RFPP02111600001_-_Solicitation.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

1. REQUISITION NUMBER

5. SOLICITATION NUMBER

RFPP02111600001

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

06/10/2016

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

08/12/2016 2:00 PM 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

X

11. DELIVERY FOR FOB DESTINATION

UNLESS BLOCK IS MARKED

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

BOTVCODE15. DELIVER TO

Federal Bureau of Prisons FCI Otisville 2 Mile Drive

OTISVILLE, NY 10963

CODE BOTV16. ADMINISTERED BY

Federal Bureau of Prisons FCI Otisville 2 Mile Drive

OTISVILLE, NY 10963

FACILITY

CODE

CODE

TELEPHONE NO.

17a. CONTRACTOR/

OFFEROR

BOTVCODE18a. PAYMENT WILL BE MADE BY

Federal Bureau of Prisons FCI Otisville 2 Mile Drive

OTISVILLE, NY 10963

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 (FCI) located in Otisville, New York.

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

RFPP02111600001 Page 1 of 55

0005-16

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

RFPP02111600001 Page 2 of 55

Table of Contents

Section Description Page Number

1 Solicitation/Contract Form 2 Commodity or Services Schedule

2.1 Contract Pricing

2.2 Performance Work Statement

3 Contract Clauses DJAR-PGD-15-02-1C Contractor Certification of Compliance with Federal Tax Requirements - Solicitation - (DEVIATION 2015-02) (March 2015) 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) DJAR-PGD-15-02-1A Corporte Representation Regarding Felony Conviction Under Any Federal Law or Unpaid Delinquent Tax Liability - (DEVIATION 2015-02) (March 2015)

52.218-000 CONTINUING CONTRACT PERFORMANCE DURING A PANDEMIC INFLUENZA

OR OTHER NATIONAL EMERGENCY (May 2008) 2852.223-70 Unsafe Conditions Due to the Presence of Hazardous Material (June 1996) 52.21-603-70 Contracting Officer's Representative (COR) (June 2012) 52.24-403-70 Notice of Contractor Personnel Security Requirements (OCT 2005) DJAR-PGD-15-03 Security of Department Information and Systems 52.216-18 Ordering (Oct 1995) 52.216-19 Order Limitations (Oct 1995) 52.216-21 Requirements (Oct 1995) 52.217-8 Option to Extend Services (Nov 1999) 52.217-9 Option to Extend the Term of the Contract (Mar 2000) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997) 52.232-19 Availability Of Funds For The Next Fiscal Year (Apr 1984) 52.252-6 Authorized Deviations in Clauses (Apr 1984)

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

2011) 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-15-02-2B Contractor Internal Confidentiality Agreements or Statements Prohibiting or Restricting Reporting of Waste, Fraud, and Abuse - Award - (DEVIATION 2015-02) (March 2015) .27 DJAR-PGD-15-02-2C Contractor Certification of Compliance with Federal Tax Requirements - Award

- (DEVIATION 2015-02) (March 2015)

5.3 Sub-Contracting Certification

52.212-5 Contract Terms and Conditions Required To Implement Statutes or Executive Orders--Commercial Items (Mar 2016) 52.224-1 Privacy Act Notification (Apr 1984) 52.224-2 Privacy Act (Apr 1984)

4 List of Attachments

4.1 Special Contract Conditions

5 Solicitation Provisions 52.209-12 Certification Regarding Tax Matters (Feb 2016) 52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016) 52.212-3 Offeror Representations and Certifications--Commercial Items (Apr 2016) 52.209-7 Information Regarding Responsibility Matters (Jul 2013)

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

52.233-2 Service of Protest (Sept 2006) 52.252-5 Authorized Deviations in Provisions (Apr 1984)

5.1 Tailoring

2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998) 52.212-2 Evaluation - Commercial Items (Oct 2014)

5.2 Submission and Evaluation of Proposals

RFPP02111600001 Page 3 of 55

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 located in Otisville, New York.

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

12.000000 MO $____________ $___________________

0002 Comprehensive Medical Services for the Federal Correctional Institution located in Otisville, New York.

Option Year 1: 13 months from Date of Award (DOA) through 24 months from DOA.

12.000000 MO $____________ $___________________

0003 Comprehensive Medical Services for the Federal Correctional Institution located in Otisville, New York.

Option Year 2: 25 months from Date of Award (DOA) through 36 months from DOA.

12.000000 MO $____________ $___________________

0004 Comprehensive Medical Services for the Federal Correctional Institution located in Otisville, New York.

Option Year 3: 37 months from Date of Award (DOA) through 48 months from DOA.

12.000000 MO $____________ $___________________

0005 Comprehensive Medical Services for the Federal Correctional Institution located in Otisville, New York.

Option Year 4: 49 months from Date of Award (DOA) through 60 months from DOA.

12.000000 MO $____________ $___________________

0006 Comprehensive Medical Services for the Federal Correctional Institution located in Otisville, New York.

Option to Extend Services as Authorized by FAR 52.217-8.

6.000000 MO $____________ $___________________

2.1 Contract Pricing

Blocks 19 Through 24 - Contract Pricing

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

Pricing Methodologies

Except for services based on session rates, price proposals will be calculated from benchmarks utilizing Medicare reimbursement methodologies. For each category of services to be provided, offerors will be allowed to propose a variance from the 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 ap-propriate, outlier payments calculated in accordance with Medicare reimbursement methodologies shall be made in recogni-tion of extemely costly stays. The outlier payment shall be calculated based upon the defined benchmark and will consist of the oper-ating 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 or premium to the Medicare benchmark rate which will reflect the desired level of payment for the category 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) 35614 New York-Jersey City- White Plains, NY-NJ. The Basic MS-DRG calculation shall not include any provider-specific adjustments allowed under actual Medi-care participation. Offerors may propose a discount from or a premium to Basic MS-DRG rates. (Refer to Attachment 1 of this solicit-ation.)

Medicare Part B Physician Services and Non-physician Services. The Medicare benchmark to be utilized for all physician and

RFPP02111600001 Page 4 of 55 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 99. The benchmark charges shall be those established for participating providers. Offerors may propose a dis-count from or a premium to the benchmark charges.

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 35614 New York-Jersey City-White Plains, NY-NJ. Offerors may propose a discount from or a premium to the benchmark charges.

Estimated Charges

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: 156 days (estimated) Outpatient Days: 780 days (estimated)

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

Inpatient Days: 160 days (estimated) Outpatient Days: 780 days (estimated)

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

Inpatient Days: 160 days (estimated) Outpatient Days: 780 days (estimated)

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

Inpatient Days: 160 days (estimated) Outpatient Days: 780 days (estimated)

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

Inpatient Days: 160 days (estimated) Outpatient Days: 780 days (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 contracted rates will be based upon the Medicare allowable per procedure performed. Opto-metry, Oral Surgery, Prosthetics/Orthotics, and Physical Therapy shall be based upon the provision of defined sessions.

General Surgeon: Visit duration - 8 hours (approximate) Visit quantity - 6 per contract year (approximate)

Gastroenterology: Visit duration - 8 hours (approximate) Visit quantity - 6 per contract year (approximate)

Optometrist: Session duration - 4 hours (approximate) Session quantity - 70 per contract year (approximate)

Oral Surgeon: Session duration - 4 hours (approximate) Session quantity - 4 per contract year (approximate)

Orthopedic Surgeon: Visit duration - 8 hours (approximate) Visit quantity - 8 per contract year (approximate)

Physical Therapy: Session duration - 4 hours (approximate)

RFPP02111600001 Page 5 of 55

Session quantity - 40 per contract year (approximate)

Podiatry: Visit duration - 8 hours (approximate) Visit quantity - 6 visits per contract year

Prosthetics/Orthotics: Session duration - 4 hours (approximate) Session quantity - 12 per contract year (approximate)

Psychiatrist: Visit duration - 8 hours (approximate) Visit quantity - 6 per contract year

Urologist: Visit duration - 8 hours (approximate) Visit quantity - 4 per contract year

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.

Schedule of Items

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

Schedule of Items

Base Year

Effective Date of Award (EDOA) through twelve (12) 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. Oral Surgeon: $__________ per session 2c3. Optometrist: $__________ per session 2c4. Prosthetics/Orthotics: $ _________ per session 2c5. Physical Therapy: $ __________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 1

Thirteen (13) months through twenty-four (24) 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. Oral Surgeon: $__________ per session 2c3. Optometrist: $__________ per session 2c4. Prosthetics/Orthotics: $ _________ per session 2c5. Physical Therapy: $ __________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 2

RFPP02111600001 Page 6 of 55

Twenty-five (25) months through thirty-six (36) 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. Oral Surgeon: $__________ per session 2c3. Optometrist: $__________ per session 2c4. Prosthetics/Orthotics: $ _________ per session 2c5. Physical Therapy: $ __________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 3

Thirty-seven (37) months through forty-eight (48) 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. Oral Surgeon: $__________ per session 2c3. Optometrist: $__________ per session 2c4. Prosthetics/Orthotics: $ _________ per session 2c5. Physical Therapy: $ __________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option Year 4

Forty-nine (49) months through sixty (60) 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. Oral Surgeon: $__________ per session 2c3. Optometrist: $__________ per session 2c4. Prosthetics/Orthotics: $ _________ per session 2c5. Physical Therapy: $ __________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

Option to Extend Services As Authorized by FAR 52.217-8

Six-Month Extension as Authorized by FAR 52.217-8

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. Oral Surgeon: $__________ per session

RFPP02111600001 Page 7 of 55

2c3. Optometrist: $__________ per session 2c4. Prosthetics/Orthotics: $ _________ per session 2c5. Physical Therapy: $ __________ per session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT APPLICABLE "-/+" PERCENT-

AGE. IF NO VARIANCE, ENTER "0".

All offerors are hereby advised that the successful offeror's unit pricing (to include discount percentage from or 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-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 this solicitation, should not submit proposal in response to the solicitation.

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 196,000 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 is 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 a 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 Otisville, New York. The FCI currently houses male inmates. The FCI is presently identified 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 as Attachment 2. Despite this description of the general health of the inmate population, 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 other 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 claims adjudicator. A possible conflict of interest may exist if the awardee has dual responsiblit-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 conflict of interest will be rejected without further con-sideration. This limitation on the eligibility of offerors has been imposed as authorized by Federal Acquisition Regulation (FAR) 9.506.

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

RFPP02111600001 Page 8 of 55 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 items, may withhold 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 solicita-tion. 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 outputs listed in the solicitation. Offerors 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-reference 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.1, and 2b.2)

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 Goverment 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 services. Inpatient visits for non-emergency services shall require private room accommodations with avail-able 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 accrediation certificate as part of the offeror's technical proposal. If an offeror intends to utilize a facility which is accredited or certified by any other recognized professional ac-crediting body, the offeror shall submit documentation validating this accredition or certification as a part of its proposal.

The offeror's technical proposal shall discuss in detail the diversity of services, as well as the proximity of facility providers to the FCI, that it is capable 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 contrat, 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

RFPP02111600001 Page 9 of 55

Professional services resulting from a BOP referral are necessary to be performed in a community-based setting (e.g., hospital facility, surgicial 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 the appropriate State Board of Medical Examiners, education from professional schools or universities, evidence of completion of internships 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 at www.bop.gov/news//PDFs/formulary.pdf. Requests for exemptions shall be submitted to the Contracting Officer's Representative (COR), who shall obtain the required approvals. As part of the Dis-charge 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 appropriate.

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 hold an appropriate current license to practice medicine. Providers performing these services shall apply for clinical privileges at the FCI. All clinical privileges shall be appropriate to the qualifications of the pro-vider 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 subcontract-

or. 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:

Oral Surgeon Optometrist Orthopedic Surgeon Psychiatrist Podiatrist Gastroenterologist Prosthetics/Orthotics Physical Therapist Urologist General Surgeon

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 notice 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, instiution disturbances, etc.) may dictate the cancellation of a scheduled visit with less than 48 hours written or verbal notice. In the event it becomes necessary for the contract provider to cancel a scheduled visit , the Contractor may provide qualified 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 Resource Management Manual. See also "Contract Security/Investigative

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Requirements" contained in Section 4.1 of this solicitation/contract. All contract providers and other applicable staff who 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.

Output #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 invoices shall be resolved directly with the

FCI.

Invoice Definitions. Line Items 1a. - Inpatient Facility Services, 1b. - Outpatient Facility Services, 2a. - Inpatient Physician Services, 2b. - Outpatient Physician Services, and 2c1. - Outpatient Institution Services - Other Physicians: At the outset of this contract, an invoice for services rendered under Line Items 1a, 1b, 2a, 2b, and 2c1. 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) 92 forms or Centers for Medicare and Medicaid Services (CMS) 1500 forms, as applicable, for each medical claim included in the invoice.

Following written notification to the Contractor by the Contracting Officer that a third-party medical claims adjudication services will be utilized by the FCI, an invoice for services rendered under Line Items 1a, 1b, and 2a shall be a paper invoice detailing not more than 50 individual medical claims which have been electronically trasmitted to the BOP's medical claims adjudicator via American National 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, billed code, and contract amount billed. Medical claims detailed in the invoice shall be listed first in descending order by the YREG- DOC 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 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 the FCI for all services represented by that medical claim.

Line Items 2c2, 2c3, 2c4, and 2c5 - Outpatient Institution Services - Oral Surgeon, Optometrist, Prosthetics/Orthotics, and Physical Therapy: 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 ser-vices 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-judication with a complete list of provider information, which will enable the medical claims adjudicator to accurately identify the cor-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.

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National Provider Identifier (NPI) Numbers. The Contractor shall 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 the medical claims adjudicator (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 Agree-ment as it pertains to "Business Associate."

Technical Data for Submission of Medical Claims. Prior to the submission of an invoice to the FCI, the Contractor shall electronically transmit the information found on each individual invoiced medical claim via ANSI 837 format only, to the BOP's med-ical 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 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 med-ical claims for professional services. Address information for the submission of a paper medical claim to the BOP's medical claims ad-judicator 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 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 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 re-flect 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 the invoice. The FCI will provide writ-ten notification to the Contractor when an administrative deduction is taken 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 resolution to any disagreements. If it is de-termined 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 this 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.

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 con-tract. Such prompt payment terms shall be a material part of all subcontracts/agreements awarded by the Contractor. The Contractor shall ensure that all health care providers acknowledge the following notice upon award of a subcontract/agreement for performance

RFPP02111600001 Page 12 of 55 under this contract.

Notice to Health Care Providers: All health care providers are hereby advised that the Federal Bureau of Prisons (Bureau) maintains no privity of contract with any party other than the prime contractor regarding performance of the above-referenced contract. Notwith-standing FAR 52.212-4(b), a subcontract or other agreement between the prime contractor and a health care provider is a private-party contract. As such, the Bureau will not intervene in disputes between prime contractor and any subcontractor/health care provider on any issue, including payment disputes. All subcontractors/health care providers are advised that payments due from the Bureau for performance under the prime contract will be paid only to the prime contractor. Accordingly, the prime contractor is responsible for remitting payments to subcontractors/health care providers in accordance with the terms of the negotiated subcontract/agreement, if any.