Solicitation Medical Coding Auditing and Data Entry Support.pdf

Solicitation No.

7571PS26R00027

Project Title Medical Coding, Auditing, and Data Entry Support

SECTION B – CONTINUATION OF SF-18

This is a combined synopsis/solicitation for commercial services prepared in accordance with FAR Part 12. This announcement is the only solicitation. Proposals are being requested and a separately written solicitation will not be issued.

Solicitation No. 7571PS26R00027 is issued as a Request for Proposal (RFP) for providing comprehensive medical coding, auditing, and data entry support services for the Indian Health Services.

This acquisition is set-aside for Indian Small Business Economic Enterprise (ISBEE) and Indian Economic Enterprises (IEE) Set-Aside concerns. The full text of provisions and clauses may be accessed electronically at FAR and Revolutionary FAR Overhaul.

The associated North American Industrial Classification System (NAICS) code for this procurement is 541219 – Other Accounting Services (Medical Coding Services) with a small business size standard of $25M.

1. PLACE OF PERFORMANCE

Services shall be performed in a hybrid work environment. Contractor personnel may perform services onsite at Gallup Indian Medical Center, 516 E. Nizhoni, Gallup, New Mexico, 87301, or remotely from a contractor-managed work location, as authorized by the Government and in accordance with contract requirements.

2. CONTRACT TYPE

The Department of Health and Human Services (DHHS), Office of Mission Acquisition Solutions (OMAS) anticipates awarding a single Firm-Fixed-Price contract for the Indian Health Service.

This requirement is for non-personal services as defined in FAR 37.6 (formerly FAR 37.104).

The Contractor is an independent contractor, and no employer-employee relationship exists between the Government and the Contractor or its personnel. The Government may evaluate the quality and timeliness of services provided but shall not supervise or control the Contractor’s professional medical judgment, including clinical decisions, diagnoses, or treatment recommendations.

In accordance with FAR 52.237-7, the Contractor shall indemnify and hold harmless the Government for liability arising from acts or omissions of the Contractor or its personnel during performance. The Contractor shall maintain medical liability insurance in amounts customary for the applicable specialty and acceptable to the Contracting Officer. These requirements shall apply to any subcontractor providing services under this contract.

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3. PERIOD OF PERFORMANCE (POP)

The period of performance consists of a six (6)-month base period and one (1) six (6)-month option period, which may be exercised at the Government’s discretion in accordance with FAR 52.217-9 - Option to Extend the Term of the Contract.

Base Period: 09/01/2026 – 02/28/2027 1st Option Period: 03/01/2027 – 08/31/2027

4. PRICING SUMMARY

Payment will be made for services performed and accepted in accordance with the Performance Work Statement (PWS) at the unit prices proposed in the Pricing Table.

This is a Firm-Fixed-Price contract based on a fixed, fully burdened hourly rate for a specified level of effort. The Government estimates 1,040 hours per 6-month period. Payment will be based on actual hours worked at the proposed hourly rate. The total contract value represents the maximum amount payable and shall not be exceeded without prior approval of the Contracting Officer.

Please review attachment 1 and complete the provided table.

5. POINTS OF CONTACT (POC)

a. Contact Information

Contracts Specialist (CS) Contracting Officer’s Representative

(COR)

Terry Knight TBD Terry.Knight@hhs.gov

Contracting Officer (CO) Contractor Point of Contact Terry Knight Name: TBD Terry.Knight@hhs.gov Phone:

Email:

b. Contract Administration and Authority

• The CO is the only individual authorized to bind the Government or modify the contract.

• The CO designates a COR and Alternate COR to provide technical oversight.

• The COR’s authority is limited to performance monitoring and does not include authority to:

o Modify the contract or obligate funds o Authorize additional work

Project Title o Direct contractor personnel o Change scope, schedule, price, or requirements

• The COR may:

o Monitor technical performance o Review deliverables o Conduct inspections and evaluations o Report performance issues to the CO

• The Alternate COR performs COR duties when the Primary COR is unavailable and may not exceed delegated authority.

6. PERFORMANCE WORK STATEMENT (PWS)

General

This Performance Work Statement (PWS) outlines the requirements for providing comprehensive medical coding, auditing, and data entry support services for the Indian Health Service (IHS). The Government anticipates awarding a Firm-Fixed-Price contract based on fixed, fully burdened hourly rates for a specified level of effort. The Government estimates 1,040 labor hours during each six (6)-month performance period.

The Government estimates a workload of up to 36,000 medical records during each six (6)-month performance period. The estimated record volume is provided for workload planning, staffing, and performance purposes and does not constitute the basis for payment. Payment shall be based on actual hours worked and accepted by the Government at the applicable contract hourly rate, not to exceed the funded amount established for the applicable contract period without prior written authorization from the Contracting Officer.

Actual encounter volume may vary. The Contractor shall maintain sufficient qualified personnel to meet the performance, accuracy, timeliness, and workload requirements established in this PWS within the authorized level of effort.

Services will support both inpatient and outpatient encounters across multiple departments, including General, Cardiology, Chest and TB, Diabetic, ENT, Family Planning, Gynecology, Home Care, Immunization, Internal Medicine, Mental Health, Obstetrics, Optometry, Orthopedic, Pediatric, Surgical, and other specialty areas. The contractor shall ensure compliance with HIPAA, the Privacy Act, and IHS IT security policies. The Government will furnish RPMS and VPN access through the GIMC IT Department, and the Health Information Management (HIM) Supervisor will assign coding queues.

Background

The Indian Health Service (IHS) identified a need for external medical coding support to address growing encounter backlogs and to maintain accuracy in clinical documentation and billing data.

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Internal operations have faced challenges due to high patient volume, limited staffing, and certification requirements that hindered timely coding completion. These issues have affected reimbursement cycles, compliance tracking, and reporting accuracy. The implementation of this contract will enhance the consistency and timeliness of data entry, improve the quality of coding, and ensure that medical record documentation supports accurate billing and audit readiness.

Reliable coding services directly influence the quality of patient care, resource management, and compliance with federal healthcare data standards, making this initiative critical to operational efficiency and service delivery within the Gallup Indian Medical Center and its associated clinics.

Objective

The primary objective of this contract is to obtain professional, certified medical coding and data entry services that ensure the accurate and timely processing of patient encounters within the Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) environment. The contractor shall support IHS goals of improving patient access, enhancing care quality, and strengthening management operations by maintaining a minimum of 98 percent coding accuracy and achieving timeliness standards as defined in this PWS. The objective also includes strengthening internal capacity by reducing backlogs, increasing billing efficiency, and ensuring that all data is fully compliant with applicable regulations and IHS standards. Through consistent coding and auditing practices, this contract will enhance documentation accuracy, streamline third-party billing, and contribute to organizational accountability and transparency in healthcare information management.

Scope of Work

The Government estimates that the Contractor will be assigned up to 36,000 medical records during each six (6)-month performance period. This estimated quantity is provided for workload planning and staffing purposes and does not establish a per-record pricing or payment methodology. Applying ICD-10, CPT, HCPCS, and E/M codes with correct modifiers in accordance with IHS and federal guidelines. Coding will be performed directly from electronic health records into the RPMS Patient Care Component (PCC), ensuring that each encounter is coded accurately and merged appropriately into the system within four business days of the encounter date. The Contractor shall complete coding within four (4) business days of assignment to the Contractor’s active coding queue for encounters that are complete and available in RPMS/EHR. The four (4) business day period shall begin on the next business day following documented assignment by the HIM Supervisor or the RPMS system timestamp reflecting queue assignment. Encounters delayed due to incomplete documentation, provider queries, Government system outages, credentialing delays, or other Government-controlled impediments shall be excluded from timeliness calculations until resolution and documented re-assignment. Reactivated encounters shall be completed within four (4) business days of documented re-assignment. The contractor will perform bimonthly audits on 10 percent of coded records to verify accuracy and compliance. Staff performing the work must hold current AAPC

Project Title or AHIMA certifications, and any non-certified personnel must be directly supervised by a certified coder. The contractor must demonstrate prior experience with RPMS and EHR systems.

Deliverables will include monthly coding reports submitted by the 10th business day of each month, with audits at the end of months 2, 4, and 6. All work must comply with the Indian Health Manual, HIPAA, and the Privacy Act. The contract requires a minimum of 98 percent coding accuracy, full compliance with security and confidentiality policies, and consistent on-time submission of deliverables.

Departments will include the following (inpatient/outpatient): General, Cardiology, Chest & TB, Diabetic, ENT, Family Planning, Gynecology, Home Care, Immunization, Internal Medicine, Mental Health, Obstetrics, Optometry, Orthopedic, Pediatric, Surgical, Well Child, Other B/, Family Practice, Emergency Medicine, Physical Therapy, Neurology, Rheumatology, Pharmacy, Alcohol & Substance, Day Surgery, PHN Clinic Visit, Medical Social Services, Nephrology, Telephone Call, Chart Review, Follow-Up Letter, Dental, Radiology, Podiatry, Ultrasound, Dietary, Computed Tomography, Mammography, Speech Pathology, Laboratory, Case Management Service, Labor & Delivery, Teen Clinic, Traditional Medicine, Observation, Telemedicine, Diabetes Education – Group, Diabetes Education – Individual, Diabetic Retinopathy, Colposcopy, Behavioral Health, Home Based Care, Tele-behavioral Health, Anticoagulation Therapy, Homeless, Anesthesiology, Pharmacy Primary Care Clinic, Infusion Clinic, and Palliative Care.

Only encounters that are documented, coded, and billable within RPMS/EHR and assigned to the Contractor’s coding queue are included in the scope of this contract. Administrative, non-clinical, test, training, or non-billable encounter types are excluded unless explicitly authorized in writing by the Government.

The Government recognizes that complexity varies by department and service type. The Contractor shall code encounters in accordance with assigned priorities and shall not be penalized for lower throughput in higher-complexity services when overall performance standards are met, provided that the Contractor meets the overall monthly minimum volume requirement.

Historical workload data for the preceding twelve (12) months, including encounter volumes by department and average monthly distribution, will be provided in the solicitation for pricing and staffing estimation purposes. The Government does not guarantee workload distribution by specialty but represents the data as the best available estimate. The Government may adjust monthly volume expectations proportionally in the event actual encounter volume falls below projected levels.

Offerors are responsible for proposing adequate staffing levels based on the historical data provided. The Government will not adjust pricing due to fluctuations in departmental complexity unless the total monthly volume materially deviates from projected estimates.

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The historical workload data is provided for planning and pricing purposes only. The Government does not warrant the accuracy of projections beyond the data provided and assumes no liability for variations in departmental distribution or case complexity that do not materially alter the total monthly estimated volume.

Specific Requirements/Tasks

*REFER TO SECTION 10 (SPECIFIC REQUIREMENTS/TASKS) OF ATTACHMENT 2 –

PERFORMANCE WORK STATEMENT*

SERVICE CONTRACT WAGE DETERMINATION

Wage Determination No. 2015-5451, Revision No. 28, dated 5/13/2026, is hereby incorporated.

7. INSPECTION AND ACCEPTANCE

All work performed under this contract is subject to inspection and final acceptance by the Contracting Officer (CO) or by a duly authorized representative acting within the limits of their delegated authority. The Contracting Officer’s Representative (COR) is responsible for monitoring the Contractor’s performance, evaluating the quality of services provided, and conducting technical inspections. The COR shall recommend acceptance or rejection of services to the CO; only the CO may provide final acceptance.

a. Quality Assurance:

The Contractor’s performance is subject to ongoing evaluation under the Service Unit’s Quality Assurance (QA) program to ensure compliance with professional, regulatory, and organizational standards. Reviews may include assessments of work performed, patient safety considerations, documentation accuracy, and clinical quality evaluations. The Contractor shall correct any deficiencies identified. Failure to implement corrective actions may result in termination for cause, particularly where performance endangers patients, staff, or Government property.

b. Contractor Performance Evaluation Report:

In accordance with FAR Subpart 42.15, the Government will prepare interim and final performance evaluations under the Contractor Performance Assessment Reporting System (CPARS). These evaluations will become part of the official contract file and may be used as past performance information for future acquisitions involving the Contractor, its affiliates, or significant subcontractors.

c. Contract Discrepancy Report (CDR):

If the Government identifies deficient performance, the CO may issue a Contract Discrepancy Report (CDR) describing the deficiency and required corrective action. The

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Contractor shall acknowledge receipt of the CDR and submit a written corrective action plan detailing how the issue will be resolved and prevented from recurring. The Government will review the Contractor’s response for acceptability. Completed CDRs become part of the Contractor’s performance record and may be considered in assessing present and future contractual responsibility and performance.

8. INVOICING AND PAYMENT

Invoices shall be submitted electronically on a monthly basis through the Invoice Processing Platform (IPP) at https://www.ipp.gov.

Each invoice shall include the applicable Contract Line Item Number (CLIN), billing period, hourly rate, number of hours worked, total amount due, and the Contractor’s Unique Entity Identifier (UEI). Approved timesheets shall be submitted with each invoice.

Payment shall be based on actual hours worked at the contract hourly rate. Adjusted rates resulting from revised wage determinations shall not be invoiced until incorporated into the contract by modification.

Invoices shall not be submitted directly to the CO, Contracting Officer’s Representative (COR), or Finance Office unless authorized in writing. Improper submission may delay payment.

Payment will be made in accordance with FAR 52.212-4 and HHSAR 352.232-71.

Refunds

In the event of an overpayment, the Contractor shall remit payment to the Government as directed by the Contracting Officer.

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SECTION C – CONTRACT CLAUSES

FAR 52.252-2 - Clauses Incorporated by Reference (Feb 1998) This contract incorporates one or more Federal Acquisition Regulation (FAR) clauses by reference and/or in full text, with the same force and effect as if they were provided in full text.

Upon request, the Contracting Officer will make the full text of any clause available. The full text of FAR clauses may also be accessed electronically at the following links: FAR and Revolutionary FAR Overhaul.

Per FAR Class Deviation 2025-09 Amendment 1: System updates may lag policy updates. The System for Award Management (SAM) may continue to require entities to complete representations based on provisions that are not included in this solicitation. Contracting officers will rely on representations from offers based on provisions in the solicitation. Entities are not required to, nor are they able to, update their entity registration to remove these representations in SAM.

FAR

Clause Title Date

52.202-1 Definitions Jun 2020 52.203-3 Gratuities Apr 1984 52.203-6 Alt I

Restrictions on Subcontractor Sales to the Government Jun 2020

52.203-12 Limitation of Payments to Influence Certain Federal Transactions Jun 2020 52.203-17 Contractor Employee Whistleblower Rights Nov 2023 52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements. Jan 2017 52.204-9 Personal Identity Verification of Contractor Personnel Jan 2011 52.204-13 System for Award Management - Maintenance Nov 2025 (DEV) 52.204-14 Service Contract Reporting Requirements Nov 2025 (DEV) 52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded.

Nov 2025 (DEV)

52.209-10 Prohibition on Contracting with Inverted Domestic Corporations Nov 2025 (DEV) 52.212-4 Contract Terms and Conditions – Commercial Products and Commercial Services Nov 2025 (DEV) 52.219-6 Notice of Total Small Business Set-Aside Nov 2025 (DEV) 52.219-14 Limitations on Subcontracting Nov 2025 (DEV)

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52.222-3 Convict Labor Nov 2025 (DEV) 52.222-35 Equal Opportunity for Veterans Nov 2025

(DEV)

52.222-36 Equal Opportunity for Workers with Disabilities Nov 2025 (DEV) 52.222-37 Employment Reports on Veterans Nov 2025 (DEV) 52.222-40 Notification of Employee Rights Under the National Labor Relations Act Nov 2025 (DEV) 52.222-41 Service Contract Act Labor Standards Nov 2025 (DEV) 52.222-42 Statement of Equivalent Rates for Federal Hires Nov 2025 (DEV) 52.222-44 Fair Labor Standards Act and Service Contract Labor Standards – Price Adjustment Nov 2025 (DEV) 52.222-50 Combating Trafficking in Persons Nov 2025 (DEV) 52.222-54 Employment Eligibility Verification Nov 2025 (DEV) 52.222-55 Minimum Wages for Contractor Workers Under Executive Order 14026 Nov 2025 (DEV) 52.222-62 Paid Sick Leave Under Executive Order 13706 Nov 2025 (DEV) 52.224-1 Privacy Act Notification Apr 1984 52.224-2 Privacy Act Apr 1984 52.224-3 Privacy Training Jan 2017 52.226-8 Encouraging Contractor Policies to Ban Text Messaging While Driving. May 2024 52.232-33 Payment by Electronic Funds Transfer – System for Award Management Oct 2018 52.232-40 Providing Accelerated Payments to Small Business Subcontractors. Mar 2023 52.233-3 Protest After Award Nov 2025 (DEV) 52.233-4 Applicable Law for Breach of Contract Claim Nov 2025 (DEV) 52.237-2 Protection of Government Building, Equipment, and Vegetation Apr 1984 52.237-3 Continuity of Services Jan 1991 52.240-91 Security Prohibitions and Exclusions Nov 2025 (DEV) 52.240-93 Basic Safeguarding of Covered Contractor Information Systems Nov 2025 (DEV) 52.242-13 Bankruptcy Jul 1995 52.244-6 Subcontracts for Commercial Products and Commercial Services Nov 2025 (DEV) 52.245-1 Government Property Sep 2021 52.245-9 Use and Charges Apr 2012 52.252-6 Authorized Deviations in Clauses Nov 2020

FAR 52.217-8 - Option to Extend Services (Nov 1999) The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 15 days.

FAR 52.217-9 - Option to Extend the Term of Contract (Mar 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within 15 days; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 15 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

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(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 1 year.

This contract incorporates the following Health and Human Services Acquisition Regulation (HHSAR) clauses by reference, with the same force and effect as if they were provided in full text. The full text of these clauses is available upon request from the Contracting Officer or may be accessed electronically at: HHSAR.

HHSAR

Clause No. Title Date

352.203-70 Anti-Lobbying Dec 2015 352.224-70 Privacy Act Feb 2024 (DEV) 352.224-71 Confidential Information Feb 2024 (DEV) 352.226-6 Indian Economic Enterprise Subcontracting Limitations Mar 2022

352.226-7 INDIAN ECONOMIC ENTERPRISE

REPRESENTATION

Dec 2015

352.239-73 Electronic Information and Technology Accessibility Notice

Dec 2015

352.239-74 Electronic and Information Technology Accessibility Dec 2015

The following HHSAR clauses are included in this contract in full text:

HHSAR 352.232-71 - Electronic Submission of Invoice Payment Requests (Feb 2022)

(a) Definitions. As used in this clause— Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements identified in FAR 32.905(b), “Content of Invoices” and the applicable Payment clause included in this contract.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system. Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

(c) The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with HHS procedures. Unless otherwise agreed to by the contracting officer per HHSAR 352.232-71(c), the use of IPP shall take precedence over previously established invoicing procedures.

(d) If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer's written authorization with each payment request. Unless otherwise agreed to by the contracting officer per HHSAR 352.232-71(c), the use of IPP shall take precedence over previously established invoicing procedures.

HHSAR 352.237-70 - Pro-Children Act (Dec 2015)

(a) Public Law 103-227, Title X, Part C, also known as the Pro-Children Act of 1994 (Act), 20 U.S.C. 7183, imposes restrictions on smoking in facilities where certain federally funded

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Page 11 of children's services are provided. The Act prohibits smoking within any indoor facility (or portion thereof), whether owned, leased, or contracted for, that is used for the routine or regular provision of: (i) kindergarten, elementary, or secondary education or library services or (ii) health or day care services that are provided to children under the age of 18. The statutory prohibition also applies to indoor facilities that are constructed, operated, or maintained with Federal funds.

(b) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all subcontracts awarded under this contract for the specified children's services. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act. Failure to comply with the Act may result in the imposition of a civil monetary penalty in an amount not to exceed $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. Each day a violation continues constitutes a separate violation.

HHSAR 352.237-71 - Crime Control Act-Reporting of Child Abuse (Dec 2015)

(a) Public Law 101-647, also known as the Crime Control Act of 1990 (Act), imposes responsibilities on certain individuals who, while engaged in a professional capacity or activity, as defined in the Act, on Federal land or in a federally-operated (or contracted) facility, learn of facts that give the individual reason to suspect that a child has suffered an incident of child abuse.

(b) The Act designates "covered professionals" as those persons engaged in professions and activities in- eight different categories including, but not limited to, teachers, social workers , physicians, dentists, medical residents or interns, hospital personnel and administrators, nurses, health care practitioners, chiropractors, osteopaths, pharmacists , optometrists, podiatrists, emergency medical technicians , ambulance drivers, alcohol or drug treatment personnel, psychologists, psychiatrists, mental health professionals, child care workers and administrators, and commercial film and photo processors. The Act defines the term "child abuse' as the physical or mental injury, sexual abuse or exploitation, or negligent treatment of a child.

(c) Accordingly, any person engaged in a covered profession or activity under an HHS contract or subcontract, regardless of the purpose of the contract or subcontract, shall immediately report a suspected child abuse incident in accordance with the provisions of the Act. If a child is suspected of being harmed, the appropriate State Child Abuse Hotline, local child protective services (CPS), or law enforcement agency shall be contacted. For more information about where and how to file a report, the Childhelp USA, National Child Abuse Hotline (1-800-4-A- CHILD) shall be called. Any covered professional failing to make a timely report of such incident shall be guilty of a Class B misdemeanor.

(d) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all applicable subcontracts awarded under this contract. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act.

HHSAR 352.237-72 - Crime Control Act-Requirement for Background Checks (Dec 2015)

(a) Public Law 101-647, also known as the Crime Control Act of 1990 (Act), requires that all individuals involved with the provision of childcare services to children under the age of 18 undergo a criminal background check. "Child care services" include, but are not limited to, social services, health and mental health care, child (day) care, education (whether or not directly

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Page 12 of involved in teaching), and rehabilitative programs. Any conviction for a sex crime, an offense involving a child victim, or a drug felony, may be grounds for denying employment or for dismissal of an employee providing any of the services listed above.

(b) The Contracting Officer will provide the necessary information to the Contractor regarding the process for obtaining the background check. The Contractor may hire a staff person provisionally prior to the completion of a background check, if at all times prior to the receipt of the background check during which children are in the care of the newly-hired person, the person is within the sight and under the supervision of a previously investigated staff person.

(c) By acceptance of this contract or order, the Contractor agrees to comply with the requirements of the Act. The Act also applies to all applicable subcontracts awarded under this contract. Accordingly, the Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understands, and complies with the provisions of the Act.

HHSAR 352.237-73 - Indian Child Protection and Family Violence Act (Dec 2015)

(a) This contract is subject to the Indian Child Protection and Family Violence Act, Public Law 101-630 (25 U.S.C. 3201 et seq.) The duties and responsibilities required by this contract may involve regular contact with or control over Indian children. Public Law 101-630 prohibits employment, including Personal Service Contracts, with anyone who has been convicted of any crime of violence. Any such conviction should immediately be brought to the attention of the Contracting Officer. The contractor will be subject to a character investigation, conducted by the Indian Health Service, Office of Human Resources. Until such time as the contractor has been notified of completion of the investigation, the contractor shall have no unsupervised contact with Indian children. In order to initiate this background investigation, the contractor must provide information as required in this contract or as directed by the Contracting Officer.

(b) As a prerequisite to providing services under this contract, the Contractor is required to complete and sign the declaration found in Section J of this contract.

HHSAR 352.237-75 - Key Personnel (Dec 2015) The key personnel specified in this contract are considered to be essential to work performance.

At least 30 days prior to the contractor voluntarily diverting any of the specified individuals to other programs or contracts the Contractor shall notify the Contracting Officer and shall submit a justification for the diversion or replacement and a request to replace the individual. The request must identify the proposed replacement and provide an explanation of how the replacement's skills, experience, and credentials meet or exceed the requirements of the contract (including, when applicable, Human Subjects Testing requirements). If the employee of the contractor is terminated for cause or separates from the contractor voluntarily with less than thirty days’ notice, the Contractor shall provide the maximum notice practicable under the circumstances.

The Contractor shall not divert, replace, or announce any such change to key personnel without the written consent of the Contracting Officer. The contract will be modified to add or delete key personnel as necessary to reflect the agreement of the parties.

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SECTION D – DOCUMENTS, EXHIBITS AND ATTACHMENTS

Attachment No.

Description

No. of Pages

1 Fillable Table 2

Performance Work Statement

3 IHS IEE Representation Form 1

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SECTION E – SOLICITATION PROVISIONS

FAR 52.252-1 Solicitation Provisions Incorporated by Reference (Feb 1998) This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at the following links: FAR and Revolutionary FAR Overhaul (end of provision)

FAR

Clause Title Date

52.203-11 Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions.

Sep 2024

52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements-Representation. Jan 2017

52.204-7 System for Award Management - Registration Nov 2025 (DEV) 52.229-11 Tax on Certain Foreign Procurements – Notice and Representation. Jun 2020 52.212-1 Instructions to Offerors-Commercial Items Nov 2025 (DEV) 52.233-2 Service of Protest Sep 2006 52.240-90 Security Prohibitions and Exclusions Representations and Certifications Nov 2025 (DEV) 52.252-5 Authorized Deviations in Provisions Nov 2020

FAR 52.209-2 - Prohibition on Contracting with Inverted Domestic Corporations- Representation (Nov 2025) (DEV)

(a) Definitions. As used in this clause— Inverted domestic corporation means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Subsidiary means an entity in which more than 50 percent of the entity is owned—

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(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

(b) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-3(b) applies or the requirement is waived in accordance with the procedures at 9.108-5.

(c) Representation. The Offeror represents that-

(1) It □ is, □ is not an inverted domestic corporation; and

(2) It □ is, □ is not a subsidiary of an inverted domestic corporation.

(End of provision)

FAR 52.209-5 - Certification Regarding Responsibility Matters (Nov 2025) (DEV) (a)(1) The Offeror certifies, to the best of its knowledge and belief, that—

(i) The Offeror and/or any of its Principals—

(A) Are □ are not □ presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) Have □ have not □, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property (if offeror checks "have", the offeror shall also see 52.209-7, if included in this solicitation);

(C) Are □ are not □ presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision; and

(D) Have □, have not □, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds the threshold at 9.104-5(a)(2) for which the liability remains unsatisfied. Federal taxes are considered delinquent if both of the following criteria apply:

(1) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if a pending administrative or judicial challenge remains. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(2) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) The Offeror has □ has not □, within a 3-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.

(2) "Principal," for the purposes of this certification, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

(b) The Offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(c) A certification that any of the items in paragraph (a) of this provision exists will not

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Failure of the Offeror to furnish a certification or provide such additional information as requested by the Contracting Officer may render the Offeror nonresponsible.

(d) This provision does not require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a). The knowledge and information of an Offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If the Government later determines that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to the Government, the Contracting Officer may terminate the contract resulting from this solicitation for default.

(End of provision)

FAR 52.209-7 - Information Regarding Responsibility Matters (Nov 2025) (DEV)

(a) Definitions. As used in this provision— Administrative proceeding means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables.

Federal contracts and grants with total value greater than $10,000,000 means—

(1) The total value of all current, active contracts and grants, including all priced options; and

(2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules).

Principal means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

(b) The offeror □ has □ does not have current active Federal contracts and grants with total value greater than $10,000,000.

(c) If the offeror checked "has" in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:

(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:

(i) In a criminal proceeding, a conviction.

(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more.

(iii) In an administrative proceeding, a finding of fault and liability that results in–

(A) The payment of a monetary fine or penalty of $5,000 or more; or

(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.

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(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.

(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.

(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management, which can be accessed via https://www.sam.gov (see 52.204-7).

(End of provision)

FAR 52.209-11 - Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Nov 2025) (DEV)

(a) The Government will not enter into a contract with any corporation that—

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that–

(1) It is □ is not □ a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is □ is not □ a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

FAR 52.212-2 - Evaluation – Commercial Products and Commercial Services (Nov 2025)

(DEV)

(a) Evaluation factors. The Government will award a contract resulting from this solicitation to the responsible Offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following evaluation factors in the relative order of importance will be used to evaluate offers:

1. Technical Approach

2. Staffing and Qualifications

3. Past Performance

4. Price

(b) Options (if applicable). The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. The

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(c) Notice of award. A written notice of award or acceptance of an offer furnished to the successful Offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

This contract incorporates the following HHSAR provisions by reference, with the same force and effect as if they were provided in full text. The full text of these provisions is available upon request from the Contracting Officer or may be accessed electronically at: HHSAR.

HHSAR

Provision No. Title Date

352.226-1 Indian Preference Dec 2015 352.226-4 Notice of Indian Small Business Economic Enterprise set-aside Nov 2015 352.226-6 Indian Enterprise Subcontracting Limitations Mar 2022

SECTION F – INSTRUCTIONS TO OFFERORS AND EVALUATION

EVALUATION (IHS SUPPLEMENTAL GUIDANCE)

(Supplementing FAR 52.212-2 and FAR 12.203)

Evaluation will be conducted in accordance with FAR Part 12 and FAR 52.212-2.

The Government (Indian Health Service) intends to award a single, all-inclusive Firm-Fixed-Price contract for Medical Coding, Auditing, and Data Entry Support services to the responsible Offeror whose proposal is determined to be most advantageous to the Government, considering price and the evaluation factors identified below. Only proposals that comply with all solicitation instructions and requirements will be evaluated.

Offerors shall submit technical, past performance, and price volumes.

Technical Volume: Demonstrate coding methodology, staffing plan, quality control plan, and ability to meet timeline.

Past Performance Volume: Provide up to three (3) relevant contracts in the past 5 years.

Price Volume: Firm-fixed price proposal with cost breakdown.

Offerors shall provide:

• Offeror Name

• UEI Number

• Point of Contact (name, phone, email)

• A description demonstrating the offeror’s capability to perform all requirements in the Performance Work Statement (PWS).

• Resume(s) or qualification summary for proposed personnel

The Government will evaluate the Offeror’s ability to provide qualified Medical Coding, Auditing, and Data Entry Support for IHS capable of meeting all the requirements of the PWS.

Technical Qualifications will be evaluated for clarity, completeness, feasibility, and compliance with applicable professional and contractual standards.

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The Government will assess strengths, weaknesses, and any risks associated with the offeror’s proposal and determine the level of confidence in successful performance.

Evaluation Factors for Award:

Factor 1 – Technical Approach (40%): Understanding of coding requirements, methodology, and compliance.

Technical approach will be evaluated for understanding of RPMS coding requirements, methodology for meeting timeliness and accuracy standards, internal quality control procedures, and risk mitigation planning.

Factor 2 – Staffing & Qualifications (25%): Certifications, experience, and capacity to meet quotas.

Factor 3 – Past Performance (20%): Quality, timeliness, and customer satisfaction on prior contracts.

The Government will evaluate past performance based on the recency and relevance of prior work and will assess the level of confidence in the offeror’s ability to successfully perform the requirement.

Evaluation will consider:

• Quality of performance

• Timeliness and reliability of staffing

• Responsiveness and customer service

• Successful performance in Federal, Tribal, or healthcare environments

• Ability to recruit, credential, and retain qualified healthcare personnel

• Recency: Contracts performed within the last 5 years

• Relevance: Similar scope and complexity

Offerors shall provide up to three (3) relevant contracts or jobs of similar scope within the past 5 years. Include:

• Customer/organization

• Location

• Dates of performance

• Description of work performed

• Contract value (if available)

• Point of contact (name, phone, and email)

In addition, IHS may evaluate:

• CPARS reports

• Other federal past performance records

• Subcontractor performance (IAW FAR 12.203(a)(2))

• Past performance information already known to the Government

• Prior IHS contracts

• Commercial References or other relevant sources

• The Government may consider information obtained from a source that was not provided by the offeror.

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Past performance will be assessed as a level of confidence (e.g., High Confidence, Some Confidence, Neutral Confidence, or Low Confidence). A lack of past performance will be evaluated as Neutral Confidence and will not be considered unfavorable.

Factor 4 – Price (15%): The Government will evaluate price for reasonableness. The Government may perform a price realism analysis for the limited purpose of assessing performance risk.

The Offeror’s price proposal will be evaluated for reasonableness, completeness, and consistency with the proposed technical approach using the pricing information submitted in the Pricing Table.