Medical Claims

Notice Type: Combined Synopsis/Solicitation

Synopsis: COMBINED SYNOPSIS/SOLICITATION

This is a combined synopsis/solicitation for Medical Claims Support Services commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) subpart 12.6, Streamlined Procedures for Evaluation and Solicitation for Commercial Items, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued.

Solicitation number 36C10G19R0018 is issued for this combined synopsis/solicitation; this solicitation is being issued as a Request for Proposal (RFP). This combined synopsis/solicitation incorporates provisions and clauses in effect through Federal Acquisition Circular (FAC) 2019-05 dated August 12, 2019.

The Office of Finance, under the direction of the Deputy Assistant Secretary for Finance, the Department of Veteran s Affairs (VA s) Deputy Chief Financial Officer, is comprised of over 1,000 staff located in the Office of Financial Systems and Operations, the Office of Financial Policy, and two field sites - the Financial Services Center (VA-FSC) in Austin, Texas, and the Debt Management Center (DMC) in St. Paul, Minnesota. It maintains stewardship of Departmental resources and provides financial information, financial statements and reports on VA s appropriations and general, revolving, special, and deposit funds for cost and obligation accounting.

As a franchise fund organization within the VA Franchise Fund, the VA-FSC must sustain its operations through charges to federal customers on a fee for service basis. In order to support the VA-FSC's customer, the Veterans Health Administration (VHA) and the Veteran Access to Care Act of 2014 (H.R. 4810; 113th Congress) requires the VA-FSC to maintain and support a claim processing capability.

The VA-FSC has a considerable vested interest in processing healthcare claims. If the VA-FSC does not maintain services for medical claim processing, it would lose its ability to support its healthcare claims processing services to VHA in accordance with Veteran Access to Care Act of 2014 (H.R. 4810; 113th Congress), which would result in serious financial harm to Veterans. Current VA-FSC customers include, but are not limited to, 18 Veteran Integrated Service Networks (VISNs) throughout the United States (US), Veterans Choice Program, Department of Health and Human Services, dialysis medical claims (Medicare), and compensation claims resulting from Veterans exposure to contaminated water at Marine Corps Base Camp Lejeune, North Carolina. Future growth for FSC product lines may include the processing of all medical claims that will not be part of the VA Community Care Network contract.

The associated North American Industrial Classification System (NAICS) code for this procurement is 524292 and the associated size standard is 1000 employees. This acquisition is set aside for SDVOSBs. Vendors must be registered and verified at the time of submission of quotes under the NAICS 524292.

This acquisition is in accordance with FAR Part 12 Acquisition of Commercial Items, and FAR Part 15 Contracting by Negotiation for Medical Claims Processing as identified in Attachment A, Cost/Price Schedule. All interested companies shall provide a quote for all Contract Line Item Numbers (CLINs) listed in Attachment A, Cost/Price Schedule.

The VA is looking to establish a one-year contract with two 12-month options.

The FAR provision at 52.212-1, Instructions to Offerors -- Commercial, applies to this acquisition including attached addenda to the provision.

The FAR provision at 52.212-2, Evaluation -- Commercial Items, and the specific evaluation criteria as attached addenda also applies to this acquisition. The Government will award a contract resulting from this solicitation to the responsible vendor that provides a quote that conforms to the solicitation and which is determined to be the most beneficial (i.e., best value) to the government, considering technical capability, past performance, and price.

Offerors shall include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications -- Commercial Items, with its offer, if not available in SAM

This requirement is a 100% set-aside for Service Disabled Veteran Owned Small Businesses under the authority of 38 U.S.C. 8127(d). SDVOSB contractors must be verified and viewable in VetBiz www.vip.vetbiz.gov prior to submission of proposal and prior to award of contract. Status as a qualified SDVOSB concern is under the authority of 38 CFR Part 74 in accordance with the VA Acquisition Regulation (VAAR) Part 819. Eligibility determination is performed by the Center for Veterans Enterprise (CVE).

To be eligible for award the SDVOSB must be considered small under 524292 NAICS code. System for Award Management (SAM): https://www.sam.gov/portal/public/

The clause at FAR 52.212-4, Contract Terms and Conditions -- Commercial Items, applies to this acquisition.

The clause at FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders - Commercial Items, applies to this acquisition and the additional FAR clauses cited in the clause are applicable to the acquisition

All questions should be submitted no later than 30 August 2019 at 2:00 PM (EDT)

Quotes are due 13 September 2019 at 11:59 PM (EDT) to Glenn Burton at glenn.burtonjr@va.gov and Sharon.Redman@va.gov