Mod 6 LSJ _Redacted_1.pdf

United States Department of the Interior

INTERIOR BUSINESS CENTER

Washington, DC 20240

JUSTIFICATION FOR AN EXCEPTION TO FAIR OPPORTUNITY

AUTHORITY: FAR 16.505(b)(2)

CONTRACT # D04D18F0445

1. Identification of the agency and the contracting activity, and specific identification of the document as a “Justification for an Exception to Fair Opportunity.”

This is a Justification for an Exception to Fair Opportunity for the Department of the Interior (DOI), Interior Business Center (IBC), Acquisition Services Directorate (AQD), Division I Branch III, on behalf of the Defense Health Agency (DHA) for a Charge Description Master (CDM) for the DHA electronic health records (EHR) system.

2. Nature and/or description of the action being approved.

This action will be a modification to extend the period of performance for a previously placed firm fixed price task order D0418F0445 with Deloitte Consulting, LLC, which was awarded under the Government-Wide Acquisition Contract (GWAC) National Institutes of Health Information Technology Acquisition and Assessment Center Solutions and Partners 3 (NITAAC CIO-SP3). Deloitte’s active contract number on CIO-SP3 is HHSN316201200018W. As this action is seeking a six-month extension outside the bounds of already established options under 52.217-8 or 52.217-9, this extension is considered out of scope of the original contract, thus requires the approval of a Justification for an Exception to Fair Opportunity.

3. A description of the supplies or services required to meet the agency’s needs (including the estimated value).

The Military Health System (MHS) consists of 36 hospitals with secondary care capabilities, 15 medical centers with tertiary care capabilities supporting residency programs, and 381 medical clinics providing only basic primary care, throughout the Continental United States and overseas.

The MHS is transitioning to a new electronic health record (EHR) called MHS Genesis. In order for the Medical Business Community to utilize the Cerner Patient Accounting Module (CPAM) of MHS Genesis, many business practices and processes must be amended, and new practices/processes adopted to effectively utilize the module as designed. Industry practice is to document, and bill patient encounters based on an itemized list of charges which require a Charge Description Master (CDM) to exist within the module. A Charge Description Master (CDM), or chargemaster, is a comprehensive listing of medical items, procedures, and services that may be reflected in itemized bills, that are then billed via an electronic billing system, RevX, to a patient, payer, or healthcare provider. Current MHS practice does not require a CDM;

therefore, development of a CDM is one of the major lines of effort necessary to transition to MHS Genesis.

Currently, support for the development of the CDM is being performed under a six-month extension provided for under FAR clause 52.217-8. This additional six-month extension to the existing task order will provide continued program management and technical expertise support for the continued development of the Charge Description Master (CDM) and its integration into the overall HER Genesis. It is determined that an additional six-month extension is required in order to maintain a steady state of development, in accordance with the current milestone schedule. To abruptly suspend progress at this point, while the follow-on requirement is competed, would significantly impact the schedule and viability of the CDM and the EHR. The authority to sole source will be FAR 16.505(b)(i)(C). The authority for the change to the existing contract will be 52.212-4.

The Independent Government Estimate (IGE) for this period will be the same as the value of the first extension period of the task order, , which was executed in Modification 5.

4. Identification of the exception to fair opportunity (see 16.505(b)(2)) and the supporting rationale, including a demonstration that the proposed contractor’s unique qualifications or the nature of the acquisition requires use of the exception cited at FAR 16.505(b)(2)(i)(C) – The order must be issued on a sole-source basis in the interest of economy and efficiency because it is a logical follow-on to an order already issued under the contract, provided that all awardees were given a fair opportunity to be considered for the original order.

This six-month period of performance extension is intended to allow enough time for DOI to solicit and compete a follow-on five year contract for the remaining development, deployment and maintenance of the new electronic health record system without experiencing a gap in service for the support currently provided under the existing contract. As detailed in the performance work statement for the extension and the follow-on requirement, there are numerous tight and carefully timed milestones required by the development plan. Any performance gap within these milestones will severely impact DHA’s ability to continue to successfully integrate and deploy Genesis and its various critical subsystems, RevX and MHS CDM. If DHA is not allowed to continue performance with the same contractor in order to complete the next critical milestone, in accordance with the development plan, there could be a significant and unacceptable delay, which could push the milestones back approximately three years due to the need for a new contractor to get up to speed and develop the system to the point that Deloitte has reached. Any delay would have an unacceptable impact on the timely continuation of MHS GENESIS deployment and would significantly delay the scheduled initial deployment of the MHS GENESIS billing solution, RevX, in January 2022. Delays in continued deployment of MHS GENESIS and/or the initial deployment of RevX would compromise the completion of the MHS GENESIS deployment contract and could result in fiscal liability to the Government in the form of penalty payments to the MHS GENESIS contractor. The incumbent contractor, Deloitte, has been intricately involved with the project since its inception. Deloitte is the only known contractor uniquely knowledgeable of the military cost allocation system, MIPRS, and how it will integrate into the EHR. No contractor would be able to immediately reach the necessary level of understanding as Deloitte, thus no other firm would be able to immediately meet the near term milestones required of this period. The DHA identified this requirement in the September / October 2020 time period. Funding by DHA budget staff was delayed until the Continuing Resolution was lifted. Given other DHA Contracting Office priorities and confusion over the need for an Inter-Agency Agreement (IAA), once funding had been provided, final signing of the IAA and Contracting Officer (KO) sign-out was received February 18, 2021.

5. A determination by the ordering activity contracting officer that the anticipated cost to the Government will be fair and reasonable.

The Contractor has agreed to accept the current performance period’s firm fixed pricing and payment schedule for the coming six months, until the follow-on contract is awarded. The current period of performance pricing was determined fair and reasonable at the time of award under the auspices of competition.

6. Any other facts supporting the justification.

None.

7. A statement of the actions, if any, the agency may take to remove or overcome any barriers that led to the restricted consideration before any subsequent acquisition for supplies and services is made.

Once the current critical milestone has been complete, there are no further known barriers to competition regarding the follow-on requirement. It is anticipated that the solicitation for a competitive follow-on requirement will be released by the end of March 2021 with award targeted for the summer of 2021.