Fiscal Intermediary Services for Dental Reimbursement and Dental General Services

Amendment No. Two (2) to incorporate questions and answers regarding the solicitation..

The solicitation is hereby amended to change the period of performance from a base year with 4 one-year options to a base period of 6-months with one 6-month option period..

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in FAR (Federal Acquisition Regulations) Subpart 12.6 and Subpart 13.5, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.
The solicitation number is 18-241-SOL-00003 and is issued as a Request For Proposal. The solicitation document and incorporated provisions and clauses are those in effect through FAC (Federal Acquisition Circular) 2005-99.
This is an Open Market solicitation. NAICS code is 524114 - Direct Health and Medical Insurance Carriers, Small Business Size Standard is $38.5 Million.
The unit pricing must be all inclusive (to include but not be limited to travel, lodging, per diem, fringe benefits, federal, state, and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.
Contract Line Items:

Base Year: October 1, 2018 through September 30, 2019
1. Administrative Fixed-Fee per-transaction $_________
Estimated transactions per year is 1,750 referrals.

Option Year One (1): October 1, 2019 through September 30, 2020
2. Administrative Fixed-Fee per-transaction $_________
Estimated transactions per year is 1,750 referrals.

Option Year Two (2): October 1, 2020 through September 30, 2021
3. Administrative Fixed-Fee per-transaction $_________
Estimated transactions per year is 1,750 referrals.

Option Year Three (3): October 1, 2021 through September 30, 2022
4. Administrative Fixed-Fee per-transaction $_________
Estimated transactions per year is 1,750 referrals.

Option Year Four (4): October 1, 2022 through September 30, 2023
5. Administrative Fixed-Fee per-transaction $_________
Estimated transactions per year is 1,750 referrals.

The Great Plains Area Office is soliciting proposals for a Firm Fixed-Price, Non-Personal Services contract for fiscal intermediary services for dental reimbursement and dental general services for patient referrals for the following locations within the Great Plains Area:

Belcourt, North Dakota
Fort Yates, North Dakota
Fort Thompson, South Dakota
Kyle, South Dakota
Lower Brule, South Dakota
McLaughlin, South Dakota
Pine Ridge, South Dakota
Rapid City, South Dakota
Rosebud, South Dakota
Sisseton, South Dakota
Wagner, South Dakota
Wanblee, South Dakota

IHS is requesting offers for a fixed-fee per-transaction that will be deducted from the funded amount of PRC (Purchased Referred Care) funds. Funding is by location and will be incorporated on an incremental basis or as funds become available.

Example: $100,000.00 for Service Unit A and a fixed-fee per-transaction of $.045 each or 4.5%.

$ 95,500.00 - Dental reimbursement and/or dental referrals
$ 4,500.00 - Fixed-fee per-transaction
$100,000.00

Fiscal intermediary services for dental reimbursement and dental general services include: (List is not all-inclusive.) (See SOW for specifics.)
A. Render a determination (from treatment plans, preoperative radiographs, and a schedule of allowed services) that allows the participating contracting dentist and the patient to know the services covered by the IHS and the amount of benefits payable before treatment is initiated in 100% of the cases referred.
B. Reimburse the dentists who have provided dental health services (clinical services) as authorized utilizing an attending Dentist's Statement form.
C. Review of Dental Health services provided through the contract for certification that (1) the services on the standard claim form were performed and (2) that professional standard quality of care, appropriateness of services and patient management were maintained.
D. Furnish Reports: Record of Services Provided, Record of Post-Treatment Review, Summary of Expenditures, Summary of Claims Rejected, and Grievance Summaries.
E. Applicable Standards include but are not limited to: Joint Commission, Centers for Medicare and Medicaid Services, Health Insurance Portability and Accountability Act, and Privacy Act of 1974.

The period of performance will be from October 1, 2018 through September 30, 2019 with four 1-year options with performance dates of October 1, 2019 through September 30, 2020, October 1, 2020 through September 30, 2021, October 1, 2021 through September 30, 2022, and October 1, 2022 through September 30, 2023, respectively.

The Wage Determination applicable to this solicitation is unknown at this time. The following Wage Determinations are being provided for those that expressed an interest in the solicitation:
Wage Determination No. 2015-5373, Revision No. 8, dated 07/03/2018.
Wage Determination No. 2015-5621, Revision No. 6, dated 08/08/2018.
Wage Determination No. 2015-5831, Revision No. 8, dated 07/13/2018.

INSTRUCTION TO OFFERORS: Proposal must contain the following documents in order to be considered responsive and eligible for an award:

Completion of the attached FAR and HHSAR (Health and Human Services Acquisition Regulations) provisions and clauses applicable to this acquisition, including:

FAR 52.212-1 - Instructions to Offerors - Commercial Items (Jan 2017). This information must be submitted by the Offeror. See Section L for full text. See Section M for Past Performance Questionnaire Form.

FAR 52.212-2 - Evaluation - Commercial Items (Oct 2014).
The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. All evaluation factors other than cost or price, when combined, are significantly more important than cost or price. The following factors shall be used to evaluate offers:

The following factors shall be used to evaluate offers: See Section M for Subfactors.

Technical Proposal
1. Technical Capabilities
2. Technical Approach
3. Key Personnel
4. Past Performance and Experience
5. Cost Proposal

FAR 52.212-3 - Offeror Representations and Certifications - Commercial Items (Nov 2017).
This must be completed by the Offeror. See attachment for full text. The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (q) of this provision.

FAR 52.212-4 - Contract Terms and Conditions - Commercial Items (Jan 2017) (Incorporated by Reference); and

FAR 52.212-5 - Contract Terms and Conditions Required to Implement Statutes or Executive Orders - Commercial Items (Jul 2018).

The full text of a clause may be accessed electronically at:
https://www.acquisition.gov/?q=browsefar
Awardee will be required to submit a Certificate of Liability Insurance within 5 business days following award notification from the Great Plains Indian Health Service.

The Defense Priorities and Allocations System (DPAS) is Not Applicable to this solicitation.

Questions regarding this solicitation must be submitted by August30, 10:00am CDT/CST. Submit by e-mail to connie.valandra@ihs.gov.

Proposal is due on September 14, 2018 @10:00am CDT/CST. Submit proposal to:
Great Plains Area Indian Health Service
Attn: Connie Valandra, Contract Specialist
Federal Building, Room 309
115 4th Avenue Southeast
Aberdeen, South Dakota 57401-4360
Telephone: 605/226-7567
Facsimile: 605/226-7669
E-mail: connie.valandra@ihs.gov
Note to the Proposed Offeror:

HHS Subcontracting Plan Template
This solicitation requires the completion and submission of a Subcontracting Plan with the offer/proposal. Failure to submit the subcontracting plan will deem the offer/proposal to be unacceptable. See Section J Attachments for the form.

Security Clearance
Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the IHS (Indian Health Service). Before starting work requiring routine access to IHS facilities or systems each person must complete an FBI National Criminal History Check (Fingerprint Check) adjudicated by an IHS employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five business days for IHS processing of fingerprints taken electronically at an IHS site and thirty business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of IHS sites with electronic fingerprint capability is available from the Contracting Officer.

The IHS utilizes the eQIP (Electronic Questionnaire Investigations Processing) system to process background investigations. Contractors are required to work with the Service Unit Background Coordinator or other designee to properly complete their eQIP entry without error. Proper submission of the eQIP entry to the OPM (Office of Personnel Management) is required prior to the individual being allowed to begin their performance under this contract. Computers have been provided to the Service Unit for this purpose.

OIG Exclusion List
No contract award shall be made to a vendor or provider listed on the OIG Exclusion List (http://exclusions.oig.hhs.gov) throughout the duration of the contract. Should a candidate be found with a non-favorable security clearance it shall be the contractor's responsibility to replace the candidate working under the contract/purchase order with a suitable candidate. It shall be the responsibility of the contractor to notify the Acquisition Office is there is a change in provider.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the LEIE (HHS Office of Inspector General List of Excluded Individuals/Entities), http://exclusions.oig.hhs.gov. As soon as practicable prior to the performance of the work, the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to IHS is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour, or Cost-Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed-Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

The Government will pay for the cost to process the contractor's suitability clearances. However, multiple investigations for the same position may, at the Contracting Officer's discretion, lead to a reduction(s) in the contract price of no more than the cost of the investigation(s).

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