P03-JOFOC-InterqualAddonUMsoftware.pdf

Last Updated: 02/01/22 Page 1 of 2

DEPARTMENT OF VETERANS AFFAIRS

Justification for Single Source Awards IAW FAR 13.106‐1 For

Over Micro‐Purchase Threshold but Not Exceeding the SAT ($250K)

Acquisition Plan Action ID: VA‐24‐00006052 / 36C249‐23‐AP‐3583

1. Contracting Activity: Department of Veterans Affairs, Veterans Integrated Service Network (VISN) 09, Network Contracting Office (NCO) 9. PR/2237: 486‐24‐1‐3980‐0002

2. Brief Description of Supplies/ Services required and the intended use/Estimated Amount:

Addon software module ‐ InterQual Imaging Criteria, which includes InterQual Anonymous Review. This module is found under Interqual’s Ambulatory Care Planning suite, which is a hosted, cloud‐ based solution that lets you perform an interactive review with InterQual Criteria without specifying member data. Address high‐volume, high‐cost imaging studies.

With over 200 imaging studies, the criteria provide the most comprehensive coverage of imaging studies for pediatric, adolescent, and adult populations in the industry, including CT, MRI, and PET. The criteria also help identify the most appropriate imaging studies based on the member’s clinical presentation and the best medical evidence available. The product will be used as a reference for Utilization Managers across the VISN. The product will give an interactive source for the managers to reference when determining clinical decisions and supports the most appropriate care. The estimated item cost is $46861.45 for Year 1 with four one‐year options. The total cost for 5 years is $247750.45.

3. Unique characteristics that limit availability to only one source, with the reason no other supplies or services can be used: Interqual Criteria is an evidence‐based clinical support solution for payers, providers, and government agencies, who want to help ensure clinically appropriate medical‐utilization decisions. Interqual’s Criteria has three criteria suites, each with its own various quantity of addon modules. The Imaging Criteria addon software module works only with Change Healthcare Technologies’ (formerly known as McKesson) Utilization Management (UM) information system (IS) platform. This UM IS has been in place VHA‐wide for several years now and is the set standard per VHA Directive 1117, Utilization Management Program.

No other manufacturer or software publisher can meet or modify their product(s) to meet this requirement without substantial duplication of cost and severe adverse impact to VA‐ Utilization management workflow. This is true because the established UM IS platform architecture would have to be replaced with the other provider’s UM IS platform. This replacement action would disrupt current operations and incur a loss of over several millions of dollars invested in the current UM IS platform, while also requiring the government to outlay additional millions of dollars for implementation of the new UM IS platform; thus, affirming that this duplication of cost to the Government is not expected to be recovered through competition.

4. Description of market research conducted and results or statement why it was not conducted: Spoke with VHA and VISN 9 Utilization Management Program Managers about

Last Updated: 02/01/22 Page 2 of 2

DEPARTMENT OF VETERANS AFFAIRS

Justification for Single Source Awards IAW FAR 13.106‐1 For

Over Micro‐Purchase Threshold but Not Exceeding the SAT ($250K)

Acquisition Plan Action ID: VA‐24‐00006052 / 36C249‐23‐AP‐3583 the current company that can provide the same service. By researching using online searches, Veterans Benefits Administration (VBA) Contact Center Portal, GSA, and NASA SEWP it was determined that only Change Healthcare Technologies, LLC offered the interactive source for the managers to reference when determining clinical decisions and supports the most appropriate care. Change Healthcare Technologies, LLC has the current contract with VA on the Inpatient Utilization Management, InterQual, tool for utilization managers. The Imaging criteria portion was left to VISNs to determine the need of the Imaging criteria software. VISN 9 Utilization Program Manager and the QM Chief of Quality Management determined this is a necessity for our VISN to ensure the proper level of care is given to the veteran.

5. Contracting Officer's Certification: Purchase is approved in accordance with FAR13.106‐1(b).

I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

9/1/2023

X Sascha Hertslet, CFCM NCO9, Contracting Officer, Supply East Signed by: SASCHA HERTSLET