P03_-_Single_Source_Justification_Optum_Medical_Reference_PCAC.pdf

VHAPM Part 813.106 Page 1 of 2 Original Date: 08/30/17 Revision 01 Eff Date: 04/23/2018

DEPARTMENT OF VETERANS AFFAIRS

Justification for Single Source Awards IAW FAR 13.106-1 For

Over Micro-Purchase Threshold but Not Exceeding the SAT ($250K)

HIG SST ScienceDirect Journals Subscription

Acquisition Plan Action ID: 36C776-19-AP-0091

1. Contracting Activity: Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Program Contracting Activity Central (PCAC), 6150 Oak Tree Blvd, Suite 300, Independence, OH 44131, Purchase Request Number is: 776-19-1-3156-0005.

2. Brief Description of Supplies/Services required and the intended use/Estimated Amount: A web-based business tool which provides medical reference information and timely updates on code sets (Current Procedural Terminology (CPT), International Classification of Diseases-9th Edition (ICD-9), International Classification of Disease-10th Edition (ICD-10), Healthcare Common Procedure Coding System (HCPCS), American Dental Association (ADA)) provided by the authoritative source. These tools are used to support the VA Medical Centers, enterprise-wide, for queries on reporting of Veteran care services, billing activities, Clinical Documentation Improvement (CDI) efforts, and Diagnosis Related Group (DRG) validation. The tool must be a web-based standalone tool that is not integrated into VistA. To meet the needs of the organization, thirteen (13) individual login accounts would be necessary for the general medical references, five (3) individual login accounts for the Clinical Documentation Improvement references through the Encoder Pro portal, and (3) three individual login accounts for the Revenue Cycle Pro/DRG Grouper Calculator. Estimated amount: $7,550.00 (base year) $38,610.00 (base and option years).

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used: National coding guidelines, as well as CMS guideline, change throughout the year. It is essential that the up-to-date information regarding coding changes be available to staff to provide accurate information to our customers. Users will have the current reference information available to respond to clinical questions, VA Medical Center and Consolidated Patient Account Center (CPAC) billing/Utilization Review (UR) staff questions, provide documentation improvement guidance to providers in real time versus researching numerous sources for the answer, and quickly group diagnosis and procedure codes to their applicable DRG and exact provider's reimbursement for both ICD-9 and ICD-10 codes for DRG validation. The web-based application is available from any internet connection, and is not tied or limited by location of the employee. Market research has indicated only one source, Optum 360°, can provide the multitude of references available from Optum in one product or one location, and the Medical Reference Engine is a proprietary product of Optum 360° and no other providers offer the Optum software or are qualified as a third-party distributor.

4. Description of market research conducted and results or statement why it was not conducted: In accordance with FAR Part 10, market research has been conducted for this acquisition. The following techniques were used:

https://www.acquisition.gov/?q=/browse/far/13

VHAPM Part 813.106 Page 2 of 2 Original Date: 08/30/17 Revision 01 Eff Date: 04/23/2018

a) FBO.gov

A notice of intent to sole source was posted on FBO on October 25, 2018 with a due date of November 8, 2018 10:00 am EST for comments concerning the sole source. No responses were received.

b) VetBiz.gov

VIP was queried on October 25, 2018 in an attempt to locate Service-Disabled Veteran- Owned Small Business (SDVOSB) and Veteran-Owned Small Business (VOSB) concerns utilizing NAICS code 519130. The search provided 172 results. All 172 vendors were emailed the notice of intent to sole source with an opportunity to provide a capability statement. No responses were received.

c) DSBS

A search of DSBS was conducted on November 8, 2018 utilizing the NAICS code 519130 and key words “Medical Reference” and “Optum.” The search provided zero results.

d) Optum 360°

Previous market research performed in September 2017 established that an inquiry was made to Optum requesting information asking if the online medical reference engine was proprietary to Optum. Optum confirmed that Medical Reference Engine is a webhosted proprietary application produced and marketed by Optum 360°.

Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106-1(b). I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

Name Date Title https://acquisition.gov/far/current/html/Subpart%2013_1.html#wp1125466 VHACLEMorgK2 Typewritten Text 11/08/2018

VHACLEMorgK2 Typewritten Text : Kymberly Morgan

VHACLEMorgK2 Typewritten Text : Contracting Officer