RFPP02031600003_-_Solicitation.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30

1. REQUISITION NUMBER

5. SOLICITATION NUMBER

RFPP02031600003

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

05/13/2016

7. FOR SOLICITATION INFORMATION

CALL:

a. NAME

Vikram Sighamony vsighamony@bop.gov

b. TELEPHONE NUMBER (No collect calls)

(O) 972-352-4516 (F) 972-352-4545

8. OFFER DUE DATE / LOCAL

TIME

07/15/2016 2:00PM CST

CODE BFAO

Federal Bureau of Prisons Field Acquisition Office U.S. Armed Forces Reserve Complex 346 Marine Forces Drive Grand Prairie, TX 75051

9. ISSUED BY X UNRESTRICTED OR SET ASIDE: % FOR

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS: 622110

SIZE STANDARD: $38,500,000

10. THE ACQUISITION IS

SEE

SCHEDULE

11. DELIVERY FOR FOB DESTINATION

UNLESS BLOCK IS MARKED

NET 30

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER DPAS

(15 CFR 700)

13b. RATING

RFQ IFB X RFP

14. METHOD OF SOLICITATION

BDANCODE15. DELIVER TO

Federal Bureau of Prisons FCI Danbury

33-1/2 PEMBROKE ROAD

ROUTE 37

DANBURY, CT 06811

CODE BDAN16. ADMINISTERED BY

Federal Bureau of Prisons FCI Danbury

33-1/2 PEMBROKE ROAD

ROUTE 37

DANBURY, CT 06811

FACILITY

CODE

CODE

TELEPHONE NO.

17a. CONTRACTOR/

OFFEROR

BDANCODE18a. PAYMENT WILL BE MADE BY

Federal Bureau of Prisons FCI Danbury

33-1/2 PEMBROKE ROAD

ROUTE 37

DANBURY, CT 06811

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER SEE ADDENDUM

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS

CHECKED

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Comprehensive Medical Services for the Federal Correctional Institution in Danbury, Connecticut.

See Section 2 -Schedule of Items, Section 2.1 - Contract Pricing, and 2.2 - Performance Work Statement

See Continuation Sheet(s) (Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA X ARE ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ____ COPIES TO

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE

TERMS AND CONDITIONS SPECIFIED.

29. AWARD OF CONTRACT: REF. _____________________________ OFFER

DATED _________________ . YOUR OFFER ON SOLICITATION (BLOCK 5)

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN,

IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (TYPE OR PRINT)

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

RFPP02031600003 Page 1 of 56

BOP39720

Typewritten Text Funds to be obligated by individual task orders

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: _________________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

PARTIAL FINAL

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

COMPLETE PARTIAL FINAL

36. PAYMENT 37. CHECK NUMBER

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

RFPP02031600003 Page 2 of 56

Table of Contents

Section Description Page Number

1 Solicitation/Contract Form 2 Commodity or Services Schedule

2.1 Contract Pricing/Sub-Contract Certification

2.2 Performance Work Statement

3 Contract Clauses 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) 2852.223-70 Unsafe Conditions Due to the Presence of Hazardous Material (June 1996) BOP 2852.237-76 Notice of Contractor Personnel Security Requirements (OCT 2005)

BOP 2852.237-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS

(JUNE 2004)

52.218-000 CONTINUING CONTRACT PERFORMANCE DURING A PANDEMIC INFLUENZA

OR OTHER NATIONAL EMERGENCY (May 2008)

BOP 2852.242-71 EVALUATION OF CONTRACTOR PERFORMANCE UTILIZING CPARS (APR

2011) 52.252-6 Authorized Deviations in Clauses (Apr 1984) DJAR-PGD-15-02-2B Contractor Internal Confidentiality Agreements or Statements Prohibiting or Restricting Reporting of Waste, Fraud, and Abuse - Award - (DEVIATION 2015-02) (March 2015) .20 DJAR-PGD-15-02-2A Corporte Representation Regarding Felony Conviction Under Any Federal Law or Unpaid Delinquent Tax Liability - Award (DEVIATION 2015-02) (March 2015) DJAR-PGD-15-03 Security of Department Information and Systems DJAR-PGD-15-02-2C Contractor Certification of Compliance with Federal Tax Requirements - Award (Deviation 2015-02) (March 2015) 52.216-19 Order Limitations (Oct 1995) 52.216-18 Ordering (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.216-21 Requirements (Oct 1995) 52.232-19 Availability Of Funds For The Next Fiscal Year (Apr 1984) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders -- Commercial Items (Mar 2016) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997)

4 List of Attachments

4.1 Special Contract Conditions

5 Solicitation Provisions

5.2 Submission and Evaluation of Proposals

52.233-2 Service of Protest (Sept 2006) 52.209-7 Information Regarding Responsibility Matters (Jul 2013)

5.1 Tailoring

52.252-5 Authorized Deviations in Provisions (Apr 1984) DJAR-PGD-15-02-1B Contractor Internal Confidentiality Agreements or Statements Prohibiting or Restricting Reporting of Waste, Fraud, and Abuse - Solicitation - (DEVIATION 2015-02) (March 2015) 2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998)

52.27-103-71 FAITH-BASED AND COMMUNITY-BASED ORGANIZATIONS (AUG 2005)

52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) DJAR-PGD-15-02-1C Contractor Certification of Compliance with Federal Tax Requirements - Solicitation - (DEVIATION 2015-02) (March 2015) DJAR-PGD-15-02-1A Corporte Representation Regarding Felony Conviction Under Any Federal Law or Unpaid Delinquent Tax Liability - (DEVIATION 2015-02) (March 2015) 52.212-2 Evaluation - Commercial Items (Oct 2014) 52.212-3 Offeror Representations and Certifications--Commercial Items (Apr 2016)

RFPP02031600003 Page 3 of 56

Section 2 - Commodity or Services Schedule

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 Comprehensive Medical Services for the Federal Correctional Institution in Danbury, Connecticut.

Base Year: Effective Date of Award (EDOA) through 12 months from EDOA.

12.000000 MO $____________ $___________________

0002 Comprehensive Medical Services for the Federal Correctional Institution in Danbury, Connecticut.

Option Year 1: 13 months through 24 months from EDOA.

12.000000 MO $____________ $___________________

0003 Comprehensive Medical Services for the Federal Correctional Institution in Danbury, Connecticut.

Option Year 2: 25 months through 36 months from EDOA.

12.000000 MO $____________ $___________________

0004 Comprehensive Medical Services for the Federal Correctional Institution in Danbury, Connecticut.

Option Year 3: 37 months through 48 months from EDOA.

12.000000 MO $____________ $___________________

0005 Comprehensive Medical Services for the Federal Correctional Institution in Danbury, Connecticut.

Option Year 4: 49 months through 60 months from EDOA.

12.000000 MO $____________ $___________________

2.1 Contract Pricing/Sub-Contract Certification

Blocks 19 through 24 - Contract Pricing/Sub-Contract Certification

Overview

Services are required to be provided in accordance with the Performance of Work Statement included in this solicitation/contract. Of-ferors are required to submit, as a part of their business proposal, a completed copy of Schedule of Items/Sub-Contract Certification.

Pricing Methodology

Except for services based on session rates, price proposals will be calculated from benchmarks utilizing Medicare reimbursement methodologies. For each category of service to be provided, offerors will be allowed to propose a variance from benchmark Medicare rate in the form of a discount from or a premium to Medicare rates established by the Centers for Medicare and Medicaid Services.

The rates established in the resulting contract shall not be construed as participation in the Medicare program; contract rates will merely be equated to Medicare rates of reimbursement without reductions for deductibles, copayments, or coinsurance. When appro-priate, outlier payments calculated in accordance with Medicare reimbursement methodologies shall be made in recognition of extremely costly stays. The outlier payment shall be calculated based upon the defined benchmark and will consist of the operating portion only. This structuring of the pricing methodology is not intended to be restrictive of any offeror; offerors need only to propose that percentage discount from the premium to the Medicare benchmark rate which will reflict the desired level of payment for the cat-egory of services rendered. If during contract performance, it is determined that a necessary contract deliverable is not covered by Medicare reimbursement methodologies, a separate rate shall be negotiated for such deliverable(s).

Medicare Part A. The Medicare benchmark to be utilized for all services covered by Medicare Part A shall be the most current Basic MS-DRG payment (i.e., Operating Federal Rate) established for Core Based Statistical Area (CBSA) 14860, Bridgeport-Stamford-Norwalk, CT. The Basic MS-DRG calculation shall not include any provider-specific adjustments al-lowed under actual Medicare participation. Offerors may propose a discount from or a premium to Basic MS-DRG rates. (Refer to At-tachment 1 of this solicitation.)

Medicare Part B Physician Services and Non-Physician Services. The Medicare benchmark to be utilized for all physician and non-physician services covered by Medicare Part B shall be those rates established in the most current Medicare Part B Fee Schedule for Payment Locality 0, Connecticut. The benchmark charges shall be those established for participating providers. Offerors may pro-pose a discount from or a premium to the benchmark charges.

RFPP02031600003 Page 4 of 56

Medicare Part B Facility Services (including hospital outpatient services and ambulatory surgical centers). The Medicare benchmark to be utilized for all facility services covered by Medicare Part B shall be the most current APC and ASC rates calculated for CBSA 14860, Bridgeport-Stamford-Norwalk, CT . Offerors may propose a discount from or a premium to the benchmark charges.

Clinical Laboratory Services. The benchmark rate to be utilized for clinical lab tests covered by Medicare Part B shall be those rates established in the most current Medicare Part B Fee Schedule for the State of Connecticut. Offerors may propose a discount from or a premium to the Medicare rate. Contract billings shall include the applicable Current Procedural Terminology (CPT) code or HFCA Common Procedure Coding System (HCPCS) code for bill verification processing. See Laboratory Testing, in the section below, for the yearly estimates of the most common tests.

Estimated Quantities

Estimated quantities for the base year and all option years are detailed below. The estimated quantities provided are not a representa-tion to the offeror/contractor that the estimated quantities will be required or ordered or that conditions affecting requirements will be stable or normal.

Inpatient and Outpatient Facility and Physician Services

Base Year - Effective Date of Award (EDOA) through twelve (12) months from EDOA

Inpatient Days: 170 days (estimated) Outpatient Days: 750 days (estimated) Clinical Lab Tests: 8,268 (estimated)

Option Year 1 - Thirteen (13) months through twenty-four (24) months from EDOA

Inpatient Days: 250 days (estimated) Outpatient Days: 925 days (estimated) Clinical Lab Tests: 8,268 (estimated)

Option Year 2 - Twenty-five (25) months through thirty-six (36) months from EDOA

Inpatient Days: 250 days (estimated) Outpatient Days: 925 days (estimated) Clincal Lab Tests: 8,268 (estimated)

Option Year 3 - Thirty-seven (37) months through forty-eight (48) months from EDOA

Inpatient Days: 250 days (estimated) Outpatient Days: 925 days (estimated) Clinical Lab Tests: 8,268 (estimated)

Option Year 4 - Forty-nine (49) months through sixty (60) months from EDOA

Inpatient Days: 250 days (estimated) Outpatient Days: 925 days (estimated) Clinical Lab Tests: 8,268 (estimated)

Outpatient Institution Services

Estimated quantities shall remain constant for the base year and all option years. For Medicare-based services, duration of visits is lis-ted for informational purposes only, as contract rates will be based upon the Medicare allowable per procedure performed. Because Medicare rates are typically not available for Optometery serices, these categories shall be paid by defined sessions.

Orthopedic Surgeon Visit duration - 4 hours (approximate) Visit quantity - 48 per contract year (approximate)

Neurologist Visit duration - 4 hours (approximate) Visit quantity - 24 per contract year (approximate)

Urologist Visit duration - 4 hours (approximate) Visit quantity - 12 per contract year (approximate)

Dermatologist Visit duration - 4 hours (approximate)

RFPP02031600003 Page 5 of 56

Visit quantity - 24 per contract year (approximate)

Podiatrist Visit duration - 4 hours (approximate) Visit quantity - 24 per contract year (approximate)

Optometrist Visit duration - 8 hours (approximate) Visit quantity - 55 per contract year (approximate)

Physical Therapist Visit duration - 4 hours (approximate) Visit quantity - 24 per contract year (approximate)

Cardiologist Visit duration - 4 hours (approximate) Visit quantity - 12 per contract year (approximate)

Note: Session-priced items which exceed the established session or are less than a full session shall be pro-rated to the nearest quarter hour.

Laboratory Testing

Order Code Name Count (yearly estimate)

GLOB 1,669

GYN/PAP 1,500

D Dimer 3

RPR 272

VIT B12 76

PAP-HPV 300

PT 253

FOLATE RBC 16

ESR 62

C UCV 100

ANTI TPO 142

APTT 84

TNT 3

TNI 5

PROLACTIN 76

FRUCT 8

FSH 76

C URINE 89

LIP 20

VIT D 25OH 172

HGB ELECT 6

HEP C PCRQ 53

PSA 500

ANAS 169

HPY IGG 198

CCP 30

G6PD 57

STATE FTA 20

C PEP 76

THYGLOB 30

DHEAS 20

C RESP 20

ACETONE 35

ION CA 45

CA 125 56

INSULIN 25

PTH 30

TESTO 15

ESTRADIOL 44

CORTISOL 10

DRVVT 96

TTI 1

HIV-1 789

SS A/RO 50

RFPP02031600003 Page 6 of 56

SS B/LA 50

ANA 50

ACL 1

LYME 2

PARVO GM 1

FOLATE 30

FREE TESTO 2

DNA FARR 6

ACE 20

IGF-II 1

RENIN 2

DHEAUNCJ 1

ALPHA SUB 1

HLA B27 2

ABSC PHS 10

ABSC INT 10

ABHORTYPE 3

C CHLAM DN 150

C LOW RESP 40

C STAPH 150

C STREP 100

C EAR 15

C BF/T 120

C GRAM 100

CGC DNA 100

Schedule of Items Offerors shall complete the following Schedule of Items. All proposed pricing and participation targets will be evaluated in accord-ance with FAR 52.212-2, Evaluation - Commercial Items, and Section 5.2 of this solicitation, Evaluation of Proposals.

Schedule of Items

Base Year

Effective Date of Award (EDOA) through twelve (12) months from EDOA

1a. Inpatient Faciltiy Services: - _____ Discount or + ______ Premium to Medicare Part A 1b. Outpatient Facility Services: - _____ Discount or + ______ Premium to Medicare Part B 1c. Clinical Lab Services: - _____ Discount or + ________ Premium to Medicare Part B, most current Clincal Lab Fee Schedule for the State of Connecticut 2a. Inpatient Physician Services: - _____ Discount or + ______ Premium to Medicare Part B 2b. Outpatient Physican Services: - _____ Discount or + ______ Premium to Medicare Part B

Outpatient Institution Services:

2c. Other Physicians: - ______ Discount or + _______ Premium to Medicare Part B 2c1. Optometrist: $ __________ per session (8 hours session)

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATES, INSERT APPLICABLE "-

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

Option Year 1

Thirteen (13) months through twenty-four (24) months from EDOA

1a. Inpatient Faciltiy Services: - _____ Discount or + ______ Premium to Medicare Part A 1b. Outpatient Facility Services: - _____ Discount or + ______ Premium to Medicare Part B 1c. Clinical Lab Services: - _____ Discount or + ________ Premium to Medicare Part B, most current Clincal Lab Fee Schedule for the State of Connecticut 2a. Inpatient Physician Services: - _____ Discount or + ______ Premium to Medicare Part B 2b. Outpatient Physican Services: - _____ Discount or + ______ Premium to Medicare Part B

RFPP02031600003 Page 7 of 56

Outpatient Institution Services:

2c. Other Physicians: - ______ Discount or + _______ Premium to Medicare Part B 2c1. Optometrist: $ __________ per session (8 hours session)

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATES, INSERT APPLICABLE "-

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

Option Year 2

Twenty-five (25) months through thirty-six (36) months from EDOA

1a. Inpatient Faciltiy Services: - _____ Discount or + ______ Premium to Medicare Part A 1b. Outpatient Facility Services: - _____ Discount or + ______ Premium to Medicare Part B 1c. Clinical Lab Services: - _____ Discount or + ________ Premium to Medicare Part B, most current Clincal Lab Fee Schedule for the State of Connecticut 2a. Inpatient Physician Services: - _____ Discount or + ______ Premium to Medicare Part B 2b. Outpatient Physican Services: - _____ Discount or + ______ Premium to Medicare Part B

Outpatient Institution Services:

2c. Other Physicians: - ______ Discount or + _______ Premium to Medicare Part B 2c1. Optometrist: $ __________ per session (8 hours session)

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATES, INSERT APPLICABLE "-

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

Option Year 3

Thirty-seven (37) months through forty-eight (48) months from EDOA

1a. Inpatient Faciltiy Services: - _____ Discount or + ______ Premium to Medicare Part A 1b. Outpatient Facility Services: - _____ Discount or + ______ Premium to Medicare Part B 1c. Clinical Lab Services: - _____ Discount or + ________ Premium to Medicare Part B, most current Clincal Lab Fee Schedule for the State of Connecticut 2a. Inpatient Physician Services: - _____ Discount or + ______ Premium to Medicare Part B 2b. Outpatient Physican Services: - _____ Discount or + ______ Premium to Medicare Part B

Outpatient Institution Services:

2c. Other Physicians: - ______ Discount or + _______ Premium to Medicare Part B 2c1. Optometrist: $ __________ per session (8 hours session)

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATES, INSERT APPLICABLE "-

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

Option Year 4

Forty-nine (49) months through sixty (60) months from EDOA

1a. Inpatient Faciltiy Services: - _____ Discount or + ______ Premium to Medicare Part A 1b. Outpatient Facility Services: - _____ Discount or + ______ Premium to Medicare Part B 1c. Clinical Lab Services: - _____ Discount or + ________ Premium to Medicare Part B, most current Clincal Lab Fee Schedule for the State of Connecticut 2a. Inpatient Physician Services: - _____ Discount or + ______ Premium to Medicare Part B 2b. Outpatient Physican Services: - _____ Discount or + ______ Premium to Medicare Part B

Outpatient Institution Services:

2c. Other Physicians: - ______ Discount or + _______ Premium to Medicare Part B 2c1. Optometrist: $ __________ per session (8 hours session)

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATES, INSERT APPLICABLE "-

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

All offerors are hereby advised after the successful offeror's unit pricing (to include discount percentage from our premium percentage to the benchmark Medicare rate) for the base year and all option years is public information, in accordance with Federal Acquisition Regulation (FAR) 15.503(b)(1)(iv). Accordingly, all successful unit pricing will be released to unsuccessful offerors with the notifica-

RFPP02031600003 Page 8 of 56 tion of award as well as to the general public when requested. Any party who objects to the release of their own unit pricing informa-tion, should they be awarded a contract in response to the solicitation, should not submit a proposal in response to the solicitation.

Sub-Contract Certification:

This contract does ___________ does not ___________ provide for subcontracting possibilites.

If answer is in the affirmative, offeror will submit ___________ a sub-contracting plan in accordance with the requirements of FAR 52.219-9, Small Business Subcontracting Plan.

2.2 Performance Work Statement

I. Background

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 cus-tody and care of approximately 195,000 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 individu-als awaiting trial in Federal court. It is the mission of the Federal BOP to protect society by confining offenders in the controlled en-vironments 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 ac-complish 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 ser-vices to Federal inmates by BOP staff. When a medical need arises which cannot be provided within prison walls by BOP staff, refer-rals are then made to community-based providers. It is the goal of this solicitation to establish contractual agreement that will provide necessary professional and facility services for both inpatient admissions and outpatient encounters.

The BOP intends to make a single award to a responsible entity for the provision of Comprehensive Medical Services for the Federal Correctional Institution (FCI) located in Danbury, Connecticut. The FCI currently houses female and male inmates. The FCI is presently designated as a Care Level II BOP facility. Care Level II is an intermediate classification on the four-level scale where Care Level I represents the healthiest inmates and Care Level IV represents inmates with serious health issues. Criteria for categorizing an inmate in the Care Level II category is included in Attachment II. Despite this description of the general health of the inmate popula-tion, however, needs for inmate healthcare may arise at varying levels of complexity.

In evaluating offers, the Government will evaluate the proximity of the proposed community based-providers, in addition to the factors, and give preference to those providers located nearest the FCI. Although a mileage restriction has not been placed on this ac-quisition, 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 BOP's requirement for the provision of health care to the inmates of the FCI. A poten-tial 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 claim adjudicator. A possible conflict of interest may exist if the awardee has dual responsibilit-ies 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.

Offers received from any firm which holds or participates in a separate contract/agreement for BOP medical claims adjudication ser-vices must address any potential organizational conflict of interest that may arise and must provide a detailed explanation of how such conflicts will be avoided. Offers received from any firm which holds or participates in a separate contract/agreement for BOP medical claims adjudication services which fail to adequately address/resolve potential conflicts of interest will be rejected without further consideration. This limitation on the eligibility of offerors has been imposed as authorized by Federal Acquisition Regulation (FAR) 9.506, Procedures.

III. Statement of Output

Within this Performance Work Statement (PWS), necessary services are described in terms of output rather than specific task assign-

RFPP02031600003 Page 9 of 56 ments. The BOP desires to make an award to the offeror who can provide the best value, considering the diversity of available services and price, among other criteria specified in Section 5.2. Therefore, the Government may award any or all line items, may withold award of any or all line items, or may award to an offeror who proposes less than the full complement of services contained in this so-licitation. Accordingly, output items 1 and 2 are optional deliverables while output items 3, 4, and 5 are applicable to all services provided. Offerors are encouraged to submit comprehensive proposals committing to provide all output listed in the solicitation. Of-ferors who propose less comprehensive approaches will be evaluated accordingly.

Output #1: Provide inpatient and outpatient facility services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of health care to members of the general public. (Cross-referencing pricing cat-egories 1a and 1b.)

Output #2: Provide professional services which conform to community standards and all local, state, and Federal laws and reg-ulations applicable to the delivery of health care to members of the general public. (Cross-reference pricing categories 2a, 2b, 2c, and 2c1.)

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

Output #4: Manage medical record information in a manner which promotes continuity of care while observing restrictions on the release of information.

Output #5: Maintain open avenues of communication, facilitating the exchange of information between the contract provider, contract facility, and the Government regarding the contract services.

IV. Compliance with Contract Requirements

The Contractor's efforts under this contract shall be monitored to ensure that the required output is achieved. The Government reserves the right to inspect and evaluate in a reasonable manner all services rendered during the performance of this contract. The Contractor's performance will be measured by the Government utilizing the outcome measure indicators provided in Attachment 3.

The Contractor is responsible for all management and quality control actions necessary to meet the quality standards set forth by this contract. Prior to commencing performance, the Contractor shall develop and submit a Quality Control Plan (QCP) for the FCI's ap-proval. Once the QCP is approved by the FCI, the Contractor shall utilize the QCP to guide and rigorously document the implementa-tion of the required management and quality control actions to achieve the specified output.

V. Specific Requirements

Output #1: Provide inpatient and outpatient facility services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of health care to members of the general public.

Output #1 is an optional deliverable. However, if the offeror proposes to provide these services, the following minimum requirements apply. Throughout the performance of this contract, the Contractor shall not utilize any provider that appears on the List of Excluded Individuals/Entities (LEIE) maintained by the Department of Health and Human Services.

If proposed, the Contractor shall provide facility services on an as-needed basis in a manner which adheres to community standards of quality and cost-effective medical care. The services required to satisfy Output #1 may include inpatient facility and outpatient facil-ity, including emergency room services. Inpatient visits for non-emergency services shall require private room accommodations with available space for up to three armed or unarmed guards per inmate.

It is the FCI's preference to obtain the services of facilities that are accredited by the Joint Commission. Offerors utilizing facilities which maintain accreditation by the Joint Commission shall submit a copy of the current accreditation certificate as part of the offer-or's technical proposal. If an offeror intends to utilize a facility which is accredited or certified by any other recognized professional accrediting body, the offeror shall submit documentation validating this accreditation or certification as a part of its proposal.

The contractor may perform comprehensive laboratory services for lab testing not currently performed under an existing laboratory contract. If proposed, the contractor will provide all laboratory testing required by the FCI including but not limited to the tests in-cluded in the section titled "Laboratory Testing" in Section 2.1. The contractor will establish a means of transportation for lab samples on an as needed basis, including weekend and holidays. The scheduling of pick-ups will be coordinated between the institution's Health Services department and the contractor. With the exception of laboratory tests requested on an emergency basis, all lab test specimen pick-ups wil be scheduled at least 12 hours in advance. The contractor will ensure timely reporting of all laboratory test res-ults, normally within 180 minutes for stat tests and within two (2) working days for all other test results. Panic lab values will be re-layed to the appropriate medical staff within a timely manner. The contractor will provide a typed and dated report within ten (10) days of the test(s) being performed. All laboratory services will be conducted in accordance with BOP policies, and confidentiality of test results must be maintained.

The offeror's technical proposal shall discuss in detail the diversity of services, as well as the proximity of facility providers to the

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FCI, that it is capable of providing to achieve Output #1.

Output #2: Provide professional services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of health care to members of the general public.

Output #2 is an optional deliverable. However, if the offeror proposes to provide these services, the following minimum requirements shall apply. Throughout the performance of this contract, the Contractor shall not utilize any provider that appears on the List of Ex-cluded Individuals/Entities (LEIE) maintained by the Department of Health and Human Services.

Community-Based Services

Professional services resulting from a BOP referral are necessary to be performed in a community-based setting (e.g., hospital facility, surgical center, physician's office, etc.). If proposed, the Contractor shall provide the services of professional medical staff who have appropriate educational qualification, experience, licensure, and board certification (where required) to achieve Output #2. This output specifically excludes the provision of radiological interpretations of BOP-provided films, images, or other media.

If requested by the Contracting Officer, the Contractor shall be required to document primary source verification of the credentials for each provider including: current license from appropriate State Board of Medical Examiners, education from professional schools or universities, evidence of completion of interships and/or residences as appropriate.

Whenever possible, appointments for specialty care should be available within 14 calendar days from the date of referral to the spe-cialty provider. This practice promotes the safety and security of the federal prisoner, the escorting correctional staff, and the general public. The medical urgency of any referral must receive consideration in the scheduling and delivery of professional services.

For prescriptions to be filled by the FCI pharmacy, contract providers shall only prescribe pharmaceutical drugs that are listed in the approved BOP Formulary. The BOP Formulary can be accessed athttp://www.bop.gov/resources/health_care_mngmt.jsp. Requests for exemptions shall be submitted to the Contracting Officer's Representative (COR), who shall obtain the required approvals. As part of the Discharge instructions, the issuance of sample medication to any Federal inmate shall be prohibited.

The offeror's technical proposal shall discuss in detail the diversity of services, as well as the proximity of professional providers to the FCI, that it is capable of providing to achieve Output #2.

Institution-Based Services As an additional tool to satisfy Output #2, professional services may be performed within the confines of the FCI. If the resulting con-tract does not provide for telemedicine consultation or all of the on-site clinics listed, the FCI reserves the right to pursue such con-tracts. The FCI also reserves the right to determine the manner of an inmate's referral, i.e., via on-site clinic, via community-based re-ferral, via telemedicine consult, or any other method the FCI determines to be reasonable and approrpriate.

If the Contractor performs on-site specialty clinics at the FCI, the following minimum requirements shall apply. Contract services shall be provided on-site within the Health Services Unit of the FCI. Consultations shall be limited to the chief complaint on the BOP consultation form. Services shall include diagnosis and treatment of medical conditions with appropriate referral, if necessary, to a specialist at the contract medical facility. Scheduling of clinics shall be subject to the mutual agreement of the FCI and the contract provider. Scheduling of inmates for on-site clinics shall be performed by the FCI.

Providers performing institution-based services shall be licensed to practice medicine in the State of Connecticut. Providers perform-ing these services shall apply for clinical privileges at the FCI. All clinical privileges shall be appropriate to the qualifications of the provider and the resources of the facility where care is provided. Any clinical privileges granted due to the award of this contract shall be contingent upon the continuation of this contract and upon the provider's continued affiliation with the Contractor or any subcon-tractor. Continuation of privileges at the FCI shall be at the sole discretion of the FCI.

The following specialty clinics/sessions may be conducted at the FCI, contingent upon an acceptable offer. The BOP reserves the right to award some, all, or none of the following on-site clinics:

Orthopedic Surgeon Neurologist Urologist Dermatologist Podiatrist Optometrist Physical Therapist Cardiologist

In the event it becomes necessary for the Government to cancel a scheduled visit, the FCI will provide the contract provider with 48-hour written or verbal notice prior to canceling a visit. However, certain circumstances beyond the control of the FCI (e.g., fog or other Acts of God, institution disturbances, etc.) may dictate the cancellation of a scheduled visit with less than 48 hours written or

RFPP02031600003 Page 11 of 56 verbal notice. In the event it becomes necessary for the contract provider to cancel a scheduled visit, the Contractor may provide quali-fied replacement professional staff or may reschedule a mutually agreed upon replacement session. Prior to utilizing replacement staff, the Contractor must obtain preliminary clearance from the Contracting Officer or COR, in accordance with the security and priv-ileging requirements of this contract.

All contract personnel providing services within the confines of the FCI shall have a complete background investigation conducted in accordance with BOP Program Statement 3000.03, Human Resources Management Manual. See also "Contract Security/Investigative Requirements" contained in Section 4.1 of this solicitation/contract. All contract providers and other applicable staff who will enter the FCI to perform services on a recurring basis shall be required to attend a four-hour institution orientation course held at the FCI or a mutually acceptable site. A "refresher" orientation must be completed annually. The Contractor's costs for contract staff to attend this training shall be the responsibility of the Contractor. The Contracting Officer or COR will be responsible for scheduling training for all applicable contract staff.

Ouput #3: 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 be-low. 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.

Invoice/Medical Claims Adjudication. The FCI will employ a process of invoice/medical claims adjudication to ensure, at a minim-um, that the services billed by the Contractor were properly authorized and ordered by the FCI, 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, the FCI 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 the FCI, the Con-tractor shall comply with all reasonable requests for additional invoice/medical claim/medical record documentation. All invoice pay-ments shall be made by the FCI and any disagreements regarding the paid amount of any invoice shall be resolved directly with the

FCI.

Invoice Definitions. Line Items 1a - Inpatient Facility Services, 1b - Outpatient Facility Services, 1c - Clinical Labs Services, 2a

- Inpatient Physician Services, 2b - Outpatient Physician Services, 2c - Outpatient Institution Services - Other Physicians: At the onset of this contract, an invoice for services rendered under Line Items 1a, 1b, 1c, 2a, 2b, 2c, and 2c1 shall be a paper version of an invoice containing not more than 50 individuals medical claims. Each invoice shall be supported with paper copies of Universal Billing (UB) 92 forms or Centers for Medicare and Medicaid Services (CMS) 1500 forms, as applicable, for each medical claim in-cluded in the invoice.

Following written notification to the Contractor by the Contracting Officer that a third-party medical claims adjudication service will be utilized by the FCI, an invoice for services rendered under Line Items 1a, 1b, 1c, 2a, 2b, 2c, and 2c1 shall be a paper invoice detail-ing not more than 50 individual medical claims which have been electronically transmitted to the BOP's medical claims adjudicator via American Nationsl Standards Institute (ANSI) 837 format that also conforms to Medicare and Health Insurance Portability and Accountability Act of 1996 (HIPAA) electronic billing standards. 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 of service, billing 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 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 to be adjunctive dental care will be submitted to the FCI for verification.

The Contractor shall not submit a medical claim for processing that the Contractor know, 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 or processing and invoicing the FCI for all services represented by that medical claim.

Line Item 2c1 - Outpatient Institution Services - Optometrist: An invoice for services rendered under these line items 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.

Provider Information.

Submission of Provider Data to the BOP's Medical Claims Adjudicator. Within ten calendar days after notification that a third party medical claims adjudication service will be utilized by the FCI, the Contractor shall provide the BOP's medical claims ad-judicator with a complete list of provider information, which will enable the medical claims adjudicator to accurately identify the cor-

RFPP02031600003 Page 12 of 56 rect payable amount for any provider performing services under the contract. Specific informational requirements are provided in At-tachment 4. Provider information supplied to the BOP's medical claims adjudicator should be appropriately marked to identify the data as proprietary information so that it may be adequately protected by the BOP and its contracted medical claims adjudicator. Provider information shall be submitted directly to the BOP's medical claims adjudicator. As individual providers are added to the Contractor's network, the Contractor shall provide the information listed in Attachment 4 to the medical claims adjudicator no less than three busi-ness days prior to filing medical claims electronically for services rendered by such new providers.

National Provider Identifier (NPI) Numbers. The Contractor shal utilize only providers who have a current National Pro-vider Identifier (NPI) number.

Electronic Trading Partner Agreement. The BOP will execute the Electronic Trading Partner Agreement with medical claims adju-dicator (Attachment 5). The Contractor shall participate in the medical claims adjudication process described herein as a "Business Associate" of the BOP. As a Business Associate, the Contractor agrees to abide by all terms of the Trading Partner Agreement as it pertains to Business Associates.

Technical Data for Submission of Medical Claims. Prior to the submission of an invoice to the FCI, the Contractor shall electronic-ally transmit the information found on each individual invoiced medical claim via ANSI 837 format only, to the BOP's medical claims adjudicator. After the Contractor's electronic transmission to the BOP's medical claims adjudicator, the Contractor shall promptly sub-mit a paper copy of the invoice to the FCI. The Contractor will also post the ANSI 837 file in an FTP site set up and maintained by the BOP's medical claims adjudicator. The only exceptions to the electronic filing requirement shall be corrected medical claims for pro-fessional services. Address information for the submission of a paper medical claim to the BOP's medical claims adjudicator is provided in Attachment 6, along with other pertinent details.

Procedures for Filing Corrected Medical Claims.

Facility Services. If it becomes necessary to file a corrected medical claim for facility services, the Contractor shall electronic-ally transmit the information found on each individual corrected medical claim via ANSI 837 format only, to the BOP's medical claims adjudicator. After the Contractor's electronic transmission to the BOP's medical claims adjudicator, the Contractor shall promptly submit a paper copy of the invoice or credit memo, as applicable, to the FCI. Invoices for corrected medical claims shall be clearly marked as such and shall detail information pertaining to the original medical claim submission (including any amount(s) pre-viously 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 the BOP's medical claims adjudicator. The word "CORRECTED" shall be prominently displayed on the paper medical claim. After the Contractor's submission to the BOP's medical claims adjudicator, the Contractor shall promptly submit a paper copy of the invoice or credit memo, as applicable, to the FCI. 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 relect the credit amount due for the corrected medical claim submission.

Payment by the FCI. The FCI will pay all invoices directly to the Contractor. If the invoiced amount of a medical claim exceeds the adjudicated amount of that medical claim, the FCI will take an administrative deduction from an invoice payment.

If the Contractor is in disagreement with the paid amount of a medical claim, the Contractor will provide written notification to the FCI of the disagreement along with supporting documentation for why the Contractor believes the medical claim was paid incorrectly.

The FCI will interface between the Contractor and the medical claims adjudicator to bring any resolution to any disagreements. If it is determined that a medical claim was paid incorrectly by the FCI, interest on the underpayment will be paid when required by the Prompt Payment Act.

Timeliness of Medical Claims. Medical claims shall be submitted/invoiced within 90 calendar days after an inmate's discharge or outpatient encounter or other service provided under the contract. Medical claims which are submitted/invoiced beyond the 90-day re-quirement shall constitute a performance deficiency under this output and shall be documented in the Contractor's performance evalu-ations. Medical claims which are submitted/invoiced within the acceptable time period, but are found to contain errors or require fur-ther justification, will be rejected and shall be resubmitted/re-invoiced by the Contractor within 30 calendar days from the date of re-jection. Upon resubmission, invoices for corrected medical claims shall bear the new date of submission.

No later than November 1 of each year, the Contractor shall stimulate the billing process by reviewing its records, including those of subcontracted providers, to determine an estimated amount of outstanding charges for services provided through September 30 of that year. Based upon information generated through this review process, the Contractor shall provide a written estimate to the FCI of out-standing fiscal year obligations, supported by adequate documentation. This estimate and supporting documentation shall be provided to the Contracting Officer no later than December 1 of each year. The Contractor shall put forth its best efforts to ensure the accuracy of the annual estimate provided to the Government.

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Prompt payment to health care providers. In accordance with FAR 12.213, the Contractor shall implement commercial practices for health care payers in the surrounding community for prompt payment of all health care providers performing services under this contract. Such prompt payment terms shall be a material part of all subcontracts/agreements awarded by the Contractor.