47QFWA22R0008 Questions and Answers 4.18.2022.xlsx
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- 47QFWA22R0008
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This is a combined synopsis/solicitation for medical services to support the Department of Defense Medical Examination Review Board. The General Services Administration is seeking a contractor to provide initial medical examinations, additional medical services, and connectivity between DoDMERB, applicants, and medical providers. Required services include a subcontracted network of medical providers and a portal to facilitate examinations and referrals. The base period of performance is one year beginning May 2022 with four one-year options. Proposals are due through GSA ASSIST by April 2022 with evaluation factors of technical approach, past performance, experience, and price. A pre-proposal conference will be held in April and the incumbent contract expires June 2022.
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Sheet1
| Question # | RFP Section | Page | Question | Response |
| 1 | A pricing CLIN for transition-in costs does not appear in Appendix M. In order to effectively evaluate a new offeror's pricing, will Government provide a specific CLIN for transition-in? Otherwise, a new contractor will have to embed this pricing in the other CLINs which would make them appear artificially higher compared to the current contractor as they will not have these costs. | Reference revised Appendix M. | ||
| 2 | I.3 | 56 | Would the Government provide us with the end date of the Period of Performance on the current incumbent contract? | The current contract expires on June 30, 2022. |
| 3 | The Current CMAC Reimbursement Rates for Range of Procedures breaks out reimbursement rates by Physician/Non-Physician and Facility/Non-Facility. Historically and current practice for Finance is to the reference the National Non-Facility CMS Rate when pricing new services. |
| Can we assume the Maximum Allowable Costs for services performed will be the Physician Non-Facility Reimbursement Rates? | Reference revised Section C.7.8.3.3. | ||||
| 4 | C.2 | 5 | With regard to IME electronic signature by a licensed independent practitioner (LIP), will the Government also allow scanning and digitization of paper records received from providers? | Yes. | |
| 5 | 11.1 | 19 | The vast majority of Federal occupational health and readiness programs require a more comprehensive provider screening process to continuously monitor the quality and security of the provider network. Examples include DODM 6025.13 (7/23/20) Enclosure 4, Section 3 Credentials Management, which requires more extensive monitoring for MHS providers. These are similar standards adopted by Federal programs administered by DoD/DHA, DOJ, DHS and the VA. Would the Government consider changing the provider credentialing and monitoring requirements to match a healthcare industry standard (such as NCQA credentialing verification) that meets the standards outlined in DODM 6025.13 and provides a higher level of quality and continuous monitoring that will ensure the best network possible? | No. If DoDMERB was purchasing healthcare services with the 'intent to treat' we would consider more stringent standards. However for the purposes of a 'report only' occupational pre-placement screening exam with no expectation of diagnosis or qualification judgement, we only require the provider is currently licensed and in good standing in his/her practice jurisdiction or state. That said if an offeror chooses to leverage a national credentialing standard above and beyond state level requirments at no additional cost to the Government, we would not object. | |
| 6 | Appendix D | 66 | Please provide the latest version of these forms (DD2807-2 in Appendix D is dated Oct 2018 and there is an updated version dated December 2021 that makes that version obsolete) | Reference revised Appendix D. | |
| 7 | C.2 | 5 | Would the government consider allowing Board Eligible physicians practicing in their specialty or sub-specialty to provide AMS services? Board Eligible is defined as recent graduates who have completed their residency within the previous three years from an accredited residency. After this three-year window has elapsed, the practitioner is not eligible for services unless they become fully Board Certified. | No. | |
| 8 | C.2 | 5 | Is DoDMERB able to provide details related to the seasonality of exam volume distribution throughout a calendar year? (i.e.: Exam volumes increase by 30% throughout May, June and July [Q2 and Q3] as applicant processing increases at those times.) | Yes, however the quality of the data is low confidence. Offerors are cautioned that AMS requests are not constant or predictable and therefore Appendix K should not be relied upon. Reference Appendix I (Exams by Month) and Appendix K (AMS by Month). | |
| 9 | 7.2.6 | 10 | Please confirm that the contractor will maintain and develop the fields that will be used for online scheduling? | The contractor does not necessarily need to 'schedule' the applicant's IME to the level of date/time. In fact, this would be discourged as the applicants need flexibility. | |
| 10 | 2.6 | 35 | Given that Quality Control Plans are often in excess of 10 pages, will the Government consider excluding the Quality Control Plan from page count? | The QCP has a separate ten (10) page limit and has been excluded from the Technical/Management Approach twenty (20) page limit. Reference revised Section L.3.3.1. | |
| 11 | 2.6 | 35 | Given the amount of information the Government is requesting, would the Government consider increasing the page count for the technical volume to 30 pages? | The Technical/Management Approach has a twenty (20) page limit. The QCP has a separate ten (10) page limit and been excluded from the Technical/Management Approach twenty (20) page limit. Reference revised Section L.3.3.1. | |
| 12 | L.3 | 27 | Would the gov’t consider allowing tables and graphics to have a font size no smaller than 8 pt.? | Reference revised Section L.3. | |
| 13 | L.3.3.1 | 29 | Would the Gov’t consider allowing the QCP to be outside the 20-page limit of the Vol III? | Volume III does not have a twenty (20) page limit. The Technical/Management Approach under Volume III has a twenty (20) page limit. The QCP has a separate ten (10) page limit and been excluded from the Technical/Management Approach twenty (20) page limit. Reference revised Section L.3.3.1. | |
| 14 | L.3.3.1 | 28 | Would the Gov’t consider allowing a 30-page limit for the Tech/Mgmt Vol? Suggest a limit 20 page for Tech Approach and 10 pages for the methodologies, controls, and techniques used to ensure proper management (mgmt. approach)? | The Technical/Management Approach, which is under Volume III, has a twenty (20) page limit. The QCP and OCI Mitigation Plan, both required under the Technical/Management Approach, are excluded from the twenty (20) page limit. The QCP has a separate ten (10) page limit and the OCI Mitigation Plan, if applicable, has no page limit. | |
| 15 | L.3.3.2 | 29 | Would the Gov’t confirm the Previous Experience section is to be included in the Vol III but is outside the 20-page limit. | Volume III consists of Technical/Management Approach (L.3.3.1), Previous Experience (L.3.3.2), Past Performance (L.3.3.3) and Small Business Participation Plan (L.3.3.4). Each of these sections has its own page limitations. Previous Experience has a maximum of six (6) pages – maximum three (3) references/ maximum two (2) pages per reference). | |
| 16 | L.3.3.3 | 30 | Would the Gov’t confirm the Past Performance Reference (Attachment 3) is to be included in the Vol III but is outside the 20-page limit. | Volume III consists of Technical/Management Approach (L.3.3.1), Previous Experience (L.3.3.2), Past Performance (L.3.3.3) and Small Business Participation Plan (L.3.3.4).Each of these sections has its own page limitations. Past Performance requires the submittal of a maximum three (3) Past Performance Questionnaire Forms (Attachment 2) and a maximum three (3) Past Performance Reference Information Sheets (Attachment 3). | |
| 17 | L.3.3.2 & L.3.3.3 | 29/30 | Is it the Gov’ts intent for the Previous Experience references and the Past performance references to be the same projects? Or is it acceptable to use different references for each? | Past Performance information shall be for the Previous Experience submitted under L.3.3.2. Reference revised Section L.3.3.3. | |
| 18 | L.3.3.1 & H.7 | 30/46 | The RFP does not state a specific transition time frame. Would the gov’t consider a 45-day transition plan? | The Transition Period is expected to be approximately May 17, 2022 - June 30, 2022, with full performance beginning on July 1, 2022. However, dates are always subject to change. | |
| 19 | Sections B - J | 3 | Will the Gov’t be providing an SF 1449 for submission with this proposal? | No. The successful offeror will be required to sign the SF 1449 prior to award. | |
| 20 | 7.2.2.1 & 7.2.2.1.2.1 | 10 | When an applicant states yes on the DD 2807-2 or physician on the DD2808 does the contracting agent automatically generate an additional questionnaire for the applicant to fill out? For example, the applicant states they have a history of back pain does the contracting agent then generate the back pain questionnaire to be completed by the applicant prior to the IME or does that occur under the direction of DoDMERB upon completion of the IME? | Yes. | |
| 21 | 7.2.2.1.2.1 | 10 | Other than the 28 questionnaires listed on the DODMERB Forms tab are there any additional questionnaires that DoDMERB currently has for further clarification? | No, not at the present time. However, from time to time DoDMERB will have to edit or add forms, though infrequently. A recent example of an added form is the questionnaire relating to COVID-19 infection. Some of the questionnaires on the DoDMERB website are not intended to be completed prior to the IME because they require the applicant’s own physician to attest to a given condition or treatment, etc. An example is the hypothyroidism questionnaire. Therefore, only those questionnaires completed by the applicant ONLY pertaining to endorsed conditions on the 2807-7 are to be completed in conjunction with the 2807-2 and reviewed by the provider conducting the IME. | |
| 22 | 7.8.1.1 & F.2.1 | 13 &27 | Should the contracting agent find an area that is incomplete/inaccurate by applicant or physician prior to submission of the completed IME to DoDMERB count as an error of service? | Yes and no. |
1) IF the applicant fails to complete a portion of the exam (such as refusing the visual examination of genitalia) then it should be documented as such and sent otherwise complete to DoDMERB. This will not be considered an error of service.
2) Ideally, the applicant should not be able to progress to completion of the 2807-2 and generated questionnaires if a question is unanswered. However, if the contractor’s portal cannot support that kind of document flow then the contractor shall attempt to reconcile with the applicant. If the applicant does not follow-up/comply to complete the missing question(s) then that should be documented and forwarded to DoDMERB as such. This would not be considered an error of service.
| 3) | If the applicant fully completes his/her 2807-2 and associated questionnaires, and complies with the complete exam, but the questions are not addressed by the examining provider or an exam element is omitted, the contractor should rectify this with the provider prior to providing the exam to DoDMERB. In short, omissions on the part of the provider/contractor in such instances would be considered an error of service. | ||||
| 23 | C.2 | 5 | Where a network provider is able to provide all three IME components (optometric, hands-on medical examination, and audiometric screening) the entire IME can be performed by a single (i.e. one individual) licensed independent practitioner (LIP). Is that correct? If not, please clarify LIP requirements for each of the three IME components. | Yes for the hands on examination and audiometric evaluation. However, only an Optometrist or Ophthalmologist can perform/sign the Optometric screening exam. The audiometric exam may be performed by a properly trained technician under the supervision of the examining/signing provider. If the contractor schedules the audiometric exam with a facility/provider other than the one completing/signing the physical exam, then the audiometric provider should be a fully credentialed audiologist., ENT physician, etc. | |
| 24 | C.7.2.2.1.2.1 | 10 | Are the additional questionnaires provided by DoDMERB? | Yes. | |
| 25 | C.7.2.2.1.3 | 10 | Are there specific requirements for the digital signature function or may the Offeror define the function? | The Offeror may define the function provided minimum industry standards are met. | |
| 26 | C.7.2.3, C.7.2.4, and | ||||
| C.7.2.7 | 10 | Request additional technical requirements for the electronic transfer of completed IMEs and AMS into the DoDMERB system. Are there current defined interfaces? Is the transfer specifications discrete data elements or PDF file transfers? | 1) At this time, there are no system-to-system interfaces or APIs. |
2) Currently, on a daily basis, the medical contractor sends a batch of IME and AMS to DoDMERB staff via the DoD SAFE website. The DoDMERB staff then manually upload the documents to the DMACS SharePoint site via the drag and drop feature within DMACS. These documents are PDFs.
3) Currently, on a daily basis, the medical contractor uploads text files to the DMACS public site to add new applicants. Medical contractor staff do this manually via their user accounts on the DMACS public site.
| 27 | C.7.5.5.2 | 11 | Is there a source reference for the definition of depressed and high crime rate areas? | There is not a specific reference or table as crime rates and geographic risks are fluid. The expectation is that the contractor will use appropriate discretion and is responsive when complaints/concerns arise | |
| 28 | K.3.2 | 23 | The RFP contains FAR 52.215-20 and per RFP Section B.4 this is a commercial, performance based, Firm Fixed Unit Price (FFUP) contract under FAR Parts 12, 15, and 37. Request removal of FAR 52.215-20. | Removed; however, the Government reserves the right to request other than certified cost and pricing data if it is needed to make a fair and reasonable price determination. | |
| 29 | L.3 | 27 | It is our assumption that the content and format of Attachments 1 and 3 are used in Volume III and that these pages must also conform to the proposal format instructions (e.g. font, font size, margins, etc.). Is this assumption correct? If not, please clarify (e.g. do the Attachments need to remain as is in format)? | If Attachments 1 and 3 are taken out of their current format, then they must conform to the proposal format instructions. If Attachments 1 and 3 are left in their current format, then only the information that is added must be done so in accordance with the proposal format instructions. | |
| 30 | L.3.1.6 | 28 | It is our assumption that the content and format of Appendix J is used in Volume I and that these pages must also conform to the proposal format instructions (e.g. font, font size, margins, etc.). Is this assumption correct? If not, please clarify (e.g. does the Appendix J need to remain as is in format)? | If Appendix J is used, then it may remain in its current format and is not subject to the proposal format instructions. | |
| 31 | Attachment 2 – Past Performance Questionnaire Form | 41-42 | It is our assumption that the PDF file format of the Past Performance Questionnaire can be converted to MS Word file format for ease of completion and submitted in same file format. Is this assumption correct? If not, please provide a standalone version of Attachment 2 in MS Word file format. | Yes. | |
| 32 | Appendix M – Pricing Spreadsheet | CPT Code 71020 is obsolete, please provide an updated CPT code for “Forward a radiologist's report of NEW x-ray films of chest.” | Reference Revised Appendix M. | ||
| 33 | Appendix M – Pricing Spreadsheet | CPT Code 96101 – Psychological Testing has been replaced with 96130, please advise if the updated CPT Code should be used. | Reference Revised Appendix M. | ||
| 34 | Appendix M – Pricing Spreadsheet | CPT Code 96117 – Psychological Testing has been replaced with 96132, please advise if the updated CPT Code should be used. | Reference Revised Appendix M. | ||
| 35 | Appendix M – Pricing Spreadsheet | CPT Code 99521 is obsolete, please provide an updated CPT code for “Office - Consult - Evaluation by speech therapist/speech pathologist.” | Reference revised Appendix M. | ||
| 36 | Appendix M – Pricing Spreadsheet | For CLIN 0006 there is a listing of 101 CPT Codes for exams/tests. It is our assumption that these exams/tests will be billed when Additional Medical Services (AMS) are performed. Pricing for AMS services is determined by CMAC San Francisco, CA rates per RFP Section C.7.8.3.3. Please clarify if an offeror is to provide pricing for each CPT code under CLIN 0006. And if the offeror is to enter pricing, is it the CMAC San Francisco, CA rates or a proposed price? | CPT Codes can only be billed when the service is performed. The offeror is to provide proposed pricing for each CPT code under CLIN 0006. Reference revised Section C.7.8.3.3. | ||
| 37 | C.7.8.3.3 | 15 | During the PreProposal Conference information was shared indicating the CMAC rates referenced in this Section are used for DoDMERB to gain a ball park understanding of what things cost and not a cap on pricing for those CPT codes as we heard it. It was further conveyed it's not the intention to look at what we are charging against CMAC rates because there is an understanding Contractor needs to incorporate needed uplifts. However, the language in this Section reads as a cap. | ||
| Accordingly, would Government please confirm if the CMAC rates are the maxiumum allowable cost (cap) that contractor is allowed to "bill" for the respective CPT code or not? | Reference revised Section C.7.8.3.3. | ||||
| 38 | C.7.6.4 | 13 | Partial exams require a cover page explaining what work has been done to attempt to complete the exam, as well as an explanation that this exam is a partial- is there a special form, or standard template expected from this? If not, can the Government define the fields required by the cover page? | DoDMERB's intention is to collaboartively develop a cover page with the awardee. | |
| 39 | L.1 | 25 | Will the Government extend the due date to May 6 to allow for adequate time to adjust responses to the Q&A that will not be released until the week of April 11? | RFP due date remains April 29, 2022 at 10:00 AM Central Time. | |
| 40 | L.3.3.2/M.2.8 | 30/36 | Given that during the pre-proposal conference it was confirmed that Previous Experiences & Past Performances had to be for the same projects, and that performances from the last 5 years were allowed, can the Government confirm that section 2.8 should define relevancy as being within the past five years of the closing date of the solicitation to be in alignment with the Previous Experience window? | Reference revised Section M.2.3.3. | |
| 41 | Appendix M – Pricing Spreadsheet | Will the government consider a separate CLIN for Program Management and Support Services? | No. | ||
| 42 | Appendix M – Pricing Spreadsheet | If the government will not consider a separate CLIN for Program Support Services, which CLIN should these costs be allocated to? | Reference Section M.2.2.1. | ||
| 43 | Appendix M – Pricing Spreadsheet | Would the government consider a separate CLIN for the transition period? | Reference revised Appendix M. | ||
| 44 | Tonometry Exam | During the preproposal conference the tonometry exam was referenced, however it does appears to be omitted in the exam components. |
| Is measuring intraocular pressure be a required to be a component of the initial eye exam? | No requirement for tonometry or IOPs. | ||||
| 45 | C.7.8.3.3 | Is it the intention of the Gov’t to direct all vendors to use the CMAC rate for San Francisco to develop the price to the client? | Reference revised Section C.7.8.3.3. | ||
| 46 | Please confirm that all front matter of the volumes, such as TOC, Acronym table, table and figure lists, compliance matrix, etc. is outside of page count. | Any submitted pages such as TOC, acronym table, etc. are considered part of the page count. | |||
| 47 | Since the DODMETS website has been in use for so many years, would the government consider asking the incumbent to release the domain to the winning bidder? | No. | |||
| 48 | H.6 | Due to the nature of this program will 508 compliances be excluded from this contract for the contractor systems? | There will be no requirement for Section 508 compliance for the contractor's portal. | ||
| 49 | C.11.2.3 | 20 | Is the data associated with this program considered CUI? If yes, what basis will be applied under – federal law, or agency regulation, etc.? | All applicant PII/PHI is now CUI. This is a relatively new requirement and DoDMERB does not yet have a technical solution in place to overprint or otherwise appropriately mark PII/PHI documents arising from the DMACS system (printed, emailed out, etc). Currently, only the new DD form 2807-2 is pre-marked CUI. Given this, DoDMERB has, and will treat applicant information as CUI, and expects that the contractor will do the same. DoDMERB does not expect the contractor to have a technical solution for portion marking in place at the start of the contract but would expect the contractor to work collaboratively with DoDMERB to develop a solution on the both sides of the Government/Contractor equation. The contractor will not be expected to support or fund any portion of the government’s solution and similarly the government will not support or develop the contractor's solution. The expectation is that a mutually agreed upon technical solution will be in place NLT one (1) year from initiation of the contract. Though likely to be denied, in the interim DoDMERB will also explore a limited CUI Marking Waiver c/w Title 32 - National Defense Subtitle B - Other Regulations Relating to National Defense CHAPTER XX - INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION PART 2002 - CONTROLLED UNCLASSIFIED INFORMATION (CUI) Subpart C - CUI Program Management § 2002.38 Waivers of CUI requirements. | |
| 50 | C.11.2.3 | 20 | Will marking and labeling requirements of CUI be enforced? | Reference Question #49. | |
| 51 | C.11.2.3 | 20 | How will the gov’t evaluate the system security requirements of the awardee are met when determining contract award? | a. For a contractor leveraging a cloud service for storing, manipulation, transmitting Applicant information, the contractor should provide appropriate documentation to the government indicating attainment of the appropriate FEDRAMP Authorization to Operate (ATO). The PWS provides the links needed to accomplish this. b. For a contractor not leveraging a cloud service but rather utilizing in house storage/transmission services (internal servers etc.), then the contractor shall provide annually written confirmation (formal attestation) of compliance with Basic Safeguarding Requirements in Section 11.3.3 Table 1 of the PWS. | |
| 52 | H.7 | 46 | Due to the level of effort and cost required in performing system security validation, will the transition period need to include a security audit of the awardee’s system? | A system audit is not expected to be conducted. If the awardee requests an audit for the purposes of ensuring compliance and seeking technical input, an audit would be requested through the Defense Health Agency IT support element (J6). | |
| 53 | L.3.3.1 | Would the gov’t provide the data fields contained in the flat file to initiate exam requests? | The file format will be determined after contract award. L.3.3.1 requires demonstration of the ability to support flat file transfer regarding applicant demographic data; it does not require the exact data fields be demonstrated. | ||
| 54 | Revised Appendix M – Pricing Spreadsheet | Within App M the list of CPT codes currently reflects several codes across the various pricing sheets with the same CPT Code / Number but different descriptions and estimated amounts is this a misprint? | |||
| (92004 and 94010) | The same CPT code can be used; however, the specific details regarding the request will be provided to the Contractor at the time the AMS is requested. | ||||
| 55 | Revised Appendix M – Pricing Spreadsheet | Is this a standard exercise stress test using the Bruce Protocol? | Yes. | ||
| 56 | C.7.8.3.3 | Can the Gov’t further define what AMI’s DODMERB feels are amenable to Telehealth services? | This is relatively new to DODMERB so it is expected that this position will evolve in collaboration with the contractor. In principle, Mental/Behavioral Health consultations are considered appropriate for telehealth unless specified otherwise. Additionally, provided the consultant is properly set up, many dermatology consults would be considered telehealth amenable. Others would be looked at on a cases by case basis, then seek to further mature this process as experience is gained with telehealth AMS in the DODMERB context. | ||
| 57 | Revised Appendix M – Pricing Spreadsheet | (CPT code 90791: Psychiatric diagnostic interview evaluation) What are the most common psychiatric conditions that DODMERB requests an AMI requiring a psychiatric interview for and are there any additional testing measures that are commonly requested with it? | The most common conditions for which CPT 90791 is pursued are for applicants with a history of 1) Anxiety, 2) Depression, 3) Cutting or Non-suicidal Self Harm, 4) Suicidality. In these cases specialized testing is generally not indicated. | ||
| 58 | Is blood work (i.e., CBC, UA, BMP, etc.) ordered as a standalone test by DoDMERB or typically ordered under the request of a consulting physician under an additional medical screening? | Lab work is generally ordered as a stand alone AMS such as CBC in the case of an applicant with a reported history of iron deficiency anemia. It is possible but not common that lab work is ordered in conjunction with a specialty consultation unless the consultant requests such lab work in conjunction with the consultation. | |||
| 59 | L.3.3.1 | 29 | Can the Government confirm that if the start date is changed to a later date the full performance date will be given an equal extension? For example if transition period doesn’t begin until June 1, 2022 may Contractor assume the full implementation date would then be moved July 15, 2022? | If the start date is changed to a later date, the transition period will be decreased. If the start date were to be pushed out to May 22, 2022, then the transition period would be decreased to forty (40) days. | |
| 60 | Can the Government provide the IME volumes for 10/2020 and 10/2021? This date is especially important given Government indicated that Oct is within DoDMERB’s busy season. | Available historical data has been provided. Reference Appendix I - Historical Data - Exams by Month 2019-2022. |
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