MedEvac RFP QnA_Amendment 2_Final.pdf

Emergency Medical Support and Evacuation (MedEvac) Services Solicitation/Request for Proposal (RFP) No. 80JSC026MEDEVAC5Q

Amendment 2 RFP Questions and Answers

1. Question: Is there any incumbent/recompete or this is a brand-new project? If yes, could you please provide us with their award number or even if the customer bought similar services in the past.

Answer: Once on the subject Solicitation/RFP webpage (here’s the link SAM.gov) scroll down to the “Attachments” section and click “Download All.” Open the document entitled 5.

Request for Information (RFI) Questions and Answers (see 1st screenshot below) and scroll down to Question and Answer No. 16 as this question was answered (see 2nd screenshot below) during the RFI.

2. Question: The Solicitation/RFP Notice ID on references 80JSC026MEDEVAC5Q. However, on Block 5, Page 1, of the SF 1449 the Solicitation of the Attachment entitled “RFP_Solicitation 80JSC027R0003 MedEvac_Final.pdf” references 80JSC027R0003. The same number 80JSC027R0003 is also annotated on the bottom of all of the other pages of this document, at the top of all of the pages in Attachment entitled, “Request for Information (RFI) Questions and Answers.pdf,” and it is also one of the Attachment names. Since the Solicitation/RFP says Offerors must include the solicitation number with their responses, I have a question. Which solicitation number should be referenced, 80JSC026MEDEVAC5Q or 80JSC027R0003?

Answer: Reference solicitation number 80JSC026MEDEVAC5Q when responding to the subject Solicitation/RFP.

3. Question: For SOW 2.2.2 and Section L, Technical Capability Question 1.f, may the CAMTS, NAAMTA Global, or EURAMI accreditation requirement be satisfied by the subcontracted/team-member air ambulance operator(s) actually performing the medical transportation, while the prime contractor provides overall program and medical management? Or is the prime contractor itself required to hold one of the identified accreditations?

Answer: NASA is contracting for a service. The service provided needs to meet this accreditation requirement. Offerors will need to demonstrate their service meets this requirement.

In Section L, Instructions to Offerors, paragraph L. 1. A, as part of your approach, you should “describe your teaming arrangements.” Also “explain how it flows down the contract terms and conditions to its subcontractors and teaming partners.” As part of your teaming arrangement your subcontractor may be the party that holds the accreditation. Also, paragraph L. 1. F, provide evidence that demonstrates how your quality assurance program ensures that only appropriately trained, certified, and credentialed medical staff, equipment and transports are used to provide services within your company’s limits. Please provide similar evidence for any subcontractors. Additionally, please submit proof of CAMTS, NAAMTA Global and/or EURAMI certification or equivalent. For equivalent certification, please provide narrative on applicability and a compliance mapping matrix alongside the technical proposal.

4. Question: Could you please confirm whether an offeror may serve as the prime contractor in a coordination role and meet the applicable AOC/FAA or equivalent national approvals, airmedical accreditation, licensed-clinical-personnel and country-coverage requirements through fully disclosed subcontractors or teaming partners, or whether the prime contractor must directly hold each certification and capability?

Answer: See answer to Question 3.

5. Question: For SOW 2.2.1.b; RFI Q&A No. 5 - Please clarify NASA's expectations when a NASA physician or flight surgeon accompanies a patient during an international medical evacuation.

Specifically, should offerors guarantee this capability for every mission or validate it case by case based on aircraft configuration, payload, range, medical requirements, and applicable licensing or credentialing restrictions?

Answer: NASA expects Offerors to provide the capability for a NASA physician or flight surgeon to accompany the patient during medical evacuations whenever NASA requests this, as specified in SOW 2.2.1.b. Offerors should plan for this on every mission, but NASA may not use request it if a NASA physician isn’t co-located with the patient. If operational limitations prevent accommodating all requested travelers, the contractor must provide sufficient rationale to the NASA COR and provide alternate transportation within 24 hours for remaining travelers (SOW 2.2.1.d).

6. Question: For SOW 2.2.1.b; RFI Q&A No. 5 - Please define the anticipated role of the NASA physician, including whether the physician would participate in patient care or serve in an advisory or observational capacity, and whether the transport provider's medical director and onboard medical team would retain final clinical authority.

Answer: See RFI Q&A No. 5, which stated that NASA may request a NASA physician/flight surgeon to accompany the traveler for continuity of care. In alignment with that prior clarification, the NASA physician may participate directly in patient care, may serve in an advisory or observational capacity, or may perform both roles depending on the medical circumstances and NASA’s direction at the time of the event. While NASA expects collaborative medical decision-making, the transport provider’s medical director and onboard medical team retain final clinical authority for patient care during transport, consistent with all licensing, credentialing, regulatory, and accreditation requirements.

Additionally, per SOW 2.1.3, the Contractor is required to co-develop with NASA the notification process and define the integration protocols for how NASA physicians’ interface with Contractor medical personnel, including communication pathways, scope-of-participation, and operational protocols during a medical event and transport. These integration protocols will ensure clarity regarding clinical roles, information flow, and coordination during all medical evacuations involving NASA medical staff.

7. Question: For SOW 2.2.1.b, 2.2.1.c, 2.2.1.d; Section L, Minimum Requirements, Item 2 (Scenarios), Scenario A - If operational limitations prevent accommodating all requested travelers, please provide NASA's order of priority among the patient, required transport medical crew, NASA physician, and other accompanying travelers.

Answer: In general, this is NASA’s order of priority for the NASA travelers:

1. Patient

2. NASA physician/flight surgeon

3. Other NASA accompanying travelers This priority may be adjusted based on NASA’s needs for a specific event.

If the transport cannot accommodate all, at least one accompanying traveler specified by NASA must be accommodated. Alternate transportation for remaining travelers must be provided within 24 hours (SOW 2.2.1.c, 2.2.1.d).

8. Question: For SOW 2.2.1.c, 2.2.1.d - Please confirm whether offerors may propose a larger or alternative aircraft with corresponding cost and scheduling implications.

Answer: Yes, Offerors may propose larger or alternative aircraft to meet mission requirements, provided all costs remain within the firm-fixed-price membership as specified in Section B. No additional costs beyond the contractually agreed prices will be incurred by NASA (SOW 2.2.1.c, 2.2.1.d;

Section B). Additional pricing terms will not be accepted (Section M, B. Price section).

Per SOW 2.2.1.a, the service includes comprehensive medical transport services appropriate for the condition of a sick or injured traveler; providing medical personnel, medical escorts, equipment and transportation that are fully certified and licensed, in accordance with local laws and regulations where operations are performed, to ensure the sick or injured traveler is provided the proper services to be stabilized prior to and during air and surface medical transport. The service must also meet the additional requirements in SOW 2.2.0.

Offerors are reminded of the Section M evaluation criteria for award is based on the Technical Capability and Price factors.

9. Question: For SOW 3.1.1, 3.1.3; RFI Q&A No. 14 - How does NASA define compliance with the six-hour readiness requirement? Specifically, does the six-hour period begin upon formal mission activation, and must the aircraft be crewed, fueled, and ready at its operating base, positioned at a designated staging location, airborne, or available at the patient pickup location within that period?

Answer: As clarified in RFI Q&A No. 14, NASA’s six-hour readiness requirement is tied to the scheduled Soyuz landing time. When NASA issues a Call-Up/Execution order, the Contractor’s aircraft must be positioned at the NASA-approved staging location near the Soyuz landing site in Kazakhstan, fully crewed, fueled, medically configured, and mission-ready approximately six hours prior to the Soyuz landing. This staging location is agreed upon between NASA and the Contractor as part of the Call-Up/Execution order.

10. Question: For SOW 3.1.2, 3.1.3; Section L attachment 1 (Russia and Kazakhstan Medical Facilities) – Could you please identify the anticipated contingency landing areas, staging locations, patient pickup points, receiving destinations, aircraft capabilities, and medical configurations that offerors should use when developing their operational and pricing assumptions for Kazakhstan and Russia?

Answer: Section L Attachment 1. Russia and Kazakhstan Medical Facilities captures the list of medical facilities near NASA’s main operational areas in Russia and Kazakhstan. This attachment is updated to capture which towns/cities are relevant to Soyuz landing areas in

Kazakhstan applicable to SOW 3.1.2 and 3.1.3. Also, per this SOW, the receiving destination is Ellington Airfield in Houston, Texas.

Please note that SOW Section 3 is specific to air ambulance for medical transport for Soyuz landings, while SOW Section 2 applies to air ambulances for all NASA travelers worldwide, of which NASA has many travelers to Russia and Kazakhstan.

11. Question: For the SOW 2.2.1.a; Section L, Minimum Requirements, Item 1.g; RFI Q&A Nos. 6 and 7 - Will NASA or another U.S. Government entity provide or facilitate any government-to-government coordination, diplomatic clearances, sponsor documentation, visas, sanctions-related authorizations, airport access, or other permissions required for operations in Kazakhstan or Russia? Alternatively, should offerors assume sole responsibility for establishing and maintaining all such authorizations before mission activation?

Answer: The offeror should assume sole responsibility for establishing and maintaining all such authorizations. See RFI Question and Answer 7 for further information.

12. Question: For SOW 3.1.1, 3.1.3; RFI Q&A No. 14 - Where mandatory government approvals, sanctions restrictions, airspace limitations, or local permitting timelines make six-hour aircraft positioning impracticable, may offerors propose an alternative response model that provides immediate local medical stabilization and ground support while an appropriately configured evacuation aircraft is mobilized from a preapproved regional hub?

Answer: No, the timeline the Offeror should follow for a Soyuz crew landing event is described in SOW 3.1.2 and 3.1.3. “NASA will order the reservation at least 10 days prior to the Soyuz crew landing event. Within 36 hours of NASA reservation, the Contractor shall provide a Reservation Readiness Package consisting of a dedicated tail-number assignment, overflight and landing permits, diplomatic route clearances, aircraft medical and transport capabilities, and staffing plan.” These Soyuz Crew landing events currently occur every 8 months on a regular cadence. Please note that SOW 3.1.4 specifically states that “there is no requirement for an observation or stabilization period at a local medical facility prior to medical transport via air ambulance.”

13. Question: For SOW 3.1.1, 3.1.2; RFI Q&A No. 13 - Will NASA provide historical or planning data regarding prior Soyuz contingency activations, including frequency, locations, response timelines, passenger requirements, aircraft types, and the operational model previously used?

This information would allow offerors to develop a more reliable readiness structure and firm, supportable pricing.

Answer:

Please reference RFI Question and Answer No.13 for frequency and historical data regarding prior Soyuz contingency activations. NASA has consistently ordered the Reservation but has not ordered the Call-up/Execution service under the current Medevac 4 contract. For context, the NASA GV aircraft is the primary aircraft to perform this air ambulance via medical transport for the Soyuz landing, but the service provided under Medevac 5 contract is a backup air ambulance via medical transport service. It is purposefully designed with both the reservation and call-up/execution timelines to protect for an unforeseen contingency in which the NASA GV aircraft is unavailable for any reason.

14. Question: For SOW 2.3.3, 2.3.4, 2.3.5, 3.1.1 - Does NASA consider operations within Russia an unconditional requirement at contract award, or should offerors maintain a legally compliant contingency capability that remains subject to the sanctions, licensing, airspace, diplomatic, and security conditions in effect at the time of activation?

Answer: NASA expects the Contractor to provide the full scope of the Medevac 5 services to support NASA travelers in Russia at contract award.

15. Question: Can you confirm whether the travel day quantities identified in Section B represent maximum covered travel days under the fixed-price membership or planning estimates? If actual travel exceeds those quantities during a performance period, how would that be handled contractually?

Answer: The travel days in Section B represent the maximum covered travel days under the fixed-price membership. If NASA needs to increase the maximum covered travel days during the performance period, the parties may use the Section I Changes clause.

16. Question: Section 2.2.5 states that the contractor is responsible for all evacuation and additional medical travel service costs. Does NASA expect unlimited coverage on both a per-occurrence and aggregate basis, or may offerors propose commercially reasonable coverage limits?

Answer: NASA expects the costs incurred by the Contractor for all evacuation and medical travel services provided by the Contractor to be covered under the fixed price membership pricing in Section B. Additional pricing terms will not be accepted (reference Section M, B.

Price section). See attachments 3 & 4 for the NASA Actual Incidence Data and Internal Risk assessment.

17. Question: Section 1.1.6 includes a contractor indemnification requirement. Can NASA provide additional clarification on the intended scope of this provision and whether commercially reasonable liability limitations or insurance-backed risk allocation provisions would be considered acceptable?

Answer: The solicitation does not provide for liability caps, mutual indemnification provisions, or alternative risk-allocation structures. NASA does not anticipate modifying the indemnification requirement or accepting limitations that would shift Government liability for contractor-controlled activities.

18. Question: Section 2.3.4 references medical facilities in Russia and Kazakhstan that NASA will identify as critical facilities. For proposal planning purposes, can NASA identify which facilities are expected to fall into that category?

Answer: See Attachment 1. Russia and Kazakhstan Medical Facilities for the list of critical facilities.

19. Question: NASA has provided historical incident frequency information and travel-day data. Is NASA able to provide any anonymized historical cost information, cost ranges, or aggregate severity data associated with past assistance, guarantee-of-payment, commercial return, or evacuation cases?

Answer: See Attachment 3. NASA Actual Incidence Data - 2011 - June 2026. This shows how many medical incidents NASA reported to the Contractor over the past 15 years. During these 15 years, there were 13 relevant cases requiring contractor support. There were no Level 4 incidents, which required air ambulance transport. There were five Level 3 cases, in which the Contractor provided a commercial return flight to the US for the injured/sick traveler. There were two Level 2 cases that required professional medical care in a hospital/clinic but treated locally without transport to the US. Finally, there were six Level 1 cases, which were considered minor incidents or only required the Contractor to provide advisory/support services. All these incidences were covered by the fixed-price membership pricing. NASA does not have insight to cost data the Contractor expended to support these events.