VA791-16-R-0086-A00019001.docx
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- Community Care Network (CCN)
- Solicitation number
- VA79116R0086
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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
BY
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) A00019 See Block 16c.
Department of Veterans Affairs Commodities & Services Acquisition Svc (003B6E) 555 Corporate Circle Golden
CO
80401-5621 Department of Veterans Affairs Commodities & Services Acquisition Svc (003B6E) 555 Corporate Circle Golden
CO
80401-5621 To all Offerors/Bidders
VA791-16-R-0086
01-09-2018
X X X The purpose of this amendment is to provide an update on the status of the Community Care Network Acquisition.
VA has completed evaluations for CCN Region 4. No award will be made under this solicitation for Region 4, and the Region 4 competition will be cancelled. Requirements for Region 4, as noted below, are deleted.
Regions 1, 2, and 3 are unaffected at this time and the VA continues the evaluations for those Regions.
The VA may change its requirements for Region 4 and thereafter anticipates a new acquisition strategy to be executed under a new solicitation. See attached pages for further details of all sections deleted from this request for proposals.
David F Little Contracting Officer
CONTINUATION PAGE
Summary of Changes:
The following terms and conditions are deleted:
1. Section A.2 paragraph 4, Region 4 column is deleted in its entirety:
Region 4
Texas
New Mexico
Arizona
California
Nevada
Utah
Colorado
Wyoming
Idaho
Oregon
Washington
Montana
Alaska
Hawaii
Northern Mariana Islands
Guam
American Samoa
2. Section A.2 (OPTIONAL) CLIN XX12AC Region 4 table is deleted in its entirety:
Region 4:
| Tier |
| Number of unique Approved Referrals for a period of performance |
| One (1) |
| 0 – 331,400 |
| Two (2) |
| 331,401 – 773,300 |
| Three (3) |
| 773,301 – 1,215,200 |
| Four (4) |
| 1,215,201 – 1,657,000 |
3.
Page 1 of
4. Section A.2.4 Pricing Schedule Region 4 – TX, NM, AZ, CA, NV, UT, CO, WY, ID, OR, WA,MT, AK, HI, Northern Mariana Islands, Guam, America Samoa is deleted in its entirety:
| CLIN |
| DESCRIPTION |
| UNIT |
| BASE |
| OPTION I |
| OPTION II |
| OPTION III |
| OPTION IV |
| OPTION V |
| OPTION VI |
| OPTION VII |
| 4001 |
| Healthcare Services |
| Each |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| 4002 |
| Reimbursement for Highly Rural Care Areas |
| Each |
| Up to ___% Medicare |
| Up to ___% Medicare |
| Up to ___% Medicare |
| Up to ___% Medicare |
| Up to ___% Medicare |
| Up to ___% Medicare |
| Up to ___% Medicare |
| Up to ___% Medicare |
| 4003 |
| Durable Medical Equipment |
| Each |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| 4004 |
| Home Health Care (Skilled and Unskilled) |
| 4004AA |
| Skilled Home Health |
| Each |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| Up to 100% Medicare |
| 4004AB |
| Unskilled Home Health |
| Each |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| 4005 |
| Seasonal Influenza Vaccination |
| Each |
| $_____ |
| $_____ |
| $_____ |
| $_____ |
| $_____ |
| $_____ |
| $_____ |
| $_____ |
| 4006 |
| Non-CMS Medical and Surgical Services, VA Fee Schedule |
| Each |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| Up to VA Fee Schedule |
| 4007 |
| Non-CMS, Non-VA Fee Schedule Medical and Surgical Services |
| Each |
| Pursuant to regulation |
| Pursuant to regulation |
| Pursuant to regulation |
| Pursuant to regulation |
| Pursuant to regulation |
| Pursuant to regulation |
| Pursuant to regulation |
| Pursuant to regulation |
| 4008 |
| Home Infusion Therapy |
| Each |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| See CLIN 4001, 4006, or 4007 as applicable in accordance with Section A.2, paragraph 8. |
| 4009 |
| Pharmacy: Urgent and Emergent Prescriptions pricing based on Average Wholesale Price (AWP) |
| 4009AA |
| Brand Name Medications |
| Percent |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| 4009AB |
| Generic Medications |
| Percent |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| Up to % _____AWP |
| 4009AC |
| Dispensing Fee |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4010 |
| Dental Services |
| Each |
| Negotiated rates per ADA CDT code |
| Negotiated rates per ADA CDT code |
| Negotiated rates per ADA CDT code |
| Negotiated rates per ADA CDT code |
| Negotiated rates per ADA CDT code |
| Negotiated rates per ADA CDT code |
| Negotiated rates per ADA CDT code |
| Negotiated rates per ADA CDT code |
| 4011 |
| Administrative Fees |
| 4011AA |
| Healthcare Services: Administrative Services Per Member Per Month (PMPM) |
| Each Active Veteran 0-35,000 |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each Active Veteran 35,001-75,000 |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each Active Veteran 75,001+ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4011AB |
| Dental: Administrative Services Per Member Per Month (PMPM) |
| Each Active Veteran 0-7,500 |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each Active Veterans 7,501-15,000 |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each Active Veteran 15,001+ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4011AC |
| Pharmacy Benefits Management: Administrative Services Fee: Per Member Per Month (PMPM) |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4012 |
| (Optional) Appointment Scheduling and Comprehensive Care Coordination |
| 4012AA |
| Optional: Implementation for Appointment Scheduling and Comprehensive Care Coordination, VA Facility |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4012AB |
| Optional: Implementation for Appointment Scheduling and Comprehensive Care Coordination, Contractor’s Site |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4012AC |
| Optional: Appointment Scheduling and Comprehensive Care Coordination Services |
| Per Month Tier 1 |
(0 – 331,400 unique Approved Referrals)
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
Per Month Tier 2 (331,401 – 773,300 unique Approved Referrals)
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
Per Month Tier 3 (773,301 – 1,215,200 unique Approved Referrals)
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
Per Month Tier 4 (1,215,201 – 1,657,000 unique Approved Referrals)
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
Per Month Tier 5 (1,657,001 + unique Approved Referrals)
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4013 |
| (Optional) Care Coordination Follow-up |
| 4013AA |
| Optional: Implementation for Care Coordination Follow-up |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4013AB |
| Optional: Care Coordination Follow-up per Lot 50 cases |
| Each |
(0-35,000 unique Approved Referrals or 700 Lots)
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
Each (35,001-75,000 unique Approved Referrals or 800 Lots)
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| Each (75,001+ unique Approved Referrals or 1500+ Lots) |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| $______ Per Lot 50 |
| 4014 |
| (Optional) Comprehensive Case Management |
| 4014AA |
| Optional: Implementation for Comprehensive Case Management |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4014AB |
| Optional: Comprehensive Case Management Per Member Per Month (PMPM) |
| Each (unique Approved Referral 0-35,000) |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each (unique Approved Referral 35,001-75,000) |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each (unique Approved Referral 75,001+) |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4015 |
| (Optional) Comprehensive Disease Management |
| 4015AA |
| Optional: Implementation for Comprehensive Disease Management |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4015AB |
| Optional: Comprehensive Disease Management Per Member Per Month (PMPM) |
| Each (unique Approved Referral 0-35,000) |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each (unique Approved Referral 35,001-75,000) |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| Each (unique Approved Referral 75,001+) |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4016 |
| Implementation |
| Each |
| $______ |
| $______ |
| N/A |
| N/A |
| N/A |
| N/A |
| N/A |
| N/A |
| 4017 |
| RESERVED |
| 4018 |
| Data |
| Not Separately Priced (NSP) |
| NSP |
| NSP |
| NSP |
| NSP |
| NSP |
| NSP |
| NSP |
| NSP |
| 4019 |
| RESERVED |
| 4020 |
| Agreed Upon Procedures Audit |
| Each |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| $______ |
| 4021 |
| MILL BIL |
| Each |
| Up to 70% Medicare |
| Up to 70% Medicare |
| Up to 70% Medicare |
| Up to 70% Medicare |
| Up to 70% Medicare |
| Up to 70% Medicare |
| Up to 70% Medicare |
| Up to 70% Medicare |
5.
6. Section B.16 Performance Work Statement Section 2.2.1 Table with the potential list of sites the VA recommends for consideration for SHCD Region 4 column is deleted in its entirety:
Region 4
| Urban |
| Rural |
| Portland (648) |
| Amarillo (504) |
| Spokane (668) |
| Fort Harrison (436) |
7. Section B.16 Performance Work Statement Section 3.5 Table 5 Region 4 column is deleted in its entirety:
CCN Region 4
Texas
New Mexico
Arizona
California
Nevada
Utah
Colorado
Wyoming
Idaho
Oregon
Washington
Montana
Alaska
Hawaii
Northern Mariana Islands
Guam
American Samoa
8. Section B.16 Performance Work Statement Section 6.1 the following requirement is deleted in its entirety: “For CCN Region 4, 7AM to 7PM requirement applies to Hawaii as well. American Samoa, Northern Mariana Islands, and Guam may have more limited coverage as agreed to by VA and the Contractor.”
9. Section B.16 Performance Work Statement Section 6.2 the following requirement is deleted in its entirety: “For CCN Region 4, 7AM to 7PM requirement applies to Hawaii as well. American Samoa, Northern Mariana Islands, and Guam may have more limited coverage as agreed to by VA and the Contractor.”
10. Section E.5.10.6 Region 4 Table is deleted in its entirety:
Region 4:
| CLIN |
| Description |
| Weight |
| Sub-Weight |
| XXX2 |
| Reimbursement for Highly Rural Care Areas |
| 41.6% |
| XXX5 |
| Seasonal Influenza Vaccination |
| 2.6% |
| XXX9 |
| Urgent and Emergent Medications |
| 3.8% |
| 100.0% |
Brand Name Medication
14.0%
Generic Medication
79.5%
Dispensing Fee
6.5%
| XX10 |
| Dental Services |
| 18.1% |
| XX11 |
| Administrative Fees |
| 18.2% |
| 100.0% |
| XX11AA |
| Administrative Services for Healthcare Services |
0-35,000 Active Veterans
19.6%
35,001-75,000 Active Veterans
22.4%
75,001+ Active Veterans
48.2%
| XX11AB |
| Administrative Services for Dental |
0-7,500 Active Veterans
4.6%
7,501-15,000 Active Veterans
4.5%
15,001+ Active Veterans
0.6%
| XX11AC |
| Administrative Services Fee for Pharmacy Benefits Management |
0.1%
| XX12 |
| (Optional) Appointment Scheduling and Comprehensive Care Coordination |
| 10.4% |
| 100.0% |
| XX12AA |
| (Optional) Implementation for Appointment Scheduling and Comprehensive Care Coordination at a VA Facility |
0.1%
| XX12AB |
| (Optional) Implementation for Appointment Scheduling and Comprehensive Care Coordination at Contractor Facility |
1.1%
| XX12AC |
| (Optional) Appointment Scheduling and Comprehensive Care Coordination |
Tier 1 Volume:
43.6%
Tier 2 Volume:
50.6%
Tier 3 Volume:
4.6%
Tier 4 Volume: (no usage planned)
0.0%
Tier 5 Volume: (no usage planned)
0.0%
| XX13AB |
| (Optional) Care Coordination Follow-up |
| 1.9% |
| 100.0% |
0-35,000 or 700 lots
23.9%
35,001-75,000 or 800 lots
27.3%
75,001+ or 1500+ lots
48.8%
| XX14AB |
| (Optional) Comprehensive Case Management Program Administration |
| 1.8% |
| 100.0% |
0-35,000
14.9%
35,001-75,000
16.9%
75,001+
68.2%
| XX15AB |
| (Optional) Comprehensive Disease Management Program Administration |
| 0.4% |
| 100.0% |
0-35,000
11.9%
35,001-75,000
13.6%
75,001+
74.5%
| XX16 |
| Implementation |
| 1.2% |
100.0%
11. Section C.23 Region 4 Guaranteed Contract Minimums and Contract Maximums are deleted from the tables in their entirety:
| Region |
| Minimum per Option Period |
| 4 |
| $ 7,110,000 |
| Region |
| Maximum |
| 4 |
| $ 27,960,092,095.00 |
12. Section D Attachments will not be revised; any and all information pertaining to Region 4 contained in any attachment listed is deleted in its entirety.
13. Section E.5 Solicitation Attachments will not be revised; any and all information pertaining to Region 4 contained in any attachment listed is deleted in its entirety.
[End of Summary of Changes]
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