75H70524Q00015 Audit and Coding Services WEHC.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Bemidji MN 56601 2225 Cooperative Ct NW, Rm 200 Indian Health Service

IHSWHITEEARTH CODE 16. ADMINISTERED BYCODE

X

X

X

541611

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR235

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

02/26/2024 1400 CT

02/02/2024

WINONA KITTO

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBERa. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70524Q00015

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 14IHS1489139OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

OGEMA MN 56569

40520 CO HWY 34

Indian Health Service

WHITE EARTH HEALTH CENTER

15. DELIVER TO

Bemidji MN 56601 2225 Cooperative Ct NW, Rm 200

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$24.5

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Indian Health Service

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

1 Virtual Auditing and Coding Services For White Earth Health Clinic

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

IEE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

142 of

75H70524Q00015

VIRTUAL AUDITING AND CODING SERVICES

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

B.1 CONTRACT ADMINISTRATION DATA

Contract Administration: All contract administration matters will be handled by the following individuals:

CONTRACTOR NAME AND ADDRESS:

SAM Number (UEI): _________________ Cage: _____________

Name: ____________

Phone: ____________ E-Mail: _____________________________

Person responsible for Contractor Performance Assessment Reporting System (CPARS), reporting if different from above:

Name: ______________

Title: _______________

CONTRACTOR REGISTRATION: All required information must be in the System for Award Management (SAM) at www.sam.gov.

GOVERNMENT:

Winona Kitto Indian Health Service 2225 Cooperative Ct NW, Rm 202 Bemidji, MN 56601

Winona.kitto@IHS.Gov

NAICS:

The associated North American Industrial Classification System (NAICS) code for this procurement is 541611 with a small business size standard of $30M

CONTRACT TYPE: Firm-Fixed Price

B.2 INVOICES: In accordance with the Prompt Payment Act, payment will be due 15 days after receipt of services or receipt of a proper invoice, whichever is later.

Electronic Invoicing and Payment Requirements - Invoice Processing Platform (IPP)

Payment requests must be submitted electronically through the U. S. Department of the Treasury's Invoice Processing Platform System (IPP). "Payment request" means any request for contract financing payment or invoice payment by the Contractor. To constitute a proper invoice, the payment request must comply with the requirements identified in the applicable Prompt Payment clause included in the contract, or the clause 52.212-4 Contract Terms and Conditions - Commercial Items included in commercial item contracts. The IPP website address is: https://www.ipp.gov.

http://www.sam.gov/

Under this contract, the following documents are required to be submitted as an attachment to the IPP invoice:

- A copy of the Contractor’s invoice shall be included with the IPP invoice. If no invoice is attached, the Invoice will be rejected;

- List of deliverables;

- Timesheets if applicable - Number of hours worked with corresponding labor category and rate

352.232-71 Electronic Submission of 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.

Guidance for proper registration and training:

IPP is a secure, web-based electronic invoicing system. Respondents are required to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov

Training for vendors can be located at: https://www.ipp.gov/vendors/training-vendors

If you require assistance registering or IPP account access, please contact the Department of the Treasury's IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov

Improperly prepared invoices or statements shall be returned to the contractor and may delay payment.

B.3 PAYMENT

a) The IHS Bemidji Division of Finance is designated for payment processing. Payment shall be made by electronic funds transfer (EFT). Payment shall be made in arrears.

b) The Contractor’s rate identified for services described herein is considered as an all-inclusive rate. All-inclusive is defined to include but is not limited to services, travel, lodging, liability insurance, fringe benefits, federal, state and local taxes, and all other costs pertinent to the performance of this contract.

Improperly prepared invoices or statements shall be returned to the contractor and may delay payment.

B.3 PLACE OF PERFORMANCE: VIRTUAL

WHITE EARTH HEALTH CENTER NAYTAHWAUSH HEALTH CENTER

40520 COUNTY HIGHWAY 34 238 CHURCH STREET

OGEMA, MN 56569 NAYTAHWAUSH, MN 56566

PINE POINT SATELLITE CLINIC

47520 282nd STREET

PONSFORD, MN 56575

https://www.ipp.gov/ https://www.ipp.gov/vendors/training-vendors mailto:IPPCustomerSupport@fiscal.treasury.gov

B.4 PERIOD OF PERFORMANCE: BASE PLUS (4) OPTION YEAR

YEAR/POP

YEARLY

ESTIMATED

QUANTITY

UNIT OF

ISSUE

UNIT

PRICE

TOTAL

AMOUNT

BASE 1,200 Encounter OPTION YR 1 1,200 Encounter OPTION YR 2 1,200 Encounter OPTION YR 3 1,200 Encounter OPTION YR 4 1,200 Encounter

BASE + FOUR (4) OPTION YRS

B.5 Statement of Work

PURPOSE OF CONTRACT:

White Earth Health Center and Indian Health Services depends on contracting outside resources with a wide range of expertise to provide services not readily available within IHS. This firm fixed-price contract will provide medical coding and data entry auditing services for the White Earth Health Center and its satellite clinics.

PERFORMANCE WORK STATEMENT:

CONTRACTOR:

a. Shall review coded and data-entered visits in all service categories (ambulatory, chart review, telecommunications, not found, event-historical, etc.) and for various clinic types (obstetrics and gynecology, optometry, dental, pharmacy, laboratory, radiology and other clinics as needed) via the IHS RPMS, EHR, PCC and VISTA Imaging. Will follow the IHS and National Reporting and Official Coding Guidelines.

b. Will utilize the IHS EHR, PCC, ADT, Dentrix, Point of Sale and VISTA Imaging systems to review notes and supporting documentation of ancillary tests, special studies and results to ensure accuracy of the assigned codes to the highest level of specificity.

c. Will verify the accuracy of the evaluation and management (E&M). The coder will verify ICD-10 diagnosis code(s), CPT, HCPCS, modifiers to make sure an appropriate diagnosis code is assigned for the service(s) provided.

d. Visit data from PCC or Integrated Problem List (IPL) will be reviewed for accuracy and completeness to the highest allowable level so the facility receives the appropriate level of reimbursement. When there is an application of “billing/claims” guidelines based on the payer – the guideline should be applied via the Third-Party Billing (TPB) system.

e. The contractor shall have a minimum of three (3) years’ coding experience and be a certified coder (copy of certification, AHIMA and/or AAPC, etc.). Will apply National Coding Guidelines, IHS Guidelines and any other applicable guidelines to provide quality coding services.

f. The contractor shall have a minimum of one (1) year experience using RPMS PCC Data Entry Operator and Supervisor options, including the coding queue, and experience in ADA codes, Point of Sale and Dentrix systems in order to process all contracting medical documents as required.

g. The contractor will also serve as a technical advisor to the Service Unit Executive Leadership Team. Contractor will provide an overview presentation to providers, coders and ancillary staff on all audit findings.

h. Compliance auditing for E&M, ICD-10-CM, ADA, HCPCS (supplies) and CPT procedures/services will be based on the facility’s number of providers (MD, DO, CNP and all specialty services). No more than ten (10) of each provider’s outpatient visits will be audited. The only visits that will be audited are those visits that have third party eligibility (Medicare, Medicaid and private insurance). The accuracy formula shall be the number of records audited divided by the number of coding errors found. Errors will consist of incorrect principles/primary diagnosis or sequencing, incorrect E&M code selection based on the provider’s documentation in the visit (HPI, ROS, etc.) incorrect ICD-10 coding assignments, acute and chronic conditions coded correctly, manifestation codes not coded, injury and poisoning codes not coded. A final summary for each provider will be completed and the auditor will meet remotely with each provider and/or the medical staff to discuss the coding and provider documentation findings and recommendations. The auditor will meet remotely with the service unit coding staff to discuss coding errors and recommendations. The auditor will also provide an overall presentation remotely to the Service Unit Executive Leadership Team.

i. Conference calls will be held quarterly if needed upon review of audit. Agendas will be provided prior to each conference call and a written report provided to the Service Unit Executive Leadership Team and H I M Department addressing any issues or concerns with coding.

j. Perform audits on individual processes of the service unit staff per request of the service units or area office, in accordance with IHS and National Standard Auditing Practices. Contractor will not audit their own processes.

k. The contractor will assist the service unit in developing an audit program and measurements for the revenue cycle.

Develop site specific baseline metrics and measurable standards to measure current state of the revenue cycle for effectiveness and to build in accountability. Offer training reference materials for staff on the use of various audit techniques and measurements.

DATA ENTRY:

Follows IHS guidelines for reviewing data that includes date, type and location of visit; providers of service, measurements; diagnoses and procedures; health problems and treatment plans; personal and family history; reproductive factors; and a variety of other health-related information.

AUDITING SERVICES:

The contractor shall provide all qualified personnel to perform auditing services. The contractor shall provide training for individual staff and program development on various functions pertaining to the revenue generation cycle. The auditing services shall include the following:

a. The contractor shall identify key management objectives and accountability in the revenue generation cycle.

The contractor shall develop timeliness to accomplish key management objectives and develop methods for accountability.

b. The contractor shall eliminate redundancy of work within the revenue generation cycle, refine and implement new workflow processes.

c. In the implementation of new workflow processes and training, the contractor shall comply with industry standards, applicable IHS rules and regulations, state and federal law, including but not limited to the OIG recommendations on compliance programs and HIPAA requirements.

d. The contractor shall work with the pertinent staff and programs to recommend a process change and develop evaluation criteria for the effectiveness of the change.

e. The contractor shall recommend a concurrent program for providers and other staff to improve documentation to ensure proper and accurate coding for revenue generation purposes.

f. The contractor shall recommend an audit program and measurements for coding and data entry provider documentation. The audit program shall include baseline metrics, measurable standards to measure current state of coding for effectiveness and to build in accountability and provide training resource material on the use of various audit techniques and measurements.

g. The contractor shall address, define and recommend the use of automated systems as it applies to the revenue generation cycle.

h. The contractor shall perform a revenue generation cycle assessment regarding coding that will include auditing and monitoring of coding, provider documentation, billing processes and collection processes as requested by Service Unit Executive Leadership Team.

SPECIAL REQUIREMENTS:

Contractor shall make recommendations to improve data entry, outpatient coding, billing and accounts receivable as appropriate. Provide feedback when necessary to Service Unit Executive Leadership Team to ensure accuracy and compliance.

REPORTING REQUIREMENT:

The contractor will be responsible for auditing coded and data entered patient visits. Audit reports for data entry, outpatient coding, including discrepancies/patterns of improper code assignments and documentation issues shall be processed quarterly or at the request of Service Unit Executive Leadership Team.

For the coding auditing the minimum quantity of hours will be 800 hours and the maximum quantity of hours will be 1200 during each 12-month period.

The contractor shall furnish at least the stated minimum quantity and if and as ordered, the contractor shall furnish additional quantities not to exceed the stated maximum quantity of visits and hours.

Provide compliance auditing services on an as-needed basis to the White Earth Health Center and satellite clinics at Naytahwaush and Pine Point.

The contractor shall view data from EHR and RPMS for accuracy and completeness for appropriate ICD-10-CM and CPT codes, ensuring that IHS receives the appropriate level of reimbursement based on codes and provider documentation.

INDIAN HEALTH SERVICES RESPONSIBILITIES:

a. Will need a Business Associate Agreement.

b. White Earth Health Center shall provide VPN access to EHR.

c. White Earth Health Center will provide VPN access to RPMS.

CONTRACTOR QUALIFICATIONS:

A. The contractor shall meet and maintain the following professional qualifications:

a. Utilize a staff of certified coders;

b. Preferred experience with IHS and EHR, RPMS, Point of Sale, Dentrix;

c. Maintain positive references.

B. Additional credentialing information may be required by IHS. The required certifications and other required credentialing information by the contractor shall be consistent with and meet the credentialing and privileging requirements of IHS.

C. The contractor will comply with all Federal Regulations and comply with Indian Health Services Third-Party Resource and Internal Control Policy, the debt collection policy and the Indian Health Services statistical and reporting systems for all departments. The contractor will comply with the American Hospital Association (AHA), The American health Information Management Association (AHIMA), the Center for Medicare and

Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) ICD-10-CM Official Guidelines for Coding and Reporting and the Current Procedural Terminology (CPT) Guidelines and any specific IHS coding and data entry policies and procedures.

D. The contractor will have access with restrictions as defined by the White Earth Health Center to the following RPMS modules and other access as requested by the contractor and agreed upon by IHS for revenue enhancement purposes.

a. Patient registration system;

b. Third-party billing system;

c. Patient care component/EHR, dental and pharmacy, and ancillary;

d. Other as deemed necessary by IHS/area staff;

e. Knowledge of rules, operations and business practices of the Indian Health Service as described in the

Third-Party Revenue Accounts Management and Internal Controls in the Indian Health Manual Part 5- Managements Services, Chapter 1;

f. Adherence to IHS and HIPAA regulations and computer security;

g. Knowledge of medical terminology, anatomy and physiology, clinical medicine, diagnostic tests, pharmacology and the various medical specialties as required in areas of responsibility;

h. Ability to use designated reference materials. To include Official ICD-10 Ambulatory Outpatient Coding

Guidelines, CPT, E&M and HCPCS Coding;

i. Knowledge of the Resource Patient Management System (RPMS) data entry system, IHS third-party billing package and IHS accounts receivable package and IHS electronic health record (EHR);

j. Will keep current to include training with RPMS package and patches;

k. The contractor must have at least three (3) years’ experience working with health care facilities in developing revenue enhancement initiatives. Must have three (3) years’ experience in coding (ICD-10, HCPCS and CPT4). Must have knowledge of a compliance program and requirements. Must be familiar with the third-party billing RPMS. Must have basic knowledge of Minnesota Medicare, Medicaid, private insurance and other related alternate resource programs.

B.6 ADMINISTRATIVE DATA:

Method of Payment:

a) The IHS Bemidji Division of Finance is designated for payment processing. Payment shall be made by electronic funds transfer (EFT). Payment shall be made in arrears.

b) The Contractor’s rate identified for services described herein is considered as an all-inclusive rate. All-inclusive is defined to include but is not limited to services, travel, lodging, liability insurance, fringe benefits, federal, state and local taxes, and all other costs pertinent to the performance of this contract.

B.7 CONTRACTING OFFICER REPRESENTTIVE (COR).

The COR will be appointed in writing by the CO after the contract is awarded. The CO will provide a copy of this designation and COR contact information to the Contractor.

The role of program and technical personnel in monitoring the contract is to assist and advise the Contracting Officer, and act as the COR when so designated by the Contracting Officer. The COR does not have the authority to change or alter the order amount, terms and conditions.

COR activities include—

1. Providing technical monitoring during contract performance and advising the Contracting Officer relating to delivery, acceptance, or rejection of deliverables in accordance with the terms of the contract;

2. Assessing contractor performance;

3. Recommending necessary changes to the schedule of work and period of performance to accomplish the objectives of the contract (The COR shall provide the Contracting Officer a written request along with an appropriate justification and a funding document, if additional funds are needed.)

4. Reviewing invoices/vouchers and recommending approval/disapproval by the Contracting Officer, including providing comments regarding anything unusual discovered in the review;

5. Reviewing and recommending approval or disapproval of technical submissions, subcontractors, overtime, travel, and key personnel changes;

6. Assisting the Contractor in the resolution of technical problems encountered during performance; and

7. Participating, as necessary, in various phases of the contract closeout process;

8. Provide receiving authorization within two days of services/items received or invoiced

POINT OF CONTACT:

TBD

FEDERAL ACQUISITION REGULATIONS

52.252-2 Clauses Incorporated by Reference. This contract incorporates one or more clauses by reference, with same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

Also, the full text of a clause may be accessed electronically at this address: www.acquisition.gov

52.202-1 Definitions.

52.204-19 Incorporation by Reference of Representations and Certifications.

52.204-23 Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities.

52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services 52.223-18 Encouraging Contractor Policies to Ban Text Messaging While Driving.

52.225-13 Restrictions on Certain Foreign Purchases.

52.232-39 Unenforceability of Unauthorized Obligations.

52.232-40 Providing Accelerated Payments to Small Business Subcontractors.

52.233-3 Protest after Award.

52.233-4 Applicable Law for Breach of Contract Claim.

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 thirty (30) days of contract expiration.

(End of clause)

52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within 30 days; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 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.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 60 (months).

http://www.acquisition.gov/

FAR DEVIATION CLAUSE 52.223-99 ENSURING ADEQUATE COVID SAFETY PROTOCOLS FOR

FEDERAL CONTRACTORS (OCT 2021)

52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR.

Funds are not presently available for performance under this contract beyond TBD. The Government’s obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise for performance under this contract beyond 9/30/2019, until funds are made available to the Contracting Officer for performance and until the Contractor receives notice of availability, to be confirmed in writing by the Contracting Officer.

52.226-1 Utilization of Indian Organizations and Indian-Owned Economic Enterprises

(a) Definitions. As used in this clause:

Indian means any person who is a member of any Indian tribe, band, group, pueblo, or community that is recognized by the Federal Government as eligible for services from the Bureau of Indian Affairs (BIA) in accordance with 25 U.S.C.1452(c) and any "Native" as defined in the Alaska Native Claims Settlement Act (43 U.S.C.1601).

Indian organization means the governing body of any Indian tribe or entity established or recognized by the governing body of an Indian tribe for the purposes of 25 U.S.C., Chapter 17.

Indian-owned economic enterprise means any Indian -owned (as determined by the Secretary of the Interior) commercial, industrial, or business activity established or organized for the purpose of profit, provided that Indian ownership constitutes not less than 51 percent of the enterprise.

Indian tribe means any Indian tribe, band, group, pueblo, or community, including native villages and native groups (including corporations organized by Kenai, Juneau, Sitka, and Kodiak) as defined in the Alaska Native Claims Settlement Act, that is recognized by the Federal Government as eligible for services from BIA in accordance with 25 U.S.C.1452(c).

Interested party means a prime contractor or an actual or prospective offeror whose direct economic interest would be affected by the award of a subcontract or by the failure to award a subcontract.

(b) The Contractor shall use its best efforts to give Indian organizations and Indian -owned economic enterprises (25 U.S.C.1544) the maximum practicable opportunity to participate in the subcontracts it awards to the fullest extent consistent with efficient performance of its contract.

(1) The Contracting Officer and the Contractor, acting in good faith, may rely on the representation of an Indian organization or Indian-owned economic enterprise as to its eligibility, unless an interested party challenges its status or the Contracting Officer has independent reason to question that status.

(c) The Contracting Officer, subject to the terms and conditions of the contract and the availability of funds, will authorize an incentive payment of 5 percent of the amount paid to the subcontractor. The Contracting Officer will seek funding in accordance with agency procedures.

52.233-2 Service of Protest.

(a) Protests, as defined in section 33.101 of the Federal Acquisition Regulation, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the Contracting Officer (addressed as follows) by obtaining written and dated acknowledgment of receipt from: Bemidji Area Office, 2225 Cooperative Ct NW, Bemidji, MN. 56601

(b) The copy of any protest shall be received in the office designated above within one day of filing a protest with the

GAO.

(End of provision) https://www.acquisition.gov/far/part-33#FAR_33_101

HEALTH & HUMAN SERVICES ACQUISTION REGULATION (HHSAR)

This contract incorporates one or more clauses 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. Also, the full text of a clause may be accessed electronically at this address:

http://www.hhs.gov/policies/hhsar/subpart301-1.html

352.208-70 Printing and Duplication 352.211-3 Paperwork Reduction Act 352.222-70 Contractor Cooperation in Equal Employment Opportunity Investigations.

352.223-70 Safety and Health 352.224-70 Privacy Act.

352.224-71 Confidential Information 352.227-70 Publications and Publicity 352.239-73 Electronic Information and Technology Accessibility Notice 352.239-74 Electronic and Information Technology Accessibility 352.232-71 Electronic Submission of Payment Requests (Feb 2022)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 APPLICABLE DOCUMENTS:

• Federal Acquisition Regulations (FAR): http://www.acquisition.gov/far

• Health And Human Services Acquisition Regulation (HHSAR) http://www.hhs.gov/regulations/hhsar/subpart301-1.html

• Health Insurance Portability and Accountability Act (HIPAA) of 1996. http://www.ihs.gov/hipaa/

• Privacy Act of 1974. http://www.ihs.gov/PrivacyAct/documents/privacy-act-1974.pdf

• Public Law 107-347, The E-Government Act of 2002, Title III—Information Security, cited as the Federal Information Security Management Act of 2002 (FISMA), December 17, 2002.

http://csrc.nist.gov/groups/SMA/fisma/

• IHS IT Security Directives: http://www.hhs.gov/ocio/securityprivacy/index.html

• Indian Health Service (IHS) Location map:. http://www.ihs.gov/bemidji/index.cfm?module=bmj_health_facs

• Indian Health Service OIT Division of Information Security Federal Regulations and Guidelines for Information Security: https://home.ihs.gov/security/index.cfm?module=dsp_dis_sec_laws

• Clinger-Cohen Act of 1996: https://www.fismacenter.com/Clinger%20Cohen.pdf

• Office of Management and Budget (OMB) Regulations and Circulars not limited to Circular A-130:

https://www.whitehouse.gov/omb and OMB-07-16 : https://www.cippguide.org/2010/05/04/omb-memorandum- 07-16-safeguarding-against-and-responding-to-the-breach-of-personally-identifiable-information/

• Paperwork Reduction Act: https://www.gpo.gov/fdsys/pkg/PLAW-104publ13/html/PLAW-104publ13.htm

• Children’s Online Privacy Protection Act (COPPA): https://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/childrens-online-privacy-protection-rule http://www.acquisition.gov/far http://www.hhs.gov/regulations/hhsar/subpart301-1.html http://www.ihs.gov/hipaa/ http://www.ihs.gov/PrivacyAct/documents/privacy-act-1974.pdf http://csrc.nist.gov/groups/SMA/fisma/ http://www.hhs.gov/ocio/securityprivacy/index.html http://www.ihs.gov/bemidji/index.cfm?module=bmj_health_facs https://home.ihs.gov/security/index.cfm?module=dsp_dis_sec_laws https://www.fismacenter.com/Clinger%20Cohen.pdf https://www.whitehouse.gov/omb ps://www.cippguide.org/2010/05/04/omb-memorandum-07-ps://www.cippguide.org/2010/05/04/omb-memorandum-07-https://www.gpo.gov/fdsys/pkg/PLAW-104publ13/html/PLAW-104publ13.htm

• BUSINESS ASSOCIATES AGREEMENT

• White Earth Health Center departmental policies and procedures (available upon request)

• Attachment 1 Business Associates Agreement (Fill-in)

D.2 DEFINITIONS

Acceptance: the act of an authorized representative of the Government by which the Government, for itself or as agent of another, assumes ownership of existing supplies tendered, or approves specific services rendered as partial or complete performance of the contract (Refer FAR 52.212-4 (a)), Approval: Acknowledgment by the designated Government employee that submittals, deliverables, or administrative documents conform to the contractual requirements.

Area: A defined geographical region for IHS administrative purposes. Area Offices may administer several service units.

Contract Health Service: means health services provided at the expense of the Indian Health Service from public or private medical or hospital facilities other than those of Indian Health Service.

Clinical Medical Director (CMD): Chief medical officer in each service unit, responsible for supervision of all medical staff.

Chief Executive Officer (CEO): Director of an IHS "Service unit area" designated for purposes of administration of Indian Health Service programs

Contracting Officer (CO): serves as an agent of the government whose acts are binding on the principal to the extent that these acts are within the authority given to the Contracting Officer. Also, means a person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings

Contract: means a mutually binding legal relationship obligating the seller to furnish the supplies or services

CSP (Cloud Service Provider) requirement that the CSP needs to be FEDRAMP authorized once federal data is placed in the system

Contractor: The seller awarded a contract and shall provide supplies and/or services to the government.

Cultural Awareness: Realization and respect for American Indian and Alaska Native practices.

Family Practice Physician (FPP): medical specialty devoted to comprehensive health care for people of all ages

Purchase Delivery Order: means an order for services placed against an established contract or with government sources.

Federal Acquisition Regulations (FAR): is established for the codification and publication of uniform policies and procedures for acquisition by all executive agencies

FedRAMP: Government-wide program that provides a standardized approach to security assessment, authorization, and continuous monitoring for cloud-based services.

Fiscal Intermediary: Contractor whom processes payments for all appropriate invoicing for the IHS CHS, address; IHS CHS Fiscal Intermediary. P. O. Box 13509, Albuquerque, NM 87192-3509

Health Center: An outpatient facility with a full range of ambulatory services, including primary care providers, nursing, laboratory, pharmacy, and x-ray, which are available 40 or more hours a week.

Hospital: a hospital with a full range of ambulatory services, including primary care providers, nursing, laboratory, pharmacy, and x-ray

Past Performance Information: The Government shall use a performance evaluation system to be utilized in documenting contracting performance.

Physician: means a doctor of medicine or osteopathy legally authorized to practice medicine and surgery at an Indian Health Service facility, or by the state in which he or she practices.

Contract Officer Representative (COR): Contracting Officer’s Representative (COR). The CO authorizes the COR to perform functions in administering the technical aspects of the contract. This includes but not limited to: correspondence directly with the Contractor with copies to the CO; hold conferences; approve all technical data submitted by the contractor; and provide technical monitoring during contract performance. The COR has no authority to change or modify the contract.

Service Unit: The Bemidji Area is comprised of three regional areas referred to as service units. Service units are located across north central Minnesota. The facilities range from small ambulatory care clinics (health centers) to full service hospitals. The facilities are located on Indian reservations.

Quality Control Plan (QCP): Contracts for commercial items generally rely on contractors’ existing quality assurance system.

Quality Assurance Surveillance Plan: defines the government responsibility to ensure that the contractor has performed in accordance with the Performance Work Statement (PWS) standards

Nonpersonal Health Care Services (FAR Subpart 37) as defined in the Federal Acquisition Regulations.

D.3 BACKGROUND INVESTIGATION:

This position is covered by the provisions of P.L. 101-630, the Indian Child Protection and Family Violence Act. Contract provider shall be subjected to and must pass a background investigation to include fingerprinting prior to commencement of work. The investigation at a minimum shall entail both a national criminal history fingerprint search performed by the FBI and an investigation of conduct in following areas; residence, employment, education, references.

Contractor is responsible for obtaining fingerprints and submitting to IHS upon notice of award.

If fingerprinting is done outside an Indian Health Service facility (e.g. local police department), the contractor is responsible for all associated costs in obtaining and submitting acceptable fingerprints to IHS. Repeat fingerprinting and distribution efforts shall be at the expense of the contractor.

Contractor shall recommend a candidate capable of passing a background check.

D.4 SECURITY NOTICE

HHS-Controlled Facilities and Information Systems Security

(a) To perform the work specified herein, Contractor personnel are expected to have routine (1) physical access to an HHS-controlled facility; (2) logical access to an HHS-controlled information system; (3) access to sensitive HHS data or information, whether in an HHS-controlled information system or in hard copy; or (4) any combination of circumstances

(1) through (3).

(b) To gain routine physical access to an HHS facility, logical access to an HHS-controlled information system, and/or access to sensitive data or information, the Contractor and its employees shall comply with Homeland Security Presidential Directive (HSPD)-12, Policy for a Common Identification Standard for Federal Employees and Contractors;

Office of Management and Budget memorandum (M-05-24); and Federal Information Processing Standards Publication (FIPS PUB) Number 201; and with the personal identity verification and investigation procedures contained in the following documents:

(1) HHS Information Security Program Policy.

(2) HHS Office of Security and Drug Testing, Personnel Security/

Suitability Handbook, dated February 1, 2005.

(3) HHS HSPD-12 Policy Document, v. 2.0.

(c) This contract/order will entail the following position sensitivity level(s): “SENSITIVE”

(d) The personnel investigation procedures for Contractor personnel require that the Contractor prepare and submit background check/investigation forms based on the type of investigation required. The minimum Government investigation for a non-sensitive position is a National Agency Check and Inquiries (NACI) with fingerprinting. More restricted positions--i.e., those above non-sensitive, require more extensive documentation and investigation. The Contractor shall notify the Contracting Officer in advance when any new personnel, who are subject to a background check/investigation, will work under the contract and if they have previously been the subject of national agency checks or background investigations.

(e) Investigations are expensive and may delay performance, regardless of the outcome of the investigation. Delays associated with rejections and consequent re-investigations may not be excusable in accordance with the FAR clause, Excusable Delays--see FAR 52.249-14. Accordingly, the Contractor shall ensure that any additional employees whose names it submits for work under this contract have a reasonable chance for approval.

(f) Typically, the Government investigates personnel at no cost to the Contractor. However, multiple investigations for the same position may, at the Contracting Officer's discretion, justify reduction(s) in the contract price of no more than the cost of the additional investigation(s).

(g) The Contractor shall include language similar to this ``HHS-Controlled Facilities and Information Systems Security'' language in all subcontracts that require subcontractor personnel to have the same frequency and duration of (1) physical access to an HHS-controlled facility; (2) logical access to an HHS-controlled information system; (3) access to sensitive HHS data/information, whether in an HHS-controlled information system or in hard copy; or(4) any combination of circumstances (1) through (3).

(h) The Contractor shall direct inquiries, including requests for forms and assistance, to the Contracting Officer or designee.

(i) Within 7 calendar days after the Government's final acceptance of the work under this contract, or upon termination of the contract, the Contractor shall return all identification badges to the Contracting Officer or designee.

SECTION E: SOLICITATION INSTRUCTIONS

52.212-2 Evaluation—Commercial Products and Commercial Services.

(a) 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 factors shall be used to evaluate offers:

- Past Performance 60%

- Price 40%

Past Performance when combined with price, is greater than price.

(a)Provide relevant Past Performance, to include relevant contracts, period of performance and references for evaluation.

Past Performance – Must include relevant past performance of auditing and coding services. You must provide three (3) Relevant Professional References to include name, telephone number, email and contract information. Contract information to include the amount, term of the contract and which agency you have performed said services.

(b) Options. 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. Evaluation of options shall not obligate the Government to exercise the option(s). Price – Pricing must reflect all-inclusive hourly rate and follow on option year pricing.

(c) A written notice of award or acceptance of an offer, mailed or otherwise 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)