group immediately.

3.6.3 At the discretion of an individual VA facility and for the purpose of assisting VA facility's billing staff in selecting appropriate episodes of treatment for billing and in copying treatment records, the Contractor's employees may be allowed direct access to the records of a patient that the Contractor has identified as having a pending workers' compensation case.

3.7 REFUNDS: The Contractor shall submit to the Department of Veterans Affairs complete documentation of all cases where a refund by VA of payments received is recommended. Minimum data to be submitted by the Contractor are:

3.7.1 Proof of payment.

3.7.2 Date of payment.

3.7.3 Payee.

3.7.4 Payor

3.7.5 Reason for Overpayment

3.7.6 Amount of overpayment

3.7.7 Recipient name

3.7.8 Employer name

3.7.9 VA claim number.

3.7.10 Gross lien and net lien computation

3.7.11 All patient history itemizations

3.8 ACCOUNTING: The Contractor shall maintain an accounting system for this contract which provides for:

3.8.1 Accounting on the accrual basis.

3.8.2 Full accountability over all Contractor collections for and remittances of money to VA

3.8.3 Full accountability for all accounts receivable to include, by patient, the amount claimed, amount collected, and balance due.

3.8.4 No accounts receivable to be assigned by the Contractor.

3.8.5 Subsequent to the agreement termination date or the expiration of any authorized extensions, originals of all claim files, as deemed necessary by VA, will be turned over to VA within 30 days. Additionally, VA may require that the Contractor provide copies or originals of claim files at any time prior to the termination of the agreement within 30 days after notice. All required copies of claim files will be maintained and delivered to VA, and organized in a manner enabling easy access alphabetically by patient's name. The Contractor will bear the cost of reproduction. The production of the claim files shall be in electronic format.

3.8.6 Claim files being maintained in alphabetical order by patient's name.

3.9 LITIGATION ASSISTANCE: The Contractor shall appear on behalf of VA at hearings before judges of the WCAB and before the Appeals Board itself upon a Petition of Reconsideration. Upon written authorization by VA Revenue Law Group, the Contractor may file a Petition for a Writ of Review with the California Court of Appeal regarding a recovery claim that it has pursued before the WCAB.

3.10 PREAGREEMENT CASES: This contract shall not cover any cases currently being handled by an existing contractor pursuant to any prior contract.

3.11 REQUEST FOR BILLS: In cases other than those identified through computer-matching, as described in 2.1.1, the Contractor shall direct a request for bills through VA Revenue Law Group and bills will be forwarded to the Contractor by the VA facility through VA Revenue Law Group.

3.11.1 Prior to finalizing any claim, the Contractor shall ensure that VA bills for all treatment related to the industrial injury have been obtained.

3.12 REFUND OF FEES: In the event that recovery funds under the contract are sent directly to VA instead of to the Contractor, thereby preventing the Contractor from subtracting its fee for services, Contractor shall submit to the Contracting Officer’s Representative (COR) documentation of the recovery, including VA bill numbers, and the fee owed. The COR will coordinate refund of the fee with the Accounts Management Division of the Consolidated Patient Accounts Center.

3.13 LABOR MATERIALS, EQUIPMENT, AND FACILITIES: The Contractor shall furnish all labor, materials, equipment, and facilities necessary for completion of the work as defined in the Work Statement except those specifically identified as to be furnished by VA.

3.14 REORGANIZATION OR MERGER: The Contractor shall submit in writing to the Contracting Officer all proposed reorganization or merger plans for VA approval prior to entering into said reorganization or merger

GOVERNMENT RESPONSIBILITIES

4.1 DELIVERABLES: VA will provide the following:

4.1.1 Documentation: VA shall furnish without cost to the Contractor bills and medical records for each billable case identified by the Contractor and for any case identified by VA and referred to the Contractor at the VA Revenue Law Group's discretion. VA may also provide patient data in a format compatible with Contractor's computer systems for use in matching patient data with California workers compensation filings.

4.1.2: The VA Revenue Law Group will identify the appropriate VA Revenue Law Group contact for each case under this contract.

4.1.3 Reorganization or Merger: VA shall review and accept or reject in writing proposals by the Contractor to enter into a reorganization or merger.

4.1.4 Printed Materials: VA shall review and approve or disapprove in writing the form and content of all printed material or releases pertaining to this agreement (informational and instructional). This approval or disapproval may be in the form of electronic communications.

4.1.5 VA Hospital Billing Rates: For all workers' compensation billing for care subsequent to 9/1/1999, VA generates bills according to an itemized system of Reasonable Charges published in the Federal Register. The Contractor may obtain these rates from the Federal Register via the Internet. VA Revenue Law Group will provide a copy of the all-inclusive rates prior to 9/1/1999, as requested by the Contractor.

4.1.6 Witnesses: VA shall furnish, without cost to the Contractor, medical or other witnesses, or written statements from such witnesses, necessary to prosecute contested cases before the WCAB.

4.2 CLAIM DISPUTES: VA retains all rights to compromise or waive VA claims. All requests for compromise or waiver must be referred to VA Revenue Law Group for decision. VA's decision to compromise or waive a claim shall be final, binding on the Contractor, and not subject to dispute by the Contractor. VA reserves the right to cease recovery on any claim at any time without further obligation to the Contractor.

DEFINITIONS

5.1 AWARD: Amount allowed to VA by the WCAB. It may be equal to or less than the claim and may include an award of interest.

5.2 BILL: A statement of charges created according to rates published in the Federal Register in the case of VA-provided care.

5.3 CASE FILE HISTORY: A summary of events and actions kept as they transpire, listed chronologically by date on a separate piece of paper within the case file or within the electronic case file.

5.4 CLAIM: Any amount subject to recovery by VA. A claim is considered "opened" when it is initiated by the Contractor, "closed/collected" on the date final payment has been received by VA and "closed/uncollected" on the date it is forwarded to VA by the Contractor.

5.5 CONTRACTING OFFICER: Any person who, either by virtue of his/her position or by appointment in accordance with procedures prescribed by the Federal Acquisition Regulation, is currently a Contracting Officer with the authority to enter into and administer this contract and make determinations and findings with respect thereto, or with any part of such authority.

5.6 CONTRACTING OFFICER'S REPRESENTATIVE (COR): A person designated by the Contracting Officer to generally supervise the work performed under this contract and to furnish technical guidance and advice.

5.7 INDUSTRIAL INJURY: A condition arising out of employment and occurring in the course of employment, including continuous trauma, occupational disease, and industrial aggravation of a pre-existing condition.

5.8 LIEN: A VA lien filed in a Worker's Compensation Appeals Board (WCAB) action, as provided in the California Labor Code and WCAB Rules of Practice and Procedure.

5.9 LITIGATION/CIVIL ACTION: Proceedings in a court of law not before the WCAB, an administrative body.

5.10 NOTICE OF LIEN: The Contractor will submit the lien forms required by the WCAB or electronic equivalent mandated by the WCAB.

5.11 NO COST: As defined in this agreement, the cost of performance under this agreement is not due or payable to the Contractor by VA by any other means than the fee for collection defined herein.

5.12 PATIENT: An eligible person who, as a result of a work-related-injury, including but not limited to chronic conditions or diseases incident to the person's employment, has received or will receive hospital, medical, surgical, or dental care or treatment, including prostheses and medical appliances, provided or paid for by VA.

5.13 QUALITY ASSURANCE: Those actions taken by VA to evaluate services required under the agreement to determine that they meet the requirements of the Work Statement.

5.14 QUALITY CONTROL: Those actions taken by a Contractor to control the provision of services so that they will meet the requirement of the Work Statement.

5.15 UNIQUE IDENTIFIER: The patient's Social Security Number, by which the patient's medical records are kept at a VA facility.

5.16 VA CHARGES: For care provided at or paid for by VA facilities, VA charges are determined by reference to the schedule published in the Federal Register. For care provided under a sharing agreement pursuant to 38 U.S.C.§ 8111 or § 8153, they are the cost of such care as provided for in the sharing agreement.

5.17 VA FACILITY: Medical facilities operated by VA at which the related care was provided or paid for.

5.18 WCAB RULES OF PRACTICE AND PROCEDURE: Those portions of the California Code of Regulations commencing at 8CCR § 10300, that deal with claims arising from industrial injury.

6 CONTRACT CLOSEOUT

6.1 All accounts are to be returned to the appropriate VA Revenue Law Group Office upon termination of collection activity.

6.2 The Contractor shall retain the case file 5 years from the expiration of the contractual periods. At such time paper records shall be destroyed by shredding, or if requested by VA Revenue Law Group, returned to the Revenue Law Group. If any patient information is contained on a computerized system, the information shall be erased or otherwise destroyed. Violations of these requirements may subject the Contractor to penalties specified in the Privacy Act of 1974.

6.3 PAYMENT DUE DATE: Payments to VA under this contract will be due on a regular basis not to exceed 21 days after receipt, except by prior arrangement with Revenue Law Group.

7 Modifications: Only those services specified within are authorized under the contract. Any modification to the contract shall be in writing. The modification will be prepared by the VA Contracting Officer prior to becoming effective. The Contractor is cautioned that only the Contracting Officer may authorize services and that reimbursement will not be made unless this prior authorization is obtained.

8 Designation of Contracting Officer's Representative (COR): A Technical Representative of the Contracting Officer (COR) will be designated to represent the Contracting Officer in furnishing technical guidance and advice under this contract. The foregoing is not to be construed as authorization to Interpret or furnish advice and information to Contractor relative to the financial or legal aspects of the contract. Those matters are the responsibility of the Contracting Officer and shall not be delegated.

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SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2023)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the Contracting Officer (see 32.607-2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or

(C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor.

(vii) The interest charge made under this clause may be reduced under the procedures prescribed in FAR 32.608-2 in effect on the date of this contract.

(j) Risk of loss. Unless the contract specifically provides otherwise, risk of loss or damage to the supplies provided under this contract shall remain with the Contractor until, and shall pass to the Government upon:

(1) Delivery of the supplies to a carrier, if transportation is f.o.b. origin; or

(2) Delivery of the supplies to the Government at the destination specified in the contract, if transportation is f.o.b. destination.

(k) Taxes. The contract price includes all applicable Federal, State, and local taxes and duties.

(l) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work.