SF30 Amendment No. 0001.pdf

0011868798-0001

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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 (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to address industry generated questions and answ ers, as w ell as to revise the Performance Work Statement (PWS), attachment four (4) of the Combined Synopsis and Solicitation.

POC: J. Chris Finkenstadt, john.c.finkenstadt2.civ@health.mil

1. CONTRACT ID CODE PAGE OF PAGES

J 1 7

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

16C. DATE SIGNED

BY 23-Feb-2023

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

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

8. NAME AND ADDRESS OF CONTRACTOR (No., Street , County, State and Zip Code) X W81K0023R0010

X 9B. DATED (SEE ITEM 11)

15-Feb-2023

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

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

12. ACCOUNTING AND APPROPRIATION DATA (If required)

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

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

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.

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

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

D. OTHER (Specify type of modification and authority)

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

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

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

23-Feb-2023

CODE

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

2539 GARDEN AVENUE

FT SAM HOUSTON TX 78234-0000

W81K00 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W81K0023R0010

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 30 - BLOCK 14 CONTINUATION PAGE

The following have been added by full text:

CONTINUATION PAGE

Industry Generated Questions and Answers

1. Q: "What is the anticipated volume of x-rays per year?"

A: Approximately 200 chest x-rays will be needed.

2. Q: "What is the anticipated volume of lab tests per year?"

A: Please see the attached spreadsheet.

3. Q: "Are you looking to have weekly scheduled dates of service for x-ray and lab services? OR- Will you be wanting all services “as needed”?"

A: Daily as needed.

4. Q: “The RFQ attachment 3 states no interpretations, but attachment 4, states2.8. The reading of x-rays will be sent by mail and will be read at Reynolds Army Health Clinic.Can you please verify whether you will be wanting interpretations or not?"

A: PWS should state performance of x-rays. Reynolds Army Health Clinic will actually read the results of the chest x-rays.

MCAAP Lab Tests Spreadsheet

LAB TEST Orders/ year

ALP (Alkaline Phosphatase) 2

AMH (3 days) (Antimullerian Hormone)

B12 2

Bilirubin Direct 2

Blood Type, ABO 20

Blood Type, Rh 20

BMP (Basic Metabolic Panel) 2

Cadmium 2

CBC with Differential 1,200

Cholesterol, total 2

Chromium, serum 2

CMP (Comprehensive Metabolic Panel)

1,200

Estradiol 2

Fe (Iron) 2

Flouride Urine 2

Folate 2

FSH 2

G6PD 100

GGT (GGPT) 2

Haptoglobin 2

HBsAb 2

HBsAG 2

HCG Qualitative 2

Heavy Metals 2

Hepatitis ABC Acute Panel 5

HGBAlC 300

HIV Ab Screen 20

LDH 2

LH 2

Lipid Profile 200

Liver Profile 2

Magnesium 2

Met/HGB 2

Prolactin 2

PSA 2

Pseudocholinesterase Count 5

Reticulocyte 2

Rubella 2

Rubeola 2

Sars-COV-2 PCR 2

SHBG 2

Sperm Analysis 2

T3, Free 2

T3 Total 2

T4, Free 2

T4, Total (Thyroxine) 2

Testosterone, Total 2

Testosterone, Free 2

TG (Thyroglobulin) Antibody 2

TPO (Thyroperoxidase)Antibody 2

TSH 2

UA with microscopic 1,300

Uric Acid 2

Zinc Protoporphrin 80

Varicella 10

Labs Not Listed 100ish

REVISED PERFORMANCE WORK STATEMENT (PWS):

ATTACHMENT 4

PERFORMANCE WORK STATEMENT

Laboratory and Radiology Services for

United States Army Occupational Health Clinic (USAOHC), McAlester Army Ammunition Plant (MCAAP)

1. BACKGROUND.

1.1. Reynolds Army Health Clinic, Fort Sill, Oklahoma requires the non-personal services of laboratory and Radiology services in support of the U.S. Army Occupational Health Clinic (USAOHC), McAlester Army Ammunition Plant (MCAAP), Bldg. 5, 1 C-Tree Road, McAlester, OK 74501. MCAAP USAOHC supports a small population of military personnel, their families, veterans, and beneficiaries. Located 150 miles from Dallas, Texas, 150 miles from Oklahoma City, Oklahoma, and more than 90 miles from Tulsa, Oklahoma, timely laboratory, and radiology services are needed to support the population. Due to the timely laboratory requirements, these services need to be provided in close proximity to McAlester, Oklahoma.

1.2. The Occupational Health Clinic requires laboratory and radiology services for the testing of CXR, CBC, Urinalysis; Liver Profile; LDH: GGT; Lipid Panel; TSH; Chem 8 Panel; G6PD; Free T4; Free T3; Free Testosterone, Total; FSH; LH; PRL; SHGB; CMP; TG Antibody; TPO Antibody; Estradiol Levels; HIV Screen;

Uric Acid; Cholesterol Total; Lead, Blood; Zinc Protoporphyrin; Magnesium; Cadmium; PSA; ABO Type; RH type; Fluoride; Peripheral Smear Referral; Chem 20; RBC cholinesterase; varicella/rubella/rubeola titers, methemoglobin, HBsAb, occasional special labs to include urine heavy metals, Sars-COV-2 PCR Test, and performance of chest x-rays.

1.3. Abbreviation appendix: CXR=chest x-ray, CBC=complete blood count, LDH=lactate Dehydogenase, LFT=liver function test, UA=urinalysis, F1=fluoride, HIC=human immunodeficiency virus, GHCG=beta- human chorionic gonadotropin, PCR=polymerase chain reaction, PSA=prostate specific antigen, Pb=lead, ZPP=zine protoporphyrin, RBC=reb blood cell, CA=calcium, HBsAb=hepatitis B surface antibody, GGT= Gama-glutamyl transerase, TSH= thyroid-stimulating hormone, G6PD= Glucose-6-Phosphate Dehydrogenase, ABO=Type-blood type, RH Type- RHtype, CAP=college of American Pathologists.

2. Scope of Work:

2.1. The contractor shall provide laboratory and radiology services including, but not limited to, the following:

CXR, CBC, Urinalysis; Liver Profile; LDH: GGT; Lipid Panel; TSH; Chem 8 Panel; G6PD; Free T4; Free T3; Free Testosterone, Total; FSH; LH; PRL; SHGB; CMP; TG Antibody; TPO Antibody; Estradiol Levels; HIV Screen;

Uric Acid; Cholesterol Total; Lead, Blood; Zinc Protoporphyrin; Magnesium; Cadmium; PSA; ABO Type; RH type; Fluoride; Peripheral Smear Referral; Chem 20; RBC cholinesterase; varicella/rubella/rubeola titers, methemoglobin, HBsAb, occasional special labs to include urine heavy metals, Sars-COV-2 PCR Test, and performance of chest x-rays.

2.2. All bills shall be itemized to show the procedures done along with the corresponding CPT codes.

2.3. Laboratory shall be CAP accredited (or any other nationally recognized accrediting body for laboratories), and Radiology dept accredited by a recognized radiological accrediting body. Must provide Proof of Certifications.

2.4. The following labs shall have a turnaround time of no greater than 48 hrs if required: CBC, LDH, LFT, UA, HIC, urine, bHCG, chem 8, PSA, and lipid profile.

2.5. All phlebotomy supplies shall be provided by contractor (needed, tubes, vacutainer interface, Styrofoam boxes, cold packing's etc.)

2.6. Contractor shall provide phlebotomy services if service cannot be performed on site at MCAAP Occupational Health Clinic.

2.7. Lab results must be faxed to MCAAP Occupational Health Clinic.

2.8. The chest x-ray images will be sent by mail to Reynolds Army Health Clinic and will be read by Radiologists at Reynolds Army Health Clinic.

2.9. LAB TESTS

ALP (Alkaline Phosphatase) AMH (3 days) (Antimullerian Hormone) B12 Bilirubin Direct Blood Type, ABO Blood Type, Rh BMP (Basic Metabolic Panel) Cadmium CBC with Differential Cholesterol, total Chromium, serum CMP (Comprehensive Metabolic Panel) Estradiol Fe (Iron) Flouride Urine Folate

FSH

G6PD

GGT (GGPT)

Haptoglobin HBsAb HBsAG HCG Qualitative Heavy Metals Hepatitis ABC Acute Panel HGBAlC HIV Ab Screen

LDH

Lead, Blood

LH

Lipid Profile Liver Profile Magnesium Met/HGB Prolactin

PSA

Pseudocholinesterase Reticulocyte Count Rubella Rubeola Sars-COV-2 PCR

SHBG

Sperm Analysis T3, Free T3 Total

T4, Free T4, Total (Thyroxine) Testosterone, Total Testosterone, Free TG (Thyroglobulin) Antibody TPO (Thyroperoxidase)Antibody

TSH

UA with microscopic Uric Acid Heavy Metals Zinc Protoporphrin Varicilla

2.10. X-RAY

Chest X-ray

3. Contractor Manpower Reporting "ACCOUNTING FOR CONTRACT SERVICES-The Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the contractor will report ALL contractor manpower (including subcontractor manpower) required for performance of this contract.

4. Exclusion from Participation in Federal Health Care Programs (October 2015)

4.1. The Contractor shall not employ or contract with any individual or entity (hereinafter collectively referred to as “person”) to provide items or services that will be included in invoices submitted to the Government under this contract if such person is listed on the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) or the TRICARE Sanctioned Provider List. The Government is legally prohibited from paying for provision of items or services by such persons. The prohibition extends to services beyond direct patient care, such as services of persons in executive or leadership roles and administrative and management services, whether or not such services are billed separately. The LEIE may be found at http://oig.hhs.gov/fraud/exclusions.asp, and the TRICARE Sanctioned Provider list at http://www.health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/Quality-And-Safety-of- Healthcare/Program-Integrity/Sanctioned-Providers. The LEIE and TRICARE Sanctioned Provider List are hereinafter collectively referred to as “the Lists.”

4.2. Prior to start of contract performance, the Contractor shall (a) query the Lists to determine whether the name of any person the Contractor employs or contracts with to provide services or items for which payment may be made under this contract appears on the Lists, and (b) certify to the Contracting Officer that the Contractor has queried the Lists and no such names appear on either of the Lists.

4.3. During performance of the contract, and prior to persons other than those whose names were queried in accordance with paragraph 2, above, (hereinafter “new persons”) providing services or items under the contract, the Contractor shall (a) query the Lists as in paragraph 4.2., and (b) certify to the Contracting Officer that the names of such new persons do not appear on either of the Lists.

4.4. Should any person providing items or services under the contract appear on either of the Lists at any time during contract performance, the Contractor shall (a) in cases where the Contractor identified the person, notify the Contracting Officer, and (b) promptly remove that person from the contract.

4.5. Violation of any aspect of the above paragraphs shall be considered a material breach of the contract and may result in termination of the contract.

4.6. The Contractor is further advised that, in accordance with Civil Monetary Penalties Law [CMP] (codified at 42 USC § 1320a-7a):

a. There are steep civil monetary penalties associated with billing the Government for providing items or services by a person on either of the Lists, and with failing to return to the Government any overpayments received for provision of such items or services.

b. Billing under the contract for provision of items or services by a person on either List may also result in exclusion of the person that employs or contracts with such person.

5. HHS OIG has issued a Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs with additional information on the CMP. The Special Advisory Bulletin may be found at http://oig.hhs.gov/exclusions/files/sab-05092013.pdf.

APPENDIX A

PERFORMANCE REQUIREMENTS SUMMARY (PRS)

The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Performance Requirement Performance Standard Acceptable Quality Level

(AQL)

Surveillance Method

Invoices submitted with correct CPT codes.

IAW PWS Para 2.2. 100% compliance Periodic Inspection

Accreditation current for both radiology and laboratory departments.

IAW PWS Para 2.3. 100% compliance Periodic Inspection

Turnaround time for specified labs meets requirements.

IAW PWS Para 2.4. 100% compliance Periodic Inspection

Results appropriately communicated.

IAW PWS Para 2.7. 100% compliance Periodic Inspection

(End of Summary of Changes)