VA259-17-R-0100-A00006012.docx

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 19 (NCO19)

4100 E. MISSISSIPPI AVE., SUITE 900

GLENDALE, COLORADO 80246-3055

Date: June 23, 2017

VISN 19 Home Oxygen VA259-17-R-0100

Clarification Question #9 to Responses Submitted

Original Question: Attachment 1, Oklahoma City VA Health Care System, Line Item #0015, Stationary Liquid Oxygen Contents. “Listed as EACH. All other VA Medical Centers and Health Care Systems quantified as LBS? Please advise.”

Original Response: “Initial unit was lb. It should have been lbs (pounds). However after review of the CLIN, Line Item #0015 the unit has been changed to either cylinder (CY) or refills (each). See revised Line Items/ Price Schedule.”

1. New Clarification Question: Per the updated pricing document for Oklahoma City, the total annual quantities only reflect 24 pounds. May this total be corrected, as a stationary liquid oxygen system may hold up to 100 pounds?

NCO-19 Response: Stationary Liquid Oxygen Contents have been removed from the Oklahoma City Line Items/Price Schedule.

Clarification Questions #24 and #140:

24. Original Question: Note Eastern Colorado shows 7760 oxygen patens with 5 having portable systems and those 5 using 141,000 lb contents while Salt Lake shows 4500 oxygen patients with 4000 portable systems and using 100 lb of contents. Do we complete both the line item pricing pages, Attachment1, and the pricing pages in the body of the RFP or just the line item pricing pages for those centers we wish to submit?

Original Response: “Yes, both the item pricing pages and the pricing pages in section b.4 of the RFP should be complete. However, only complete the schedule(s) for the locations you are submitting a proposal for. For example, if you are not offering on Denver, leave it blank.”

140. Original Question: Beginning on page 6, there is B.4 PRICE/COST SCHEDULE, and all that is requested is the yearly amount per station (base year and each option year). Are you asking contractors to fill out Section B.4 PRICE/COST SCHEDULE in addition to the Pricing attachments for each station? Or do you only want contractors to provide our pricing on the pricing attachments relating to each station?

Original Response: “Yes fill out section B.4 PRICE/COST SCHEDULE in addition to the pricing attachments for all stations you wish to submit a proposal for. Both price schedules need to be completed for all stations your company wishes to propose to.”

1. New Clarification Question: Per the updated PWS dated 6/9/2017, Section B.4 was not included. Will the proposals due on 7/10/2017 need to include Section B.4 from the original solicitation released?

NCO-19 Response: Section B.4 was inadvertently removed. However this amendment has added section B.4 PRICE/COST SCHEDULE. Proposals due on 7/10/2017 will need to complete both B.4 PRICE/COST SCHEDULE and the associated pricing attachments.

Clarification Questions #15 and #113:

15. Original Question: My company currently contracts for provision of medical oxygen and durable medical equipment for VA patients throughout VISN 15. We are interested in submitting a proposal for medical oxygen service in VISN 19. One of our initial questions regarding requirements defined in your recent solicitation (VA259-17-R-0100) is related to the role of a respiratory therapist during the potential switchover to a new contractor. Is a respiratory therapist required during the initial switchover, or can the initial visit by a new contractor be accomplished by a certified delivery technician?

Original Response: “Based on the scenario you described it will depend on the type of equipment. However, the initial switchover must accomplished by a licensed Clinician (RRT, RN, CRT)”

113. Original Question: We are assuming that an RRT, CRT or RN will not be required to visit every patient transferred to the contractor at the time of transition – is that correct?

Page 23 17 Service Transition

Original Response: “Correct, a RRT, CRT, or RN will not be required to visit every patient transferred to the contactor at the time of transition. Only a new set ups or a change in the prescription will require a certified RRT, CRT, or RN visit, Section 21a of the PWS.”

1. New Clarification Question: The responses provided for questions 15 and 113 may be interpreted as contradictory. May you please clarify if a Clinician will be required to complete the transition of an existing O2 patient?

NCO-19 Response: The response to question 15 should read as follows, an RRT, CRT, or RN will not be required to visit every patient currently under the current contract. Only a new set ups or a change in the prescription will require a certified RRT, CRT, or RN visit. Refer to Section 21a of the PWS and Section 17b Service Transition (Phase In/Phase Out) of the PWS, “Any requirement for an RRT, CRT, or RN visit shall be coordinated between the Contractor and COR.”

Clarification Questions #50, #118 and #134:

50. Original Question: Specific Tasks “a. Oxygen therapy delivery system including but not limited to home oxygen and home respiratory equipment. Initial setup(s) for home oxygen at the patient’s residence shall be performed by a certified respiratory therapist (CRT), registered respiratory therapist (RRT) or a Registered Nurse (RN), which is licensed in accordance with the governing standards of the location where the services are to be provided.” Would the Government allow a qualified technician to provide the initial setup of home respiratory equipment, and a follow-up CRT/RRT/RN visit be completed within a determined amount of time, i.e. within 4 or 5 days of setup?

Original Response: “No, a technician may not provide an initial set up for oxygen.”

118. Original Question: May initial equipment setups be done by a service technician with a follow up by the RT for the education within 24 hours of setup (or within a set amount of hours agreeable with the VA and the contractor)? Page 31 21. Specific Tasks

Original Response: “Yes, a qualified technician may provide an initial set up for oxygen only set up however nothing else. A follow up will need to be completed within 72 hours by a CRT/RRT/RN.”

134. Original Question: Page 31, Section 21 – Specific Tasks – This section requires that an RT, CRT, or RN perform all initial setups for home oxygen. This is not a requirement for Medicare, Medicaid, commercial insurance, or State Respiratory requirements. We can bid it this way, but the VA could save some significant dollars if they removed this requirement. Could this requirement go away? If not, could the initial set up be performed by a trained technician, and then a follow up visit (in person, by phone, or telemedicine) be performed within the first 24-48 hours after set up by the CRT/RRT/RN?

Original Response: “No, the initial set up must be conducted by a CRT/RRT/RN and the follow up will need to be completed within 72 hours by a CRT/RRT/RN in person.”

New Clarification Question: The responses provided for questions 50, 118 and 134 may be interpreted as contradictory. May you please clarify if a Qualified Technician may complete the initial Oxygen setup of a patient, followed by Clinician visit within 72 hours of the initial setup?

NCO-19 Response: A technician may not provide an initial set up for oxygen. The response to 118 should read as follows, the initial set up must be conducted by a CRT/RRT/RN and the follow up will need to be completed within 72 hours by a CRT/RRT/RN in person.

New Clarification Question: If the initial oxygen setup must be setup by a CRT/RRT/RN is it required for the CRT/RRT/RN to also conduct a 72 hour follow-up visit?

NCO-19 Response: The initial set up must be conducted by a CRT/RRT/RN and the follow up will need to be completed within 72 hours by a CRT/RRT/RN in person.

Clarification Question #58 and #63:

58. Original Question: Patient Travel The VA facility(ies) will be responsible for approving the travel, notifying the contractor of the travel dates, and what equipment are approved, no later than five (5) calendar days before travel date.” Is it correct to assume the Government will provide notification to the contractor via written order, no later than five (5) calendar days before travel date?

Original Response: No, paragraph 26 of the PWS has been revised please review as the process has been updated, “The Veteran will contact the Contractor to initiate the travel request. The Contractor shall be responsible for arranging and coordinating all home oxygen for Veterans who travel both within and outside their respective contracted jurisdiction. The Contractor shall notify the VA facility(ies) concerning the travel request no later than five (5) calendar days before travel date. The VA facility(ies) will be responsible for approving the travel and requested equipment and will respond to the Contractor’s notification within 2 (two) calendar days.” Please review the paragraph.

63. Original Question: “Authorized Veteran Travel Areas: The Contractor shall be responsible for arranging and coordinating all U.S. States and U.S. territories.” For travel outside a contractor’s coverage area, arrangements may be delayed, if a sub-contractor is required to be obtained. Is it the Government’s intent for the contractor to have facilities available throughout the United States and US territories?

Original Response: No, however the Contractor should have the capability and resources to coordinate oxygen services for the veterans who request travel services throughout the United States and US territories. No veteran shall go without oxygen due to travel.

1. New Clarification Question: May you please clarify if travel throughout the United States and US territories should be interpreted to include travel for the unincorporated US territories such as Puerto Rico, Guam, Northern Mariana Islands, US Virgin Islands and American Samoa?

NCO-19 Response: Travel does not include the unincorporated US territories such as Puerto Rico, Guam, Northern Mariana Islands, US Virgin Islands and America Samoa.

2. New Clarification Question: If interpretation should include unincorporated US territories, may you clarify if travel to these areas would only include services of a portable concentrator?

NCO-19 Response: Travel does not include the unincorporated US territories such as Puerto Rico, Guam, Northern Mariana Islands, US Virgin Islands and America Samoa.

Follow-up Questions to Revised Performance Work Statement:

13) Place of performance: “The reserve supply shall accommodate home oxygen patients who are either being discharged from the hospital or visiting (appointments, etc.) and require a supply of oxygen to reach their home. Adequate inventory levels shall be maintained by the Contractor, as determined by the facility COR. This reserve supply shall be provided at no additional cost to the Government. The area of service shall be all patients serviced by VISN 19, regardless of where patient resides.”

1. Clarification Question: Is the reserve supply only for patients who are already established within the VISN 19 home oxygen program?

NCO 19 Response: Yes, the reserve supply is for patients who are participating in the VISN 19 home oxygen program and who are VA patients discharged from the hospital or visiting (appointments, etc.) and require a supply of oxygen to reach their home.

Past Performance:

The previous due date for Past Performance Questionnaires to be submitted was 4/10/2017. For contractors who had questionnaires submitted on their behalf, will another past performance questionnaire request be required? If so, may you please advise on a new due date for the questionnaires to be submitted to the Government?

NCO-19 Response: No additional past performance questionnaires need to be sent if they were previously submitted. However, you should include the previous submitted completed questionnaires as part of your revised proposal.

Work Load Data Follow-up Questions:

a. Cheyenne:

Per the PWS, Cheyenne reflects an estimated 1700 patients per month, equating to an estimated 20,400 per year.

1. Clarification Question: Line items 0001 through 0003AA do not appear to correlate to the estimated quantities provided in the PWS. May the Government please clarify the quantities provided within the CLINs?

NCO-19 Response: The quantities of Line Items 0001 through 0003AA are accurate. Not all patients utilize a POC.

2. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO 19 Response: CLINs 0001 through 0003AA have been revised to separate maintenance.

3. Clarification Question: CLIN 0016 states “Dual Lumen Conserver to include travel shipping fee”. May the Government please clarify its intent for the use of this CLIN, as a Dual Lumen Conserver is utilized with a portable gaseous system? Is it the Government’s intent for this to be shipped to a patient when traveling?

NCO-19 Response: CLIN 016 Dual Lumen Conserver is for home use, the line item has been revised, all travel and shipping verbiage has been removed.

4. Clarification Question: May the Government please clarify its intent for CLINs 0017 through 0017AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLINs 0017 through 0017AB have been revised to separate maintenance. Line Item 0017 is Contractor owned.

5. Clarification Question: May the Government please confirm the quantities listed in CLINs 0013 through 0014AA, as the quantities for the cylinder refills do not appear to correlate with the quantities estimated for the portable gaseous systems?

NCO-19 Response: Quantities listed for CLINS 0013 through 0014AA are correct please refer to the size of the cylinder in the description of the line item.

b. Eastern Colorado:

Per the PWS, Eastern Colorado reflects an estimated 7000 patients per month, equating to an estimated 84,000 per year.

1. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO-19 Response: CLINs 0001 through 0003AA have been revised to separate maintenance.

2. Clarification Question: May the Government please clarify the quantities for CLIN 0007, as the amount reflected appears to be an over-inflated quantity?

NCO-19 Response: Estimated quantity for CLIN 0007 have been verified and are based on past usage history

3. Clarification Question: May the Government please clarify its intent for CLINs 0009 and 0009AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLINS 0009 and 0009AB will be used based on a veteran’s prescription. According to the description in CLIN 0009 this equipment is contractor owned.

4. Clarification Question: May the Government please confirm the quantities listed for CLIN 0016, as it appears this does not correlate with the estimated 5 to 30 cylinders per patient listed in the Q/A response question #137. Per the quantities listed, this would average 50 cylinders per patient every month.

NCO-19 Response: CLIN 0016 is based on past usage. This can fluctuate depending on the veteran populations various prescriptions.

5. Clarification Question: May the Government please confirm the quantities listed for CLIN 0016AA, as it appears this does not correlate with the estimated 5 to 30 cylinders per patient listed in the Q/A response question #137. Per the quantities listed, this would average 42 cylinders per patient every month.

NCO-19 Response: CLIN 0016AA is based on past usage. This can fluctuate depending on the veteran populations various prescriptions.

c. Eastern Oklahoma:

Per the PWS, Eastern Oklahoma reflects an estimated 1200 patients per month, equating to an estimated 14,400 per year.

1. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO-19 Response: CLINs 0001 through 0003AA have been revised to separate preventative maintenance.

2. Clarification Question: May the Government please clarify when CLIN 0004AD would be utilized in lieu of CLINs 0004 or 0004AA?

NCO-19 Response: Line items 0004, 0004AA, and 0004AD have been revised. Use of these line items will depend on a veteran’s prescription.

3. Clarification Question: May the Government please clarify the quantities listed in CLINs 0005, 0005AA, 0014 and 0014AA, as the quantities listed appear to be under estimated.

NCO-19 Response: The quantities listed in CLINs 0005, 0005AA, 0014, and 0014AA have been revised and verified.

4. Clarification Question: May the Government please clarify the quantities listed in CLIN 0007, as the quantities listed appear to be under estimated. A reservoir may hold up to 100 LB of LOX.

NCO-19 Response: The quantities listed in CLINs 0007 have been revised and verified.

5. Clarification Question: May the Government please clarify its intent for CLINs 0009 and 0009AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLINS 0009 and 0009AB will be used based on a veteran’s prescription. According to the description in CLIN 0009 this equipment is contractor owned.

d. Grand Junction:

Per the PWS, Eastern Oklahoma reflects an estimated 1700 patients per month, equating to an estimated 20,400 per year.

1. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO-19 Response: CLINs 0001 through 0003AA have been revised to separate maintenance.

2. Clarification Question: May the Government please clarify when CLIN 0004AC would be utilized in lieu of CLINs 0004 or 0004AA?

NCO-19 Response: Some veterans travel more than ninety days continuously, this CLIN would be used in the instance that maintenance is required during travel.

3. Clarification Question: May the Government please confirm the quantities listed for CLIN 0015, as it appears this does not correlate with the estimated 5 to 30 cylinders per patient listed in the Q/A response question #137. Per the quantities listed, this would average 51 cylinders per patient every month.

NCO-19 Response: CLIN 0015 has been verified and is correct. These estimates quantity is based on historical usage.

4. Clarification Question: May the Government please confirm the quantities listed for CLIN 0016, as does not correlate with the estimated 5 to 30 cylinders per patient listed in the Q/A response question #137. Per the quantities listed, this would average 55 cylinders per patient every month.

NCO-19 Response: CLIN 0016 has been verified and is correct. These estimates quantity are based on historical usage.

5. Clarification Question: May the Government please clarify its intent for CLINs 0009 and 0009AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLINS 0009 and 0009AB will be used based on a veteran’s prescription. According to the description in CLIN 0009 this equipment is contractor owned.

e. Sheridan:

Per the PWS, Eastern Oklahoma reflects an estimated 1040 patients per month, equating to an estimated 12,480 per year.

1. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO-19 Response: CLINs 0001 through 0003AA have been revised to separate maintenance.

2. Clarification Question: May the Government please confirm the quantities listed in CLINs 0010 and 0010AA, as they are under estimated, as compared to CLINs 0005.

NCO-19 Response: CLIN 0010 and 0010AA have been verified. These estimated quantities are based on historical usage.

f. Oklahoma City:

Per the PWS, Eastern Oklahoma reflects an estimated 1001 patients per month, equating to an estimated 12,012 per year.

1. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO-19 Response: CLINs 0001 through 0003AA have been revised to separate maintenance.

2. Clarification Question: May the Government please clarify the quantities listed in the CLINs, as they do not appear to correlate with the estimated number of patients provided?

NCO-19 Response: Line items have been revised and verified for accuracy.

3. Clarification Question: May the Government please clarify when CLIN 0004AC would be utilized in lieu of CLINs 0004 or 0004AA?

NCO-19 Response: CLIN 0004AC has been removed.

4. Clarification Question: May the Government please confirm the quantities listed for CLINs 0011 and 0005, as this indicates each patient is estimated to obtain 140+ cylinders per month?

NCO-19 Response: CLIN 0011 Portable Gaseous Contents (refill cylinder E, D, C) is now CLIN 0012. Both 0012 and 0005 have been updated and verified for accuracy.

5. Clarification Question: May the Government please confirm the quantities listed for CLINs 0011AA and 0005AA, as this appears to indicate each patient is estimated to receive 1 cylinder refill per month?

NCO-19 Response: Portable Gaseous Contents (refill cylinder, M6) is now CLIN 0012AA. Both 0012AA and 0005AA have been updated and verified for accuracy.

6. Clarification Question: May the Government please clarify its intent for CLINs 0006 through 0006AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLINS 0006 through 0006AB will be used based on a veteran’s prescription. According to the description in CLIN 0006 this equipment is contractor owned.

g. Salt Lake City:

Per the PWS, Salt Lake City reflects an estimated 4500 patients per month, equating to an estimated 54,000 per year.

1. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO-19 Response: CLINs 0001 through 0003AA have been revised to separate maintenance.

2. Clarification Question: May the Government please clarify when CLIN 0004AC would be utilized in lieu of CLINs 0004 or 0004AA?

NCO-19 Response: Use of CLIN 0004 or 0004AA would depend on a veteran’s prescription. CLIN 0004AC is for maintenance.

3. Clarification Question: May the Government please clarify the quantities listed in CLIN 0005 as they appear to be over-inflated?

NCO-19 Response: CLIN 0005 has been revised for accuracy.

4. Clarification Question: May the Government please clarify the quantities for CLIN 0005AB, as it would indicate only 1 cylinder refill per patient, as per CLIN 0005?

NCO-19 Response: CLIN 005AB has been reviewed and verified for accuracy.

5. Clarification Question: May the Government please clarify the quantities for CLIN 0005AC, as it would indicate only 1 cylinder refill per patient, as per CLIN 0005AA?

NCO-19 Response: CLIN 005AC has been reviewed and verified for accuracy.

6. Clarification Question: May the Government please clarify its intent for CLIN 0005AA, as a M6 cylinder is used for portability, where as an H cylinder is typically utilized as a stationary cylinder for cluster headaches or back-up purposes?

NCO-19 Response: CLIN 0005AA has been revised to read MM tanks versus M tanks.

7. Clarification Question: May the Government please clarify its intent for CLINs 0009 and 0009AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLINS 0009 and 0009AB will be used based on a veteran’s prescription. According to the description in CLIN 0009 this equipment is contractor owned.

h. Montana:

Per the PWS, Montana reflects an estimated 2300 patients per month, equating to an estimated 27,600 per year.

1. Clarification Question: May the Government please clarify its intent for CLINs 0001 through 0003AA, as it is unclear if the CLINs would reflect the monthly rental, initial setup only and/or the maintenance visits required every 90 days?

NCO-19 Response: CLINs 0001 through 0003AA have been revised to separate maintenance.

2. Clarification Question: May the Government please clarify its intent for CLIN 0004AA, as a M6 cylinder is used for portability, where as an H/J cylinder is typically utilized as a stationary cylinder for cluster headaches or back-up purposes?

NCO-19 Response: CLIN 0004AA left off the other tank sizes as well (The line item is revised to read M6/B, C, D and E). We have not necessarily prescribed H/J tanks for cluster headaches. We have been using for veterans living off the grid who do not have power, or frequent power outages.

3. Clarification Question: May the Government please clarify its intent for CLINs 0005 and 0005AA, as a LOX system does not require equipment maintenance?

NCO-19 Response: CLIN 0005AA covers the maintenance of the portable unit, and charges for refill of LOX system.

4. Clarification Question: May the Government please clarify its intent for CLINs 0007 through 0007AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLIN 0007 is for initial setup. CLIN 0007AA is to ensure maintenance is performed on contractor owned ventilator. CLIN 0007AB is to ensure Vendor delivers/swaps out ventilator consumable items purchased by VA for veteran.

5. Clarification Question: May the Government please clarify its intent for CLINs 0017 through 0017AB, as the descriptions do not provide clarity on when the CLINs are to be utilized, whether the initial setup or monthly rentals of the Contractor Owned or Government Owned equipment?

NCO-19 Response: CLIN 0017 is for contractor supplied equipment. CLIN 0017 is for initial setup. CLIN 0017AA is for monthly rental/maintenance of equipment. CLIN 0017AB is for when VA needs the contractor to deliver consumables purchased by the VA in support of Home Fill System.

Additional Questions:

111.QUESTION: Are contractors required to have facilities in place within the VISN prior to award? Page 18 Scope. “Contractor’s facility(ies) may be inspected by the VA prior to the contract award.”

ANSWER: Yes, for continuity purposes, these facilities should be in place prior to contract award.

In regards to the answer to Q 111, if we understand correctly, no one will be awarded unless they currently do business in the VISN 19 servicing states and have a location? If this is an accurate understanding, then an RFP should not be submitted unless we currently have a location within the geographically VISN 19 area?

NCO-19 Response: For continuity purposes potential offerors should have facilities in the VISN 19 geographic area prior to contract award.

113.QUESTION: We are assuming that an RRT, CRT or RN will not be required to visit every patient transferred to the contractor at the time of transition – is that correct?

17 Service Transition

ANSWER: Correct, a RRT, CRT, or RN will not be required to visit every patient transferred to the contactor at the time of transition. Only a new set ups or a change in the prescription will require a certified RRT, CRT, or RN visit, Section 21a of the PWS.

15.QUESTION: My company currently contracts for provision of medical oxygen and durable medical equipment for VA patients throughout VISN 15. We are interested in submitting a proposal for medical oxygen service in VISN 19. One of our initial questions regarding requirements defined in your recent solicitation (VA259-17-R-0100) is related to the role of a respiratory therapist during the potential switchover to a new contractor. Is a respiratory therapist required during the initial switchover, or can the initial visit by a new contractor be accomplished by a certified delivery technician?

ANSWER: Based on the scenario you described it will depend on the type of equipment. However, the initial switchover must accomplished by a licensed Clinician (RRT, RN, CRT)

134.QUESTION: Page 31, Section 21 – Specific Tasks – This section requires that an RT, CRT, or RN perform all initial setups for home oxygen. This is not a requirement for Medicare, Medicaid, commercial insurance, or State Respiratory requirements. We can bid it this way, but the VA could save some significant dollars if they removed this requirement. Could this requirement go away? If not, could the initial set up be performed by a trained technician, and then a follow up visit (in person, by phone, or telemedicine) be performed within the first 24-48 hours after set up by the CRT/RRT/RN?

ANSWER: No, the initial set up must be conducted by a CRT/RRT/RN and the follow-up will need to be completed within 72 hours by a CRT/RRT/RN in person.

Please provide clarification to Q 113, 15 and 134. They all seem to be asking the same thing but there are different answers.

NCO-19 Response: The response to question 15 should read as follows, an RRT, CRT, or RN will not be required to visit every patient currently under the current contract. Only a new set ups or a change in the prescription will require a certified RRT, CRT, or RN visit. Refer to Section 21a of the PWS and Section 17b Service Transition (Phase In/Phase Out) of the PWS, “Any requirement for an RRT, CRT, or RN visit shall be coordinated between the Contractor and COR.”

118.QUESTION: May initial equipment setups be done by a service technician with a follow up by the RT for the education within 24 hours of setup (or within a set amount of hours agreeable with the VA and the contractor)? Page 31 21. Specific Tasks

ANSWER: Yes, a qualified technician may provide an initial set up for oxygen only set up however nothing else. A follow up will need to be completed within 72 hours by a CRT/RRT/RN.

Initial

50.QUESTION: Specific Tasks “a. Oxygen therapy delivery system including but not limited to home oxygen and home respiratory equipment. Initial setup(s) for home oxygen at the patient’s residence shall be performed by a certified respiratory therapist (CRT), registered respiratory therapist (RRT) or a Registered Nurse (RN), which is licensed in accordance with the governing standards of the location where the services are to be provided.” Would the Government allow a qualified technician to provide the initial setup of home respiratory equipment, and a follow-up CRT/RRT/RN visit be completed within a determined amount of time, i.e. within 4 or 5 days of setup?

ANSWER: No, a technician may not provide an initial set up for oxygen.

Please provide clarification to Q 118 and 50. They seem to be asking the same thing but there are different answers.

NCO-19 Response: A technician may not provide an initial set up for oxygen. The response to 118 should read as follows, the initial set up must be conducted by a CRT/RRT/RN and the follow up will need to be completed within 72 hours by a CRT/RRT/RN in person.

image10.png image1.png