McDowell-Amend_1.pdf

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a) By completing items 8 and 15, and returning or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

E. IMPORTANT: Contractor is not is required to sign this document and return copies to the issuing office.

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended. is not extended.

12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER

NUMBER IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15C. DATE SIGNED

15A. NAME AND TITLE OF SIGNER (Type or print)

16C. DATE SIGNED

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

PAGE OF PAGES

6. ISSUED BY CODE

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, county, State and ZIP Code) (X)

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

Previous edition unusable

Teresa Kennon, Contracting Officer - FAO

Amendment #1 is established to incorporate the following changes: SEE CONTINUATION SHEET (PAGE 2 OF 2)

Federal Bureau of Prisons Field Acquisition Office - US Armed Forces Reserve Complex 346 Marine Forces Drive Grand Prairie, TX 75051

Federal Bureau of Prisons FCI McDowell PO Box 1029 101 Federal Drive Welch, WV 24801

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10/22/2018

10/12/2018

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT CONTINUATION

CONTRACT ID CODES

1. Replace “OPTION TO EXTEND SERVICES AS AUTHORIZED BY FAR 52.217-8”

(located in Attachment 1: Contracting Pricing & Subcontract Certification Page 5 of 6)

Forty-nine (49) months through sixty (60) months from DOA to the following:

Option to Extend Services as Authorized by FAR 52.217-8

Sixty-one (61) months through sixty-six (66) months from EDOA.

1a. Inpatient Facility Services: - __ Discount or + ___ Premium to Medicare Part A

1b. Outpatient Facility Services: - __ Discount or + ___ Premium to Medicare Part B

2a. Inpatient Physician Services: - __ Discount or + ___ Premium to Medicare Part B

2b. Outpatient Physician Services: - __ Discount or + ___ Premium to Medicare Part B

2c. Outpatient Institution Services:

2c1. Other Physicians: - __ Discount or + ___ Premium to Medicare Part B

2c2. Optometry: $ _____________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT

APPLICABLE "-/+" PERCENTAGE. IF NO VARIANCE, ENTER "0".

2. Incorporate the following language into the following section:

Attachment 2: Performance Work Statement (Page 5 of 9):

Output #3: Submit properly-priced invoices for services rendered.

Medical Claims Adjudication. The Government anticipates the implementation of a Medical Claims

Adjudication service following the award of this procurement. Once the BOP executes an Agreement with a Medical Claims Adjudicator services, the contractor providing Comprehensive Medical services to FCI McDowell shall participate in the medical claims adjudication process. The contractor will agree to abide by all terms pertaining to any BOP medical Claims adjudication agreement. Information associated with the procedures for submission of physician data, technical data for medical claims, protocol for submitting corrected facility and physician claims will be distributed to the contractor once it becomes available.