Questions and Answers.pdf

75H71226R00001 | Amendment 0001 - Questions and Answers

AMENDMENT 0001 - QUESTIONS AND ANSWERS

Solicitation No. 75H71226R00001

Managed Teleradiology Services - Phoenix Area IHS

Notice: The following questions and Government responses are provided for clarification of the solicitation. Where a response changes the solicitation requirements, the applicable solicitation document will be revised by amendment. Offerors shall rely on the solicitation, as amended, for proposal preparation.

Q1. Medical physicist (PWS 3.0 I.b). Does Phoenix Indian Medical Center currently have an MQSA medical physicist under a separate contract or agreement? If so, will that arrangement continue, or should the offeror provide the physicist survey starting with the first survey due after award? Please also confirm the number of mammography units at PIMC, including 2D and 3D units, and the date of the most recent MQSA physicist survey.

Government Response: No. The Contractor is not required to furnish the facility Medical Physicist Survey under this contract. Phoenix Area IHS obtains medical physicist services for PIMC separately. PIMC currently has one 2D and one 3D mammography unit. The most recent Medical Physicist Survey was completed January

13, 2026. The PWS is revised by amendment accordingly.

Q2. Medical physicist pricing. Attachment 2 does not include a separate line item for the medical physicist survey. Should this cost be included in the Mammography per-read price, the Lead Interpreting Physician monthly price, or elsewhere?

Government Response: No Medical Physicist Survey pricing is required. Offerors shall not include the cost of the facility Medical Physicist Survey in the Mammography or Lead Interpreting Physician (LIP) unit prices. The

PWS is revised accordingly.

Q3. Workload by time of day (Exhibit A). Exhibit A states that the majority of PIMC examinations occur weekdays 1700 to 0800 and on weekends and holidays. Can the Government provide historical PIMC exam volumes by modality for weekday 0800 to 1700, weekday 1700 to 0800, and weekends and holidays?

Government Response: The Government does not have historical workload data readily available in the requested time-of-day categories. For additional context, PIMC experienced the following sample volumes: July

3, 2026 - Plain Film: 21; CT: 29; Ultrasound: 13. July 11-12, 2026 - Plain Film: 70; CT: 41; Ultrasound: 26. These figures are provided for informational purposes only and are not guaranteed workload quantities. Offerors shall use the estimated quantities in the solicitation and applicable Technical Exhibits for proposal pricing.

Q4. Start of performance. Given the anticipated November 2, 2026 start and the time required for credentialing by proxy, security agreements, and PACS connectivity, will the Government consider a phased start, with PIMC first and other facilities brought online as task orders are issued?

Government Response: The Government recognizes that credentialing, security agreements, connectivity, interfaces, and other implementation requirements may require transition time. Individual facilities may be activated on a phased basis as applicable requirements are completed and as authorized by the Contracting

Officer. Clinical services may not begin at a facility until applicable credentialing, privileging, security, connectivity, and Government authorization requirements are complete. Credentialing is generally anticipated to require approximately four to six weeks following receipt of a complete package. Other technical implementation activities may require additional time depending on facility requirements.

Q5. Non-cloud architecture (PWS 3.0 K.i). Please clarify what the Government considers a non-cloud architecture. For example, is a contractor-owned platform hosted in a private data center with site-to-site

VPN connectivity to IHS acceptable?

Government Response: Cloud-based solutions will not be approved for this requirement. Contractor systems must utilize a non-cloud architecture compatible with existing IHS infrastructure and comply with all applicable

IHS, HHS, HIPAA, and Federal information security requirements. The Government is not providing advance approval of any specific contractor-hosted architecture through this Q&A. Proposed solutions will be subject to applicable IHS technical and information security review and approval. Information technology and security requirements may also change during contract performance as applicable Federal, HHS, and IHS requirements are updated or implemented.

Q6. MRI (Exhibit A, CLIN 6). Exhibit A lists MRI as an option if implemented during performance. Should offerors price MRI for all five years, and will the MRI quantities be included in the Total Evaluated Price?

Government Response: Yes. Offerors shall provide MRI unit pricing for the Base Period and all four option periods as required by Attachment 2. The MRI estimated quantities identified in Attachment 2 will be included in the Total Evaluated Price for evaluation purposes. Evaluation of MRI pricing and estimated quantities does not obligate the Government to implement MRI services or order the estimated quantities.

Q7. Required documents and representations. Beyond Volumes I-III, please list every document required with the offer, such as a signed SF 1449, Attachment 2 in native Excel, and representations and certifications. Should Blocks 23 and 24 be left blank in favor of Attachment 2?

Government Response: Offerors shall submit the three proposal volumes required by Attachment 4, including the completed Attachment 2 Pricing Schedule in native Excel format. Offerors shall submit the SF 1449 with their proposal and acknowledge all amendments. Prices shall be submitted in Attachment 2; offerors are not required to enter prices in SF 1449 Blocks 23 and 24. Offerors shall complete and submit any solicitation provisions or certifications that expressly require an offeror response and are not satisfied through current SAM.gov representations and certifications.

Q8. Attachment 5 (BAA) and Attachment 1.1 (Credentialing and Privileging Agreement). Please confirm whether Attachment 5 and Attachment 1.1 are required to be completed and submitted as part of the initial proposal submission, or whether they are executed after award.

Government Response: Attachment 1.1 is provided as a sample for informational purposes and is not required to be executed with the proposal. Attachment 5, Business Associate Agreement, is not required to be executed with the initial proposal and will be completed/executed as applicable after award and before access to protected health information or performance requiring the agreement.

Q9. Past performance sources. Will the Government consider the past performance of proposed joint venture partners, teaming partners or subcontractors, and key personnel when their role in this effort is described?

Government Response: Past performance will be evaluated in accordance with Attachment 4, Section M.

Offerors may identify relevant past performance of proposed joint venture members, teaming partners, or subcontractors when the entity's role in performing this requirement is clearly described. The Government may consider relevant past performance information from the sources identified in the solicitation and will consider the relevance, recency, quality, source, and context of that information, including the extent to which the entity is proposed to perform the requirement. Key-personnel experience is not a substitute for organizational past performance unless otherwise stated in the solicitation.

Q10. Key personnel and radiologist roster. Must offerors identify the proposed Medical Director, Lead

Interpreting Physician, or individual radiologists by name in Volume I, or provide a radiologist roster with licensure and board status? If so, will these individuals be treated as key personnel subject to Government approval of substitutions?

Government Response: Offerors are not required to submit a complete radiologist credentialing roster with the initial proposal. Offerors shall identify proposed key personnel necessary to demonstrate their technical approach, including the proposed Medical Director and quality oversight personnel. Following award, the

Contractor shall provide each participating facility with the radiologist information and documentation required for credentialing and privileging before those radiologists begin providing services.

Q11. Volume I, Technical Capability page limit. Request to increase the Technical Capability page limit from

15 to 25 pages.

Government Response: The request is not approved. The Technical Capability narrative page limit remains 15 pages.

Q12. Volume II, Past Performance page limit. Request to increase the Past Performance page limit to 10 pages.

Government Response: The request is not approved. The Past Performance narrative page limit remains 5 pages.

Q13. Amendments and offer due date. Request that the offer due date be extended to at least five business days after the Government's answers to questions are issued by amendment.

Government Response: The proposal due date is extended to October 20, 2026, at 2:00 PM Mountain

Standard Time (MST). See Amendment 0001.

Q14. Historical data. Please provide, for each facility, the most recent 12 months of actual volume by modality and exam type/CPT code, priority, hour of day and day of week, including the annual number of

CT stroke-protocol studies at PIMC.

Government Response: The Government does not have the requested historical data readily available at this level of detail. Offerors shall use the estimated workload quantities provided in the solicitation and applicable

Technical Exhibits for proposal preparation and pricing.

Q15. CT workload distribution. Please provide a breakdown of CT studies by exam type and annual volume and the percentage of total CT workload represented by each study type.

Government Response: The Government does not have the requested CT workload breakdown readily available at this level of detail. Offerors shall use the estimated CT quantities provided in the applicable

Technical Exhibits and Attachment 2 for proposal preparation and pricing.

Q16. MRI workload distribution. Please provide a breakdown of MRI studies by exam type and annual volume and the percentage of total MRI workload represented by each study type.

Government Response: The Government does not have the requested MRI workload breakdown readily available at this level of detail. PIMC does not currently have MRI capability. MRI is included in the solicitation as a potential future requirement if implemented during contract performance. Offerors shall price MRI in accordance with Attachment 2.

Q17. Mammography mix. Does the mammography workload include digital breast tomosynthesis (DBT/3D mammography)? If so, please provide the approximate percentage of mammography studies that are tomosynthesis examinations and the approximate split of screening versus diagnostic mammography.

Government Response: Yes. PIMC has 2D and 3D mammography capability. PIMC advises that its current mammography imaging utilizes tomosynthesis. Approximately 70 percent of examinations are screening and 30 percent are diagnostic. These percentages are estimates provided for proposal-planning purposes and are not guaranteed workload quantities.

Q18. PIMC daytime coverage. Does PIMC have in-house radiologists during weekday business hours?

Does the Government expect the contractor to read daytime overflow, specific modalities, or coverage during in-house radiologist absences, and do the estimated volumes include all daytime studies?

Government Response: Yes. PIMC currently has in-house radiologist coverage. The Contractor may be required to provide daytime overflow coverage, including CT, DEXA, Mammography, and Ultrasound. The PIMC annual workload quantities represent estimated total imaging volumes; the Government does not guarantee that all estimated examinations will be ordered under the teleradiology contract. If Government radiologist availability decreases, including through resignation, retirement, or other staffing changes, the Contractor may be required to support increased workload up to the quantities ordered under the contract.

Q19. Protocol review. Please clarify the expected scope and frequency of imaging protocol review and approval and confirm it may be performed remotely with electronic signature.

Government Response: Protocol review and approval will be required as operationally necessary, including when Contractor radiologists are providing coverage for modalities for which protocol review is required. PIMC anticipates that broader protocol-review responsibility may be required if Government radiologist coverage is unavailable. Protocol review may be performed remotely, and electronic signatures are acceptable where permitted by applicable Government and accreditation requirements.

Q20. On-site presence and travel. Please confirm whether any on-site presence is required and, if so, the anticipated frequency, since travel is not separately reimbursable.

Government Response: No on-site presence is required. Services under this contract will be performed remotely. Travel is not anticipated or separately reimbursable.

Q21. Facility-specific credentialing agreements and timelines. Will U&O, CRSU, FYHC, and HHCC each execute a credentialing-by-proxy agreement, and will they use the same form? What process applies at the ambulatory clinics? Please provide expected timelines and clarify the five-working-day notice requirement.

Government Response: PIMC utilizes credentialing by proxy. Other participating facilities may use their respective credentialing and privileging processes. The Government anticipates credentialing will generally require approximately four to six weeks following receipt of a complete credentialing package; actual processing time may vary depending on the completeness and timeliness of required documentation and facility-specific requirements. The five-working-day notice requirement in PWS 3.0.F does not establish or shorten a facility's credentialing review period. Radiologists may not begin providing services until applicable credentialing and privileging requirements are completed.

Q22. Facility technical environment. For each facility, please identify the PACS vendor and version, VistA

Imaging/VistARad version, and any existing interface engine, VPN concentrator, or site-to-site tunnel available to the contractor.

Government Response: PIMC currently utilizes VistA Imaging/VistARad. The Government does not have additional facility-specific PACS vendor/version information available for proposal preparation. IHS utilizes centralized technical administration for VPN/tunnel interface coordination. The Contractor shall coordinate required connectivity and interfaces with the applicable IHS technical personnel following award.

Q23. HL7 interfaces. Attachment 2 estimates five HL7 interfaces in the Base Period. Please confirm whether offerors should price one interface per facility and identify each facility requiring its own interface. Please identify the HL7 version/message types and clarify whether CLIN 0007 covers VPN/tunnel setup, DICOM routing configuration, and testing.

Government Response: Offerors shall price five (5) HL7 interface implementations in the Base Period as identified in Attachment 2. Participating IHS locations may require separate interface and DICOM configuration.

Actual interface requirements will depend on facility architecture and existing configurations. CLIN 0007 shall include the Contractor's costs associated with implementation, configuration, connectivity/tunnel setup on the

Contractor side, DICOM routing configuration, testing, and other Contractor-side activities necessary to establish the required interface. The Government is responsible for Government-side interface costs as stated in the

PWS. Specific HL7 versions, message types, existing infrastructure, and implementation details will be coordinated with IHS technical personnel following award.

Q24. EHR or PACS migration. When does the Phoenix Area anticipate migrating to the new EHR (PATH /

Oracle Cerner)? Would migration require new or modified HL7 interfaces and how would that effort be ordered/funded?

Government Response: Phoenix Area IHS does not currently have a definitive migration date available for the new EHR. Any future migration requirements affecting contract interfaces or connectivity will be addressed by the Contracting Officer, as applicable, through the ordering or contract modification process. Offerors should not assume a specific migration date for proposal pricing.

Q25. Remote-site connectivity. Please describe network connectivity and bandwidth at Supai and Peach

Springs and whether their images route through the Parker PACS or require separate connections.

Government Response: Detailed connectivity, bandwidth, and routing information for Supai and Peach Springs is not available for proposal preparation. Facility-specific connectivity and routing requirements will be coordinated with applicable IHS technical personnel after award.

Q26. LIP responsibilities, level of effort, and qualifications. Please describe the specific responsibilities of the Lead Interpreting Physician under this contract, estimated level of effort, and required qualifications.

Government Response: The LIP shall meet applicable MQSA requirements and perform the LIP responsibilities identified in the PWS, including applicable MQSA inspection support, clinical consultation, quality/accreditation support, and assistance with ACR accreditation/reaccreditation activities. The Government does not prescribe a specific number of labor hours for the LIP. Offerors are responsible for determining the level of effort necessary to satisfy the PWS requirements when or if LIP services are ordered.

Q27. LIP ordering and pricing scope. Does the Government intend to order LIP services every month that mammography services are provided at PIMC? Should the monthly price include annual MQSA inspection support and triennial ACR reaccreditation activities?

Government Response: LIP services are ordered on an as-needed basis and are not guaranteed to be ordered for all 12 months of a period. The monthly LIP price shall include the Contractor's applicable MQSA and ACR support responsibilities identified in the PWS. PIMC currently anticipates requesting LIP services if

Government/in-house mammography radiologist capability is unavailable. Other participating facilities may order

LIP services as required by their operational needs.

Q28. MQSA and ACR status, sole-reader status, and outcomes audit. Please provide the current certification/accreditation status, next inspection/reaccreditation dates, expected LIP presence, sole-reader status, and availability of pathology correlation data.

Government Response: PIMC successfully completed its most recent FDA/MQSA inspection in May 2026.

PIMC's next ACR accreditation/reaccreditation milestone is anticipated in May 2027. No on-site LIP presence is required under this contract. PIMC currently maintains Government/in-house mammography radiologist capability; therefore, the Government does not represent that the Contractor will be the sole group interpreting mammography. If Contractor responsibilities change during performance, applicable MQSA/ACR requirements will be coordinated with the Contractor. The Government does not have additional pathology-correlation information available for proposal preparation.

Q29. Medical physicist. The PWS states the contractor may be required to provide the Medical Physicist

Survey. Does PIMC currently use a Government or separately contracted medical physicist? If the contractor must provide physicist services, under which CLIN should they be priced?

Government Response: See the Government's responses to Q1 and Q2. The Contractor is not required to furnish or price the facility Medical Physicist Survey. The PWS is revised accordingly.

Q30. CLIN numbering. The SF 1449 lists Item 7 as Lead Interpreting Physician Services and Item 8 as HL7

Interface Implementation and Setup; Attachment 2 reverses them. Please confirm which numbering controls.

Government Response: The solicitation will be amended to make the CLIN numbering consistent across the

SF 1449 and Attachment 2. Offerors shall use the CLIN numbering stated in the amended solicitation and revised Attachment 2.

Q31. 2D and 3D mammography unit rate. Please confirm whether 2D mammography and 3D tomosynthesis studies are to be priced at the same unit rate under the Mammography CLIN.

Government Response: Offerors shall price Mammography in accordance with Attachment 2. No separate pricing for 2D and 3D/tomosynthesis studies is requested.

Q32. Incumbency and transition. For transition planning, please identify the incumbent teleradiology contract(s) for PIMC and the contract numbers.

Government Response: Incumbent contract and award information, to the extent publicly available, may be obtained through SAM.gov or other Federal procurement databases.