Amendment_0002_fbo.pdf

11 . CONTRACT ID CODE IPA~E OF PAGES

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

I 2

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 15. PROJECT NUMBER (If applicable)

0002 05/14/2019 15B20918R00000001

6. ISSUED BY CODE 15BFAO 7. ADMINISTERED BY (If other than Item 6) CODE IBMCK

Federal Bureau of Prisons FCI MCKEAN

Field Acquisition Office 6975 ROUTE 59

U .S . Armed Forces Reserve Complex LEWIS RUN , PA 16738

346 Marine Forces Drive

Grand Prairie , TX 75051

8. NAME AND ADDRESS OF CONTRACTOR (Number. street, county, State and ZIP Code) ~ 9A. AMENDMENT OF SOLICITATION NUMBER

[g] 15B20918R00000001

9B. DATED (SEE ITEM 11)

05/03/2019

10A. MODIFICATION OF CONTRACT/ORDER NUMBE

D

10B. DATED (SEE ITEM 13)

CODE !FACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

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

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 Band 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted ;

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.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

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

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

CHECK ONE IA. 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.

D D

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).

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

D D. OTHER (Specify type of modification and authority)

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

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

SEE CONTINUATION PAGE 2 OF 2

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 1 DA, as heretofore changed, rema ins unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print) 16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

(Signature of person authorized to sign) (Signature of Contracting Officer)

R

Previous edition unusable STANDARD FORM 30 (REV. 11/2016) Prescribed by GSA FAR (48 CFR) 53 .243

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT CONTINUATION CONTRACT ID CODES

Amendment No. 0002 is established to incorporate the following changes:

PAGE OF

I. Remove the language below in its entirety, located in Attachment 4: Submission & Evaluation of Proposals Pp. I of 8.

All potential Offerors are advised that this solicitation includes the provision FAR 52.212-1, Instructions to Offerors - Commercial Items, and the clause at 52.212-4, Contract Terms and Conditions - Commercial It ems, which at paragraph (t) requires all Contractors doing business with the Federal government to be registered in the System for Award Management (SAM) database. Offerors should include their Data Universal Numbering System (DUNS) number in their offers . The Contracting Officer will verify registration in the SAM database prior to award by entering the potential awardee's DUNS number into the SAM database. Failure to complete the registration procedures outlined in the clause noted above may result in elimination from consideration for award. Instructions for registration in SAM can be found at https://www.sam.gov.

Potential Offerors who do not have a DUNS number may register with Dun and Bradstreet at http://www.dnb.com/ or by calling (800) 333-0505.

PAGES

2. Include FAR Clauses by reference 52.204-13, System/or Award Management Maintenance (OCT 2018)

3. Include FAR Provision by reference 52.204-7, System/or Award Management (OCT 2018)

Changes to Page 1 of 10 Attachment 2 Paragraph 4 and 5 FCI McKean is Federal Correctional Institution not Federal Medical Center. Also FCI McKean is a Care Level 1 facility not a Care level IV facility.

Attachment 2 Page 6 of 10 paragraph 1 in Invoice Definitions lite change is there is no 2bl.See below:

Line Items la- Inpatient Facility Services, lb - Outpatient Facility Services, 2a - Inpatient Physician Services, 2b Outpatient Physician Services, and 2cl - Outpatient Institution Services - Other Physicians: At the outset of this contract, an invoice for services rendered under Line Items I a, I b, 2a, 2b, and 2c I, shall be a paper version of an invoice containing not more than 50 individual medical claims. Each invoice shall be supported with paper copies of Universal Billing (UB)-04 forms or Centers for Medicare and Medicaid Services (CMS) 1500 forms , as applicable, for each medical claim included in the invoice.

Line Items 2c2, and 2c3 - Outpatient Institution Services -Mobile MRI and Optometrist: An invoice for services rendered under Line Items 2c 1, and 2c2 shall be a paper invoice detailing the date(s) sessions were provided, the number of sessions provided, the unit pricing applied, and the extended total amount due. The BOP will not use the services of a third party medical claims adjudicator for verification of these services.

Changes to Page I of7 -Attachment 5 Computation of Basic MS-DRG- The wage index is 0.7894 not 0.7920.

Copies of corrections attached.

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

I. Background

1of10 Attachment 2: Performance Work Statement FCI McKEAN-Comprehensive Medical Services

The Federal Bureau of Prisons (BOP) was established in 1930 to provide more progressive and humane care for Federal inmates, to professionalize the prison service, and to ensure consistent and centralized administration. Today, the BOP is responsible for the custody and care of approximately 185,000 Federal offenders. The Federal prison system is a nationwide system of prisons and detention facilities for the incarceration of inmates who have been sentenced to imprisonment for Federal crimes and the detention of individuals awaiting trial in Federal court. It is the mission of the Federal Bureau of Prisons to protect society by confining offenders in the controlled environments of prisons and community-based facilities that are safe, humane, cost-efficient, and appropriately secure, and that provide work and other self improvement opportunities to assist offenders in becoming law-abiding citizens.

As an agency under the Executive Branch of the United States Government, the BOP receives an annual appropriation of funds to accomplish its assigned mission. The public trust demands that this annual appropriation be prudently managed . Thus, dollars spent to maintain the health of the inmate population must reflect the agency's best efforts to obtain cost-effective health care consistent with community standards.

In meeting the health care needs of a growing inmate population, the BOP provides essential medical, dental , and mental health services to Federal inmates with BOP resources. When a medical need arises which cannot be provided within prison walls by BOP resources, referrals are then made to community based providers. It is the goal of this solicitation to establish a contractual agreement that will provide necessary professional and facility services for both inpatient admissions and outpatient encounters.

The Federal Correctional Institution (FCI) McKean located in Lewis Run, Pennsylvania intends to make a single award to a responsible entity for the provision of Comprehensive Medical Services as set forth in this solicitation/contract. FCI McKean consists currently houses male inmates. Presently, the FCI is identified as a Care Level I BOP facility. This administrative classification which generally suffers from serious health issues. Criteria for categorizing an inmate in the Care Level IV category is included as Attachment 6, Medical Classification - Care Level Criteria. Despite this description of the general health of the inmate population, however, needs for inmate healthcare may arise at varying levels of complexity. Classification and designation of inmates is the sole responsibility of the BOP and may change at any time without consideration to the Contractor.

In evaluating offers, the Government will evaluate the proximity of the proposed community-based providers, in addition to other factors , and give preference to those providers located nearest to FCI McKean. A mileage restriction of 40 miles has been placed on this acquisition, the Government reserves the right to determine that the proposed driving distances/conditions to community-based providers pose an unacceptable cost or security risk and to find such offers unacceptable.

II. Organizational Conflict of Interest

The objective of this solicitation is to satisfy the BO P's requirement for the provision of health care to the inmates of FCI McKean. A potential organizational conflict of interest may arise if the awardee is an entity which also holds or participates in a separate contract/agreement with the BOP as a medical claims adjudicator. A possible conflict of interest may exist if the awardee has dual responsibilities for the submission of medical claims for services rendered under the resulting contract and for the adjudication of those medical claims under a separate contract/agreement with the BOP.

6of10 Attachment 2: Performance Work Statement FCI McKEAN-Comprehensive Medical Services

Each patient (inmate) will have a primary care physician assigned at the FCI who will communicate and interact with the contractor (physician) for the purpose of coordinating care and facilitating services for the patient. This physician will not have any primary care responsibilities while the patient undergoing services and/or procedures, but will facilitate the communication process between the FCI and the contractor

Refer to Output# 1 regarding Joint Commission accreditation preference and requirements for private room accommodations. The offeror ' s technical proposal shall discuss in detail the diversity of services, as well as the proximity of providers that it is capable of providing to achieve Output #3 .

Output #4: Submit properly-priced invoices for services rendered.

Overview. Upon completion of a treatment encounter, the Contractor shall prepare and submit proper invoices for services rendered under this contract. For the purpose of this contract, a specific definition for what documentation constitutes an invoice is provided below. A proper invoice shall include the information specified in FAR clause 52.212-4, Contract Terms and Conditions - Commercial Items, paragraph (g) . Services shall be invoiced in accordance with the terms and conditions of the contract, including the payment rate structures specified in the contract.

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 service, the contractor providing Comprehensive Medical Services to FCI McKean 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.

Invoice/Medical Claims Adjudication: FCI McKean will employ a process of invoice/medical claims adjudication to ensure at a minimum, that the services billed by the Contractor were properly authorized and ordered by FCI McKean, are appropriately coded in compliance with Medicare coding policies (where applicable), are properly priced in accordance with the terms and conditions of the contract, and do not represent duplicate billings for payments already made. In addition, FCI McKean may utilize the services of a third-party medical claims adjudicator to review medical claims submitted by the Contractor under this contract. When requested by FCI McKean, the Contractor shall comply with all reasonable requests for additional invoice/ medical claim/ medical record documentation. All invoice payments shall be made by FCI McKean and any disagreements regarding the paid amount of any invoice shall be resolved directly with FCI McKean.

Invoice Definitions

Line Items la - Inpatient Facility Services, 1 b - Outpatient Facility Services, 2a - Inpatient Physician Services, 2b Outpatient Physician Services, and 2cl - Outpatient Institution Services - Other Physicians: At the outset of this contract, an invoice for services rendered under Line Items 1 a, I b, 2a,2b,and 2c 1, shall be a paper version of an invoice containing not more than 50 individual medical claims. Each invoice shall be supported with paper copies of Universal Billing (UB)-04 forms or Centers for Medicare and Medicaid Services (CMS) 1500 forms, as applicable, for each medical claim included in the invoice.

For each medical claim included on the invoice, the Contractor shall reference, at a minimum, the following information: YREGDOC number, inmate name and register number, date of service, provider

7of10 Attachment 2: Performance Work Statement FCI McKEAN-Comprehensive Medical Services of service, billed code, and contract amount billed. Medical claims detailed in the invoice shall be listed first in descending order by the YREGDOC number, second in alphabetic order by the inmate's last name, and third by ascending date of service (i .e., earliest to latest) when more than one medical claim is present for the same inmate within the same invoice.

If the Contractor's proposal encompasses the provision of community-based oral surgery and/or dental procedures, only those medical claims which represent adjunctive dental care will be submitted by the Contractor to the medical claims adjudication contractor for processing. Oral surgery and/or dental procedures which are not considered adjunctive dental care will be submitted to FCI McKean for verification.

The Contractor shall not submit a medical claim for processing that the Contractor knows or has reason to believe contains inaccurate, incomplete, or misleading information . Medical claims which contain inaccurate, incomplete, or misleading information shall be held by the Contractor and not submitted until such time as all lines are deemed to be accurate and complete. At that time, the Contractor may proceed with submitting the medical claim for processing and invoicing FCI McKean for all services represented by that medical claim.

Line Items 2c2, and 2c3 - Outpatient Institution Services -Mobile MRI and Optometrist: An invoice for services rendered under Line Items 2c 1, 2c2 and 2c3 shall be a paper invoice detailing the date(s) sessions were provided, the number of sessions provided, the unit pricing applied, and the extended total amount due. The BOP will not use the services of a third party medical claims adjudicator for verification of these services.

National Provider Identifier (NPI) Numbers: The Contractor shall utilize only providers who have a current National Provider Identifier (NPI) number.

Procedures for Filing Corrected Medical Claims

Facility Services: If it becomes necessary to file a corrected medical claim for facility services, the Contractor shall electronically transmit the information found on each individual corrected medical claim to FCI McKean. The Contractor shall promptly submit a paper copy of the invoice or credit memo, as applicable, to FCI McKean. Invoices for corrected medical claims shall be clearly marked as such and shall be separate from routine invoices. Invoices or credit memos for corrected medical claims shall detail information pertaining to the original medical claim submission (including any amount(s) previously paid and the associated invoice numbers) and shall bill only for the corrected medical claim submission or reflect the credit amount due for the corrected medical claim submission.

Physician/Professional Services: If it becomes necessary to file a corrected medical claim for physician/professional services, the Contractor shall submit the corrected medical claim in hard copy (i .e., paper) format to FCI McKean. The word "CORRECTED" shall be prominently displayed on the paper medical claim. Invoices for corrected medical claims shall be clearly marked as such and shall be separate from routine invoices. Invoices or credit memos for corrected medical claims shall detail information pertaining to the original medical claim submission (including any amount(s) previously paid and the associated invoice numbers) and shall bill only for the corrected medical claim submission or reflect the credit amount due for the corrected medical claim submission.

Payment by FCI McKean. FCI McKean will pay all invoices directly to the Contractor.

FCI McKean will provide written notification to the Contractor when an administrative deduction is taken from an invoice payment.

Submission of Proposals

1 of7

Attachment 4: Submission & Evaluation of Proposals

15B20918R00000001

FCI McKEAN-COMPREHENSIVE MEDICAL SERVICES

Proposals shall be submitted in three separate volumes in accordance with the following requirements.

Volume l - Technical Proposal Volume 2 - Past Performance Proposal Volume 3 - Business Proposal

Offerors are required to use the following method when submitting a proposal :

1. Electronic Proposals via e-mail. Offerors shall submit their scanned documents of Volumes 1, 2, and 3 electronically via e-mail to both tsjones@bop.gov and GRA/F AO CMS~@bop.gov. All documents must be in PDF format. All documents must be submitted and in the Government's control by the due date and time set forth in Block 8 of the Standard Form (SF) 1449, page l of the solicitation. Please refer to FAR 52.212-l(f)(2)(i)(A), (B), and (C). The Government e-mail system can only receive documents up to 14 megabytes (MB).

Therefore, the e-mail with attachments must be less than 14MB.

2. Offers received after the proposal deadline will be processed pursuant to FAR 52.212-1 (f). It remains the Offerors responsibility to ensure ALL DOCUMENTS are in the Government's control by the proposal due date and time.

3. The Offeror is responsible to ensure all electronic documents have good resolution and are LEGIBLE. The PDF file must also be text searchable.

4. Hard copies of proposals will not be accepted.

Instructions for Preparation of Technical Proposal

The Offeror's technical proposal will be an important consideration in the award of the resulting contract; therefore, it should be specific and complete. The technical proposal shall set forth in detail an Offeror's conceptual approach to, and interpretation of the following: stated contract goals; proposed work plan for achieving contract objective; proposed methodology and techniques of performing the contract; and the technical resources, experience and background, as well as unique or specialized skills and expertise of both the Offeror and proposed subcontractors.

The Offeror's proposal should be prepared simply and economically, providing straight-forward, concise delineation of capabilities to perform satisfactorily the contract being sought. The technical proposal should therefore be practical, legible, clear, and coherent. Unnecessarily elaborate brochures or other presentations beyond those sufficient to present a complete and effective response to this solicitation are not desired. Elaborate art work and expensive paper, bindings, and presentation aids are neither necessary nor wanted.

The technical evaluation criteria stated within this solicitation will be used by the technical panel in evaluating proposals; therefore, each technical proposal must contain enough specificity to address each evaluation factor and the terms and conditions of the Performance Work Statement. In order that an evaluation may be accomplished strictly on the merit of the material submitted, the technical proposal

Attachment 5 Computation of Basic MS-DRG

15B20918R00000001 FCI McKEAN-COMPREHENSIVE MEDICAL SERVICES

Computation of Basic MS-DRG Payments (i.e., Operating Federal Rate) CBSA Code 39 Rural Areas of Pennsylvania

Calculation of the Operating Federal Rate:

Step 1:

Step 2:

Step 3:

Step 4:

Step 5:

Select the applicable average standardized amount for the full update

Multiply the labor-related portion of the standardized amount by the applicable wage index for the geographic area

For hospitals in Alaska and Hawaii , multiply the non-labor-related portion of the standardized amount by the applicable cost-of-living adjustment factor

Add the amount from Step 2 and the non-labor-related portion of the standardized amount (adjusted, if applicable, under Step 3)

Multiply the final amount from Step 4 by the relative weight corresponding to the applicable

MS-DRG

Index Figures: Obtained from the Centers for Medicare and Medicaid Services for discharges on/after October I, 2018 .

Table IA (Full Update) National Adjusted Operating Standardized Amount:

Labor-related:

Non-labor-related:

$3,500.57 $2,145 .51

Table 4A, Wage Index for Pennsylvania (Table): 0.7894

Table, Cost of Living Adjustment Factor: Not applicable

Table 5, MS-DRG Relative Weight (MS-DRG 76, Viral Meningitis w/o CC/MCC): 0.8248

Application for MS-DRG 076 (example):

Step I:

Step 2:

Step 3:

Step 4:

Step 5:

$3500.57 $3500 .57 x 0.7894 = $273 .35 Not applicable $2763 .35 + $2145.51 = $4908 .86 $4908 .86 x 0.828 = $4048 .83

Payment for MS-DRG 076 under the contract would be $4048 .83 plus or minus any premium or discount established as the contract rate.