Solicitation 75H70724Q00099 - Clearing House and Claims Services.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225 Albuquerque Indian Health Service

CODE 16. ADMINISTERED BYCODE

X

X

522320

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR203

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

08/30/2024 1200 MD

08/02/2024

505-256-6754PATRICIA TRUJILLO

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70724Q00099

5. SOLICITATION NUMBER

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

1 54 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$47

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

The Indian Health Service (IHS), Albuquerque Area office (AAO), Santa Fe Indian Health Center (SFIHC) has a requirement for Secure Exchange Data Software - Perform Third-Party Insurance Claims Processing for Medicare, Medicaid, VA and Commercial Payers.

1 BASE: TBD, 2024 to TBD, 2025, for Secure Exchange Data Software - Perform Third-Party Insurance Continued ...

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

PATRICIA P. TRUJILLO

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

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

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Claims Processing for Medicare, Medicaid, VA and

Commercial Payers for the Santa Fe Indian Health

Center.

2 OPTION YEAR ONE: TBD, 2025 to TBD, 2026, for

Secure Exchange Data Software - Perform

Third-Party Insurance Claims Processing for

Medicare, Medicaid, VA and Commercial Payers for the Santa Fe Indian Health Center.

3 OPTION YEAR TWO: TBD, 2026 to TBD, 2027, for

Secure Exchange Data Software - Perform

Third-Party Insurance Claims Processing for

Medicare, Medicaid, VA and Commercial Payers for the Santa Fe Indian Health Center.

4 OPTION YEAR THREE: TBD, 2027 to TBD, 2028, for

Secure Exchange Data Software - Perform

Third-Party Insurance Claims Processing for

Medicare, Medicaid, VA and Commercial Payers for the Santa Fe Indian Health Center.

5 OPTION YEAR FOUR: TBD, 2028 to TBD, 2029, for

Secure Exchange Data Software - Perform

Third-Party Insurance Claims Processing for

Medicare, Medicaid, VA and Commercial Payers for the Santa Fe Indian Health Center.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

54 2 of

Secure Exchange Data Software - Perform Third-Party Insurance Claims Processing – Santa Fe Indian Health Center

Solicitation No. 75H70722Q00099 Page 4 of 59

SECTION 1: GENERAL:

1.1 SERVICES

1.1.1 The Indian Health Service (IHS), Albuquerque Area Office (AAO), Santa Fe Indian Health Center (SFIHC) has a need for Secure Exchange Data Software - Perform Third-Party Insurance Claims Processing for Medicare, Medicaid, VA and Commercial Payers, Santa Fe, New Mexico.

1.2 PRICE OR COST

1.2.1 This solicitation will result in a Firm-Fixed-Price (FFP) Purchase Order acquisition with a Base Year and 4 one-year option periods.

1.3 GENERAL CONTRACT INFORMATION:

1.3.1 As an independent Contractor; billing and collecting for the federal, state and other local city/county taxes is the burden of the Contractor, this includes the New Mexico Gross Receipt Taxes (NMGRT) for services provided in any county of the State of New Mexico.

1.3.2 The Contractor's price/cost for services under this contract should include all applicable taxes for Internal Revenue Service (IRS), State of New Mexico Taxation and Revenue agency and/or other revenue agencies. The Indian Health Service will not withhold taxes nor will it issue a W-2 to the contractor.

1.3.3 FINGERPRINTING REQUIREMENTS FOR SECURITY AND SUITABILITY:

"Prior to start of services specified by the contract scope of work, the Contractor must contact either Otis

Manuelito at (505) 256-6841, or Tamela Richards at (505) 256-6762, Division of Contract and Grants, AAO, to schedule an appointment to complete the fingerprinting process required by the IHS regulations pertinent to security and character background investigations."

1.4 CONTRACT PRICE

1.4.1 This solicitation will result in an FFP Purchase Order. The price for this contract is $ (TBD).

1.4.2 Upon delivery and acceptance of the item(s) specified in the DELIVERY Article in SECTION 7 of this contract, the Government shall pay to the Contractor resulting from the awarded contract price.

1.4.3 Upon delivery and acceptance the services described in the Performance Work Statement (PWS) and identified in the schedule of charges below, the Government shall pay to the Contractor the total prices set forth below and will be paid from the following Contract Line Item Numbers (CLINs) accordingly:

SCHEDULE OF CHARGES FOR THE BASE PERIOD:

Item # Contract Period Description of Service Total Amount

CLIN 1 BASE YEAR

TBD, 2024 – TBD, 2025

Secure Exchange Data Software - Perform Third- Party Insurance Claims Processing for Medicare, Medicaid, VA and Commercial Payers, SFIHC.

TOTAL FOR BASE YEAR: $

1.4.4 The Contractor shall be paid upon submission of an invoice and completion and acceptance (if deliverable) or verification (if service) by the Contracting Officer's Representative (COR), of the deliverables and/or services indicated below. Submit invoices in accordance with the instructions contained in FAR clause 52.232-25, Prompt Payment, and Section G.2 of this contract.

1.5 OPTION PRICES

1.5.1 Unless the Government exercises its option, pursuant to the option clause referenced in the Contract Clauses section, this contract consists only of the Base Period specified in this contract.

1.5.2 Pursuant to either the FAR Clause 52.217-8, Option to Extend Services or the FAR Clause 52.217-9, Option to Extend the Term of the Contract, set forth in Section I, Contract Clauses, of this contract, the Government may, a unilateral contract modification, require the Contractor to perform the Option Period(s) as defined in

Solicitation No. 75H70722Q00099 Page 5 of 59 the PWS of this contract. A notice that the Government intends to exercise any of the options will happen prior to the contract’s expiration date. Specific information regarding the timeframe for this notice is set forth in the OPTION PROVISION of this order. When exercising an option period, the fixed price rate of this contract is set forth below.

1.5.3 Upon the delivery and acceptance of the Option Services described in the PWS of the contract and identified in the schedule of charges below, the Government shall pay the Contractor the unit price(s) set forth below and will be paid from the following Contract Line Item Numbers (CLINs) accordingly;

1.5.4 If the Government exercises its option pursuant to the OPTION PROVISION of this contract, the Government's total estimated contract amount, represented by the sum of the price of base plus option periods and the period of performance will be as follows:

SCHEDULE OF OPTION PERIODS:

Item # Contract Period Description of Service Total Amount

CLIN 2 OPTION YEAR ONE

TBD, 2025 – TBD, 2026

Secure Exchange Data Software - Perform Third-Party Insurance Claims Processing for Medicare, Medicaid, VA and Commercial Payers, SFIHC.

TOTAL FOR OPTION YEAR ONE: $

Item # Contract Period Description of Service Total Amount

CLIN 3 OPTION YEAR TWO

TBD, 2026 – TBD, 2027

Secure Exchange Data Software - Perform Third-Party Insurance Claims

TOTAL FOR OPTION YEAR TWO: $

CLIN 4 OPTION YEAR THREE

TBD, 2027 – TBD, 2028

Secure Exchange Data Software - Perform Third-Party Insurance Claims

TOTAL FOR OPTION YEAR THREE: $

CLIN 5 OPTION YEAR FOUR

TBD, 2028 – TBD, 2029

Secure Exchange Data Software - Perform Third-Party Insurance Claims

TOTAL FOR OPTION YEAR FOUR: $

1.5.5 Note: Unit price shall be an all-inclusive rate of all other fees including travel expenses, per diem, lodging all cities, state, federal, local taxes and miscellaneous cost associated with the above services.

1.5.6 Lunch break of thirty minutes (30) permitted (as non-paid) under the contract; the contractor cannot invoice time as worked if its’ employee chooses not to take a lunch break. The Contractor also cannot invoice travel times to/from the facility site as time worked.

Solicitation No. 75H70722Q00099 Page 6 of 59

SECTION 2: DEFINITIONS:

2.1 Acceptance: Constitutes acknowledgement that the supplies or services conform to the applicable contract quality and quantity requirements, except as provided in FAR subpart 46.5 and subject to other terms and conditions of the contract.

2.2 Approval: Acknowledgment by the designated Government official that submittals, deliverables, or administrative documents (e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) conform to the contractual requirements. Government approval does not relieve the Contractor from responsibility for compliance with contract requirements.

2.3 Area: A defined geographical region for Indian Health Service administrative purposes. Each Area Office may administer several Service Units.

2.4 Contracting Officer (CO): A Government employee with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.5 Contracting Officer's Representative (COR): A federal employee who assists the ordering/issuing activity-contracting officer in the administration of task orders issued under this contract. The COR is primarily responsible for the technical assistance and day-to-day program management of the ordering activity's task orders. Ordering activities may have different designators for this employee.

2.6 Contractor: The individual award a legal binding contract to provide supplies and services.

2.7 Customer: Staff of the IHS service unit and health center.

2.8 Customer Evaluation/Input: Written comments made to the COR regarding the Contractors performance. This is one of the criteria used to evaluate the Contractor's performance.

2.9 Dependability: Qualities of being trusted and being able to repeat the same task to yield the same result.

2.10 Federal Acquisition Regulation (FAR): The FAR is the primary regulation for use by all Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

2.12 Non-Personal Services Contract: Contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

2.13 Ordering Activity: An authorized user of IHS that may issue a task order to obtain required services under this contract.

2.14 Outcome: End result.

2.15 Past Performance Information: Relevant information regarding a contractor's actions under previously awarded contracts.

2.17 Service Contract: is a contract that directly engages the time and effort of a contractor whose primary purpose is to perform an identifiable task rather than to furnish an end item of supply. A service contract may be either a non-personal or a personal contract. It can also cover services performed by either professional or nonprofessional personnel whether on an individual or organizational basis.

2.18 Service Unit: The local administrative unit of IHS.

2.19 Technical Direction: A directive to the Contractor that approve approaches, solutions, designs, or refinements; fills in details or otherwise completes the general description of work or documentation items; shifts emphasis among work areas or tasks; or furnishes similar instruction to the Contractor. Technical direction includes requiring studies and pursuit of certain lines of inquiry regarding matters within the general tasks and requirements in Section 5 of this contract.

Solicitation No. 75H70722Q00099 Page 7 of 59

SECTION 3 – GOVERNMENT-FURNISHED PROPERTY AND SERVICES:

3.1 Furnished property will be in patient information as needed to transmit information through the process.

SECTION 4: CONTRACTOR-FURNISHED ITEMS:

4.1 The Contractor will provide the Secure Exchange Data Software - Perform Third-Party Insurance Claims Processing for Medicare, Medicaid, VA and Commercial Payers, SFIHC.

Solicitation No. 75H70722Q00099 Page 8 of 59

SECTION 5 – REQUIREMENTS:

5.1 The contractor will provide the Santa Fe Indian Health Center a secure exchange data software solution to provide connectivity to various Revenue Cycle Management services, insurance verification/discovery, perform third-party insurance claims processing for Medicare, Medicaid, VA and Commercial Payers, claims attachments and denial prevention analytics with RCM Intelligence. SFIHC is looking for business and revenue continuity, to keep Software as a Service (no contractor software within the SFIHC environment), confidentiality, authentication, integrity, and non-repudiation as required.

Secure exchange managed services are needed for the medical, behavioral, and dental claims process to keep in compliance with Indian Health Service mandates.

To provide secure exchange software platform to perform third-party insurance claims processing for Medicare, Medicaid, VA and Commercial Payers.

To allow SFSU to submit, edit and receive claims for Medicare, Medicaid and other commercial insurance companies.

To allow use of Electronic claims for submission. And claims to be submitted multiple times per day.

A system must be in place to identify claims that will not be accepted by Payers. Errors will be identified, so users can correct those claims through pre-established instructions to correct claim.

Support end-to-end communication testing, implementation and daily operations of the data transfers from the contractor to Santa Fe Indian Health Clinic.

Provide staff training via internet meetings upon implementation and as needed. Provide helpful videos and support pages throughout each system will be included.

Provide routine technical support to implement corrections to service occurring as a result of errors, flaws, or other failures within its service.

Notify a designated Santa Fe point of contact (Contracting Officer’s Representative (COR)or designated department

POC) of any scheduled maintenance that shall result in downtime at least two (2) days prior to the maintenance period.

Notify a designated SFSU point of contact of any issues as that result in a disruption of data exchange capabilities. This notification shall occur as soon as possible after the disruption has been identified.

Provide customer support for reporting, documenting, tracking and resolving of service problems, which shall be available via telephone and email to the Santa Fe Service Unit technical staff during the period 7:30 am to 7:30 pm

Central Standard Time on weekdays.

Provide knowledgeable support personnel to assist with any issues regarding the processing of the medical claims.

Provide toll free telephone/technical support during normal business hours, 7:30 am to7:30 pm Central, Monday through Friday.

Compliant with HIPAA regulations.

Claim Attachments to Payers – Ability to upload and send additional documentation for those payers that require claim attachments.

REQUIRED PROVIDER SOLUTIONS FOR SFIHC:

· RCM Intelligence

· Claims Management Pro (All-Payer Revenue Cycle Management)

· Dental Claims Management

· Enhanced Insurance Discovery with Demographic Verification

· Eligibility Workflow

5.2 Work Schedule: Will be between the hours of 8:00 am to 4:30 pm. There will be no scheduled work on weekends or

Federal holidays. If there should be any change in normal working hours, this will be coordinate with the COR.

5.3 Performance Evaluation:

5.3.1 Provide on-going uninterrupted support to perform Third-Party Insurance Claims Processing for Medicare, Medicaid, VA and Commercial Payers.

Solicitation No. 75H70722Q00099 Page 9 of 59

5.3.2 Maintenance and Support to provide support and maintenance in case of any issues with data transmission with a completion of no later than 24 hours from the time of the request.

5.3.3 Services to provide on-going uninterrupted support for connectivity to various Revenue Cycle Management services, insurance verification/discovery, perform third-party insurance claims processing for Medicare, Medicaid, VA and Commercial Payers, claims attachments and denial prevention analytics with RCM Intelligence.

5.4 The Contractor will immediately report to the Contracting Officer or COR any information or circumstances that may violate any statute, policy, or procedure.

5.5 Contractor Qualification Requirements:

5.5.1 Certification. No Certification required.

5.5.2 Experience. Should at least have 3 to 5 years of experience.

5.6 Conditions of Contract Services:

5.6.1 The contractor will be subject to character investigation as required by Public Law 101-360, the Indian Health Child Protection and Family Violence Prevention Act prior to performance of a contract by utilizing the US Office of Personnel Management (OPM), Electronic Questionnaire for Investigation Processing (eQIP) system and this will include all fingerprinting procedures and clearances. The contractor will provide all requested information necessary to perform Level I and Level II background checks. The contractor will comply with the requirement to obtain security investigations. The contractor will work with the IHS to ensure that the pre-employment screening process includes the appropriate investigation questionnaires and forms to be completed. All completed forms will be reviewed by the contractor and forwarded to the government personnel. The contractor will be immediately removed from the position (at any time the investigation receives unfavorable adjudication, or, if other unfavorable information that would affect the investigation becomes known.

5.6.2 Criminal History Background Check:

Contractor’s employees whose duties and responsibilities involve regular contact or control over children are subject to a character investigation as required by Public Law 101-630, The Indian Child Protection and Family Violence Act. The minimum standards of character shall ensure that none of the individuals described in this order have been found guilty of, or entered a plea of nolo contendere or guilty to, any felonious offense, or any of two or more misdemeanor offenses, under federal, state, or tribal law involving crimes of violence;

sexual assault, molestation, exploitation, contact or prostitution; crimes against persons; or offenses committed against children. These crimes do not hold a time statue and will be evaluated the same under any Child Care “CNACI” investigation with IHS. IHS will conduct these investigations following award of a contract.

Until the character investigation has been completed and the Contracting Officer notified of the results, the Contractors’ employees must not have unsupervised contact with Indian children. Contractor’s employees are not able to work a scheduled shift until the security check is performed and clearance has been obtained by the appropriate agency. At a minimum, fingerprints are required, and upon clearance of this stage, a contractor’s employee may work a scheduled shift. However, Contractor’s employees are required to complete the detailed background application and the application is to be completed within 30 days once the contractor’s employee has been given physical and logical access. All Contractors’ employees are subject to criminal background check prior to performing services in accordance with Task Order terms and conditions.

The contractor shall ensure that each of their employees complete the Certification of Criminal History and Background Check Packet. The completed forms are to be returned to the COR.

5.6.3 Subpoenas/Testimonies:

Contractors are mandated to cooperate with the appropriate IHS managers when the contractors' employees are subpoenaed or requested by Tribal, State or Federal Parties to provide testimony. As stated in Section 5- 27.3(8)(9) of the Indian Health Manual.

5.7 Challenges to Conflicts:

Solicitation No. 75H70722Q00099 Page 10 of 59

5.7.1 First Priority: Contractor's Agency

5.7.2 Second Priority: COR

5.7.3 Third Priority: CO

5.8 When the Contractor demonstrates impaired judgement, they cannot continue working on the purchase order. The Government reserves the right to remove from the facility any Contractor employee who in the judgment of a licensed healthcare practitioner is impaired.

5.9 APPLICABLE DOCUMENTS: Not Applicable

Solicitation No. 75H70722Q00099 Page 11 of 59

SECTION 6 – QUALITY ASSURANCE SURVEILLANCE PLAN – N/A

SECTION 7 - PACKAGING AND MARKING

7.1 PACKAGING

All deliverables shall be preserved, packaged, and packed in accordance with normal commercial practices to meet the packing requirements of the carrier including which is necessary to prevent deterioration and damages due to the hazards of shipping, handling, and storing.

7.2 MARKING

Each package/container delivered to the address shown in Section 8 entitled "Contracting Officers' Representative Appointment and Authority" and shall be clearly marked as follows:

• Name of Contractor

• Contract Number

• Description of Items Contained Therein

• Consignee's Name and Address

7.3 DELIVERY

All deliverables delivered to the following addresses:

Santa Fe Indian Health Center (SFIHC) Attn: Business Office 1700 Cerrillos Road Santa Fe, NM 87505

(505) 946-9209

SECTION 8 - INSPECTION AND ACCEPTANCE

8.1 INSPECTION AND ACCEPTANCE: All work under this contract is subject to inspection and final acceptance by the Contracting Officer or the duly authorized representative of the government. The COR, as a duly authorized representative of the Contracting Officer, shall assume the responsibilities for monitoring the Contractor's performance, evaluating the quality of services provided by the Contractor and performing final inspection and acceptance of all deliverables and services called for by the contract.

8.2 FEDERAL ACQUISITION REGULATION {48 CFR CHAPTER 1) CLAUSES

FAR Clause No. Title Date

52.246-4 Inspection of Services – Fixed Priced (Aug 1996)

Solicitation No. 75H70722Q00099 Page 12 of 59

SECTION 9 - DELIVERIES OR PERFORMANCE

9.1 PERIOD OF PERFORMANCE: The period of performance is a Base Period of 12 months with four – 12-month Option Periods, unless extended by modification to this contract. The Government may exercise options to extend the period of performance in accordance with FAR Clause 52.217-9 - Option to Extend the Term of the Contract (Oct 2014); upon written notification by the Contracting Officer within 30 days of contract expiration.

9.1.1 Services under this contract shall commence NLT 10 days after all clearances occur.

Base: TBD, 2024 to TBD, 2025 Option Year 1: TBD, 2025 to TBD, 2026 Option Year 2: TBD 2026 to TBD, 2027 Option Year 3: TBD, 2027 to TBD, 2028 Option Year 4: TBD, 2028 to TBD, 2029

9.1.2 Performance must be for the period of TBD, 2024 to TBD, 2025 unless the period changed by written modification to the purchase order in accordance with FAR 52.217-9, Option to Extend the Term of the Contract.

9.1.3 Total contract award must not exceed five years. Based option year renewals on satisfactory services provided availability of funds for the appropriate fiscal year, and existing requirements.

9.2 PLACE OF PERFORMANCE: The contractor must provide a Point of Sale (POS), Clearinghouse and Claims Switching Services non-personal healthcare services to the following Albuquerque Area Indian Health Service Facility:

9.2.1 Santa Fe Indian Health Center (SFIHC)

Attn: Business Office 1700 Cerrillos Road Santa Fe, NM 87505

(505) 946-9209

9.3 Travel to and from the facility/office site are not included in the tour of duty and cannot be invoiced as part of Travel to and from the facility/office site. The hours of business are Monday through Friday, from 8:00 AM to 4:30 PM. The actual hours will be scheduled in advance through the designated COR.

9.4 GOVERNMENT HOLIDAYS: (https://www.federalpay.org/holidays)*

New Year's Day Martin Luther King's Birthday President's Day Memorial Day Juneteenth Day Independence Day Labor Day Columbus Day Veteran's Day Thanksgiving Day Christmas Day

*Any other day specifically declared by the President of the United States to be a national holiday (see www.opm.gov/fedhol).

http://www.opm.gov/fedhol

Solicitation No. 75H70722Q00099 Page 13 of 59

SECTION 10 - CONTRACT ADMINISTRATION

10.1 AUTHORITIES OF GOVERNMENT PERSONNEL: Notwithstanding the Contractor's responsibility for total management during the performance of this Contract, the administration of the Contract will require maximum coordination between the Government and the Contractor. The following individuals will be the Government's points of contact during the performance of this Contract.

10.2 CONTRACTING OFFICER

10.2.1 The IHS Contracting Officer (CO) is the only individual authorized to modify this Contract. The CO responsible for administrative and contractual issues concerning this Contract is:

Patricia Trujillo, (CO) Indian Health Service/Division of Contracts & Grants Management (DCGM) 4101 Indian School Road NE, Suite 225 Albuquerque, NM 87110 Phone: 505-256-6754 Email: Judith.mariano@ihs.gov

Sent all communications pertaining to contractual and/or administrative matters to the address above and to the Contract Specialist administering this Contract.

10.3 CONTRACTING OFFICER'S REPRESENTATIVE (COR)

10.4.1 Travis Snyder, travis.snyder@ihs.gov, (505) 946-9209, is hereby designated as COR for this service. The COR responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The COR does not have the authority to change or alter the order amount, terms and conditions.

10.4.2 Celeste Denipah, celeste.denipah@ihs.gov, (505) 946-9329, is hereby designated as the Alternate COR for this service. The Alternate COR responsibilities will be to help coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Alternate COR does not have the authority to change or alter the order amount, terms and conditions.

10.4.3 The COR and Alternate’s responsibilities will include ensuring contractor accountability. Monitoring the Contractor’s technical progress including the surveillance and assessment of performance and recommending to the CO changes in requirements. Interpreting the PWS. Performing technical evaluations as required.

Perform technical inspection and acceptance as required. Assisting the Contractor in the resolution of technical problems encountered during performance. Perform receiving and processing invoices for payment.

10.4 TECHNICAL MONITORING

(a) Performance of work under this contract must be subject to the technical direction of the COR identified above, or an Alternate COR designated in writing. The term "technical direction" includes, without limitation, direction to the Contractor that directs or redirects the labor effort. Shifts the work between work areas or locations, fills in details and otherwise serves to ensure that task areas outlined in the PWS accomplished satisfactorily.

(b) Technical direction must be within the scope of the specification(s)/work statement. The COR does not have authority to issue technical direction that

(1) Constitutes a change of assignment or additional work outside the specification(s)/ statement of work;

(2) Constitutes a change as defined in the clause entitled "Changes";

(3) In any manner causes an increase or decrease in the contract price, or the time required for contract performance;

(4) Changes any of the terms, conditions, or specification(s)/work statement of the contract;

(5) Interferes with the Contractor's right to perform under the terms and conditions of the contract; or

(6) Directs, supervises or otherwise controls the actions of the Contractor's employees.

(c) Technical direction may be oral or in writing. The COR shall confirm oral direction in writing within five work days, with a copy to the Contracting Officer.

mailto:travis.snyder@ihs.gov mailto:celeste.denipah@ihs.gov

Solicitation No. 75H70722Q00099 Page 14 of 59

(d) The Contractor shall proceed promptly with performance resulting from the technical direction issued by the COR.

If, in the opinion of the Contractor, any direction of the COR, or his designee, falls within the limitations in (b), above, the Contractor shall immediately notify the CO no later than the beginning of the next Government work day.

(e) Failure of the Contractor and the CO to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled "Disputes."

10.5 INVOICE SUBMISSION

10.6.1 The Contractor shall submit invoices per month. Advance payments will not be issued by Finance unless stated herein. Electronically send a complete invoice with all required documentation to https://IPP.gov

* Please do not sent to the CS or Finance Office any other invoice related documents such as deliverables, reports or balance statements). Failure to submit required documents directly to the offices listed above will delay prompt payment of your invoice.

10.6.2 Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule, progress payments, partial payments, deliverables, etc. All information set forth in FAR 32.905(b), Content of Invoices, must be included in all invoices for it to constitute a proper invoice.

10.6.3 Additionally, the Contractor is required to include its Unique Entity Identifier (UEI) which replaces the Data Universal Numbering System (DUNS) number on each invoice.

10.6.4 Credit memos will not be accepted as a form of refund. All refunds are to be submitted via a check addressed to:

Albuquerque Area Indian Health Service Division of Accounts Receivable 4101 Indian School Road NE, Suite 225 Albuquerque, NM 87110

Request for Taxpayer Identification Number and Certification

A form W-9 shall be submitted to the Albuquerque Area Indian Health Service Division of Accounting Services by either of the following:

1. Encrypted Email: ALB_AOAPinvoices@ihs.gov or

2. Secure Fax: (505) 256-6851

Failure to submit the required form W-9 to the office(s) listed above will delay issuance of the IRS 1099 Form.

10.6.5 All information set forth in FAR 32.905(b), Content of Invoices, must be included in all invoices for it to constitute a proper invoice.

FAR 32.905(b), Content of Invoices:

(b) Content of invoices.

(1) A proper invoice must include the following items (except for interim payments on cost reimbursement contracts for services):

(i) Name and address of the contractor.

(ii) Invoice date and invoice number. (Contractors should date invoices as close as possible to the date of mailing or transmission.)

(iii) Contract number or other authorization for supplies delivered or services performed (including order number and line item number).

(iv) Description, quantity, unit of measure, unit price, and extended price of supplies delivered or services performed.

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(v) Shipping and payment terms (e.g., shipment number and date of shipment, discount for prompt payment terms). Bill of lading number and weight of shipment will be shown for shipments on Government bills of lading.

(vi) Name and address of contractor official to whom payment is to be sent (must be the same as that in the contract or in a proper notice of assignment).

(vii) Name (where practicable), title, phone number, and mailing address of person to notify in the event of a defective invoice.

(viii) Taxpayer Identification Number (TIN). The contractor must include its TIN on the invoice only if required by agency procedures. (See 4.9 TIN requirements.)

(ix) Electronic funds transfer (EFT) banking information.

(A) The contractor must include EFT banking information on the invoice only if required by agency procedures.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the contractor must have submitted correct EFT banking information in accordance with the applicable solicitation provision (e.g., 52.232-38, Submission of Electronic Funds Transfer Information with Offer), contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer-Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(x) Any other information or documentation required by the contract (e.g., evidence of shipment).

(2) An interim payment request under a cost-reimbursement contract for services constitutes a proper invoice for purposes of this subsection if it includes all of the information required by the contract.

(3) If the invoice does not comply with these requirements, the designated billing office must return it within

7 days after receipt (3 days on contracts for meat, meat food products, or fish; 5 days on contracts for perishable agricultural commodities, dairy products, edible fats or oils, and food products prepared from edible fats or oils), with the reasons why it is not a proper invoice. If such notice is not timely, then the designated billing office must adjust the due date for the purpose of determining an interest penalty, if any.

(4) Per the Accounts Payable office, failure to submit invoices to the IPP Website can result in delayed payment of your invoice.

10.6.6 In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as "Small Business."

10.6.7 Additionally, in accordance with OMB Memorandum, M-12-16, fill prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors. Consistent with OMS Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation.

In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

10.6.8 In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - Central Contractor Registration.

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10.5.9 HHSAR 352.232-71 - ELECTRONIC SUBMISSION OF INVOICE PAYMENT REQUESTS (FEB 2022)

(a) Definitions. As used in this clause— Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements identified in FAR 32.905(b), “Content of Invoices” and the applicable Payment clause included in this contract.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system.

Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

(c) The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with HHS procedures. Unless otherwise agreed to by the contracting officer per HHSAR 352.232-71(c), the use of IPP shall take precedence over previously established invoicing procedures.

(d) If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer's written authorization with each payment request. Unless otherwise agreed to by the contracting officer per HHSAR 352.232-71(c), the use of IPP shall take precedence over previously established invoicing procedures.

10.6 GOVERNMENT FURNISHED PROPERTY:

10.6.1 The Government will provide patient information as need during the transmission of the documents.

10.7 CONTRACTOR FURNISHED PROPERTY

Not Applicable

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SECTION 11 - SPECIAL CONTRACT REQUIREMENTS

11.1 CONTRACTOR PERFORMANCE EVALUATION REPORT

11.1.1 During the life of this contract, the contractor's performance will be evaluated on an interim and final basis pursuant to FAR Subpart 42.15. Evaluation will become part of the contract file and will be used as past performance information in evaluating the Contractor's, and any significant subcontractors or affiliates, past performance on future contracts.

11.1.2 Contractor Performance Assessment Report System (CPARS) is an on-line reporting system https://www.cpars.gov/. The Contractor Performance Report is completed by the COR electronically and sent to the Contractor for review and approval at the end of each performance period as an interim report and at the end of the contract performance as a final report. After review by the Contracting Officer, the report becomes a permanent record of the Contractor's past performance.

11.2 IDENTIFICATION AND DISPOSITION OF DATA, REPORTS, AND OTHER DELIVERABLES

11.2.1 The Contractor is not permitted to make use of any data derived from these services for any purpose not directly related to and/or authorized by the Albuquerque Area Indian Health Service. All patient data/information are subject to the Privacy Act and the Confidentiality of Information Clause (HHSAR 352.224- 70)

11.2.2 Upon completion/termination of the contract, all information, statistical or analytical material or reports and other data generated by the Contractor shall become the property of Acoma-Canoncito-Laguna, Acoma, New Mexico.

11.2.3 The vendor is prohibited from gathering data, statistics, or use of material for publication and/or research for its own benefits. Dissemination of Information, prior approval shall be obtained from the Government Contracting Officer for the release or dissemination of information related to this contract.

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SECTION 12 - FEDERAL ACQUISITION REGULATIONS (FAR) 48 CFR CHAPTER CLAUSES

12.1 CLAUSES INCORPORATED BY REFERENCE - FAR 52.252-2 (FEB 1998)

This Contract incorporates FAR provisions/clauses referenced, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this website address: FAR - https://www.acguisition.gov/far/index.html.

FAR Clause Title Date

52.203-3 Gratuities Apr 1984

52.203-5 Covenant against Contingent Fees May 2014

52.203-6 Restrictions on Subcontractor Sales to the Government Jun 2020

52.203-7 Anti-Kickback Procedures Jun 2020

52.203-8 Cancellation, Rescission, and Recovery of Funds for Illegal or Improper Activity May 2014

52.203-10 Price or Fee Adjustment for Illegal or Improper Activity May 2014

52.204-7 System for Award Management Oct 2018

52.204-9 Personal identity Verification of Contractor Personnel Jan 2011

52.229-3 Federal, State, and Local Taxes Feb 2013

52.232-11 Extras Apr 1984

52.232-40 Providing Accelerated Payments to Small Business Subcontractors Mar 2023

52.233-4 Applicable Law for Breach of Contract Claim Oct 2004

52.237-3 Continuity of Services Jan 1991

52.242-13 Bankruptcy Jul 1995

52.249-8 Default (Fixed-Price Supply and Service) Apr 1984

52.253-1 Computer Generated Forms Jan 1991

Following Clauses in Full Text:

12.3 52.212-4 - CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2023)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act ( 31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

https://www.acguisition.gov/far/index.html http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 https://www.acquisition.gov/far/part-52#FAR_52_233_1

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(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice. (1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include-

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer-Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act ( 31 U.S.C.3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment - (1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act ( 31 U.S.C.3903) and prompt payment regulations at 5 CFR Part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

https://www.acquisition.gov/far/part-52#FAR_52_202_1 https://www.acquisition.gov/far/part-52#FAR_52_232_33 https://www.acquisition.gov/far/part-52#FAR_52_232_34 http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 https://www.acquisition.gov/far/part-52#FAR_52_212_5

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(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall-

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the-

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation…