36C77620R0001-0001001.docx

External Peer Review Program (EPRP) Solicitation # 36C77620R0001 Questions & Answers

1. Volume I: Technical is limited to 30 pages. Would VHA consider increasing the Technical page limit by ten (10) pages to fully address the requirements associated with the nine (9) tasks in this volume?

Response: No

2. Does VHA expect all bidders and subcontractors to include NAICS code 813920 under their SAM profile?

Response: No GAO file B-413198 found that an awardee’s failure to list the assigned NAICS code under its SAM profile did not make its proposal technically unacceptable. For subcontracting purposes pursuant to sections 8(d) of the Small Business Act, a concern is small for subcontracts which relate to Government procurements if it does not exceed the size standard for the NAICS code that the prime contractor believes best describes the product or service being acquired by the subcontract.

3. If contractor performance is to commence within thirty (30) calendar days of Contract award, when should the contractor anticipate the first pull list be provided?

Response: November 2, 2020

4. The performance period will be six (6) months base period. As a new contractor will have to invest in technology would VHA consider making the base period a full year or 18 months to allow the contractor more time to recover that investment?

Response: No

5. What is the estimated percentage of Abstraction work performed remote versus on-site in the VHA facilities?

Response: All abstraction is done remotely

6. Will VHA provide electronic health records through a data transmission to the contractor?

If yes, will the electronic health record be the full longitudinal record for each patient identified in the monthly pull list?

If yes, what are the electronic formats the patient medical record will be sent to the contractor in, i.e. XML, HL7, JSON, or CSV?

Response: Contractors are provided access to VHA facility local electronic medical record

7. Can VHA please provide the missing Attachment A – FY20 Facilities List?

Response: Facilities List has now been added to the Solicitation via Attachment I.

8. “The Contractor shall develop, maintain and provide computerized scoring algorithms incorporating the data elements for each of the review areas/review topics. Electronic versions of the scoring algorithms will be provided to RAPID-PM in both mnemonic and phrased form. Computerized scoring algorithms shall incorporate the measure specifications so that data can be abstracted from the electronic records using a computer which downloads data into transmittable files.” Can you confirm the percentage of measures currently tracked by VA which require manual abstraction of data rather than electronic abstraction?

Response: Abstracted about 80% Electronic about 20%

9. “Algorithms shall be provided electronically in a form acceptable with RAPID-PM standardized coding practices. All data first produced (as defined by Federal Acquisition Regulation 52.227-14) under this Contract by Contractor shall be delivered to VA and owned by VA, to include the algorithms.” Can you confirm if the expectation is that all measures developed using standard measure sets under NCQA HEDIS, JCAHO, and ORYX are considered to be owned by VA? Please clarify as some of these measure sets are licensed to the vendor to develop and/or available in the public domain

Response: Regardless of measure source, the algorithm is owned by VA

10. What data elements are included on the pull list?

Response: Demographic information and study interval

11. The PWS states, Abstraction shall take place during normal business hours when visiting the facility unless otherwise agreed upon by the liaison. What are those hours?

Response: M-F 8a-430p

12. There is reference to “compliance as outlined in the VHA Technical Manual”. Can VHA provide that Technical Manual?

Response: No, it is an electronic system behind the firewall, access provided upon award.

13. Will the Cerner implementation of a centralized Electronic Health Record become the primary source for data abstraction?

If yes, what is the estimated timeline?

If yes, will that source of data to be available for the contractor to receive electronic extractions/transmission?

Response: Cerner will become source of abstraction once implemented in phased rollout over the next 10 years.

14. “The measures themselves will be proposed by RAPID-PM based upon the recommendation from Program Offices in the VHA.” How far in advance will the RAPID-PM provide measures to the contractor if, as stated in section 5.1 “the contractor shall provide dataset questions within 30 days of the quarter?

Response: Measures are requested or updated quarterly, once identified contractor has 30 days

15. Deliverable 3.1 notes that “Contractor shall start record abstraction within (30) calendar days of Contract award. First abstraction shall be completed within thirty (30) calendar days of receipt of first pull list once the Contract is awarded.” Does this mean that a new contractor must be fully operational within the first 30 days including systems receiving a VHA Authority to Operate (ATO) [as noted in Section 6.5 page 41] or will VHA allow the program to proceed while the formal ATO is in process?

Response: Yes, however ATOs and even temporary ATO can/do take 3 to 6 months once the system is listed in eMASS, and the System Steward, Information System Owner and Case Manager are all assigned. I have seen some systems take over year to get ATO.

16. Neither the Solicitation or PWS formally discuss Transition In activities for a new contractor and only note the contract start for abstraction within 30 days of award. This leaves a new contractor no pre-quarter time for dataset questions and measure tool development and validation. Can VHA provide insight into how the abstraction can start within the first 30 days if there is no time outlined for transition in to develop the first dataset questions and measures ahead of the first monthly abstraction period?

Response: The incumbent contract included FAR Clause 52.237-3 Continuity of Services.

17. Would VHA consider Regional Managers with other certifications such as CPC, CCS, or CMC certification in lieu of the RHIA or RHIT certifications?

Response: No, CPC/CC/CMS certifications do not have breadth and depth of knowledge and skills required for abstraction.

18. Would VHA consider abstractor staff with CPC, CCS, or CMC Certification in lieu of the RHIA or RHIT certifications?

Response: No, see above

19. “In addition, FAR 52.217-9, Option to Extend the Term of the Contract applies to the solicitation. As such, evaluation of options under FAR 52.217-9 will be used to evaluate the total price.” Based on this statement is the pricing for the optional 6- month extension part of the evaluated price, and if so should it be added to the Attachment containing the Pricing Schedule?

Response: Yes

20. The RFP states proposals are due by May 2nd, 2020 11:59 PM. SAM.gov says Original Date Offers Due is May 01, 2020. Please clarify the due date.

Response: May 2nd

21. Can contractor staff work, with access to VA systems using a PIV card, while the NACI is pending?

Response: Yes, once Background started and fingerprints done contractors can get what is necessary for PIV and consequently access.

22. “Within 3 business days after award, the Contractor shall provide a roster of Contractor and Subcontractor employees to the COR to begin their background investigations”

Can VHA clarify if the roster due within 3 business days of award is the staff that will start day 1 of the contract to start transition in, or is VHA asking for a full roster of all staff including abstractors who would start later but in advance of abstraction?

Response: Staff that will start day one. The contractor will then provide the list of abstractors to the COR as soon as the abstractors are identified.

23. “The Contractor should coordinate the location of the nearest VA fingerprinting office through the COR/PM. Only electronic fingerprints are authorized.” Is the contractor required to use the VA fingerprinting office, or would other non-VA facilities also acceptable as long as the prints are taken electronically?

Response: The fingerprints must be taken at a VA Fingerprinting office.

24. “All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:”. There is nothing listed – can VHA confirm this is correct?

Response: Please refer to section B.9 in PWS. ( a ) (1,2,3).

25. “VA prohibits the installation and use of personally-owned or Contractor/Sub-Contractor owned equipment or software on the VA network.” Can the contractor’s solution and database for EPRP reside in the VA Enterprise Cloud or the VA Data Center?

26. If the Offeror has completed its representations and certifications in sam.gov, does the Offeror need to include all 18 pages of Section E.13 in Volume V or only paragraph (b)(2)? Does Section E.13 require a separate signature?

Response: The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u) of this provision.

Certifications and Representations - An authorized official of the firm shall sign the SF 1449 and all certifications requiring original signature. An Acrobat PDF file shall be created to capture the signatures for submission.

27. Can the Government include the Arial Narrow font for use with graphics and tables?

Response: Arial or Times New Roman fonts are required

28. Since resumes are not included in the page count will the Government allow a "Volume I - Technical Proposal Resumes" document to be submitted? Due to the large number of resumes that will be presented we feel that will make it easier for the Government to review instead of adding the resumes as an appendix.

Response: Resumes can be submitted as part of Volume I, each resume shall not exceed three pages.

29. Volume IV file format is in Excel. Attachment G - Price Schedule is in Word. Would it be allowable to submit Volume IV in PDF format?

30. As a commercial items procurement, is the breakout of labor categories, level of effort, and hourly rates, along with a basis of estimate, required in Volume IV - Price?

Response: VOLUME IV– PRICE FACTOR The Offeror shall complete the Schedule of Supplies/Services of the solicitation. Offerors will provide fixed pricing for the task order by deliverable, with a break-out of labor categories, level of effort, and hourly rates

31. In Section 2 it states, "It is up to the Contractor to determine which labor categories from those offered in the Proposal, and in what quantities, are needed to support the solution that they have developed in their technical quotation." Does this suggest that the Offeror may propose a different staffing mix (different positions, number of positions or lower level of effort) from the ones specified in the PWS Section 5.12.a as Key Personnel?

32. What period of performance or start date should be used when preparing the Price Schedule?

Response: 9/30/2020

33. "An authorized official of the firm shall sign the SF1449 and all certifications requiring original signature." There are no certifications with separate signature lines in the solicitation, other than the SF1449 and SF30s. Please list each certification that requires an original signature.

Response: SF 1449’s, SF 30’s

34. If the Offeror has attested in sam.gov that it does not provide covered telecommunications equipment or services, is any acknowledgement or response to E.6 required in Volume V?

Response: Yes, Volume V, Section E.7 addresses telecommunication

35. If the Offeror has attested in sam.gov regarding Responsibility Matters, is any acknowledgement or response to E.7 required in Volume V?

36. Is estimated quantity of 2 annual program-related meetings in addition to the biweekly status meetings noted in 5.6 Task 6 Communications?

37. 4.2 notes onsite exit conferences will be provided during quarter one and quarter three. 5.1 (2) notes a minimum of two visits a year. Is the expectation that onsite visits for exit conferences will occur in quarters one and three?

Response: Yes, that is a minimum requirement

38. The quantity for deliverable 1.2 is not specified in the PWS. Per Attachment G - Price Schedule it lists 1 for the base period and 2 for the option years (2-4). Please confirm the quantity for deliverable 12.

Response: Base year is 6 months so only 1; OY 1 will be full 2; please refer to Att. G Price Schedule

39. Base period of performance is 6 months from contract award. Is the unit/qty amount on the schedule of deliverables for a one- year period?

40. For Key Personnel requiring a full-time position, is it allowable to meet the full-time requirement with more than one person? (For example, may one full-time coordinator be filled with 2 people at half-time each to be an equivalent full-time position?)

41. Program Start-up - the RFP states that “Contractor performance will commence within thirty

(30) calendar days of Contract award. Initial abstraction shall be completed within thirty (30) calendar days of receipt of first pull list once the Contract is awarded.”

How long after the Contract award will the first pull list be sent?

How long will the VA allow for program initiation after the Contract award?

Will there be a ramp up in the size of the pull list to allow for start-up?

Will both of these items be mutually agreed upon by the Contractor and the VA?

Response: November 2, 2020… No…No

42. Contract Personnel The contract states that “Contract personnel who require access to national security programs shall have a valid security clearance“ and Paragraph 6.2.1 of Attachment A indicates that staff will Contract personnel will require a Tier1 background investigation Will any staff require a different background investigation to receive security clearance?

How long will it take the VA to get new staff security clearance? Will this time be included in the time before the first pull list is sent?

Response: Contractors are all Tier 1, Security Clearance time varies but contractors can work once fingerprints are completed and clearance continues.

43. EHR Use and Access What is the approximate mix of EHRs in use across VA Network?

% VISTA

% MHS GENESIS (Cerner)

% AHLTA

% Paper % Other (by name) How long will it take the VA to get new staff access to the VA EHRs?

Will EHR access need to be arranged and approved for the whole VA system or for each VA facility

Response: EHR mix is Vista and Cerner with proportions changing as Cerner becomes fully implemented. Contractors are provided access to facilities they are reviewing.

44. Abstraction Mix What is the average mix of the 50,000 abstractions per month/600,000 abstractions per year?

100% eCQM with no manual intervention to complete and submit (Not including oversight, quality control activities)

Response: A- varies too much; B- not relevant C- Measure changes are implemented quarterly;

45. SOW states: “In collaboration with RAPID-PM, the Contractor shall develop measure specifications based on National Quality Forum (NQF), VHA and/or external accrediting bodies measures proposed by RAPID-PM to include definitions, data set questions and automated scoring algorithms and specifications for software to be used in the abstraction process for medical record reviews as communicated by the COR/PM.“ What are the internal VHA measures?

Response: VHA measures are like external measures but are tailored to meet Program needs.

46. With regard to onsite abstractions, how many onsite abstractions es the Government anticipate occurring on a Monthly basis for those records that are in paper format?

Response: Abstraction is done remotely.

47. With regard to onsite abstractions, how will the contractor be able to determine if onsite abstraction is needed?

Response: Repeat #5

48. If there is no onsite visit to a facility within a month, can the Government describe the expectation for an Exit conference (e.g. should it occur, can it be held remotely)?

Response: Exits occur monthly either onsite or remotely, facilities have the option to choose, COR/PM approves or disapproves onsite, and can request onsite be done at their discretion.

49. For the assignment of Regional Managers, how will the VA define its regions (e.g. VISNs)?

Response: Regions are explicitly linked to VISNs and are geographically organized

50. For the assignment of Regional Managers, how many regional managers does the VHA recommend for each of the regions?

Response: 1

51. PWS states: “Some documentation may be found only in a paper format (e.g., notes from providers outside of the VHA system).” What are the requirements to access and review external provider records for care not provided by the VA?

Is this part of the onsite review and if so, will abstractors be going to providers outside the VA facility?

Response: ‘Outside/paper’ documentation is scanned into VISTA for review. Can be reviewed in EHR onsite or remotely, contractor one POC, who is the facility EPRP liaison.

52. Volume I – Technical Factor requires identification of Key Personnel proposed and their duties and responsibilities but does not request resumes. The page limitations states that individual resumes shall not exceed 3 pages per resume.

In order to VA to receive the highest qualified staff to immediately staff the contract, we recommend the staff resumes be included in Volume 1 technical Factor and they remain outside of page count. Will the Government add specific instruction under Volume 1 Technical question 2 to include all key personnel resumes’?

Response: Staff Resumes submitted with Volume I will not be included in the page count.

53. Related to electronic submission, can the Government clarify the maximum Volume file size for electronic submission?

Response: Volume file size for electronic submission is not a factor in E.5. The Table in E.5 indicates the maximum page count (when applicable) for each volume of the Offeror’s proposal, not file size.

54. Does the VA have a preferred or recommended platform for Web or Video conferencing?

Response: Teams/Adobe Connect/Skype

55. What security governance standards should be used by the contractor to perform a self-assessment?

Response: Refer to Addendum A in contract there are system sites where contractors provide that information. I believe the current system is called eMASS.

56. Extension – Due to the COVID pandemic, can we get an extension to May 8, 2020?

57. Technical Volume – Is there a preferred platform that VA would like the contractor to use?

Response: If platform is equal to format, format is addressed in E.5

58. Technical Volume – What technology stack/solution is currently being used to perform metrics and analysis?

Response: Reporting Services/SAS/SQL

59. Technical Volume – Is VA open to a proposal that includes technology as an accelerator?

60. Past Performance – How many past performances should be submitted? Minimum? Maximum?

Response: No minimum or maximum. Offerors shall submit a list of all contracts (including Federal, State, Government and commercial), (prime contracts, task/delivery orders, and/or major subcontracts) in performance at any point during the three (3) years immediately prior to the proposal submission date, which are relevant to the efforts required by this solicitation

61. Past Performance – Should Section 3 (in Past Performance Volume) be part of the Management Approach (in Technical Volume) Section 3 reads as if it is asking how the PWS work will be split among the prime contractor and subcontract?

Response: Please address this in the past performance volume. This solicitation has been proved to be technically and legally sufficient.