J_A.pdf

Attachment 1: Request for SDVOSB/VOSB Sole Source Justification Format >SAT

VHAPM Part 819.7007/7008 Page 1 of 3 Original Date: 08/30/2017 Revision 03 Eff Date: 04/03/2020

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C255-21-AP-0654 Funding Action ID: 589-21-2-5576-0011

1. Contracting Activity: Department of Veterans Affairs, VISN 15, Harry S. Truman Medical

Center

2. Nature and/or Description of the Action Being Approved: This procurement is for a new Medical Coding Contract. The is medical coding will be for Outpatient coding, medical coding inpatient PTF, medical coding inpatient professional services, medical coding ambulatory surgery.

The previous coding contract provider was not able to perform to the level required so the Option Year was not exercised.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The services provided will be for Medical Coding for Outpatient, inpatient PTF, Inpatient Professional Services, and Ambulatory Surgery. This would be delivered and billed monthly.

4. Statutory Authority Permitting Other than Full and Open Competition: 41 USC §3304(a)(5), 38 U.S. Code § 8127(c), as implemented by FAR 6.302-5 (Authorized or Required by Statute). COs may use the non-competitive (sole source) procedures authorized in VAAR 819.7007 or 819.7008 up to $5,000,000. Check the specific VAAR clause used below:

(X) 819.7007 Sole source awards to a verified service-disabled veteran-owned small business; or ( ) 819.7008 Sole source awards to a verified veteran-owned small business

5. Demonstration that the Contractor’s Unique Qualifications and/or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority):

Vendor was one of the vendors that had mandatory use contracts. Axiom currently codes inpatient, outpatient and pro fee encounters for the KCVA. This contract ensures that we meet our national turnaround times for coding, without a coding contract in place we will see failing metrics and a loss of vera funding. Currently we are without a coding contract and we have used Axiom in the past and they are aligned with the VISN and the facilities need.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable, including whether a notice was or will be publicized as required by subpart 5.2 and, if not, which exception under 5.202 applies:

A VIP search located three SDVOSB that providing Coding services. Of these three, two had been SAC contract holders. The Facility had an agreement with one of those vendors and they did not perform satisfactorily and the option year was not renewed.

VHAPM Part 819.7007/7008 Page 2 of 3

Revision 03 Eff Date: 04/03/2020

This leaves Axiom as the vendor to award too. Axiom is currently performing the services with the KC VAMC and previously held a contract with the Columbia VAMC.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and

Reasonable: Pricing is an extension of the unit prices offered by the Vendor on the BPA which expired on 12/18/2019.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons

Market Research Was Not Conducted: The option year was not exercised due to quality concerns of the Vendor. The mandatory BPAs have expired, and new ones are not in place at this time. This award will only be for six months and the Facility is expected to submit a new procurement package that will include competition once the new SAC Coding contracts are in place.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition: None.

Use of the non-competitive procedures for awards to a verified service-disabled veteran-owned small business authorized in VAAR 819.7007 for acquisitions up to $5,000,000.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition:

Axiom, 425 Marbry Place NE, Atlanta Ga 30319

11. A Statement of the Actions, if any, the Agency May Take to Remove or Overcome any Barriers to Competition before Making subsequent acquisitions for the supplies or services required: A new procurement package for a base plus four years will be submitted by the Facility for any further services after this year. There are multiple VOSB that offer the services and if new BPAs are established, the competition will be between those vendors.

12. Requirements Certification: I certify that the requirement outlined in this justification is a Bona Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Bobby Crawford Date Asst. Chief Health Administration Service Harry S Truman VAMC

BOBBY R. CRAWFORD

921454

Digitally signed by BOBBY R.

CRAWFORD 921454

Date: 2021.02.05 10:59:56 -06'00'

VHAPM Part 819.7007/7008 Page 3 of 3

Revision 03 Eff Date: 04/03/2020

13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer or Designee’s Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

William Webb Date Supervisory Contract Specialist

NCO 15

b. One Level Above the Contracting Officer (Required over SAT but not exceeding

$700K): I certify the justification meets requirements for other than full and open competition.

Peggy Becker Date Division Chief I

NCO 15

William Webb Digitally signed by William Webb Date: 2021.02.10 07:34:57 -06'00'

Peggy S. BECKER 345969 Digitally signed by Peggy S. BECKER 345969 Date: 2021.02.10 08:52:34 -06'00'

Attachment 2: Market Research Report Template

VHAPM Part 810 Market Research SOP Page 1 of 9 Revision: 05, Effective Date: 09/23/20

Title of Program/Project/Requirement: Emergency Medical Coding Contract

PART I –

I. Authority.

Market research is required in accordance with:

FAR 7.102, Acquisition Planning Policy FAR 7.103(u)(1) and (2), Agency-Head Responsibilities FAR 10.001, Market Research Policy and VAAR 810.001-70 (Class Deviation) VAAR 813.003-70(c), Policy (Class Deviation) FAR 19.202-2, Locating Small Business Sources and VAAR 819.202 (Class Deviation)

II. Procurement Information.

A. Procurement History.

Previous medical coding contract was held by Sierra 7. We chose not to exercise the option year due to performance issues. That contract expired 1/1/2020. There have been no changes in the marketplace as it comes to medical coding. There are no conflicts of interest.

B. Background.

The previous medical coding service contract expired, and the option year was not exercised as the previous coding contract provider was not able to perform to the level required.

Axiom currently codes inpatient, outpatient, and profee encounters for the KCVA. This contract ensures that we meet our national turnaround times for coding. Without a coding contract in place, we will see failing metrics and a loss of vera funding. Currently we are without a coding contract and we have used Axoim in the past and they are aligned with the VISN and the facility’s needs.

Expected dollar value of requirement is $ Suggested NAICS code: 541219 Time frame in which the market research was conducted

III. Initial Requirements

Contractor shall ensure the assignment of ICD-10-CM and ICD-10-PCS and CPT/HCPCS codes at a 95% accuracy rate. Contractor and Medical Center will agree to volume of cases to be coded weekly. Medical Center will provide a list of cases consistent with the volume agreed

to. Contractor shall notify the COTR when the “to be coded” list is complete but no later than seven (7) business days after receipt. When the Contractor cannot meet this deadline due to unforeseen circumstances, Contractor shall notify the COTR by the fifth (5) business day.

Discuss any cost effectiveness issues associated with the requirements

VHAPM Part 810 Market Research SOP Page 2 of 9 Revision: 05, Effective Date: 09/23/20

IV. Participants in Market Research

Describe the involvement of the individual Acquisition Team members and any other participants in the market research effort

NAME TITLE OFFICE TELEPHONE E-MAIL ADDRESS MARKET

RESEARCH

ROLE

Program Official

William Webb

Contracting Officer

(CO)

913-946-1969 William.webb99@va.gov

Cara Fowler

Contract Specialist 913-946-1988 Cara.woodring@va.gov

Bobby Crawford

Contracting Officer Representative

(COR)

612A 573-814- 6000x 53215

Bobby.crawford2@va.gov

V. Market Research Techniques and Sources

A. Market Research Techniques Describe techniques and sources used during market research. The following table may help structure and summarize the techniques used in the market research effort.

Check X

IF USED

SOURCES USED IN MARKET RESEARCH DETAILS OF

RESEARCH/COMMENTS

RESEARCH SOURCES (INCLUDE REFERENCES TO

ATTACHMENTS TO REPORT)

X Acquisition history reviewed Contract 36C25518A0001 X Other recent market research reviewed

Last published mandatory BPA list

X VA Vendor Information Pages (VIP) https://www.vip.vetbiz.va.gov/ (including any information supporting price reasonableness)

6 Vendors located with NAICS 541219 and keyword “Medical Coding”

X Interviewed knowledgeable individuals in industry/Government

Nikki Bufford, KC VA HIMS Chief Christina Love, KC VA Asst HIMS Chief Nikki Byerly, KC VA Deputy Chief

HIMS

Participated/Attended Tradeshows and Industry Conferences

N/A

Professional Journals, Catalog and/or Product Literature reviewed

N/A

Participated in Small Business Vendor Outreach Sessions

N/A

VHAPM Part 810 Market Research SOP Page 3 of 9 Revision: 05, Effective Date: 09/23/20

B. Market Research Sources. In accordance with FAR part 10 and VAAR part 810, market research has been conducted for this acquisition. The following additional collaborative Contracting Officer-led techniques were used:

Insert X if Checked

VETERANS FIRST CONTRACTING PROGRAM

(VAAR subpart 819.70)

REFERENCES/SOURCES CHECKED

(IDENTIFYING VIP VERIFIED SDVOSBs/VOSBs)

Details of Research/Comments (Include References to Report Attachments)

X VA Office of Small and Disadvantaged Business Utilization (OSDBU), Center for Verification and Evaluation (CVE) Vendor Information Pages (VIP) Database found at https://www.vip.vetbiz.va.gov/

6 Vendors located with NAICS 541219 and keyword “Medical Coding”

X System for Award Management (SAM) search for entity records at:

https://www.sam.gov/SAM/pages/public/index.jsf

Check X if Part of Research

PRIORITY CONSIDERATION OF

VA EXISTING CONTRACTS

X 1. See VA PPM (2016-05)(Revised AUG 2019) - Implementation of the Veterans First Contracting Program (VIEWS 01368239) concerning consideration of existing VA contracts and VA strategic sourcing regarding supplies in FSC Groups 65 and 66.

Mandatory BPAs expired 12/18/2019

2. Other VA Existing Contracts (non-mandatory but their potential availability, scope, contract type, etc., should be documented in the market research report

Research

CONSIDERATION OF NON-VA EXISTING

CONTRACTS

Federal Strategic Sourcing Initiatives or OMB Category Management contracts/sources

(Non-Mandatory except where OMB or Agency policy states otherwise)

1. Non-VA Contracts:

(Includes NASA-SEWP and BPAs under FSS Strategic Sourcing Initiative (FSSI) non-mandatory Federal Supply Schedules (other than for FSC Group 65 and 66) (FAR 8.004(a)(1) and VAAR 808.004-70).

None

2. Non-mandatory Federal Supply Schedules (non VA) (See FAR 8.004(a)(1) and VAAR

None

VHAPM Part 810 Market Research SOP Page 4 of 9 Revision: 05, Effective Date: 09/23/20

808.004-70, Use of non-mandatory sources by VA (Class Deviation).

Use of Other Sources Commercial sources (includes educational and non-profit institutions) in the open market. This is permissible IAW FAR 8.004 and VAAR 808.004-70.

Research

Sources for services to consider, as applicable and as required

Details of Research/Comments (Include References to Report Attachments)

MARKET RESEARCH FOR SERVICES

1. Services that are on the Procurement List maintained by the Committee for Purchase from People who are Blind or Severely Disabled (AbilityOne) (See FAR subpart 8.7) See VAAR 808.002, Priorities for use of mandatory Government sources, paragraph (a)(2) pertaining to Services.

None

2. Services: Federal Prison Industries (See FAR subpart 8.6) http://www.unicor.gov/ (Except if two or more SDVOSB or VOSB are identified, see

VAAR 808.603)

None

3. Also see--VA Federal Supply Schedules (FSS) in FSC Group 62I.

None

4. And see--mandatory sources reviewed, if applicable, for:

4a. Public Utility Services (see FAR part 41);

4b. Printing & Related Supplies (see FAR subpart 8.8);

4c. Leased Motor Vehicles (see FAR subpart 8.11);

4c. Helium (see FAR subpart 8.5)

N/A

5. Services: Commercial sources (includes educational and non-profit institutions) in the open market.

6 Vendors located with NAICS 541219 and keyword “Medical Coding”

VETERANS FIRST CONTRACTING PROGRAM

(VAAR subpart 819.70)—REFERENCES/SOURCES

CHECKED

Sources Sought Notices: Requests for Information (RFI) https://beta.sam.gov/

System for Award Management (SAM) search for entity records at: https://www.sam.gov

VHAPM Part 810 Market Research SOP Page 5 of 9 Revision: 05, Effective Date: 09/23/20

OTHER REFERENCES/SOURCES CHECKED

(Other ways to conduct or confirm market research)

Sources Sought Notices: Requests for Information (RFI) https://beta.sam.gov/

N/A

Pre-solicitation and/or Pre-Proposal Conferences N/A Existing intra-/inter-agency contract vehicles, e.g.

Interagency Contract Directory (ICD) at:

https://www.contractdirectory.gov/contractdirectory

None

System for Award Management (SAM) search for entity records at:

https://www.sam.gov/SAM/pages/public/index.jsf

N/A

X SBA Dynamic Small Business Database at:

http://dsbs.sba.gov/dsbs/search/dsp_dsbs.cfm

78 Small Business listed – 6 in the states surrounding Missouri

Department of Labor (DoL) Service Contract Labor Standards (Service Contract Act (SCA)) and Wage Rate Requirements (Davis-Bacon Act (DBA)) wage determination information online at:

http://www.wdol.gov/ (SERVICES ONLY)

VI. Identify Services and Sources Able to Meet the Requirement

Business Category Name of Potential Source(s)/Other POC Information

VIP verified Service-Disabled, Veteran- Owned (SDVOSB)

Axiom Corporation Better Medical Business Solutions Sierra 7

VIP verified Veteran-Owned Small Business (VOSB)

Account Medical M1 Healthcare Solutions RSP Contracting Services

Woman-Owned Small Business (WOSB) Economically Disadvantaged Woman- Owned Small Business (EDWOSB)

HUBZone Small Business Section 8(a) small business Small/disadvantaged business (SDB) Small business 78 Small Business; 6 in the states surrounding Missouri Large Business

VII. Description of the Commercial Marketplace and Prevalent Business Practices

Market place for Medical coding is competitive but stable as it relates to pricing and product availability.

There are no standard/customary terms and or conditions or industry business practices that differ from the standard Government practices.

There is no contract financing needed for this contract.

No known regulations that are unique to the requirement.

VHAPM Part 810 Market Research SOP Page 6 of 9 Revision: 05, Effective Date: 09/23/20

VIII. Pricing and Market Issues

Pricing sources were via expired BPA and direct email contact Market trends for this service are in high demand as coding effects bottom line of all medical facilities.

IX. Other Considerations

Kansas City VA has used this service and we believe this company aligns with our requirements.

There are no green considerations as the work is all done electronically via access points owned by the VA.

https://sftool.gov/greenprocurement and http://www.gsa.gov/portal/content/105365.

X. Market Analysis Summary

The market research supports awarding the contract to Axiom

XI. DETERMINATION:

Recommendation is to award Axiom a 1-year contract and put this out for quotes when the new BPA is released

______________________________ Date: __________________ Bobby R. Crawford, COR

VHAPM Part 810 Market Research SOP Page 7 of 9 Revision: 05, Effective Date: 09/23/20

PART II –

I. Contracting Officer Responsibilities:

I. Background. The codes identified below will be used when advertising this requirement, if applicable.

Title Medical Coding Services

Product or Service Code: Q601

North American Industry Classification System (NAICS): 541219

Estimated Contract Value (including options): $

Procurement History: Contract 36C25518A0001 expired January 1, 2021. Option Year was not exercised due to the Vendor not meeting the required performance standards outlined in the QASP.

II. Market Research

1. Techniques Used in Conducting Market Research:

VIP Database search for 541219 and Medical Coding SBA Database search for 541219 and Medical Coding

2. Results of Market Research: A search of the VIP Database found three SDVOSB AND three VOSB that provide Medical Coding services; however, one of the three SDVOSB was a performance history of not meeting performance standards.

III. Consideration of Small Business Opportunities

Guidance: All acquisitions for supplies and services with an anticipated value above the micro-purchase up to and including the simplified acquisition threshold (SAT); these thresholds (see FAR 2.1-1 definitions) are reserved exclusively for small businesses and shall be set aside (FAR 19.502-2(a)). If the anticipated acquisition value exceeds the SAT, the requirement must be set aside for Small Businesses if (1) there is a reasonable expectation of receipt of offers from two or more responsible Small Businesses, and (2) award will be made at a fair market price (FAR 19.502-2(b)).

The VA’s contracting order of priority is set forth in VAAR 819.7004: Contracting officers shall consider, in the following order of priority, contracting preferences that ensure contracts will be awarded—

- To SDVOSBs

- To VOSB, including but not limited to SDVOSBs,

- To small business concerns using the priorities and preferences in 819.203-

70 and VAAR subpart 819.70—

VHAPM Part 810 Market Research SOP Page 8 of 9 Revision: 05, Effective Date: 09/23/20

Note: The Small Business Jobs Act of 2010 created parity among small business socioeconomic contracting programs. As a result of this amendment to the Small Business Act, there is no order of precedence among the 8(a), HUBZone, SDVOSB or WOSB programs in FAR (see 819.203).

38 U.S.C. 8127 (i) Priority for Contracting Preferences. Provides that preferences for awarding contracts to small business concerns shall be applied in the following order of priority: (1) SDVSOBs, followed by (2) VOSBs, including SDVOSBs, then (3) 8(a) and HUBZone firms and (4) any other small business. The order of priority was established in 2006 by Public Law 109-461, as per the policy in the Small Business Act at that time. Since then, as a result of legislative amendments to the Small Business Act, the FAR has been amended to create a woman-owned small business set-aside and to provide parity among the various small business socio-economic programs. Therefore, VA has adopted the current parity policy in FAR 19.203 for procurements involving other than SDVOSBs/VOSBs.

Based on above Market Research, identify each Small Business (including its eligibility for specific socioeconomic category status) capable of performing or providing the requirement. Discuss and explain the potential for Small Business participation in this acquisition.

Awarding a sole source to SDVOSB, Axiom, would be in the best interest of the Government. They are qualified and have the necessary experience to be able to provide the required services. They also have a history of satisfactory performance at the Facility as well as at other VISN 15 facilities.

IV. Conclusions and Recommendations

A. Query of the Vendor Information Pages (VIP) Database at https://www.vip.vetbiz.va.gov/ resulted in:

Total of 5 Veteran Owned Small Business concerns in each of the individual socio-economic group in NAICS 541219:

SDVOSB – 3

VOSB - 3

B. Query of the SBA Dynamic Small Business Search (DSBS) tool at http://dsbs.sba.gov/dsbs/search/dsp_dsbs.cfm), resulted in:

Total of 6 small business concerns in each of the individual socio-economic group:

SDVOSB – 0

VOSB – 0

VHAPM Part 810 Market Research SOP Page 9 of 9 Revision: 05, Effective Date: 09/23/20

WOSB – 0

8(a) – 0 HUBZone – 0

SB - 6

C. For acquisitions above the SAT, describe considerations for a set-aside or sole source award under the following small business program set-asides:

There are two SDVOSBs capable of performing the service; however, there is an urgent and compelling need to have service begin immediately.

IV. PROPOSED PROCUREMENT METHOD

Based upon the market research conducted and the resulting analysis, adequate sources of supply for small business concerns were obtained and after reviewing VA’s VIP database to identify verified and capable SDVOSBs and VOSBs, the data supports the use of the non-competitive procedures for awards to a verified service-disabled veteran-owned small business authorized in VAAR 819.7007 for acquisitions up to $5,000,000.

Awarding a sole source to SDVOSB, Axiom, would be in the best interest of the Government. They are qualified and have the necessary experience to be able to provide the required services. They also have a history of satisfactory performance at the Facility as well as at other VISN 15 facilities.

The mandatory BPAs have expired, and new ones are not in place at this time, but are in the process of being established. This contract will only be for six months and the Facility is expected to submit a new procurement package that will include competition once the new BPAs are awarded.

This recommendation will stand alone as the sole acquisition strategy document for small business determination for informal acquisition planning. This market research information is not more than 12 months old.

Date: _________________

_________________________________ Date: __________________ William Webb, Contracting Officer

Cara J. Fowler, Contract Specialist

William Webb Digitally signed by William Webb Date: 2021.02.10 07:35:39 -06'00'

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Woodring, Cara J.

From: Crawford, Bobby R. CMOVAMC Sent: Thursday, December 31, 2020 12:25 PM To: Woodring, Cara J.

Subject: RE: 36C255-21-AP-0654 - Medical Coding

Cara, I am working on getting this put together. Here is what I received from Axiom, I can estimate our amounts based on past usage?

Mr. Crawford, It was good speaking to you. Here are rates for 2021. Please let me know if you need anything else. Thank you for the opportunity.

Outpatient $5.24 Inpatient PTF 26.00 Inpatient Professional Services $7.39 Ambulatory Surgery $9.10

Rajan Jindal Axiom Corporation 703 568 1669 Rkjindal@axiom corp.com

Bobby (Bob) R. Crawford Assistant Chief, Health Administration Service Harry S. Truman Memorial Veterans’ Hospital 800 Hospital Dr.

Columbia, MO 65201

(573) 814 6437

From:Woodring, Cara J. <Cara.Woodring@va.gov> Sent: Thursday, December 31, 2020 10:16 AM To: Crawford, Bobby R. CMOVAMC <Bobby.Crawford2@va.gov> Cc:Webb, William K. <William.Webb99@va.gov> Subject: RE: 36C255 21 AP 0654 Medical Coding Importance: High

Please get me the attached documents asap. I have as much as I can do without them done. Also, did you get a quote from Axiom? If you did, please provide it. The contract pricing is no longer valid since the contracts expired in 2019.

We are trying to get the new contract in place as fast as we can, but we need these documents in order to award.

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