RFPP02171300001_Comprehensive_Medical_Services__FDC_Philadelphia _PA.pdf

Field Acquisition Office

November 19, 2013

U.S. Depart"Qt of Justice

Federal Bureau of Prisons Administration Division

Grand Prairie, Texas 75051

Re: Request for Proposal RFPP0217130000 1 - Comprehensive Medical Services Federal Bureau of Prisons Federal Detention Center, Philadelphia, Pennsylvania

Dear Offeror:

This cover letter precedes a solicitation package prepared by the Federal Bureau of Prisons, Field Acquisition Office, for the acquisition of Comprehensive Medical Services for the Federal Detention Center, Philadelphia, Pennsylvania. Services to be provided include inpatient/outpatient facility and physician services and outpatient institution services. This package contains the following:

Cover Letter (2 pages) Solicitation (51 Pages) Attachments (31 Pages)

The package contains a total of 84 pages and has all necessary information for submitting a proposal for evaluation.

When submitting a proposal, offerors should consider all information provided herein. Please carefully follow all instructions located in the solicitation package concerning the content, format, and submission of proposals. Detailed information can be located in Section 5-2 of the solicitation.

Sealed offers shall be received on or before the deadline of January 14, 2014, at 2:00p.m. local (Central) time. Proposals shall be submitted to the following address:

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

Mailed or hand-carried proposals must be delivered to the Contract Specialist at the address shown above no later than the time specified as the deadline for receipt of proposals. The official point of receipt for hand-carried proposals will be the first floor reception area. PLEASE DO NOT SUBMIT PROPOSALS TO ANY LOCATION OTHER THAN THE ONE LISTED ABOVE. Proposals received after the deadline will be processed pursuant to FAR 52.212-1 (t).

Please place any questions you may have in writing and fax them to (972) 352-4545 to my attention or email at rkelemencky@bop.gov. We will consider all questions received and provide responses, where appropriate.

If you have any other questions, please feel free to call me at (972) 352-4529.

Sincerely, /Is// Raymond J. Kelemencky, Contract Specialist Federal Bureau of Prisons Field Acquisition Office

Enclosure

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE 1 OF

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 0385-13 51

2. CONTRACT NO. 3. AWARD/EFFECTIVE 4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE DATE i

RFPP02171300001 11/19/2013

a. NAME b. TELEPHONE NUMBER (No collect 8. OFFER DUE DATE/

7. FOR SOLICITATION

calls) LOCAL TIME

INFORMATION CALL: 01/14/.2014-

Raymond Kelemencky 972-352-4529 ibo pm Centrl

9. ISSUED BY CODE BFAO 10. THIS ACQUISITION IS ~UNRESTRICTED OR USET ASIDE: %FOR:

Federal Bureau of Prisons p WOMEN-OWNED SMALL BUSINESS ---

SMALL BUSINESS D (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

Field Acquisition Office p HUBZONE SMALL SMALL BUSINESS PROGRAM NAICS:

US Armed Forces Reserve Complex BUSINESS D EDWOSB 622110 346 Marine Forces Drive tJ SERVICE-DISABLED

SIZE STANDARD: VETERAN-OWNED

Grand Prairie, TX 75051 SMALL BUSINESS D 8 (A) $35.5 million

11. DELIVERY FOR FOB DESTINA- 12. DISCOUNT TERMS 13b. RATING

TION UNLESS BLOCK IS 0 13a. THIS CONTRACT IS A

MARKED RATED ORDER UNDER

DPAS (15 CFR 700) 14. METHOD OF SOLICITATION

D SEE SCHEDULE 0RFQ DIFB ~RFP\

15. DELIVER TO CODE BPHL 16. ADMINISTERED BY CODE IBPHL

Federal Bureau of Prisons-FOG Philadelphia Federal Bureau of Prisons-FOG Philadelphia 700 Arch Street, Philadelphia, PA 19106 700 Arch Street, Philadelphia, PA 19106

17a. CONTRACTOR/ CODE I I FACILITY 18a. PAYMENT WILL BE MADE BY CODE LBPHL

OFFEROR CODE

Federal Bureau of Prisons FDC Philadelphia P.O. Box 572 Philadelphia, PA 19106

TELEPHONE NO.

D 17b. CHECK IF REMITIANCE IS DIFFERENT AND PUT SUCH ADDRESS IN 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

OFFER BELOW IS CHECKED

D SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Comprehensive Medical Services for the Federal Detention Center (FDC) located in Philadelphia, PA See Section 2-1 Schedule of Items and 2-2 Performance Work Statement.

(Use Reverse and/or Attach Additional Sheets as Necessary)

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

~ 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212·3 AND 52.212-5 ARE ATTACHED. ADDENDA

D 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-51S ATTACHED. ADDENDA

~ARE DARE NOT ATTACHED

DARE D ARE NOT ATTACHED

D 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN D 29. AWARD OF CONTRACT: REF. OFFER COPIES TO ISSUING OFFICtt. CONTRACTOR AGREES TO FURNISH AND ---

DATED . YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED 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)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

Raymond Kelemencky, ContractingOfficer, FAO

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA- FAR (48 CFR) 53.212

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

0RECEIVED OINSPECTED 0 ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

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

REPRESENTATIVE REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 321. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED 36. PAYMENT 37. CHECK NUMBER

CORRECT FOR

0 PARTIAL OFINAL OcoMPLETE 0PARTIAL OFINAL

38. SiR ACCOUNT NO. 39. SiR 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 (YYIMMIDD) 142d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Section

Table of Contents Description

Solicitation/Contract Form

Commodity or Services Schedule

2-1 Contract Pricing/SOB Participation ................................................................................................... .S 2-2 Performance Work Statement Contract Clauses A.1 ADDENDUM TO FAR 52.212-4, Contract Terms and Conditions (Sep 2013) 52.24-403-70 Notice of Contractor Personnel Security Requirements (Oct 2005) 52.27-103-72 DOJ Residency Requirement Bureau of Prisons (June 2004) 52.218-000 Continuing Contract Performance During a Pandemic Influenza or Other

National Emergency (May 2008) 2852.233-70 Unsafe Conditions Due to the Presence of Hazardous Material (June 1996) 2852.201-70 Contracting Officer's Technical Representative (COTR)(Oct 2005) 52.216-18 Ordering (Oct 1995) 52.216-19 Order Limitations (Oct 1995) 52.216-21 52.217-8 52.217-9

Requirements (Oct 1995) Option to Extend Services (Nov 1999) Option to Extend the Term of the Contract (Mar 2000)

52.232-19 Availability of Funds for the Next Fiscal Year (Apr 1984) 52.232-99 Providing Accelerated Payment to Small Business Sub-contractors (Deviation)

(Aug 2012) 52.237-7 Indemnification and Medical Liability Insurance (Jan 1997) 52.252-6 Authorized Deviations in Clauses (Apr 1984) 52.212-5 Contract Terms and Conditions Required to Implement Statues or

Executive Orders- -Commercial Items (Sept 2013) ................................................... 25 / List of Attachments

4-1 Special Contract Conditions Solicitation Provisions A.2 ADDENDUM TO FAR 52.212-1, Instructions to Offerors- Commercial Items (Jul 2013) 5-1 Tailoring 5-2 Submission of Proposals

5-3 SUBCONTRACTING CERTIFICATION

52.209-7 Information Regarding Responsibility Matters {Jul 2013) 52.216-1 Type of Contract (Apr 1984) 52.233-2 Service of Protest (Sep 2006) 2852.233-70 Protests Filed Directly with the Department of Justice (Jan 1998) 52.27-103-71 Faith-Based and Community-Based Organization (Aug 2005) 52.212-2 Evaluation-- Commercial Items (Jan 1999) 52.212-3 Offeror Representations and Certifications (Aug 2012)

RFPP02171300001

Section 2 - Commodity or Services Schedule

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

SUPPLIES/SERVICES

Comprehensive Medical Services for the FDC Philadelphia located in Philadelphia, PA. See Sections 2-1 Schedule of Items and 2-2 Performance Work Statement.

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

Comprehensive Medical Services for the FDC Philadelphia located in Philadelphia, PA. See Sections 2-1 Schedule of Items and 2-2 Performance Work Statement.

Option Year 1: 13 months through 24 months from

DOA

Comprehensive Medical Services for the FDC Philadelphia located in Philadelphia, PA. See Sections 2-1 Schedule of Items and 2-2 Performance Work Statement.

Option Year 2: 25 months through 36 months from

DOA

Comprehensive Medical Services for the FDC Philadelphia located in Philadelphia, PA. See Sections 2-1 Schedule of Items and 2-2 Performance Work Statement.

Option Year 3: 37 months through 48 months from

DOA

Comprehensive Medical Services for the FDC Philadelphia located in Philadelphia, PA. See Sections 2-1 Schedule of Items and 2-2 Performance Work Statement.

Option Year 4:

DOA

49 months through 60 months from

RFPP02171300001

QUANTITY

12.000000

12.000000

12.000000

12.000000

12.000000

UNIT UNIT PRICE AMOUNT

MO $ $

MO $ $

MO $ $

MO $ $

MO $ $

2-1 CONTRACT PRICING/SOB PARTICIPATION

BLOCK 19 THROUGH 24- CONTRACT PRICING/SOB PARTICIPATION

Overview

Services are required to be provided in accordance with the Performance Work Statement included in this solicitation/contract. Offerors are required to submit, as a part of their business proposal, a completed copy of the Schedule of Items and Target for Participation of Small Disadvantaged Business Concerns.

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 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 co-insurance. When appropriate, 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 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 M~-DRG payment (i.e., Operating Federal Rate) established for CBSA 37964, Philadelphia, PA.

The Basic MS-DRG cejlculation shall not include any provider-specific adjustments allowed under actual Medicare participation. Offerors may propose a discount from or a premium to Basic MS-DRG rates. (Refer to Attachment I of this solicitation)

Medicare Part B Phy$ician 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 1 for Pennsylvania. The benchmark charges shall be those established for participating providers. Offerors may propose a discount 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 37964, Philadelphia, PA. Offerors may propose a discount from or a premium to the benchmark charges.

Estimated Quantities

Estimated quantities for the base year and all option years are detailed below. The estimated quantities provided are not a representation 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- Date of Award (DOA) through twelve (12) months from DOA

Inpatient Days:

Outpatient Visits:

Estimated 1 00 Days Estimated 220 Visits

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

Inpatient Days:

Outpatient Visits:

Estimated 104 Days Estimated 224 Visits

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

Inpatient Days:

Outpatient Visits:

Estimated 1 08 Days Estimated 228 Visits

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

Inpatient Days:

Outpatient Visits:

Estimated 112 Days Estimated 232 Visits

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

Inpatient Days:

Outpatient Visits:

Estimated 116 Days Estimated 236 Visits

Outpatient Institution Services

Estimated quantities shall remain constant for the base year and all option years. For Medicare-based services, duration of visits is listed for informational purposes only, as contracted rates will be based upon the Medicare allowable per procedure performed. Except optometry, contract rates will be based on the Medicare allowable per procedure performed. Optometry services shall be paid based upon the provision of defined sessions.

Optometrist

Podiatrist

Session duration - 4 hours Session quantity - 144 per contract year

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

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

Schedule of Items/Target for Pa~pation of Small Disadvantaged Busine~oncerns Offerors shall complete the following Schedule of Items and Target for Participation of Small Disadvantaged Business Concerns. All proposed pricing and participation targets will be evaluated in accordance with FAR 52.212-2, "Evaluation-Commercial Items" and "Evaluation of Proposals" in Section 5-2 of this solicitation.

BASE YEAR

Date of Award (DOA) through 12 months from DOA

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:

1. Other Physicians

2. Optometrist $

:---- Discount or + Premium to Medicare Part B ___ per session (4 hours per session)

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

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

OPTION YEAR 1

13 through 24 months from DOA

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

1 b. 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:

1. Other Physicians Discount or + Premium to Medicare Part B ---

2. Optometrist $ ___ per session (4 hours per session)

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

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

OPTION YEAR 2

25 through 36 months from DOA

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

1 b. 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 lnstitutic:>n Services:

1. Other Physicians

2. Optometrist

.---Discount or + Premium to Medicare Part B $ ___ per session (4 hours per session)

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

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

OPTION YEAR 3

37 through 48 monthsfrom DOA

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

1 b. 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 lnstitutilon Services:

1. Other Physicians Discount or + Premium to Medicare Part B ---

2. Optometrist $ ___ per session (4 hours per session)

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

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

OPTION YEAR 4

49 through 60 months from DOA

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

1 b. 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:

1. Other Physicians

2. Optometrist

::---- Discount or + Premium to Medicare Part B $ ___ per session (4 hours per session)

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

APPLICABLE"-/+" PSRCENTAGE. 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 td the benchmark Medicare rate and unit pricing for session-priced items) for the base year and all option years is ~ublic information, in accordance with the Federal Acquisition Regulations (FAR) 15.503(b)(1)(iv). Accordingly, all successful unit pricing will be released to unsuccessful offerors with the notification of award as well as to the general public when requested. Any party who objects to the release of their own unit pricing information, should they be awarded a contract in response to this solicitation, should not submit a proposal in response to this solicitation.

Target for Participaticlm of Small Disadvantaged Business (SOB) Concerns Offerors shall provide ~ participation target for utilization of small disadvantaged business (SOB) concerns (including joint venture~, teaming arrangements, and subcontracts) performing within North American Industry Classification System $ector 62, Health Care and Social Assistance. The SOB participation target identified by the offeror will be incorpor~ted into any resulting contract.

Participation Target ____ percent

The above participation target will be achieved through performance by:

[ ] the Contractor, including joint venture partners and team members (target: ____ ,percent) [ ] subcontractors (ta~get: percent)

Offerors are advised tlilat, in accordance with FAR clause 52.219-25 entitled Small Disadvantaged Business Participation Program~-Disadvantaged Status and Reporting, in order to qualify for disadvantaged status under this clause, SOB concernsi must be identified as such in the database maintained by the Small Business Administration (Pro-Net) or by contacting the SBA's Office of Small Disadvantaged Business Certification and Eligibility.

SOB Reporting Requirements: In accordance with FAR 52.219-25, the Contractor shall report on the participation of SOB c~mcerns. Reports may be on Optional Form 312, Small Disadvantaged Business Participation Report, or in the Contractor's own format providing the same information. This report is required upon completion of contrac~s containing SOB participation targets.

2-2 PERFORMANCE WORK STA~ENT

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 custody and care of approximately 219,000 Federal offenders. The Federal prison system is a nationwide system of prisons and detention facilities for the incarceration of inmates who have been sentenced to imprisonment for Federal crimes and the detention of individuals awaiting trial in Federal court.

It is the mission of the Federal Bureau of Prisons to protect society by confining offenders in the controlled environments of prison$ 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 th$ Executive Branch of the United States Government, the BOP receives an annual appropriation of funds tp accomplish its assigned mission. The public trust demands that this annual appropriation be prudently managed. Thus, dollars spent to maintain the health of the inmate population must reflect the agency's best efforts td obtain cost-effective health care consistent with community standards.

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

The Federal Detention Center (hereinafter referred to as FDC) located in Philadelphia, Pennsylvania, intends to make a single award to a responsible entity for the provision of Comprehensive Medical Services as set forth in this solicitation/contract. The FDC currently houses male and female inmates. The FDC is presently identified as a Care Level II BOP facility. Care Level II is an intermediate classification on the four level scale where Care Levell represents the healthiest inmates and Care Level IV represents inmates with serious health issues. Criteria for categorizing an inmate in the Care Levell I category is included as Attachment II. Despite this description of the general health of the inmate population, however, needs for inmate healthcare may arise at varying levels of complexity.

The FDC is located at 7oo Arch Street, Philadelphia, PA 19106. In evaluating offers, the Government will evaluate the proximity of the prqposed community-based providers, in addition to other factors, and give preference to those providers located near~st the FDC. Although a mileage restriction has not been placed on this acquisition, the Government reserves ~he right to determine that the proposed driving distances/conditions to community-based providers pose an unabceptable cost or security risk and to find such offers unacceptable.

II. Organization~! Conflict of Interest

The objective of this s~licitation is to satisfy the BOP's requirement for the provision of health care to the inmates of the FDC. A potential ~rganizational conflict of interest may arise if the awardee is an entity which also holds or participates in a separ~te contract/agreement with the BOP as a medical claims adjudicator. A possible conflict of interest may exist if the awardee has dual responsibilities for the submission of medical claims for services rendered under the re$ulting contract and for the adjudication of those medical claims under a separate contract/agreement wlth the BOP.

Offers received from ~ny firm which holds or participates in a separate contract/agreement for BOP medical claims adjudication services inust 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 sepa~ate contract/agreement for BOP medical claims adjudication services which fail to adequately address/resolve pote~tial conflicts of interest will be rejected without further consideration. This limitation on the eligibility of offerors h~s been imposed as authorized by Federal Acquisition Regulation (FAR) 9.506.

Ill. Statement of Output

Within this Performance Work Statement (PWS), necessary services are described in terms of output rather than specific task assignments. 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 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 solicitation. 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. Offerors who propose less comprehensive approaches will be evaluated accordingly.

Output #1:

Output #2:

Output #3:

Output #4:

Output #5:

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 categories 1 a and 1 b.)

Provid$ professional services which conform to community standards and all local, state and FederC~IIaws and regulations applicable to the delivery of health care to members of the general public.· (Cross-reference pricing categories 2a, 2b, and 2c)

Submit properly-priced invoices for services rendered.

Mana~e medical record information in a manner which promotes continuity of care while observing restric~ions on the release of information.

Maint~in 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 effort~ 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 indi~ators provided in Attachment Ill.

The Contractor is resppnsible for all management and quality control actions necessary to meet the quality standards set forth by lhis contract. Prior to commencing performance, the Contractor shall develop and submit a quality control plan (Q¢;P) for the FDC's approval. Once the QCP is approved by the FDC, the Contractor shall utilize the QCP to guidle and rigorously document the implementation of the required management and quality control actions to achieve the specified output.

V. Specific Req~irements

Output #1: Provi~e inpatient and outpatient facility services which conform to community standards and a)lllocal, state and Federal laws and regulations applicable to the delivery of health care to m~mbers of the general public.

Output #1 is an optionial 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 !in the List of Excluded Individuals/Entities (LEI E) maintained by the US Department of Health and Human Services. •

If proposed, the Contr~ctor 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 facili y and outpatient facility, including emergency room services. Inpatient visits for non-emergency servi es shall require private room accommodations with available space for up to three armed or unarmed guards per ihmate.

It is the FDC's prefer~nce 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

· Page 11 of 51 accreditation certificate 1as part of t~fferor's technical proposal. If an offeror i~ds 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 offeror's technical proposal shall discuss in detail the diversity of services, as well as the proximity of facility providers to the FDC, 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 option~! 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 im the List of Excluded Individuals/Entities (LEI E) maintained by the US Department of Health and Human Services.

Community-Based S~rvices

Professional services r¢sulting from a BOP referral are necessary to be performed in a community-based setting (e.g., hospital facility, sL' rgical center, physician's office, etc.). If proposed, the Contractor shall provide the services of professional medica staff who have appropriate educational qualification, experience, licensure, and board certification (where req ired) 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 Co~tracting Officer, the Contractor shall be required to document primary source verification of the credentials for eac~ 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 specialt~ provider. This practice promotes the safety and security of the federal prisoner, the escorting correctional 'taff, and the general public. The medical urgency of any referral must receive consideration in the scheduling and ~elivery of professional services.

For prescriptions to be! filled by the FDC pharmacy, contract providers shall only prescribe pharmaceutical drugs that are listed in the a proved BOP Formulary. The BOP Formulary can be accessed at www.bo . ov/news//P Fs/formula . df. 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 FDC, that it is capable of providing to achieve Output #2.

Institution-Based Se!'vices

As an additional tool t<l> satisfy Output #2, specialty services may be performed within the confines of the FDC. If the resulting contract ~oes not provide for telemedicine consultation or all of the on-site clinics listed, the FDC reserves the right to pUrsue such contracts. The FDC also reserves the right to determine the manner of an inmate's referral, i.e., yia on-site clinic, via community-based referral, via telemedicine consult, or any other method the FDC determines t~ be reasonable and appropriate.

If the Contractor perfoirms on-site specialty clinics at the FDC, the following minimum requirements shall apply.

Contract services shajl be provided on-site within the Health Services Unit of the FDC. Consultations shall be limited to the chief cofinplaint on the BOP consultation form. Services shall include diagnosis and treatment of medical conditions wi~h appropriate referral, if necessary, to a specialist at the contract medical facility. Scheduling of clinics shall be subjfct to the mutual agreement of the FDC and the contract provider. Scheduling of inmates for on-site clinics shall bE1 performed by the FDC.

Providers performing ,institution-based services shall be licensed to practice medicine in the Commonwealth of ' Page 12 of 51

Pennsylvania. Providers performirkese services shall apply for clinical privile~ at the FDC. 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 subcontractor. Continuation of privileges at the FOG shall be at the sole discretion of the FDC.

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

Optometrist Podiatrist

In the event it become~' necessary for the Government to cancel a scheduled visit, the FDC will provide the contract provider with 48-hour ritten or verbal notice prior to canceling a visit. However, certain circumstances beyond the control of the FDC (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 verbal notice. In the event it becomes necessary for the contract

I provider to cancel a sc~eduled visit, the Contractor may provide qualified replacement professional staff or may reschedule a mutually 'greed-upon replacement session. Prior to utilizing replacement staff, the Contractor must obtain preliminary clea~ance from the Contracting Officer or COR, in accordance with the security and privileging requirements of this cohtract.

All contract personnel ~roviding services within the confines of the FDC shall have a complete background investigation conducte~ in accordance with BOP Program Statement 3000.03, "Human Resource Management Manual." See also "Cqntract Security/Investigative Requirements" contained within Section 4-1 of this solicitation/contract. All contract providers and other applicable staff who will enter the FDC to perform services on a recurring basis shall pe required to attend a four-hour institution orientation course held at the FDC or a mutually acceptable site. A "refresher" orientation must be completed annually. The Contractor's costs for contract staff to attend this training shalll be the responsibility of the Contractor. The Contracting Officer or COR will be responsible for scheduling training for all applicable contract staff.

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

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

Invoice/Medical Clai~' s Adjudication. The FDC will employ a process of invoice/medical claims adjudication to ensure, at a minimum, that the services billed by the Contractor were properly authorized and ordered by the FDC, are appropriately cod din compliance with Medicare coding policies (where applicable), are properly priced in accordance with the t rms and conditions of the contract, and do not represent duplicate billings for payments already made. In add,tion, the FDC may utilize the services of a third-party medical claims adjudicator to review medical claims submi~ed by the Contractor under this contract. When requested by the FDC, the Contractor shall comply with all reaso~ble requests for additional invoice/medical claim/medical record documentation. All invoice payments shall be ma e by the FDC and any disagreements regarding the paid amount of any invoice shall be resolved directly with he FDC.

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Invoice Definitions. ILine Items 1 a - Inpatient Facility Services, 1 b -Outpatient Facility Services, 2a - Inpatient Physician $ervices, 2b - Outpatient Physician Services and 2c1-0utpatient Institution Services Other Physicians: ~'t the outset of this contract, an invoice for services rendered under Line Items 1 a, 1 b, 2a, 2b and 2c1 shall be a pa er version of an invoice containing not more than 50 individual medical claims. Each invoice shall be supported wi h paper copies of Universal Billing (US) 92 forms or Centers for Medicare and Medicaid Services (CMS) 1500jforms, as applicable, for each medical claim included in the invoice.

i Following written noti.ication to the Contractor by the Contracting Officer that a third-party medical claims adjudication service ~ill be utilized by the FDC, an invoice for services rendered under Line Items 1 a, 1 b, 2a, 2b, and 2c1 shall be a pap~r invoice d~ing not more than 50 individual medical c~s which have been electronically transmitted 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 YREGDOC number, second in alphabetic order by the inmate's last name, and third by ascending date of sEtrvice (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 r~present adjunctive dental care will be submitted by the Contractor to the medical claims adjudication contractor lfor processing. Oral surgery and/or dental procedures which are not considered to be adjunctive dental care Will be submitted to the FDC for verification.

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

Line Item: Outpatien~tnstitution Services: 2c2- Optometrist: An invoice for services rendered under line item 2c2 shall be a paper in oice detailing the date(s) sessions were provided, the number of sessions provided, the unit pricing applied, and th extended total amount due. The BOP will not use the services of a third party medical claims adjudicator for ~erification of these services.

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Provider Information.!

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Submission of Provi~er Data to the BOP's Medical Claims Adjudicator: Within ten calendar days after notification that a third lparty medical claims adjudication service will be utilized by the FDC, the Contractor shall provide the BOP's me ical claims adjudicator with a complete list of provider information, which will enable the medical claims adjudi tor to accurately identify the correct payable amount for any provider performing services under the contract. S ecific informational requirements are provided in Attachment IV. Provider information supplied to the BOP's edical claims adjudicator should be appropriately marked to identify the data as proprietary information so that it ay be adequately protected by the BOP and its contracted medical claims adjudicator.

Provider information s all be submitted directly to the BOP's medical claims adjudicator. As individual providers are added to the Cont .actor's network, the Contractor shall provide the information listed in Attachment IV to the medical claims adjudidator no less than three business days prior to filing medical claims electronically for services rendered by such new! providers.

National Provider ld~ntifier (NPI) Numbers: The Contractor shall utilize only providers who have a current National Provider lde~tifier (NPI) number.

Electronic Trading P~rtner Agreement. The BOP will execute the Electronic Trading Partner Agreement with the medical claims adjudi~ator (Attachment V). The Contractor shall participate in the medical claims adjudication process described he~ein as a "Business Associate" of the BOP. As a Business Associate, the Contractor agrees to abide by all terms qt the Trading Partner Agreement as it pertains to Business Associates.

Technical Data for S~bmission of Medical Claims. Prior to the submission of an invoice to the FDC, the Contractor shall electrpnically transmit the information found on each individual invoiced medical claim via ANSI 837 format only, to th 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 to the FDC.

The Contractor will al o 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 professional services. Address information for the submission of a paper medical claim to the BOP's medical claims adjudicator is rovided in Attachment VI, along with other pertinent details.

Procedures for Filing borrected lltdical Claims.

Facility Services: If it becomes necessary to file a corrected medical claim for facility services, the Contractor shall electronically tran~mit 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 FDC. 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 spbmission (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 submissipn.

Physician/Profession.! Services: If it becomes necessary to file a corrected medical claim for physician/professiona~ervices, the Contractor shall submit the corrected medical claim in hard copy (i.e., paper) format to the BOP's m dical claims adjudicator. The word "CORRECTED" shall be prominently displayed on the paper medical claim. fter 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 FDC. Invoices for corrected medical claims shall b~clearly marked as such and shall be separate from routine invoices. Invoices or credit memos for corrected edical claims shall detail information pertaining to the original medical claim submission (including any amount( ) previously paid and the associated invoice numbers) and shall bill only for the corrected medical claim submiss on or reflect the credit amount due for the corrected medical claim submission.

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Payment by the FDC.~The FDC 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 FDC will take an administrative deduction from the invoice. The FDC will rovide written notification to the Contractor when an administrative deduction is taken from an invoice payment. i

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If the Contractor is in dlisagreement with the paid amount of a medical claim, the Contractor will provide written notification to the FDC of the disagreement along with supporting documentation for why the Contractor believes the medical claim was~paid incorrectly. The FDC will interface between the Contractor and the medical claims adjudicator to bring re olution to any disagreements. If it is determined that a medical claim was paid incorrectly by the FDC, interest on t e underpayment will be paid when required by the Prompt Payment Act.

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Timeliness of Medic I Claims. Medical claims shall be submitted/invoiced within 90 calendar days after an inmate's discharge or utpatient encounter or other service provided under this contract. Medical claims which are submitted/invoiced be ond the 90-day requirement shall constitute a performance deficiency under this output and shall be documented i the Contractor's performance evaluations. Medical claims which are submitted/invoiced within the acceptable ime period, but are found to contain errors or require further justification, will be rejected and shall be resubmitted/r invoiced by the Contractor within 30 calendar days from the date of rejection. Upon resubmission, invoice for corrected medical claims shall bear the new date of submission.

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No later than Novemb r 1 of each year, the Contractor shall stimulate the billing process by reviewing its records, including those of sub ontracted providers, to determine an estimated amount of outstanding charges for services provided through Sep ember 30 of that year. Based upon information generated through this review process, the Contractor shall provi e a written estimate to the FDC of outstanding fiscal year obligations, supported by adequate documentation. This stimate and supporting documentation shall be provided to the Contracting Officer no later than December 1 of e ch year. The Contractor shall put forth its best efforts to ensure the accuracy of the annual estimate provided to t e Government.

Output #4:

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Man~ge medical record information in a manner which promotes continuity of care while obseJing restrictions on the release of information.

Upon request, authori~' ed BOP staff shall have access to and obtain copies of all inmate medical records and evaluation and treatment reports prepared and maintained by the contract facility and/or contract providers. Inmate medical records will b subject to review by the FDC for validation of payment and verification of services rendered.

Release of informatio shall only be made in accordance with community standards, Joint Commission regulations, I and the Privacy Act of 11974. Any r~est(s) for copies of an inmate's medical rJ..ds by the inmate or a third party shall be directed to the COR for processing.

Notwithstanding the above restrictions on the release of information, medical record information shall be provided to the FDC in order to ~nhance inmate recovery as well as continuity of care. For inpatient admissions, a faxed report documenting treatment plans will be submitted to the FDC Medical Records Department no later than 8 am each day. This form with the requested information will be provided to the Contractor by the FDC. At the completion of treatment, the Contractor shall provide the FDC with documented discharge instructions, as provided by the attending physician. Copies of all lab, x-ray, ekg, progress notes and emergency room working notes shall also accompany the pa~ient or be faxed immediately to the COR. A written report by the attending physician which documents the circumstances of the inpatient treatment, outpatient procedure, or other consultation shall be provided to the COR w·thin ten business days of the inpatient discharge, outpatient procedure, or other consultation. All lab an consultations pending at time of discharge shall be faxed to the COR upon receipt but not later than ten calendar ays past discharge.

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

The Contractor shall pr vide a Point of Contact (POC) who shall be responsible for facilitating the Contractor's delivery of health servi es under this contract.