Justification Third Party Billing Bridge 36C77626P0034_Redacted.pdf

Request for Sole Source Justification Format >SAT

VHAPG Part 806.3 OFOC Page 1 of 5 Revision: 04 Effective Date: 12/15/25 Acquisition ID#: 36C776-26-AP-0885

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C776-26-AP-0885

1. Contracting Activity: Department of Veterans Affairs, Veterans Health Administration (VHA), Program Contracting Activity Central (PCAC, 6100 Oak Tree Blvd., Suite 490, Independence, OH 44131. Purchase request number: F364531-26- 0000002.

2. Nature and/or Description of the Action Being Approved: This justification is in support of a firm-fixed price contract for Consolidated Patient Account Centers (CPACs) facilities in support of VHA, Revenue Operations, to Woman-Owned Small Business (WOSB), Receivia Inc.

3. Description of Supplies/Services Required to Meet the Agency�s Needs: The Contractor shall provide vendor contract services for the generation of outpatient claims to third party healthcare insurance carriers for seven Consolidated Patient Account Centers (CPACs) facilities nationwide. The revenue collected allows the Veterans Integrated Service Networks (VISNs) and Veteran Administration Medical Centers (VAMCs) to meet and/or exceed their Medical Care Collection Fund (MCCF) goals by optimizing third (3rd) party reimbursements used to pay for the cost of medical care provided to service-connected veterans.

Public Law 99-272 gave VA authority to seek reimbursement from third party health insurers for the cost of medical care furnished to an insured non-service connected (NSC) veteran. Public Law 101-508 expanded VA�s recovery program by providing authority to seek reimbursement from third party payers for the cost of medical care provided to ensure service-connected veterans treated for their NSC conditions.

4. Statutory Authority Permitting Other than Full and Open Competition:

(X) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per 41 USC §3304(a)(1) as implemented by

RFO 6.103-1;

( ) (2) Unusual and Compelling Urgency per 41 USC §3304(a)(2) as implemented by RFO 6.103-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per 41 USC §3304(a)(3) as implemented by RFO 6.103-3;

( ) (4) International Agreement per 41 USC §3304(a)(4) as implemented by RFO 6.103-4

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( ) (5) Authorized or Required by Statute per 41 USC §3304(a)(5) as implemented by RFO 6.103-5;

( ) (6) National Security per 41 USC §3304(a)(6) as implemented by RFO 6.103-6;

( ) (7) Public Interest per 41 USC §3304(a)(7) as implemented by RFO 6.103-7;

5. Demonstration that the Contractor�s Unique Qualifications or Nature of the Acquisition Requires the Use of the Authority Cited Above (applicability of authority): The incumbent contractor identified for this work is Receivia, Inc.

Receivia has trained staff ready to continue working immediately. This service is an immediate need as any loss of support will result in delays in processing billing accounts, and meeting revenue cycle goals and objectives. Utilizing Receivia Inc.�s services is more cost effective than re-soliciting for a short-term contract to continue the current work. Receivia employees have active background investigations, security requirements, and experienced personnel to continue to perform the work.

This would allow for services to continue immediately with no start-up costs or unacceptable delays.

. The period of performance is for a three-month base period beginning on May 1, 2026, and includes a two-month option period.

Only One Responsible Source (RFO 6.103-1) � This action is for continued support of highly specialized services. The current contract utilized by the VA for these services is IDIQ 36C77620D0016 awarded on 25 Sep 2020, with a five year ordering period and a maximum ceiling amount of $30M. The ceiling increased from $30M to $37M on March 11, 2025, and increased again from $37M to $40M on September 23, 2025. The current task order, 36C77625N0411, period of performance was from May 1, 2025, to February 28, 2026. However, on January 23, 2026, a modification was issued extending the period of performance to April 30, 2026.

The VA is currently working to solicit a competitive follow-on contract with a tentative fiscal year 2026 fourth quarter award date. This service is vital to revenue operations and would create a substantial operational risk with any gaps in service. The current contractor is meeting or exceeding all performance metrics and fully understands the requirement.

Accordingly, Receivia Inc. is the only firm capable of providing the supplies and services described in Section III above without the Veteran�s Health Administration experiencing unacceptable delays in fulfilling its requirements.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as possible (including whether a notice was or will be publicized as required by RFO Part 5 and, if not, which exception under RFO Part 5 applies): Special Notice of Intent to Sole Source, 36C77626Q0084 was posted to Contracting opportunities via SAM on February 11, 2026. The Notice

VHAPG Part 806.3 OFOC Page 3 of 5 Revision: 04 Effective Date: 12/15/25 Acquisition ID#: 36C776-26-AP-0885 stated that while not a request for competitive quotes, any responsible source who believes it is capable of meeting the requirements may submit a capability statement, which shall be considered by the agency by February 20, 2026. One response was received from an Other-Than small business.

A search of the SBA database found no Veteran-Owned Small Businesses (VOSBs) or Service-Disabled Veteran-Owned Small Businesses (SDVOSBs) under NAICS code 524292. A search of the SBA database for any small businesses utilizing NAICS code 524292 returned two (2) Woman Owned Small Businesses (WOSB) and two businesses with no current certification. The current vendor is the only source that can immediately meet the Government�s needs. Subsequently, only Receivia Inc. can immediately continue processing the billing claims.

The original market research for Contract 36C77620D0016 was completed from May 2019 to May 2020. An eRFI, 36U10120Q0047, was posted by OSDBU on the Beta SAM website in May 2019. Twenty-four (24) vendors responded and five (5) were determined to be capable of meeting the requirements: three WOSB (SAM Verified);

one SDVOSB (SAM Verified); and one Other-Than-Small Business (No SAM Record). As a result of the market research efforts, Request for Proposal (RFP) 36C77620R0014 was posted to Contracting Opportunities on August 26, 2020, as a WOSB set-aside. Five (5) offers were received. Only one offer was found technically acceptable therefore the contract was awarded to Receivia, Inc.

The most recent market research steps for the recompeted contract action include a search on the FPDS database, Small Business Administration (SBA) database, NASA SEWP, and all sources identified through the SBA search were sent an email notifying them of the sources sought notice. Sixteen responses were received. Of the sixteen responses received, three were determined capable. The solicitation will be issued as a VOSB set-aside.

The System for Award Management (SAM) was searched for entity records and Receivia Inc. does not have any exclusions, and the registration expires July 23, 2026.

Additional details of the efforts discussed can be found in the market research report in the contract file.

7. Determination by the CO that the Anticipated Cost to the Government will be Fair and Reasonable: The contracting officer will determine the price is fair and reasonable by comparing the proposed pricing to the Independent Government Cost Estimate (IGCE) per RFO 15.404-1(b)(5) and in comparison to historical prices paid for the same or similar items per RFO 15.404-1(b)(2) (previously referenced under FAR 13.106-3) to ensure that the price is determined to be fair and reasonable before the award is made.

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b. One Level Above the Contracting Officer (Required over SAT but not exceeding $900K): I certify the justification meets requirements for other than full and open competition.

c. Director of Contracting: I certify the justification meets requirements for other than full and open competition.

c. VHA RPO HCA Review and Approval: I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and recommend approval (if over $90 million) or approve ($900K to $90 million) for other than full and open competition.