S06 AMENDMENT 36C25726Q0522 0001.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

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:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(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 electronic communication 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 is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, 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 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

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

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

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.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

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

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

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

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 5

0001 09-03-2026

MSO-2026-COM-0032

36C257

Department of Veterans Affairs Network Contract Office 17 El Paso Contracting Office 11495 Turner Road El Paso TX 79936 Noel Ramirez, Contracting Officer noel.ramirez2@va.gov

SEE BLOCK 6

To all Offerors/Bidders

36C25726Q0522

X

X X

** HOUR & DATE for Receipt of Offers is EXTENDED to: 09-21-2026 2PM MDT

See CONTINUATION Page

X 1

The purpose of this amendment is to post the Questions and Answers to the solicitation and to updated the PWS and QASP.

All other terms and conditions remain unchanged.

NOEL E. RAMIREZ

Contracting Officer

VA-VHA-RPOW-2024-0115

CONTINUATION PAGE

CTX TELERADIOLOGY SERVICES

QUESTIONS & ANSWERS

1. Is there a current incumbent contractor? If yes, please provide the contract number.

A: 36C25726D0092

2. Section 2.1.1 of the PWS states that providers must comply with state licensure requirements identical to VA staff, requiring only "at least one active and unrestricted license in any state," and cites a supporting legal opinion on Federal Supremacy and State Medical Licensing in Telemedicine Contracts. Per federal requirements, a provider need only hold one state license, consistent with 38 U.S.C. § 1730C, which permits VA telehealth providers to practice across state lines using a single valid state license. However, Section E, Factor 1 requires "a full unrestricted Texas State Medical Board Licensure," without reference to any FAR/VAAR clause or statutory basis for this narrower requirement. Given the statutory authority underlying the PWS standard, we request the Government clarify whether the Texas-specific requirement in Factor 1 can be revised to align with 38 U.S.C. § 1730C and PWS Section 2.1.1, permitting any active, unrestricted state license.

A: We recognize and agree with the guidance from VA National Radiology Program that Teleradiology physicians with an unrestricted state license is sufficient.

PWS Factor 1 is changed from, “The Quoter shall describe the methodology for accomplishing each requirement in the Performance Work Statement (PWS). A comparative analysis will assess each Quoter’s technical capability relative to others. The evaluation will consider the Quoter’s understanding of the PWS objectives and the clarity of their plan to execute, manage, and control the required services and deliverables. The Government will also evaluate the Quoter’s understanding of the problems, constraints, involved organizations, and systems, as well as the effectiveness of the proposed approach to ensure successful performance. Quoters must submit copies of all licenses held in any State, Territory, or Commonwealth of the United States or the District of Columbia. Providers must hold a full unrestricted Texas State Medical Board Licensure.”

TO:

The Quoter shall describe the methodology for accomplishing each requirement in the Performance Work Statement (PWS). A comparative analysis will assess each Quoter’s technical capability relative to others. The evaluation will consider the Quoter’s understanding of the PWS objectives and the clarity of their plan to execute, manage, and control the required services and deliverables. The Government will also evaluate the Quoter’s understanding of the problems, constraints, involved organizations, and systems, as well as the effectiveness of the proposed approach to ensure successful performance.

Quoters must submit copies of all licenses, to include fully unrestricted licenses held in any State, Territory, or Commonwealth of the United States or the District of Columbia.

3. Section E, Factor 2 – Past Performance directs Quoters to complete Attachment D.2, Past Performance Questionnaire Worksheet. Neither the instructions nor the attachment specifies a minimum or maximum number of references required. Please confirm the number of PPQs the Government expects Quoters to submit.

A: A minimum of 2 Past Performance references is required.

4. STAT Turnaround Time: Section E.3, Factor 1, asks quoters to demonstrate the ability to complete final readings within 30 minutes for STAT. The PWS states the standard differently in two places: the Performance Standards list STAT at 1 hour, and the PWS STAT section requires results communicated and a preliminary reading provided within 1 hour, with the signed dictated report completed within 24 hours.

A: STAT 1 hour is correct.

PWS Section E.3, Factor 1 is changed from, “Quoters shall provide a narrative detailing how each candidate shall meet all turnaround times detailed within the PWS. Quoters shall demonstrate each candidate’s ability to complete final readings within 30 minutes for STAT and within 15 minutes from recognition of the Critical Outcome Value. Describe the mechanisms that shall be used to ensure that all reports are either electronically communicated, faxed and telephoned immediately after the readings are complete.”

TO:

“Quoters shall provide a narrative detailing how each candidate shall meet all turnaround times detailed within the PWS. Quoters shall demonstrate each candidate’s ability to complete final readings within 1 hour for STAT and within 15 minutes from recognition of the Critical Outcome Value. Describe the mechanisms that shall be used to ensure that all reports are either electronically communicated, faxed and telephoned immediately after the readings are complete.”

5. The 30-minute figure also does not reconcile internally. As written, the final reading would be due at 30 minutes while the preliminary reading is due at 1 hour, which places the final ahead of the preliminary it is meant to follow.

One hour is the operative STAT standard in the PWS, is the figure tied to the acceptable quality level and surveillance method and is consistent with ACR practice parameters for emergent interpretation. Please confirm that a 1-hour STAT turnaround is the applicable standard, and that Section E.3 will be read consistently with the PWS Performance Standards.

A: STAT 1 hour is correct – see answer to question 4.

6. Routine Turnaround Time: The solicitation states three routine figures: 72 hours in the PWS

Performance Standards, 48 hours in the PWS facility responsibilities section, and 24 hours in the PWS reports section.

Please confirm which routine standard applies. The 72-hour figure in the Performance Standards appears to be the operative one, as it is the figure tied to the acceptable quality level and the surveillance method.

Relatedly, Attachment D.1 (QASP), Section 6, item 4.7.3.1 states no numeric turnaround times.

Reflecting the confirmed STAT, Urgent, and Routine figures in Attachment D.1 would allow our quality reporting to align with the Government's surveillance from the start of performance.

A: Routine is 72 hours, Urgent/ASAP is 24 hours, and STAT is 1 hour.

PWS paragraph 4.4.4.2.1 is changed from, “Each Facility will provide necessary procedures for reports to be reviewed, edited (if required), and for electronic signature approval by the Contractor. Contractor will provide interpretation per routine exam to the respective Facility within 24 hours after receipt of images. Contractor will not be held responsible for late reports caused by delays in the respective transcription service system. All exam study interpretation reports shall be dictated into the designated Facility system and verified in the VISN Vista dictation system. Non-routine and emergency exams will be handled on a case-by-case basis, but all emergency exams will take precedence over all routine exams.”

TO:

Each Facility will provide necessary procedures for reports to be reviewed, edited (if required), and for electronic signature approval by the Contractor. Contractor will provide interpretation per routine exam to the respective Facility within 72 hours after receipt of images. Contractor will not be held responsible for late reports caused by delays in the respective transcription service system. All exam study interpretation reports shall be dictated into the designated Facility system and verified in the VISN Vista dictation system.

Non-routine and emergency exams will be handled on a case-by-case basis, but all emergency exams will take precedence over all routine exams.

Attachment D.1 QASP – Section 6, Timeliness of Reports, 4.7.3.1, Performance Requirement is changed from Prompt delivery (timeliness) of interpretations and return for routine/stat/immediate

TO:

Prompt delivery (timeliness) of interpretations and return for routine – 72 hours /stat – 1 hour /urgent – 24 hours

7. State Licensure Requirement: The solicitation states the licensure standard two ways.

Section B.2, Schedule of Services (page 6), and Section B.4, PWS, Qualifications – License, both require providers to hold at least one active and unrestricted license in any state, with no restrictions on any other license held, referencing the Legal Opinion on Federal Supremacy and State Medical Licensing Issues in Telemedicine Contracts.

Section E.3, Evaluation Factors and Criteria, Factor 1 – Technical Capability (page 72), states that providers must hold a full unrestricted Texas State Medical Board licensure.

Based on guidance from Dr. Malloy and the VA National Radiology Program, a single active and unrestricted state license is sufficient for teleradiology services performed remotely under federal supremacy. That is the standard applied on our current VA teleradiology contracts, including VA Pittsburgh Healthcare System and the five VISN 9 facilities we support – Lexington, Louisville, Memphis, Mountain Home, and Tennessee Valley. We recognize CTVHCS may have a specific basis for the Texas requirement.

Please confirm which standard applies. If Texas licensure is required, please also confirm whether it must be held at time of quote submission or by the base period start date of 1 January 2027.

We raise this directly because a Texas-specific requirement would substantially narrow the pool of SDVOSB teleradiology providers able to respond, and it affects whether we can field a competitive quote.

A: Sections B.2, B.4 and Section E.3 are updated to reflect that the guidance from VA National Radiology Program that Teleradiology physicians with an unrestricted state license is sufficient.

Licensure information is changed to reflect, “Quoters must submit copies of all licenses, to include fully unrestricted licenses held in any State, Territory, or Commonwealth of the United States or the District of Columbia.”

8. ACLS/BLS Certification: Section E.3, Part II, asks that ACLS/BLS certifications be submitted with the quote. The PWS Deliverables table lists ACLS/BLS certification as due upon award and every two years thereafter. Please confirm which timing applies.

On the underlying requirement: ACLS and BLS certification is not customarily required for telemedicine/teleradiology contracts where the interpreting physician is off-site, has no direct patient contact, and has no role in resuscitation response. The PWS assigns the facility sole responsibility for on-site LIP services, including treatment of contrast reactions. None of the VA facilities where we currently provides teleradiology services require ACLS or BLS certification for remote interpreting physicians.

Would the Government consider removing the ACLS/BLS requirement for contract physicians performing interpretation remotely? As written, it would limit the number of responsive quotes the Government receives.

A: ACLS/BLS certification is not required for off-site Teleradiology and therefor removed from the PWS.

Section E

Section E. Evaluation Factors and Criteria, paragraph, “Quoters shall provide a narrative detailing how each candidates shall meet all turnaround times detailed within the PWS. Quoters shall demonstrate each candidate’s ability to complete final readings within 30 minutes for STAT and within 15 minutes from recognition of the Critical Outcome Value. Describe the mechanisms that shall be used to ensure that all reports are either electronically communicated, faxed and telephoned immediately after the readings are complete.” is changed to:

Quoters shall provide a narrative detailing how each candidate shall meet all turnaround times detailed within the PWS. Quoters shall demonstrate each candidate’s ability to complete final readings within 1 hour for STAT and within 15 minutes from recognition of the Critical Outcome Value. Describe the mechanisms that shall be used to ensure that all reports are either electronically communicated, faxed and telephoned immediately after the readings are complete.

End of Document