36C26226Q1138 0002 Amendment Medical Transcription.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

10-21-2026

VA-27-00003230

36C262

NCO 22

Department of Veterans Affairs NCO 22 - Network Contracting 650 East Indian School Road Phoenix AZ 85012

36C262

NCO 22

Department of Veterans Affairs NCO 22 - Network Contracting 650 East Indian School Road Phoenix AZ 85012 To all Offerors/Bidders

36C26226Q1138 09-28-2026

X

X

** HOUR & DATE for Receipt of Offers is EXTENDED to: 10-23-2026 1:00PM PDT

See Continuation Page

CONTINUATION PAGE

The purpose of this amendment is as follows:

1. Extend the solicitation close date from 10/21/2026 to 10/23/2026; offers are due on 10/23/2026 NLT 1:00 PM PST

2. Period of performance remains the same 11/01/2026-10/31/2027 and subsequent option years.

3. Posting the answers to the questions received by 10/09/2026.

4. The CLIN structure has been updated to reflect only the locations that will be receiving this service IAW the updated SOW.

5. The SOW has been updated; the only locations requiring services will be Phoenix, Tucson, and Albuquerque.

6. Contractor shall acknowledge all Amendments on SF 30 blocks 15A, 15B, 15C and the original solicitation in section B.1 ACKNOWLEDGMENT OF AMENDMENTS

UPDATED STATEMENT OF WORK

1. SCOPE OF WORK:

a. The contractor shall provide all personnel, equipment, materials, management, labor, tools, facilities, software, transportation, communication, and all other necessary elements required for the satisfactory performance of the project titled “Off-Site Medical Transcription Services,” for facilities located within the VISN 22 Veteran Affairs network.

b. Services shall be performed by respective contractor personnel from a remote location(s) as established by the contractor. The method of communication between the customer and the contractor shall be established by the contractor, who shall be responsible for the continuity, performance, security, and maintenance of established system(s). Contractor shall submit the proposed system and all necessary guidance to the Contracting Officer, no later than 15 calendar days before implementation, for formal government acceptance. All transcription and verification must be performed in the United States of America. There are NO exceptions.

c. Definitions/Acronyms:

Contracting Officer (CO) - The representative of the VA who has the authority to enter, administer, terminate, modify, approve changes, or otherwise represent and bind the VA in all matters arising under or relating to this contract.

Contracting Officer’s Technical Representative (COTR). The contracting officer may delegate one or more VA employees who will be responsible for monitoring the technical performance of the contractor. A copy of the COTR delegation shall be provided to the contractor after award.

HIPAA – Health Insurance Portability and Accountability Act of 1996.

STAT – Report needs to be transcribed and uploaded quickly, generally due to a patient being admitted to the hospital or being transferred to another health care facility.

Turn-Around-Time (TAT) - TAT is the difference in time between the time the author hangs up at the conclusion of dictating into the contractor’s dictation system, and the time the contractor's completed transcription arrives in the appropriate destination at VA. The VA may implement a program that automatically calculates the difference in time between the time the author hangs up at the conclusion of dictating into the contractor’s dictation system and the time the contractor's completed transcription arrives in the appropriate destination at VA.

VA records - In this solicitation, VA records include the dictated (voice) record and the transcribed report (text), as well as any paper copy or storage medium for voice or text.

Visible Black Character (VBC) - A VBC is defined as strike able and visible characters and includes any printed letter, number, symbol, and /or punctuation mark, excluding any or all formatting (e.g., bold, underline, italics, table structure, formatting codes). All visible black characters can be seen with the naked eye as a mark, regardless of whether viewed electronically or on a printed page. Under this contract, the VBC is the ONLY acceptable unit of measure for billing and payment purposes. Any other method shall be rejected by the government.

VistA - Veterans’ Health Information Systems and Technology Architecture.

Veterans Information Systems Technology Architecture (VISTA) - The VA’s proprietary computer system running on Alpha computers utilizing Windows NT and Open M (MUMPS) by InterSystems.

2. PERFORMANCE SERVICE SCHEDULE:

a. Contractor shall provide on-demand off-site medical transcription services 24 hours daily, 365 calendar days per year. A qualified transcriptionist shall be readily available for performance to ensure standard and STAT turnaround times and shall complete the task on time, in accordance with this document.

b. Federal Holidays - Normal Federal Holidays observed are New Year’s Day, Martin Luther King, Jr. Day, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, and Christmas Day. Be advised, as the required services are performed for 24-hour, 7-day-a-week medical facilities, the transcription services shall be required accordingly. The time frames shown elsewhere in this statement of work are always applicable.

3. PERFORMANCE REQUIREMENTS:

a. Dictated material shall include a high incidence of technical/medical terminology and requires a knowledge of highly specialized vocabulary specific to a wide variety of specialty services to include, but not limited to: Anesthesiology, Blind Rehabilitation, Cardiology, Cardiothoracic Surgery, Dentistry, Dermatology, Drug and Alcohol Treatment, Endocrinology, Gastroenterology, General Medicine and Surgery, Gynecology, Hematology, Immunology, Neurology, Neurosurgery, Nephrology, Oncology, Ophthalmology, Oral Surgery, Orthopedics, Otolaryngology, Pathology, Podiatry, Psychiatry, Psychology, Plastic Surgery, Pulmonary Disease, Radiology, Renal, Rheumatology, Social Work, Spinal Cord Injury, Thoracic Surgery, Transplant, Urology and Vascular Surgery.

b. Contractor shall provide and maintain the means for required connectivity by the establishment of a toll-free number with unlimited 24-hour access available to all respective sites. Contractor shall ensure all external communication systems are secure, VA-compliant, HIPAA-compliant, and will configure, install, and maintain all remote workstation hardware and software at its transcriptionist stations. Upon request, the contractor will expeditiously provide all requested information to each respective site's Information Security Officer (ISO) and Information Resource Manager (IRM).

c. Medical reports to be transcribed shall include discharge summaries, operative reports, non-operative procedures, history and physical/assessment reports, telephonic authorizations, compensation and pension examinations, pathology and autopsy reports, progress notes, radiology reports, cardiology reports, magnetic resonance imaging, social work assessments, special procedures, and other miscellaneous medical and administrative reports as required.

d. Contractor shall maintain the security and integrity of patient information in accordance with all applicable Federal, State, Local, and VA regulations/guides/directives/etc. Violation of patient confidentiality may result in contract termination.

e. Quality Control Records: The Contractor's facilities, methodologies, and quality control procedures may be examined by the Contracting Officer, his/her designer, or respective COTRs at any time during the life of the contract. All applicable activities are to be performed in accordance with VA’s Quality Management Program.

f. The Contractor shall perform the functions required in this statement of work in accordance with the rules of medical ethics, Federal, State, and local laws, rules, and regulations.

The Contractor will not participate in, nor be a party to, any activities that conflict with Federal and/or State guidelines. In the event the Contractor encounters conflicting situations, the Contractor will notify the COTR or the Contracting Officer to resolve such issues. The Contracting Officer will document the file and refer the matter to the local privacy officer for resolution of any such situations. Neither the VA nor the Contractor will be responsible for delays or failures to perform caused by events beyond each party's control. The VA and contractor may, upon mutual consent, modify the timing and schedule of services.

g. Estimated percentage breakdown of total by type of report and facility follows:

NMVAHCS, Albuquerque: Discharge summaries (approx. 39.5%), Compensation and Pension Exams (approx. 39.5%), Operative Reports (approx. 11%), Procedure Notes (approx. 5%), Cardiac catheterization reports (approx. 3%), Miscellaneous reports (approx. 2%).

PVAHCS, Phoenix: C&P exams (approx. 49%); followed by Hospital/Discharge Summaries (approx. 27%); and Operative Reports (approx. 21%); STAT reports (approx. 2%); with the balance made up of miscellaneous reports. -

SAVAHCS, Tucson: Discharge Summaries and Operative Reports combined equally are approx. 75% of the total transcription. The 25% balance is primarily Compensation & Pension (C&P) exams.

h. Material is dictated by many different clinicians, requiring adaptation to various accents, speech, tone, voice, volume, delivery, pronunciation, and enunciation.

i. The contractor shall have the ability to adapt to monthly staff and resident changes in various medical specialties and likewise shall establish a process to facilitate users’ access to the dictation system promptly. Workload can vary significantly depending on the dictator’s response to delinquent reports and/or resident rotation.

j. The contractor shall assign a Project Manager for the purpose of supervising and training contractor personnel and ensuring compliance with the provisions of the contract. The Project Manager shall have the full authority to act on behalf of the contractor to handle day-to-day operations and problems or concerns as they arise. The Project Manager or an alternate shall be available during the VAMC’s normal business hours (8:00 AM to 4:30 PM MST, Monday through Friday). The contractor shall provide a toll-free phone number to contact the Project Manager as needed.

k. These services shall be performed completely within the United States. Under no circumstances shall any element of this contract be performed offshore. Personnel directly involved with this contract shall be U.S. citizens.

4. EQUIPMENT:

a. The contractor shall provide a minimum of dictation equipment accessible by toll-free (to the Government) telephone as follows:

i. The contractor shall be responsible for the establishment, maintenance, and all costs associated with toll-free telephone lines.

ii. Dedicated STAT lines shall not be required if the contractor's equipment allows for any document to be designated as STAT by the dictator or facility. Otherwise, each facility may require from 1 to 3 additional lines to accommodate STAT dictations.

iii. The Contractor shall have an adequate back-up system in place to maintain dictation/transcription coverage in the event of primary system failure. In case of scheduled downtime, Contractor will notify each COTR at least 72 hours in advance with the date and estimated period of downtime.

b. Contractor equipment shall have the ability to interface with VISTA, as some, but not all, transcription will be batch uploaded into VISTA. Transcription uploads shall be accomplished via the VA Virtual Private Network (VPN).

c. Some of the transcribed data will be batch uploaded into VISTA, and other reports will need to be entered “online.” Batched data must be transcribed in ASCII format, with data elements separated by delimiters. Delimiters will be specified by the appropriate VA facility.

d. For reports that cannot be transmitted to the appropriate VAMC, entering reports may require direct online data entry. Contractor will need to provide, at their expense, all equipment and sufficient asynchronous connections to VA VISTA systems at each facility to accommodate both batched and non-batched transcription. Each VAMC will provide the Contractor with appropriate access and menu options to enter reports and resolve information conflicts within dictated reports.

e. SUGGESTED SOFTWARE TO TRANSMIT TO VISTA: Microsoft Word/Windows - ASCII format; terminal emulation and communication software (KEA) with VT-220 or greater emulation. Other software may be provided, but it will not be supported by the Government. Contractor shall provide training, as needed, in the use of any software utilized other than that designated above.

f. Each facility requires dictation equipment with the capability of providing each dictator with a confirmation number, in case of document loss.

g. A facility may require transcription from tapes, disks, or cassettes during this contract. The contractor shall provide the VA with a designated mailing location able to receive Federal Express overnight deliveries. Contractor will transcribe reports using their own equipment within two days of receipt. Transcribe reports will be entered directly into VISTA via VPN access. The VA shall provide the contractor with a FedEx/UPS account number for the return of the tapes, disks, or cassettes. The facility will be responsible for erasing the tapes or cassettes upon return and verification of transcribed reports within VISTA. The Contractor’s medical transcriptionists who may store VA Protected Health Information (PHI) on PCs to perform services under this contract shall do so only on PCs with encrypted hard drives. PC hard drives shall be wiped clean after the PHI is no longer required to perform services under the contract, and also prior to the PC being disposed of or taken out of service for performance under this contract.

5. DELIVERY OF SERVICES:

a. All transcribed documents shall conform to facility-specific VA format. Format changes may be required during the contract period. Transcribed documents shall contain.

dictation date, transcription date, report or job number, and initials of the transcriptionist responsible.

b. Abbreviations shall not be used in the diagnosis, impression, and procedure sections of any dictated reports. The transcriber will spell out the diagnosis, impression, or procedure and include the abbreviation. For example, Voice dictation states AMS secondary to UTI will be transcribed as Altered Mental Status (AMS) secondary to Urinary Tract Infection (UTI). Abbreviations within the text are to be limited to those listed on an approved VISN #18 abbreviation list and those commonly used in laboratory value reporting. If a VISN #18 abbreviation list is not provided, the contractor shall use the most recent edition of STEDMAN’S ABBREVIATIONS, ACRONYMS AND SYMBOLS. Each facility will provide a listing of abbreviations that are on their DO NOT USE or Unauthorized abbreviation listing. These abbreviations shall not be used throughout any report.

c. Turnaround time is defined as a period from the end of dictation of the document to the time the work is uploaded to the respective facility. Specific document turnaround time is designated as follows:

i. Designated stat dictations, to include emergency room notes, telephone consents, operation notes, and discharge summaries shall be transcribed and transmitted within two (2) hours of dictation.

ii. History & Physical Assessments shall be transcribed and transmitted within four (4) hours of dictation.

iii. Operation reports, non-operative procedures, consultations, and inter-service transfer summary shall be transcribed and transmitted within six (6) hours of dictation.

iv. All other medical reports shall be transcribed and transmitted within 24 hours.

This would include discharge summary, progress notes, and compensation and pension, (C&P) exams.

v. Turnaround time requirements of transcription, including transmission, shall be in effect twenty-four (24) hours/day, seven (7) days/week, including Federal holidays. Transcription not completed within the required turnaround time shall be brought to the respective COTR’s attention.

vi. The contractor shall be responsible for meeting turnaround times of each facility for workload fluctuations up to 10% over the weekly average. The weekly average will be determined by the specific volume during the billing time period that TATs may have been, not been met for any given facility.

vii. The following applies to the Amarillo site only. - Dictation and transcription of microscopic and diagnostic portions of pathology cases. The transcription shall have a three (3) hour turnaround time. Normally, dictation of cases will be completed by 12:00 PM, Monday through Friday, with the transcribed reports delivered to Amarillo by 3:00 PM on the same day. The transcribed reports shall be returned to the Amarillo VA Health Care System in the same manner as the gross cut-ins are sent, i.e., encrypted reports sent via MS Outlook. The additional requirements are expected to generate approximately 15 to 20 daily reports.

6. REPORTING REQUIREMENTS:

a. The Contractor shall provide each facility’s COTR with the status of pending dictation at 8:00 AM, 12:00 PM, and 4:00 PM (MST), Monday through Friday, exclusive of Federal holidays or as designated by the individual facility. This report shall include the patient’s name, report type, dictation date, and the name of the dictator for each pending un-typed report.

b. The Contractor shall provide the status of dictated reports as requested by authorized users. This information shall be provided within ten (10) minutes of the request. These status requests shall normally be accomplished telephonically.

c. Delivery logs (summaries) shall be transmitted with each batch of transmitted transcribed reports. Each delivery log must contain the patient’s name, Social Security Number (SSN), type of report, name of the dictator, initials of the transcriber, and the date transcribed.

d. At the beginning of each business day, the Contractor shall provide a listing of the previous day’s transcribed reports (inclusive of any transcription that occurred over the immediately preceding weekend or Federal holiday), identified by patient’s name, SSN, and type of report. This daily listing shall also include the date and time of dictation, the date and time of transcription, the transcriber, priority status, visible black character count for each transcribed report, and a cumulative visible black count for all reports on the daily listing.

NOTE: In lieu of the requirements above, the contractor may provide a web-based program or PC software that will allow each facility to access the status of dictation and transcription as needed. If access is not web-based, software must be approved prior to contract award via the VISN 18 Chief Information Officer.

7. QUALITY STANDARDS:

Reports should meet the professional quality standards set forth below, including the body of the text as well as the information in the header and footer. If a problem is identified upon receipt by VA (i.e., incorrect job number, etc.), VA will contact the contractor to have the discrepancy researched via the contractor’s dictation system, individual typist, etc., for problem resolution within 24 hours. The contractor must correct all unsatisfactory work unless excused in writing by the COTR for a particular report. Consistent failure to meet any of the quality standards below (quality standard, upload standard, TAT Report standards, TAT standard, and skipped jobs standard) may be cause for termination of the contract.

a. Quality Monitor: VA staff will monitor a random sampling (20 reports) at least once per month, by comparing the completed report with the voice dictation. The random sampling may be either a sampling of all reports or a subset of reports. Any report with three or more blanks may also be included in this sample. The transcriptionist will not be held accountable for the poor quality of dictation by the dictator. A monitor will be provided to the contractor each month. If the monitor shows 5 reports out of 20 have significant errors (non-compliance), the contractor will be requested to provide a corrective action with the Contracting Officer and COTR. Three months of non-compliance with this monitor, per base or optional period, may cause of termination of this contract.

b. Significant Errors. An error is considered significant if the error changes the meaning of the report, including but not limited to:

Note: Reports containing a significant error, as defined above, are subject to a 50% payment reduction.

c. Upload Standards: Errors in titles assigned during upload, uploading to incorrect patient name, SSN, or appointment/admission/procedure date, and errors in the name of dictating provider and attending physician (if applicable) assigned during upload are subject to a 50% discount. Upload errors caused by errors or omissions on the part of the VA author do not count against the contractor's TAT performance and will not impact billing.

Uploading reports to the wrong VHA facility is considered a privacy/security violation and is a reportable incident under Federal Law. Three separate reportable incidents within a base or optional period may be a significant cause for termination of this contract. One incident of uploading a report to a non-VHA facility may be cause for termination of this contract.

d. TAT price discount: Individual reports received one hour beyond the established TAT shall be subject to a 10% payment discount. Any individual report that is 8 hours or greater beyond TAT shall be subject to a 50% payment discount.

e. Proofreading: For any words or phrases that cannot be transcribed due to difficulties in hearing the dictator's voice, the transcriptionist shall type *-* for all report types. At the discretion of the VA, the contractor shall type blank lines in place of *-* for certain report types. Any report with more than one blank on a one-page report, three blanks on a two-page report, or more will be reviewed by the contractor’s internal quality review process.

f. Spell check: Contractor will use a medical spell checker on each document and perform corrections for spelling and grammar.

g. Corrections: Any report(s) returned to the contractor for correction for reasons stated herein shall be corrected within four hours of receipt at no additional expense to VA. VA reserves the right to correct such reports without giving notice to the contractor and may offset the cost of corrected lines against payments due.

8. EQUIPMENT FAILURE:

Contractor shall maintain the resources necessary to ensure that transcription services for the VA are uninterrupted, regardless of contingency or circumstances. Any unexpected delays or downtime due to Contractor equipment failure shall be communicated to each facility within two hours via telephone to the respective Contracting Officer, COTR, and Privacy Officer at each medical facility the contractor services by email to their respective accounts. Voice backup must be maintained for a minimum of 60 days after VA is in receipt of transcribed reports. The Contractor shall not be penalized for transcription delays due to equipment failure beyond the Contractor’s control (e.g., VISTA or VPN downtime). The Government reserves the right to procure transcription services from another source, with excess costs charged back to the Contractor, in instances of Contractor equipment failure exceeding twenty-four hours.

9. RETENTION:

a. Dictation shall remain available for listening review for a minimum of 60 days from the time of the original dictation.

b. Transcribed reports shall be maintained by the Contractor on archive disks for twelve (12) months. Transcribed reports will be purged no later than 12 months from their transcribed date.

c. Dictation logs shall be retained by the Contractor for 12 months and then purged from their system.

d. The Contractor will erase all media containing VA reports that are aged more than 12 months. At each erasure, certify to the VA that the information has been destroyed. Should the need arise, the contractor should provide re-uploads of transcribed reports as far back as one year from the date of upload into Vista. In the event of failure(s) or potential failure(s), the contractor shall immediately notify the Contracting Officer, COTR, Privacy Officer, and Security Officer of each of the serviced facilities by email to their respective accounts.

10. INVOICING:

a. Billing/invoicing shall be done monthly in arrears and reflect the following:

inclusive dates of the billing period, invoice number, obligation number, contract number, total visible black character (VBC) count by report type, and total overall VBC count; and total charge submitted to each facility per report type and total facility charge. With each invoice, the contractor shall provide the necessary documentation allowing each facility to verify the total VBCs being billed. VA will discount payment for reports not delivered within specified TATs and documents that do not meet quality assurance standards. Contractor shall NOT be paid for any invoice using “per line” pricing. VBC is MANDATORY.

b. Each task order awarded under this Blanket Purchase Agreement (BPA) shall be Awarded with a Not to Exceed (NTE) spending limitation by the respective Administrative/ Ordering Contracting Officer. Monthly, the contractor shall provide the Procuring Contracting Officer with a spreadsheet detailing, as a minimum, the initial NTE limit for each site, the monthly and cumulative VBC total(s) from each site, and the remaining spending limit available for continued services. Contractor shall design the spreadsheet and submit it to the PCO for approval.

11. CONFIDENTIALITY:

a. The Contractor is subject to the provisions of the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act (HIPAA), Federal Information Security Management Act (FISMA), and all applicable VA laws and regulations, including VA Handbook 6500.6 “Contract Security” (reference 11 k. below). Additionally, Contractor shall complete a Business Associate Agreement (BAA) with each site utilizing this blanket purchase agreement. Contractor shall be limited in their access to only those VISTA menus required to perform the service. If the contractor has transcription staff who work at home, the contractor shall provide necessary information to the Information Security Officer as to how they are meeting the security requirements of HIPAA. Contract employees will provide the Contracting Officer, on an annual basis, documentation of privacy training. (See also 10. Training)

b. The Contractor shall keep confidential the contents of all medical documents entrusted to its care. Employees of the Contractor shall not disclose to any unauthorized person, firm, or corporation knowledge entrusted during performance of the contract which relates to the following, but not limited to:

i. Names of patients.

ii. Names of physicians, nurses, or any other employee of the medical center.

iii. The type or content of any dictated reports.

c. All contractor personnel shall observe the requirements imposed on sensitive data and information by law, Federal regulations, VA statutes and policy, Veterans Health Administration (VHA) policy and guidelines and the associated requirements to ensure appropriate screening of all personnel (e.g., Privacy Act of 1974, Public Law 93-579, the requirements of the FPM 731, Subchapter 2 under E.O. 10450, etc.). In accordance with FPM Chapters 731 and 7s 5 CFR Ch. 1 (1-1-95 edition) and Executive Order 10450, the security risk level assigned is considered Low Risk (LR) equating to noncritical sensitive, defined as "These positions have limited potential for adverse impact involving limited scope of duties without independent or semi-independent action or decision making". CONTRACTOR PERSONNEL who have ACCESS TO VA COMPUTER SYSTEMS SHALL BE REQUIRED TO UNDERGO A BACKGROUND INVESTIGATION COMMENSURATE WITH THE LEVEL OF SECURITY RISK. THE COSTS ASSOCIATED WITH THE BACKGROUND INVESTIGATION SHALL BE BORNE BY THE CONTRACTOR.

d. Investigative Process for Low Risk and Non-sensitive Positions. All Contractor Employees who require access to VA computer systems and will work more than six (6) months (180 days) under this contract shall be the subject of a background investigation and must receive a favorable adjudication from the VA Security and Investigations Center (SIC). This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed before the start date of the contract, the Contractor will be responsible for the actions of those individuals they provide to perform work for VA. Unless exempted under the provisions of VA Directive 0710, appointees and contract personnel appointed to Low Risk/Non-sensitive positions must be the subjects of a National Agency Check with Written Inquiries (NACI) investigation conducted by OPM. See 5 CFR §736.201(c), Investigative Requirements. HRM at VA field facilities and VA Central Office will coordinate the initiation of the NACI investigations within 14 calendar days of an individual’s appointment and make final suitability determinations for individuals in these positions. However, the initiation and adjudication of contract personnel will be handled by the Security and Investigations Center. For non-citizen contract personnel, a National Agency Check with Law Enforcement and Credit (NACLC) will be initiated by the Security and Investigations Center within 14 calendar days of the individual’s placement in the position. NACLC investigations require the same forms and processes as the NACI investigations; however, with the addition of a credit check.

e. Prior Investigations: All Contractor employees who require access to VA computer systems and will work more than six (6) months (180 days) under this contract shall be the subject of a background investigation and must receive a favorable adjudication from the VA Security and Investigations Center (SIC). This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed before the start date of the contract, the Contractor will be responsible for the actions of those individuals they provide to perform work for VA.

f. Contractor Responsibilities:

(1) The Contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the OPM, the Contractor shall reimburse VA within thirty (30) calendar days.

(2) The Contractor shall prescreen all personnel requiring access to the computer systems to ensure they are able to read, write, speak, and understand the English language.

(3) The individual must complete an original SF-85, Questionnaire for non-sensitive positions, one SF 87 OF 306, and an employment application consisting of a resume or OF 612. The HRM Officer or designee will provide these forms for completion to the newly appointed individual for a Low Risk/Non-sensitive position. Title 38 appointees or employees may submit, as applicable, VA Form 2850, VA Form 2850a, VA Form 2850b, or VA Form 2850c in place of the resume or OF 612.

(4) The individual must complete all forms and return them within 5 calendar days.

Individuals hired under contract for these positions must submit their forms to the VA Law Enforcement Training Center/SIC, 2200 Fort Roots Drive, Bldg 104, North Little Rock, AR 72114.

(5) The contractor shall designate a primary and alternate point of contact by name and phone number who will function as liaison with the COTR on day-to-day operations, and will be available from 8:00 am to 4:30 pm local time, Monday through Friday, excluding Federal Holidays

(6) The Contractor shall designate a company officer authorized to resolve ongoing problems that have not been resolved at the operations level.

(7) Closeout Deadlines: VA is required to meet monthly (or other incremental) closeout deadlines, which require that all medical records of patient encounters be completed and submitted to a centralized authority periodically. The contractor shall ensure that VA does not fail to meet this deadline due to the contractor's failure to meet the contract TAT.

(8) Validation of turnaround time: Within 24 hours of the request, the Contractor shall be able to produce accurate automated reports showing the following:

a. for a given date range, the average turnaround in hours and minutes for individual report types.

b. for a given date range, the average turnaround in hours and minutes for all report types.

(9) Contractor will ensure that the facility can digitally monitor when dictation has been received, transcribed, and transmitted to VISTA.

g. To maintain Patient Medical Records, the Contractor shall have access to the Department of Veterans Affairs System(s) of Records entitled, “Patient Medical Records - VA (24VA136).”

h. “Contractor personnel who obtain access to hardware or media which may manipulate or store drug or alcohol abuse data, sickle cell anemia treatment records, records of tests or treatment for or infection with Human Immunodeficiency Virus (HIV) or medical quality assurance records protected by 38 U.S.C. 4132 or 3305, as defined by the Department of Veterans Affairs, shall not have access to the records unless necessary to perform their contractual duties. Security of Sensitive Data (see M-11, Chapter 16, “AIS Automated Information Systems Security”, paragraph 16.09 and Appendix 16B) describes these data in greater detail. Any individual who has access to these data will disclose them to no one, including other employees of the Contractor not involved in the performance of the contractual duty for which access was obtained. Violation of these statutory provisions, as stated in Department regulations, by the Contractor or the Contractor’s employees, may involve imposition of criminal penalties.” The VA facilities shall provide access to the cited VA Manual provisions.

i. In addition to abiding by the above confidentiality statement, other statements regarding patient confidentiality and computer security may need to be signed by each contractor employee performing on this contract.

j. Under no circumstances are transcription services allowed to be performed outside the United States. Additionally, subcontracting of any work, e.g., uploading of transcriptions, will not be allowed without the express written permission of the Contracting Officer. The contractor is required to provide all services under this contract. Violations may be caused by the termination of the contract.

k. Contract Security - Contractor shall comply with all applicable requirements detailed in VA Handbook 6500.6. You may review and/or download this VA handbook at the following website: www1.va.gov/vapubs/viewPublication.asp?Pub_ID=471&FType=2.

12. TRAINING:

Qualified Personnel – The contractor will be responsible for ensuring that Contractor personnel providing work on this contract are fully trained and completely competent to perform the required work.

The Contractor shall provide a comprehensive training program during the start-up period for user personnel at each facility, including pocket-sized instruction cards for quick reference by medical center staff using the dictation system. This should include on-site visits to each facility as necessary. The Contractor shall provide updates or changes to the instruction cards as needed for each facility and provide as much advance notice as possible of any upcoming changes. The training program shall be available on an “as needed” basis to both existing medical center staff and future additions to staff over the term of the contract. The training program shall be approved in advance by each facility’s COTR.

All contractors’ personnel with access to Government computer systems and/or records comply with the Privacy Act of 1974 and HIPAA, and each has completed the VA System Access Agreements. Contractor personnel shall complete the VHA Privacy Training and VA Information/Cyber Security Awareness training before accessing the VA computer system and annually thereafter.

A web-based training site will be provided upon contract award. Violations may be caused by the termination of the contract.

13. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA):

In accordance with 45 CFR 164.502(e), the Privacy Rule will require a Business Associate Agreement (BAA) to be executed with the resulting contract.

14. TASK ORDERS:

Each facility listed in the Price Schedule may issue its own respective task orders to provide for the support of that site. An order is defined as a finished dictated report recorded into the contractor’s designated dictation system.

15. SYSTEM ACCESS:

Any remote access to VA systems that contain sensitive information must be done through the One-VA Virtual Private Network (VPN). Upon notification of contract award and prior to VA granting VPN access, the contractor will be required to complete all security requirements.

16. SECURITY APPENDIX CLAUSES:

Security clause from VAHB 6500.6 App B: The contractor, their personnel, and their subcontractors shall be subject to the Federal laws, regulations, standards, and VA Directives and Handbooks regarding information and information system security as delineated in this contract.

Security clause for VAHB 6500.6 App C: The contractor will initiate planning for the certification and accreditation of the contractor systems.

QUESTIONS AND ANSWERS

1. Section B.2 lists the Unit for CLINs 0001–4001 as 'YR' with a quantity of 1.00, while Paragraph 10.a states invoicing must be based on Visible Black Characters (VBC) and prohibits 'per line' pricing. Could the Government provide historical or estimated annual VBC or line counts across the seven facilities, or should offerors submit a flat annual firm-fixed price in Section B.2? Offerors shall submit pricing in accordance with Section B.2 of the solicitation. Invoicing shall be based on Visible Black Characters (VBC) as required by the Statement of Work. The SOW specifically states that contractors shall not be paid using line pricing and that VBC billing is mandatory. Historical VBC counts are not available for release. Offerors should propose pricing based upon the requirements contained in the solicitation and SOW.

2. Please provide the actual monthly Visible Black Character (VBC) volume and number of transcribed reports, by facility, for the most recent 12 months available. The Government does not have validated monthly Visible Black Character (VBC) volume data and report-count data available for release with this solicitation.

3. Please provide the approximate percentage of historical workload falling into each required turnaround-time category: 2-hour STAT, 4-hour, 6-hour, and 24-hour.

Historical workload percentages by turnaround category are not available.

The required turnaround times identified in the SOW are:

· STAT Reports: 2 hours

· Operation Reports: 6 hours

· Most remaining report types: 24 hours Offerors shall be capable of meeting all required turnaround standards identified within the SOW.

4. Please provide the approximate percentage of workload received during normal business hours, evenings, overnight hours, weekends, and Federal holidays. Historical workload distribution by business hours, evenings, overnight periods, weekends, and Federal holidays is not available. The contractor must be capable of providing transcription services 24 hours per day, 7 days per week, 365 days per year, including weekends and holidays.

5. Please provide the highest weekly and/or monthly workload experienced at each facility during the most recent 12 months. Additionally, does the 10% workload fluctuation identified in the SOW represent the maximum anticipated surge requirement? The Government does not have validated historical peak weekly or monthly workload data available for release.

Additionally, the SOW provided does not establish a maximum surge percentage. Therefore, the Government cannot confirm that a 10% fluctuation represents the maximum anticipated surge requirement. Contractors shall maintain sufficient capacity to meet all required performance standards throughout the period of performance.

6. Approximately what percentage of the current workload is batch uploaded into VistA versus requiring direct/online entry by contractor personnel? The Government does not track or have available historical statistics reflecting the percentage of workload uploaded through batch transmission versus direct online entry.

The SOW requires electronic transmission and upload into VistA/TIU but does not provide historical percentages for either method.

7. Please provide the incumbent or predecessor contract number. The predecessor contract referenced in available acquisition correspondence is:

36C25820F0032

8. This reference appears in prior acquisition documentation associated with the transcription requirement. The Government does not possess incumbent contractor staffing information for release under this solicitation.

9. If available, please provide the incumbent contractor’s current staffing level or level of effort supporting this requirement. The Government does not anticipate workload changes beyond those associated with normal operational requirements. However, the Government does not guarantee any minimum or maximum workload under the resulting contract.

10. Does the Government anticipate any material increase or decrease in transcription workload during the base period compared with historical workload due to changes in VA staffing, speech-recognition technology, clinical documentation practices, or other factors? The Government confirms the quantities identified within the solicitation represent the best information currently available. Offerors should prepare proposals based upon the requirements and quantities contained in the solicitation and resulting amendments.

11. Could you please assist us in confirming these quantities with the customer?

The Government confirms that offerors should prepare proposals based on the quantities and requirements identified in the solicitation. No additional workload quantities beyond those provided in the solicitation are currently available for release.

12. The solicitation requests experience information for both the prime contractor and proposed subcontractors, but the SOW also states that subcontracting may not occur without the express written permission of the Contracting Officer. Would an SDVOSB prime be permitted to propose an experienced medical-transcription subcontractor as part of its initial offer, subject to the applicable limitations on subcontracting and Government approval? Yes. Offerors may propose subcontractors as part of their initial proposal for evaluation purposes. However, any subcontracting arrangement under the resulting contract remains subject to review and written approval by the Contracting Officer. Submission of a proposal identifying a subcontractor does not constitute Government approval of the subcontracting arrangement. The successful contractor must comply with all applicable limitations on subcontracting and contract requirements. The SOW states that the contractor shall not subcontract work or any portion of the work without prior approval from the Contracting Officer.

13. If the proposed subcontractor is also a certified SDVOSB and otherwise qualifies as a similarly situated entity under VAAR 852.219-73/75, may its performance count toward the prime contractor's limitation-on-subcontracting requirement? Offerors shall comply with all applicable VAAR, FAR, SBA, and solicitation requirements regarding limitations on subcontracting and similarly situated entities. The Government will evaluate proposals in accordance with the solicitation terms. Offerors are responsible for ensuring compliance with all applicable regulatory requirements

14. The SOW requires all transcription and verification activities to be performed in the United States and by U.S. citizens. Would U.S.-citizen personnel physically performing services in Puerto Rico satisfy this requirement? Yes. The SOW requires all transcription and verification services to be performed in the United States of America, including U.S. territories. Puerto Rico is a U.S. territory; therefore, U.S.-citizen personnel physically performing contract services in Puerto Rico would satisfy this requirement.

15. Workload: Please provide estimated annual and monthly visible black character (VBC) volumes for each of the seven facilities, historical report counts and average report lengths, and the anticipated proportions of STAT and other turnaround categories. Are there minimum guaranteed quantities or maximum workload limits? The Government does not have validated historical VBC volumes, report counts, average report lengths, or workload distribution data available for release.

The SOW establishes required turnaround times but does not provide historical percentages by report category. Offerors shall be capable of meeting all turnaround-time requirements identified in the solicitation and SOW.

The Government does not guarantee minimum quantities. Any applicable funding limitations or not-to-exceed amounts will be administered in accordance with the contract terms

16. Pricing format: Section B.2 requests one annual price for each contract year, while the SOW requires VBC-based billing and prohibits per-line pricing. Should offerors submit a per-VBC rate for each year together with an estimated annual total? If so, what estimated quantities should all offerors use, and should rates be uniform across facilities and report types? Offerors shall submit pricing in accordance with Section B.2 of the solicitation.

The SOW requires billing based on Visible Black Characters (VBCs) and specifically states that contractors shall not be paid using line pricing and that VBC billing is mandatory. The Government is not providing estimated VBC quantities for proposal purposes. Offerors shall structure their pricing consistent with the solicitation instructions and SOW requirements

17. Payment: Will payment be based on actual accepted VBCs multiplied by the proposed rate, or on…