Amendment 4.pdf

! OF PAGES1 . CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT \PA~E

I 3r' PROJECT NO. 2. AMENDMENTIMODIFICATION NO. 3. EFFECTIVE DATE

Amendment #4 02/02/2012

4. REQUISITIONIPURCHASE REQ. NO. (If applicab/e)

6. ISSUED BY CODE

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

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6) CODE I Federal Bureau of Prisons FMC Carswell J Street Building 3000 Fort Worth, TX 76127

(X) 9A AMENDMENT OF SOLICITATION

r--:-: NO.

[g] RFPP05051100003

98. DATED (SEE ITEM t1)

10/25/2011 lOA. MODIFICATION OF CONTRACTIORDER NO.

CODE IFACILITY CODE

0 10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

o The above numbered solicitation is amended as set forth in lIem 14. The hour and date specified for receipt of Offers 0 is extended, 0 is not extended.

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

(a) By completing items 8 and 15, and returning copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWlEDGMENT TO BE RECEIVED AT THE

PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER If by lIirtue of this amendment your desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12 ACCOUNTING AND APPROPRIATION DATA (If required)

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

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE

o o

A THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14-A--R--E-M""'A-D-E-IN---TH:-E--C-0-N-TRA-C-T-0-R-D-E-R-N-0.,...

IN ITEM 10A.

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

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

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

E. IMPORTANT: Contractor 0 is not, 0 is required to sign this document and return _____ copies to the issuing office.

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

Attached you will find information regarding Amendment #4 to RFPP050511 00003.

The deadline for receipt of proposals is extended to Friday, February 17, 2012 at 2:00 p.m. local time.

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

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

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to Sign)

. . .NSN 7540 01 152 8070

Previous edition unusable

15C. DATE SIGNED

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

Mike Miller

16;;'~ES OF AMERICA

(Signature of Contrac1inli Officer)

16C. DATE SIGNED

2/R/~z..

STANDARD FORM 30 (REV. 10·83)

Prescribed by GSA FAR (48 CFR) 53.243

Amendment #4 FtFPPOSOSll00003

Comprehensive Medical Services FMC Carswell

RFPP050511 00003 is hereby amended to incorporate the following changes:

Replace Attachment #1 Block 20 - Performance Work Statement and Attachment #2, Schedule of Items / SDB Participation and Subcontract Certifications with the attached Revised Attachments.

Attachment #1 (Revised Amendment #4) Block 20 Performance Work Statement (16 Pages)

Attachment #2 (Revised Amendment #4) Schedule ofltems / SDB Participation and Subcontract Certification (12 Pages)

Attachment #4 Tailoring and Instructions to Offerors is amended as follows:

Within Section III, Evaluation of Proposals, the Price section is replaced with the following:

Price

Pricing categories are listed below in descending order of importance.

1a. Inpatient Facility Services

2a. Inpatient/Outpatient Physician Services

lc. Outpatient Facility Services

2c.3. Outpatient Institution Services (After-Hour Physicians)

2c.l. Outpatient Institution Services (Other Professional Services)

2c.2. Outpatient Institution Services (Dialysis Treatment)

lb. Long-Term Care Facility Services

2cA. Outpatient Institution Services (Optometrist)

2b. Inpatient/Outpatient Physician Anesthesia Services

2c.6. Outpatient Institution Services (Ultrasound Technician)

2c.7. Outpatient Institution Services (Echocardiograrn Technician)

2c.5. Outpatient Institution Services (Laboratory Director / Pathologist)

RFP05051100003

ATTACHMENT #1

REVISED AMENDMENT #4

BLOCK 20 - PERFORMANCE WORK STATEMENT

I. Background

The Federal Bureau ofPrisons (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 217,000 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.

The defined mission of the BOP is as follows:

It is the mission of the Federal Bureau ofPrisons to protect society by confining offenders in the controlled environments of prisons and community-based facilities that are safe, humane, cost-efficient, and appropriately secure, and that provide work and other self improvement opportunities to assist offenders in becoming law-abiding citizens.

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

In meeting the health care needs of a growing inmate population, the BOP provides essential medical, dental, and mental health services to Federal inmates by BOP staff. When a medical need arises which cannot be provided within prison walls by BOP 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 Medical Center Carswell (hereinafter referred to as FMC) located in Fort Worth, Texas, 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 FMC currently houses female inmates. The FMC is presently identified as a Care Level IV BOP facility. This is an administrative classification which provides for the designation of an inmate popUlation which generally suffers from serious health issues. Criteria for categorizing an inmate in the Care Level Level IV category is included as Attachment #5. Despite this description of the general health of the inmate population, however, needs for inmate healthcare may arise at any time, in any specialty, and any level of complexity. Classification and designation of inmates is the sole responsibility of the BOP and may be changed at any time without consideration to the Contractor.

In evaluating offers, the Government will evaluate the proximity of the proposed community based providers, in addition to other factors, and give preference to those providers located nearest the FMC. Although a mileage restriction has not been placed on this acquisition, the Government reserves the right to determine that the proposed driving distances/conditions to community-based providers pose an unacceptable cost or security risk and to find such offers unacceptabIe.

II. Organizational Conflict of Interest

The objective of this solicitation is to satisfy the BOP's requirement for the provision ofhealth care to the inmates ofthe FMC. A potential organizational conflict of interest may arise if the awardee is an entity which also holds or participates in a separate contract/agreement with the BOP as a medical claims adjudicator. A possible conflict of interest may exist if the awardee has dual responsibilities for the submission of proper invoices (i.e., medical claims) for services rendered under the resulting contract and for the adjUdication of those invoices (i.e., 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 services must address any potential organizational conflict of interest that may arise and must provide a detailed explanation of how such conflicts will be avoided. Offers received from any firm which holds or participates in a separate contract/agreement for BOP medical claims adjudication services which fail to adequately address/resolve potential conflicts of interest will be rejected without further consideration. This limitation on the eligibility of offerors has been imposed as authorized by Federal Acquisition Regulations (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 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 Attachment #4. Therefore, the Government may award any or all line items, may withhold award of any or all line times, or may award to an offeror who proposes less than the full complement of services contained in this solicitation. Accordingly, output items 1, 2, and 3 are optional deliverables while output items 4, 5, and 6 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: Provide inpatient and outpatient facility services which conform to community standards and all local, state and Federal laws and regulations applicable to the delivery ofhealth care to members of the general public. (Cross-reference pricing pricing categories 1 a, 1 b, and 1 c.)

Output #2: Provide professional services which conform to community standards and all local, state and Federal laws and regulations applicable to the delivery ofhealth care to members of the general public. (Cross-reference pricing categories 2a, 2b, 2c.l, 2c.3, 2cA and 2c.5.)

Output #3: Provide dialysis (including hemodialysis and peritoneal dialysis) services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of health care to members ofthe general pUblic. (Cross-reference pricing categories 2c.l and 2c.2.)

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

Output #5: Manage medical record information in a manner which promotes continuity of care while observing restrictions on the release of information.

Output #6: Maintain open avenues of communication, facilitating the exchange of information between the contract provider, contract facility, and the Government regarding the contract services.

IV. Compliance with Contract Requirements

The Contractor's efforts under this contract shall be monitored to ensure that the required output is achieved. The Government reserves the right to inspect and evaluate in a reasonable manner all services rendered during the performance of this contract. The Contractor's performance will be measured by the Government utilizing the outcome measure indicators provided in Attachment #6.

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 FMC's approval. Once the QCP is approved by the FMC, the Contractor shall utilize the QCP to guide and rigorously document the implementation 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.

If proposed, the Contractor shall provide facility services on an as-needed basis in a manner which adheres to community standards ofquality and cost-effective medical care. The services required to satisfY Output #1 may include inpatient facility and outpatient facility, including emergency room services. In order to promote a safe and secure environment for inmates and the public during non-emergency inpatient visits, it is the FMC's preference to receive private room accommodations with available space for up to three armed or unarmed guards per inmate.

Offerors who propose other type of room accommodations shall describe in detail the proposed accommodations and shall at a minimum promote the safe and secure custody of the inmate.

Preference will be given to those who offer private room accommodations.

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

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

Community-Based Services

Professional services resulting from a BOP referral are necessary to be performed in a community-based setting (e.g., hospital facility, surgical center, physician's office, etc.). If proposed, the Contractor shall provide the services ofprofessional 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 X-rays.

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 30 calendar days from the date of referral to the specialty 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 FMC 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/newsIIPDFs/formulary.pdf. Requests for exemptions shall be submitted to the Contracting Officer's Technical Representative (COTR), 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 ofprofessional providers to the FMC, that it is capable ofproviding 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 FMC. If the resulting contract does not provide for telemedicine consultation or all of the on-site clinics listed, the FMC reserves the right to pursue such contracts. The FMC also reserves the right to determine the manner of an inmate's referral, i.e., via on-site clinic, via community-based referral, via telemedicine consult, or any other method the FMC determines to be reasonable and appropriate.

Ifthe Contractor performs on-site specialty clinics at the FMC, the following minimum requirements shall apply. Contract services shall be provided on-site within the Health Services Unit ofthe FMC. 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, ifnecessary, to a specialist at the contract medical facility. Scheduling ofclinics shall be subject to the mutual agreement of the FMC and the contract provider. Scheduling of inmates for on-site clinics shall be performed by the FMC.

Providers performing institution-based services shall be licensed to practice medicine in the State ofTexas. Providers performing these services shall apply for clinical privileges at the FMC. All All clinical privileges shall be appropriate to the qualifications of the provider and the resources ofthe facility where care is provided. Any clinical privileges granted due to the award ofthis contract shall be contingent upon the continuation of this contract and upon the physician's continued affiliation with the Contractor or any subcontractor. Continuation ofprivileges at the FMC shall be at the sole discretion of the FMC. Non-physician providers shall maintain active www.bop.gov/newsIIPDFs/formulary.pdf licenses from the State of Texas, as applicable.

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

After-Hour Physicians Audiology Cardiology Dermatology Dialysis Services EEG Services Echocardiogram Technician Endocrinology Gastroenterology General Surgery Infectious Disease Laboratory Director / Pathologist Nephrology Neurology Neurosurgery Obstetrics and Gynecology Oncology Ophthalmology Optometrist Orthopedic Surgery Orthotics Otorhinolaryngology (ENT) Pain Management Podiatry Pulmonary Medicine Radiologist (Fluoroscopy, Diagnostic Mammograms, CT Readings, and Ultrasound Readings only) (Excludes X-Ray Readings) Rheumatology Sleep Study Ultrasound Technician Urology

Mobile clinics such as EEG and Sleep Studies require the contractor to provide portable equipment necessary to conduct the services on-site at the FMC.

In the event it becomes necessary for the Government to cancel a scheduled visit, the FMC will provide the contract provider with 48-hour written or verbal notice prior to canceling a visit.

However, certain circumstances beyond the control of the FMC (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 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, staff, the Contractor must obtain preliminary clearance from the Contracting Officer or COTR, in accordance with the security and privileging requirements of this contract.

All contract personnel providing services within the confines of the FMC shall have a complete background investigation conducted in accordance with BOP Program Statement 3000.03, "Human Resource Management Manual." See also "Contract Security/Investigative Requirements" contained within Attachment #3 of this solicitation/contract. All contract providers and other applicable staffwho will enter the FMC to perform services on a recurring basis shall be required to attend a four-hour institution orientation course held at the FMC 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 COTR will be responsible for scheduling training for all applicable contract staff.

Additional Requirements for Services Provided On-site at the FMC

After-hours Physician Coverage: The contractor shall provide a physician(s) who are Advanced Cardiac Life Support (ALCS) certified to be present in the Health Services Unit at the FMC from 6:30 P.M. until 6:30 A.M., Monday through Friday. Twenty-four hour coverage shall be provided on Saturday, Sunday, and on official Government holidays. All services provided shall be performed in accordance with currently accepted medical practices and procedures. The physician shall be responsible for taking all emergency calls within the institution and providing urgent and emergency care as needed. Response to all urgent/emergency calls shall be immediate.

Physicians are also responsible for providing various healthcare services, as outlined by the Clinical Director, to inpatient and outpatient medical/surgical, mental health, chronic ambulatory inmates and general population inmates.

Additionally, physicians shall conduct complete inpatient/outpatient history and physical examinations, to include pelvic examinations, breast examinations, and Papanicolaou smears (pap) as indicated. The pelvic, breast and Pap smear examinations may only be deferred by documented patient refusal or a documented clinical contra-indication to perform any or all of the female specific examinations.

The physician shall also perform after hours psychiatric seclusion and restraint assessments and write the appropriate restraint or seclusion orders, with the assistance ofFMC Mental Health Staff, in compliance with FMC policy and Joint Commission requirements (all restraint or seclusion orders written by the physician will be countersigned by FMC Mental Health Staff the next normal work day). The FMC will provide the appropriate training on restraint and seclusion policy and procedures.

The FMC will provide the physician with private quarters. The physician, however, will practice medicine in the area where he/she is needed in the institution.

The physician assigned to a shift will not leave the institution during their 12 or 24 hour shift without an appropriate replacement that is approved, in advance, by both the Contractor and the FMC. Additionally, the physician cannot be on-call for another medical facility at the same time he/she is scheduled to work at the FMC. Late arrivals or early departures are not authorized.

Time shall be considered to start when the individual arrives at the Front Lobby of the FMC and shall be considered to end when the individual departs the Front Lobby.

At the beginning and end of each shift, the scheduled physician will sign hislher name in a log book. Additionally, the contractor will record the time he/she began the shift, the time he/she terminated the shift, the number ofphysicals performed, and all other patient encounters in the spaces provided in the log book.

All supplies that the contractor may need will be provided by the FMC. These supplies normally include examination equipment and material for recording findings. If special examination equipment is required by the contractor, he/she must make this known to appropriate personnel at the FMC.

Laboratory Director Services: The Contractor shall provide a Pathologist to serve as the consultant Laboratory Director to an in-house "High Complexity" laboratory to provide management of the services. The Laboratory Director will monitor laboratory services at the FMC and ensure test management and services meet the applicable standards of care, including requirements established by the College of American Pathologists (CAP), Clinical Laboratory Improvement Act of 1988 (CLIA), and Joint Commission, and are consistent with the BOPIFMC written policies and procedures for Laboratory Services and the BOPIFMC written plan for Quality AssurancefUtilization Review for Clinical Laboratory and Pathology services. The Laboratory Director will review the standards and documentation to satisfy the appropriate accrediting organizations relative to laboratory certifications and ensure all interpretive laboratory guidelines are followed. The Laboratory Director will review the FMC's Laboratory Procedure Manuals, proficiency evaluation reports, quality control reports, quality assurance indicator reports, methodology crossover correlation reports, and verification of new test procedures to ensure all interpretive laboratory guidelines are followed and to ensure continued provision of high quality laboratory analyses. The Laboratory Director will consult with the Clinical Director concerning the review and implementation of hospital policy with regard to laboratory services.

The Laboratory Director will review and approve proficiency testing evaluation reports, quality assurance reports and monthly quality control statistics generated by FMC in coagulation, hematology, chemistry, serology, urinalysis and bacteriology. The Laboratory Director will provide consultation on quality control, quality assurance program indicators and laboratory problem solving and assist in solving problems related to methods or instruments as indicated by statistical analyses. Additional quality control assistance may be required upon request. The Laboratory Director will consult with FMC laboratory staff to establish an evaluation protocol to include the running ofcommercial controls to generate within run and run-to-run data and perform follow-up data calculations and provide written reports signed by a Pathologist before a new test is placed in service at FMC's Laboratory. The Laboratory Director will coordinate and submit written reports to the FMC laboratory staff and/or Clinical Director, or designee, when requested.

The Laboratory Director shall maintain a close working relationship with the FMC Clinical Director and Laboratory Supervisor. The Laboratory Director will act as a Laboratory Medicine Consultant to the physicians of the medical staff, if so requested, and provide interpretive expertise in clinical laboratory medicine and anatomic pathology and participate in the Quality Tissue Committee upon a mutually agreed upon schedule. The Laboratory Director shall delegate duties to the Laboratory Technical Director/Supervisor, but oversee the operation and administration of the laboratory services.

The Laboratory Director shall be available Monday through Friday between 8:00 AM. and 4:00 P.M., excluding Federal holidays, as necessary to provide administrative Clinical Laboratory and Pathology oversight for the FMC Laboratory. The Laboratory Director shall be accessible to FMC Laboratory staff to provide pathologist consultations by telephone, electronic mail or on site. Additionally, the Laboratory Director shall personally visit the FMC Laboratory, a minimum ofonce a quarter to provide necessary on-site oversight. Scheduling of on-sight visits will be subject to the mutual agreement between the FMC Laboratory staff and the consultant Laboratory Director.

The Laboratory Director shall provide expertise in connection with laboratory instrument selection, demonstration and implementation, and offer advice concerning equipment purchases, suitable technology and personnel needs and assist the FMC in the training of the Laboratory Technicians and Technologists, and other assigned staff on an as requested basis. The Laboratory Director will recommend services, equipment, personnel, or techniques to the Laboratory staff to improve quality of patient care.

In the event the contractor finds it necessary to provide an alternate Pathologist for temporary services, this individual will be subject to the same credentialing, privileging, and security requirements, prior to providing on-site oversight services to the FMC Laboratory. Any Laboratory Director designee must be approved in advance in writing by the FMC Clinical Director.

Output #3: Provide dialysis services which conform to community standards and all local, state, and Federal laws and regulations applicable to the delivery of healthcare to members of the general public.

Output #3 is an optional deliverable. However, if the offeror proposes to provide these services, the following minimum requirements apply.

General Information: The contractor shall provide the complete management, staffing, and operation ofthe FMC's 16 chair Dialysis Services Unit at the FMC. The FMC Dialysis Service Unit will nonnally receive male (inmates from the Federal Correctional Institution Fort Worth) and female patients between the hours of 6:00 a.m. and 3:00 p.m., Monday, Wednesday, and Friday, including Federal Holidays.

The contractor shall provide services to both acute and chronic dialysis patients, including those with communicable and infectious diseases. Peritoneal dialysis treatments will also be provided as needed. Each patient win be treated according to the treatment plan outlined by the Nephrologist.

The contractor shall be responsible for determining the professional and administrative staffing required to operate the FMC Dialysis Services Unit. Staffing shall include but not be limited to the following: Director, Nephrologist, Nurses and/or Dialysis Technicians, and Dietician.

A quarterly report shall be submitted and include the following minimum data: list of inmates, inmate numbers, number of corresponding treatments, any problems experienced during the quarter, and any other applicable data as determined by BOP. A copy of the quarterly report shall be forwarded by the contractor to the following individuals by the tenth day preceding the end of the reporting quarter: Contracting Officer's Technical Representative (COTR) and Health Services Administrator. .

Equipment and Supplies: The Government will provide the required equipment to provide dialysis treatment.

The contractor shall provide all necessary supplies, excluding pharmaceuticals and needles for dialysis treatment, with the exception of peritoneal dialysis.

The Contractor is responsible for providing all necessary pharmaceuticals, supplies, and training for peritoneal dialysis.

The contractor shall perform user maintenance labor (cleaning, disinfection, de-scaling, etc.) on the Government's dialysis and Reverse Osmosis (RO), equipment. Maintenance supplies will be provided by the FMC.

The contractor shall be responsible for the proper handling ofbiomedical waste and contaminated materials, and will prepare it for disposal according to policies and procedures issued at the FMC. The FMC will provide the disposal boxes and provide disposal service.

Specialized equipment and dialysis supplies may be furnished by the contractor, at no expense to the Government, to enhance the dialysis treatment capabilities, as determined by the contractor, after prior notification and approval (i.e., security, safety, and biomedical clearances) at the FMC.

The offeror's technical proposal shall discuss in detail the staffing approach and proposed operational procedures for accomplishing Output #3, including a proposed plan for securing substitute services in the event of employee/subcontractors absences or an institution utility failure.

The staffing plan must include a detailed description of the healthcare staff, including subcontractors, and the corresponding levels ofexpertise, certification, and licensure, which will be utilized to perfonn the necessary dialysis services.

All physician services, which are provided during on-site administration of dialysis services, shall be billed separately according to the established rate for Outpatient Institution Services (Other Physicians). The contract rate for the provision ofdialysis treatments shall be on a per treatment basis.

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

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

InvoicelMedical Claims Adjudication. The FMC 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 FMC, are appropriately coded in compliance with Medicare coding policies (where applicable), are properly priced in accordance with the tenns and conditions ofthe contract, and do not represent duplicate billings for payments already made.

In addition, the FMC 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 FMC, the Contractor shall comply with all reasonable requests for additional invoice/medical claim/medical record documentation. All invoice payments shall be made by the FMC and any disagreements regarding the paid amount ofany invoice shall be resolved directly with the FMC.

Invoice Definitions.

Line Items 1a - Inpatient Facility Services, 1b - Outpatient Facility Services, Ic Long Term Care Facility Services, 2a - Inpatient/Outpatient PhysiCian Services, 2b Inpatient/Outpatient Physician Anesthesia Services, and 2c.l - Outpatient Institution Services - Other Physicians: At the outset ofthis contract, an invoice for services rendered under Line Items la, lb, lc, 2a, 2b, and 2c.l shall be a paper version ofan invoice containing not more than 50 individual medical claims. Each invoice shall be supported with paper copies of Universal Billing (UB) 92 fonns or Centers for Medicare and Medicaid Services (CMS) 1500 fonns, 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 service will be utilized by the FMC, an invoice for services rendered under Line Items la, lb, lc, 2a, 2b, and 2c.1 shall be a paper invoice detailing not more than 50 individual medical claims 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 (HIP AA) electronic billing standards. For each medical claim included on the invoice, the Contractor shall shall reference, at a minimum, the following information: YREGDOC number, inmate name and 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 service (i.e., earliest to latest) when more than one medical claim is present for the same inmate within the same invoice.

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 FMC for all services represented by that medical claim.

Line Items 2c.2- Outpatient Institution Services - Dialysis Treatments, 2c.3 - Outpatient Institution Services - After-Hour Physicians, 2c.4 - Outpatient Institution Services Optometrist and 2c.5 - Outpatient Institution Services - Laboratory Director I Pathologist:

An invoice for services rendered under Line Item 2c.2, 2c.3, 2cA, and 2c.5 shall be a paper invoice detailing the date( s) sessions or treatments were provided, the number of sessions or treatments provided, the unit pricing applied, and the extended total amount due. The BOP will not use the services of a third party medical claims adjudicator for verification of these services.

Provider Information.

Submission of Provider Data to the BOP's Medical Claims Adjudicator. Within ten calendar days after notification that a third party medical claims adjudication service will be utilized by the FMC, the Contractor shall provide the BOP's medical claims adjudicator with a complete list of provider information, which will enable the medical claims adjudicator to accurately identify the correct payable amount for any provider performing services under the contract. Specific informational requirements are provided in Attachment #11. 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 #11 to the medical claims adjudicator no less than three business days prior to filing medical claims electronically for services rendered by such new providers.

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

Electronic Trading Partner Agreement. The BOP will execute the Electronic Trading Partner Agreement with the medical claims adjudicator (Attachment #10). The Contractor shall participate in the medical claims adjudication process described herein as a "Business Associate" of the BOP. As a Business Associate, the Contractor agrees to abide by all terms of the Trading Partner Agreement as it pertains to Business Associates.

Technical Data for Submission of Medical Claims. Prior to the submission of an invoice to the FMC, the Contractor shall electronically transmit the information found on each individual invoiced medical claim via ANSI 837 format only, to the BOP's medical claims adjudicator.

After the Contractor's electronic transmission to the BOP's medical claims adjudicator, the Contractor shall promptly submit a paper copy of the invoice to the FMC. The Contractor will also post the ANSI 837 file in an FTP site set up and maintained by the BOP's medical claims adjudicator. The only exceptions to the electronic filing requirement shall be corrected medical claims for professional services. Address information for the submission of a paper medical claim to the BOP's medical claims adjudicator is provided in Attachment #12, along with other pertinent details.

Procedures for Filiug Corrected Medical Claims.

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

Payment by the FMC. The FMC 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 FMC will take an administrative deduction from the invoice. The FMC will provide written notification to the Contractor when an administrative deduction is taken from an invoice payment.

Ifthe Contractor is in disagreement with the paid amount of a medical claim, the Contractor will provide written notification to the FMC of the disagreement along with supporting documentation for why the Contractor believes the medical claim was paid incorrectly. The FMC will interface between the Contractor and the medical claims adjudicator to bring resolution to any disagreements. If it is determined that a medical claim was paid incorrectly by the FMC, 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 requirement shall constitute a performance deficiency under this output and shall be documented in the Contractor's performance evaluations. Medical claims which are submitted/invoiced within the acceptable time period, butare found to contain errors or require further justification, will be rejected and shall be resubmitted/reinvoiced by the Contractor within 30 calendar days from the date of rejection. Upon resubmission, invoices for corrected medical claims shall bear the new date of submission.

With the exception of the fourth quarter of each fiscal year, the Contractor shall stimulate the billing process by reviewing its records, including those of subcontracted providers, to determine an estimated amount ofoutstanding charges for services through the end of the previous quarter.

During the fourth quarter, the review shall consist of records for services through August 31 of that fiscal year. Based upon infonnation generated through the review, the contractor shall provide a written estimate of outstanding obligations, supported with adequate documentation.

This estimate and supporting documentation shall be provided to the Contracting Officer no later than January 15, April 15, July 15 and September 15 of each year. The Contractor shall put forth its best efforts to ensure the accuracy of the annual estimate provided to the Government.

Output #5: Manage medical record information in a manner which promotes continuity of care while observing restrictions on the release of information.

Upon request, authorized 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 be subject to review by the FMC for validation of payment and verification of services rendered. Release of information shall only be be made in accordance with community standards, Joint Commission regulations, and the Privacy Act of 1974. Any request( s) for copies of an inmate's medical records by the inmate or a third party shall be directed to the COTR for processing.

Notwithstanding the above restrictions on the release of information, medical record information shall be provided to the FMC in order to enhance inmate recovery as well as continuity of care.

At the completion of treatment, the Contractor shall provide the FMC with documented discharge instructions, as provided by the attending physician. 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 COTR within ten business days of the inpatient discharge, outpatient procedure, or other consultation.

Output #6: Maintain open avenues of communication, facilitating the exchange of information between the contract physician, contract facility, and the Government regarding the contract services.

The Contractor shall provide a Point of Contact (PaC) who shall be responsible for facilitating the Contractor's delivery of health services under this contract. The pac shall have sufficient clinical knowledge to enable preliminary technical consultation, with referral to a specialist if necessary. The Contractor shall designate this individual in writing to the Contracting Officer prior to the start date of the contract. Alternate paC's may be designated; however, the Contractor must identify those times when an alternate shall be the primary pac (i.e., after-hours and weekend referrals).

There shall be an open line of communication between the Contractor, its representatives, and the FMC to ensure that only those services ordered by the institution are provided, unless required for intervention in a life-threatening emergency. In the event of a life-threatening emergency, the Contractor shall contact the COTR within a 24-hour time period or the next normal working day.

All FMC referrals shall be the sole responsibility and decision of the Government. No inmate may be transferred to another medical facility, with exception of emergency cases, without advanced approval by authorized FMC medical staff.

VI. Enhancements to the Basic Contract Requirements

Offerors are encouraged to propose enhancements to the basic contract requirements which will facilitate the FMC's ability to conform to the BOP's stated mission. Due to security concerns inherent in transporting an inmate into the community for medical care, it is the FMC's preference to treat inmates within the confines of a secure perimeter whenever possible.

Offerings which assist the FMC in mitigating security concerns are considered beneficial to the Government and will be evaluated for merit. Enhancements are not additional line items.

Pricing for offered enhancements must be absorbed in the line item structure established within Attachment #2. Offerings of enhancements that are separately-priced line items will not be considered or accepted. The Government reserves the right to reject any offered enhancements that are determined not to be in the best interest of the Government.

The offeror's technical proposal shall discuss in detail any such enhancements proposed, including relevant terms and a detailed discussion of the merits of offered enhancements.

VII. Infants Born to Inmates and Inmates Who Release from BOP Custody

The BOP has the authority to pay for immediate postnatal care ofa child born to a female inmate when the BOP finds itself responsible for the cost by default (no other resource can be compelled to pay). The BOP may assume financial responsibility for the medical expenses of a child for the first three (3) days after a routine vaginal birth or up to seven (7) days for a Caesarean section.

This financial responsibility may be extended for a limited time for extenuating circumstances on a case-by-case basis. The Contractor shall bill the BOP according to established contract rates.

In the event the infant's medical needs exceed the BOP's authority for financial responsibility, the Contractor shall coordinate the application for financial assistance (e.g., Medicaid) for the infant. Once the BOP's obligations as set forth in this paragraph are concluded, no further payment will be made on behalf of the inmate's infant child.

Offerors are advised that the BOP retains responsibility only for inmates in the custody of the BOP. The BOP's responsibilities, including fiscal responsibilities, end with the inmate's release from custody.