TI Amendment 2.pdf

11. CONTRACT 10 CODE OF PAGES

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT rA~E

L

4. REQUISITION/PURCHASE REQ. NO. 15. PROJECT NO. (If applicable)

Amendment #2

3. EFFECTIVE DATE2. AMENDMENTIMODIFICATION NO.

06/22/2011

7. ADMINISTERED BY (If other than Item 6) CODE6. ISSUED BY CODE I Federal Bureau of Prisons

Field Acquisition Office

Federal Bureau of Prisons FCI Terminal Island

1299 Seaside Avenue

346 Marine Forces Drive

U.S. Armed Forces Reserve Complex Terminal Island, CA 90731

Grand Prairie, TX 75051

SA. AMENDMENT OF SOLICITATION8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) (X)

~ NO.

RFPP06141100001[g] 9B. DATED (SEE ITEM 11)

05/09/2011 lOA. MODIFICATION OF CONTRACT/ORDER NO.

0 lOB. DATED (SEE ITEM 13)

CODE IFACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITA 1 IONS

[8] The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers [8] is extended, o 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 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or 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 virtue 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 A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO.

IN ITEM lOA. o

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

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:o D. OTHER (Specify type of modification and authority) o

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

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

RFPP06141100001 is hereby amended as follows:

Sealed Offers shall be received on or before the deadline of Wednesday, July 20, 2011, at 2:00p.m. local time.

Attachment #1, Performance Work Statement and Attachment #2, Schedule of ItemslSDB PartiCipation have been amended to:

Provide additional information regarding the Laboratory Director/Pathologist.

Delete the requirement of Outpatient Institution Services / Podiatrist.

Add the requirement of Outpatient Institution Services (Orthotist/Prosthetist)

Amend Visit and Session Quantities for Orthopedic Surgeon

Except as provided 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 lac. DATE SIGNED

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

15B. CONTRACTOR/OFFEROR

(Signature ofperson authorized to sign)

. - -NSN 7540 01 1528070

Previous edition unusable

15C. DATE SIGNED

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

Michael Miller, Contracting Officer

16B'lft?3rEs OF AMERICA,.1 f.-A.

(Signature of Contracting Officer) b/tyt?d/

STANDARD FORM 30 (REV. 10-83) <

Prescribed by GSA FAR (48 CFR) 53.243

RFPP06141100001

REVISED ATTACHMENT #1

BLOCK 20 - PERFORMANCE WORK STATEMENT

I. Background

The Federal Bureau of Prisons (BOP) was established in 1930 to provide more progressive and humane care for Federal inmates, to professionalize the prison service, and to ensure consistent and centralized administration. Today, the BOP is responsible for the custody and care of approximately 212,000 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 Correctional Institution (hereinafter referred to as FCI) located in Terminal Island, California, 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 FCI currently houses male inmates. The FCI is presently identified as a Care Level ill BOP facility. Care Level ill is an intermediate classification on the four-level scale where Care Level I represents the healthiest inmates and Care Level N represents inmates with serious health issues. Criteria for categorizing an inmate in the Care Level ill 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 FCI. 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 unacceptable.

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 of the FCI. 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 ifthe awardee has dual responsibilities for the submission ofproper 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 ofhow 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 I 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: 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 ofthe general public. (Cross-reference pricing categories la and lb.)

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 ofthe general public. (Cross-reference pricing categories 2a and 2b.)

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

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

Output #5: Maintain open avenues ofcommunication, 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 FCr's approval. Once the QCP is approved by the FCr, the contractor shall utilize the QCP to guide and rigorously document the implementation ofthe 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, ifthe offeror proposes to provide these services, the following minimum requirements apply.

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

It is the FCI's preference to obtain the services of facilities that are accredited by The Joint Commission. Offerors utilizing facilities which maintain accreditation by The Joint Commission shall submit a copy of the current accreditation certificate as part of the offeror's technical submission. 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 FCI, 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 offered, the Contractor shall provide the services of professional medical staff who have appropriate educational qualification, experience, licensure, and board certification (where required) to achieve Output #2. This output specifically excludes the provision of radiological interpretations of BOP-provided films, images, or other media.

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

For prescriptions to be filled by the FCI pharmacy, contract providers shall only prescribe pharmaceutical drugs that are listed in the approved BOP Formulary. The BOP Formulary can be accessed at www.bop.gov/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 FCI, 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 FC!. If the resulting contract does not provide for telemedicine consultation or all ofthe on-site clinics listed, the FCI reserves the right to pursue such contracts. The FCI also reserves the right to determine the manner ofan inmate's referral, i.e., via on-site clinic, via community-based referral, via telemedicine consult, or any other method the FCI determines to be reasonable and appropriate.

Ifthe Contractor performs on-site specialty clinics at the FCI, the following minimum requirements shall apply. Contract services shall be provided on-site within the Health Services Unit of the FC!. 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 FCI and the contract provider. Scheduling of inmates for on-site clinics shall be performed by the FC!.

Providers performing institution-based services shall be licensed to practice medicine in the State ofCalifomia. Providers performing these services shall apply for clinical privileges at the FCI.

All clinical privileges shall be appropriate to the qualifications ofthe 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 ofprivileges at the FCI shall be at the sole discretion of the FCI.

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

Cardiologist

Dermatologist

Gastroentero10gist www.bop.gov/newsIIPDFs/formulary.pdf

General Surgeon Nephrologist Neurologist Ophthalmologist Orthopedic Surgeon

- Orthotist / Prosthetist Optometrist Laboratory Director / Pathologist

Additional Requirements for Services Provided On-site at the FeI

Laboratory Director Services! The Contractor shall provide a Pathologist to monitor the Laboratory services at the FCI and ensure that 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 (CLlA), and the Joint Commission and are consistent with the BOPIFCI written policies and procedures for Laboratory Services and the BOPIFCI written plan for Quality Assurance/ Utilization Review for Clinical Laboratory and Pathology services. Furthermore, the consultant Laboratory Director shall maintain a close working relationship with the FCI Health Service Administrator and Clinical Director.

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

However, certain circumstances beyond the control of the FCI (e.g., fog or other Acts of God, institution disturbances, etc.) may dictate the cancellation of a scheduled visit with less than 48 hours written or verbal notice. In the event it becomes necessary for the contract provider to cancel a scheduled visit, the Contractor may provide qualified replacement professional staff or may reschedule a mutually agreed-upon replacement session. Prior to utilizing replacement staff, the Contractor must obtain preliminary clearance from the Contracting Offit::er or COTR, in acconlance with the security and privileging requirements ofthis contract.

All contract personnel providing services within the confines of the FCI shall have a complete background investigation conducted in accordance with BOP Program Statement 3000.03, "Human Resource Management Manual." See also "Contract SecuritylInvestigative Requirements" contained within Attachment #3 of this solicitation/contract. All contract providers and other applicable staff who will enter the FCI to perform services on a recurring basis shall be required to attend a four-hour institution orientation course held at the FCI or a mutually acceptable site. A "refresher" orientation must be completed annually. The Contractor's costs for contract staff to attend this training shall be the responsibility of the Contractor. The Contracting Officer or COTR will be responsible for scheduling training for all applicable contract staff.

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

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

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

In addition, the FCr may utilize the services of a third-party medical claims adjudicator to review medical claims submitted by the Contractor under this contract. When requested by the FCI, the Contractor shall comply with all reasonable requests for additional invoice/medical claim/medical record documentation. All invoice payments shall be made by the FCI and any disagreements regarding the paid amount ofany invoice shall be resolved directly with the FCI.

Invoice Definitions.

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

Following written notification to the Contractor by the Contracting Officer that a third-party medical claims adjudication service will be utilized by the FCI, an invoice for services rendered under Line Items 1 a, 1 b, 2a, and 2b.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 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 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 FCI for all services represented by that medical claim.

Line Items 2b.2 - Outpatient Institution Services - Optometrist and 2b.3 Outpatient Institution Services - Laboratory Director I Pathologist: An invoice for services rendered under Line Items 2b.2 and 2b.3 shall be a paper invoice detailing the date(s) sessions were provided. the number of sessions provided. the unit pricing applied. and the extended total amount due. The BOP will not use the services ofa third party medical claims adjudicator for verification of these services.

Provider Information.

Submission of Provider Data to the BOP's Medical Claims Adjudicator. Within ten calendar days after notification that a third party medical claims adjudication service will be utilized by the FCI. the Contractor shall provide the BOP's medical claims adjudicator with a complete list ofprovider 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 #12. 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 #12 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 #11.) 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 ofthe Trading Partner Agreement as it pertains to Business Associates.

Technical Data for Submission of Medical Claims. Prior to the submission of an invoice to the FCI, the Contractor shall 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 FC!. 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 #13, along with other pertinent details.

Procedures for Filing Corrected Medical Claims.

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

PhysicianlProfessional 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 FCr. 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 FCI. The FCI will pay all invoices directly to the Contractor. If the invoiced amount of a medical claim exceeds the adjudicated amount ofthat medical claim, the FCI will take an administrative deduction from the invoice. The FCI 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 ofa medical claim, the Contractor will provide written notification to the FCI ofthe disagreement along with supporting documentation for why the Contractor believes the medical claim was paid incorrectly. The FCI will interface between the Contractor and the medical claims adjudicator to bring resolution to any disagreements. Ifit is determined that a medical claim was paid incorrectly by the FCI, interest on the underpayment will be paid when required by the Prompt Payment Act.

Timeliness of Medical Claims.

Medical claims shall be submitted/invoiced within 90 calendar days after an inmate's discharge or outpatient encounter or other service provided under 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, but are 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.

No later than November 1 ofeach year, the Contractor shall stimulate the billing process by reviewing its records, including those ofsubcontracted providers, to determine an estimated amount ofoutstanding charges for services provided through September 30 ofthat year. Based upon information generated through this review process, the Contractor shall provide a written estimate to the FCI of outstanding fiscal year obligations, supported by adequate documentation.

This estimate and supporting documentation shall be provided to the Contracting Officer no later than December 1 of each year. The Contractor shall put forth its best efforts to ensure the accuracy of the annual estimate provided to the Government.

Output #4: Manage medical record information in a manner which promotes continnity 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 FCI for validation ofpayment 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 ofan 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 FCI in order to enhance inmate recovery as well as continuity of care. At the completion of treatment, the Contractor shall provide the FCI 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 ofthe inpatient discharge, outpatient procedure, or other consultation.

Output #5: 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 ofContact (POC) who shall be responsible for facilitating the Contractor's delivery ofhealth services under this contract. The POC 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 POC's may be designated; however, the Contractor must identify those times when an alternate shall be the primary POC (i.e., after-hours and weekend referrals).

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

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

VI. Enhancements to the Basic Contract Requirements

Offerors are encouraged to offer enhancements to the basic contract requirements which will facilitate the Fcrs 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 Fcrs preference to treat inmates within the confines of a secure perimeter whenever possible. Offerings which assist the FCI 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 ofenhancements 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 discuss in detail any such enhancements proposed, including relevant terms and a detailed discussion ofthe merits ofoffered enhancements.

VII. Inmates Who Release from BOP Custody

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. Once released from custody, the former inmate will become personally liable for any fm1her medical treatment received. When an inmate's term ofcommitment expires while the the inmate is in inpatient status in a contracted facility, the BOP will use its best effort to notifY the contractor in advance of the inmate's projected release date. In preparation ofa pending release from BOP custody, the contractor shall provide planning assistance to an inmate who requires continuing or follow-up medical care that extends beyond his or her projected release date.

Should an inmate's release date come while in inpatient status in a contracted hospital, the inmate's place ofconviction and/or legal residence is outside the local area, and there are no other entities assuming custodial responsibility for the inmate, the BOP will accept financial responsibility for the inmate's medical care until the BOP can satisfy its obligation provide release transportation for the inmate.

RFPP06141100001

REVISED ATTACHMENT #2

SCHEDULE OF ITEMS/SDB PARTICIPATION

I. Overview

Services are required to be provided in accordance with the Performance Work Statement (Attachment #1) ofthis solicitation/contract. Offerors are required to submit, as a part oftheir business submission, a completed copy of Attachment #2, Section IV, Schedule of Items/Target for Participation of Small Disadvantaged Business Concerns.

II. 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 ofa 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, co-payments, or co-insurance. When appropriate, outlier payments calculated in accordance with Medicare reimbursement methodologies shall be made in recognition of extremely costly stays. Inpatient outlier payments 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 ofany offeror; offerors need only to offer that percentage discount from or premium to the Medicare benchmark rate which will reflect the desired level ofpayment for the category ofservices 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 services covered by Medicare Part A shall be the most current Basic MS-DRG payment (i.e., Operating Federal Rate) established for CBSA 31084, Los Angeles - Long Beach-Glendale, CA. The Basic DR G calculation shall not include any provider-specific adjustments allowed under actual Medicare participation.

Offerors may offer a discount from or a premium to Basic MS-DRG rates. (Refer to Attachment #7 of this solicitation)

Medicare Part B Physician Services. The Medicare benchmark to be utilized for physician/professional services covered by Medicare Part B shall be those rates established in the most current Medicare Part B Fee Schedule for Payment Locality 18, Los Angeles, California.

The benchmark charges shall be those established for participating providers. Offerors may offer 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 31084, Los Angeles - Long Beach-Glendale, CA. Offerors may offer a discount from or a premium to the benchmark charges.

III. Estimated Quantities

Estimated quantities for the base year and all option periods 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- Effective Date of Award (EDOA) through twelve (12) months from EDOA

Inpatient: Estimated 400 Days Outpatient: Estimated 450 Visits

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

Inpatient: Estimated 400 Days Outpatient: Estimated 450 Visits

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

EDOA

Inpatient: Estimated 400 Days Outpatient: Estimated 450 Visits

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

EDOA

Inpatient: Estimated 400 Days Outpatient: Estimated 450 Visits

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

Inpatient: Estimated 400 Days Outpatient: Estimated 450 Visits

Outpatient Institution Services

Estimated quantities shall remain constant for the base year and all option periods. Optometry and Pathology shall be paid based upon the provision of a defined session.

For Medicare based services, duration of visits is listed for informational purposes only. Except for Optometry and Pathology, contract rates will be based upon the Medicare allowable per procedure performed.

Cardiologist: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year 12 Estimated

Dermatologist: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year - 6 Estimated

Gastroenterologist: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year - 12 Estimated

General Surgeon: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year 12 Estimated

Nephrologist: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year - 6 Estimated

Neurologist: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year - 12 Estimated

Ophthalmologist: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year - 12 Estimated

Orthopedic Surgeon: Visit Duration - 4 hours (Approximate) Visit Quantity Per Contract Year 36 Estimated

Orthotist !Prosthetist: Visit Duration - 2 hours (Approximate) Visit Quantity Per Contract Year 12 Estimated

Optometrist: Session Duration - 8 hours Session Quantity Per Contract Year - 36 Estimated

Laboratory Director / Pathologist: Session Duration - 1 hour Session Quantity Per Contract Year - 12 Estimated

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

IV. Schedule of Items/Target for Participation of Small Disadvantaged Business Concerns

Offerors shall complete the following Schedule ofltems and Target for Participation of Small Disadvantaged Business Concerns. All pricing and participation targets will be evaluated in accordance with Attachment #4, "Evaluation ofProposals" of this solicitation.

Schedule of Items

BASE YEAR

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

la. Inpatient Facility Services: -___ Discount or +___ Premium to Medicare Part A

lb. Outpatient Facility Services: -___ Discount or +___ Premium to Medicare Part B

2b. Outpatient Institution Services:

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

2. Optometrist $_____----'per seSSIOn

3. Laboratory Director / Pathologist $_____--<per seSSIOn

NOTE: IF OFFERING A V ARIANCE FROM THE BENCHMARK MEDICARE RATE,

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

OPTION YEAR 1

13 through 24 months from EDOA

la. Inpatient Facility Services: -___ Discount or + ___ Premium to Medicare Part A

lb. Outpatient Facility Services: -___ Discount or +___ Premium to Medicare Part B

2b. Outpatient Institution Services:

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

2. Optometrist $._____-tper session

3. Laboratory DirectorlPathologist $._____--'per seSSIOn

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

INSERT APPLICABLE "-/+" PERCENTAGE. IFNO VARIANCE, ENTER "0".

OPTION YEAR 2

25 through 36 months from EDOA

la. Inpatient Facility Services: -___ Discount or +___ Premium to Medicare Part A

lb. Outpatient Facility Services: -___ Discount or +___ Premium to Medicare Part B

2b. Outpatient Institution Services:

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

2. Optometrist $._____-tper session

3. Laboratory DirectorlPatho logist $._____--'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 months from EDOA

la. Inpatient Facility Services: -___ Discount or +___ Premium to Medicare Part A

lb. Outpatient Facility Services: -___ Discount or +___ Premium to Medicare Part B

2b. Outpatient Institution Services:

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

2. Optometrist $_____--r:per session

3. Laboratory Director / Pathologist $_____-<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 EDOA

la. Inpatient Facility Services: -_____ Discount or +___ Premium to Medicare Part A

lb. Outpatient Facility Services: - Discount or + Premium to Medicare Part B

2a. Inpatient/Outpatient Physician Services:

Discount or + Premium to Medicare Part B

2b. Outpatient Institution Services:

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

2. Optometrist $_____--r:per session

3. Laboratory Director / Pathologist $_____----tper session

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

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

Target for Participation of Small Disadvantaged Business (SDB) Concerns

Offerors shall provide a participation target for utilization of small disadvantaged business (SDB) concerns (including joint ventures, teaming arrangements, and subcontracts) performing within North American Industry Classification System Sector 62, Health Care and Social Assistance.

The SDB participation target identified by the offeror will be incorporated 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 (target: _______--'percent)

Offerors are advised that, 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, SDB concerns 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.