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FBO DAILY - FEDBIZOPPS ISSUE OF FEBRUARY 16, 2018 FBO #5929
DOCUMENT

R -- eInsurance – Healthcare Clearinghouse (HCH) Spt Eligibility Trans EDI (VA-17-078813) - Attachment

Notice Date

2/14/2018
 

Notice Type

Attachment
 

NAICS

541990 — All Other Professional, Scientific, and Technical Services
 

Contracting Office

Department of Veteran Affairs;PCAC-ST. LOUIS;11152 South Towne Square;Saint Louis MO 63123
 

ZIP Code

63123
 

Solicitation Number

36C77718Q0012
 

Response Due

2/22/2018
 

Archive Date

3/24/2018
 

Point of Contact

William Singleton
 

E-Mail Address

4.6656
 

Small Business Set-Aside

N/A
 

Description

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) 1 17 00001 02-14-2018 None 00776 Department of Veteran Affairs PCAC-ST. LOUIS 11152 South Towne Square Saint Louis MO 63123 00776 Department of Veterans Affairs PCAC-ST. LOUIS 11152 South Towne Square St. Louis MO 63123 To all Offerors/Bidders 36C77718Q0012 X X 1 February 22, 2018 4PM EST See CONTINUATION Page X 1 The purpose of this amendment is to answer questions and amend the PWS and the original RFQ in response to those answers. Please note that any changes made herein will be incorporated into the original RFQ and subsequently into the awarded contract. Please note that although the date of submission did not the time has changed from 10:00 hours to 15:00 hours. The Instruction to Offerors is attached as well as the answers to all questions asked. CONTINUATION PAGE eInsurance QUESTIONS & ANSWERS 14 February 2018 Potential Offeror Question (Q1): Where are the instructions for proposal preparation? We see the Addendum to 52.212-1, but not 52.212-1. Government Answer (A1): See Amendment Potential Offeror Question (Q2): Since CAQH is not required until time of award, why is EHNAC required at the time of proposal submission? Please amend to require both accreditations at the time of award. Government Answer (A2): Both EHNAC and CAQH CORE are required by all vendors at the time of contract award. Shall be a fully Accredited Healthcare Network (HNAP-EHN and ePAP-EHN accredited) by the Electronic Healthcare Network Accreditation Commission (EHNAC) (https://www.ehnac.org/) at the time of contract award and maintain accreditation for the duration of the Contract. Shall be certified by the Council for Affordable and Quality Healthcare (CAQH); per Section 104 of the Patient Protection and Affordable Care Act as following the  Phase I & II CAQH CORE Operating Rules for HIPAA  Eligibility & Claim Status  (270/271) at the time of contract award and maintain certification for the duration of the Contract. Potential Offeror Question (Q3): To the best of our knowledge, no SDVOSB with an active registration in VetBiz is currently accredited by either EHNAC or CAQH, as required below, nor can they obtain accreditation at the time of award on their own. Shall be a fully at the time of contract award Accredited Healthcare Network (HNAP-EHN and ePAP-EHN accredited) by the Electronic Healthcare Network Accreditation Commission (EHNAC)  (https://www.ehnac.org/) at the time of proposal submission and maintain accreditation for the duration of the Contract. Shall be certified by the Council for Affordable and Quality Healthcare (CAQH); per Section 104 of the Patient Protection and Affordable Care Act as following the Phase I & II CAQH  CORE Operating Rules for HIPAA Eligibility & Claim Status (270/271) at the time of award and maintain certification for the duration of the Contract. Any SDVOSB will have to team with an organization that does have the required accreditation, which will automatically mean that the limitations on subcontracting cannot be met. While we understand the implications of the Kingdomware decision, from a practical standpoint, we do not believe that there are at least two qualified and responsible firms that can meet the requirements of this RFQ as an SDVOSB set-aside, if the limitations on subcontracting are retained without change. The VA already has significant knowledge of and contract experience since 2003 with electronic health care clearinghouses, and knows, or should reasonably know that the characteristics of the market and industry and of this solicitation in particular as currently stated are impossible to achieve. We ask that VA seek an appropriate waiver from SBA to this limit in accordance with CFR 19 Par. 125.6 (g). Government Answer (A3): VA will not seek an SBA waiver for this contract as per 13 CFR 125.6. VA requires all vendors performing electronic healthcare transactions to carry both EHNAC accreditation and CAQH CORE certificates. As per Department of Veterans Affairs, Deputy Assistant Secretary for Information Security memo dated September 2, 2016; EHNAC provides a valuable service through accreditation programs that promote the standards, best practices, administrative simplification, open competition and protection of information exchange regarding security, privacy, and confidentiality in the [healthcare] marketplace HIPPA covered entities are bound by the provisions found in the HIPAA Privacy and Security rules (45 CFR Parts 160 & 164, Subparts A & C Security Standards for the Protection of Electronic Protected Health Information; Standards for Privacy of Individually Identifiable Health Information; HITECH Act 2009; and the Affordable Care Act (ACA). These mandates specifically reference the NIST SP 800-53, NIST SP 800-66 and include penalties for failure to comply and for breaches. Vendors who carry EHNAC accreditation(s) do not have to seek separate privacy and security accreditation from the Department of Veterans Affairs, Office of Information Technology (OIT), which can be a lengthy process. An EHNAC accreditation also ensures a respected industry leader and non-governmental agency has thoroughly and independently verified vendor(s) meet the requirements for privacy, security and performance of electronic health networks as stipulated by HIPAA. In addition, both the State of Maryland (http://mhcc.maryland.gov/mhcc/pages/hit/hit_ehn/hit_ehn_application_process.aspx) and the State of New Jersey (http://www.state.nj.us/dobi/proposed/ad060605.pdf) require EHNAC accreditation to conduct electronic transaction business in their states, and several VA Medical Centers operate in these states. Coalition for Affordable Quality Healthcare  (CAQH) Committee on Operating Rules for Information Exchange (CORE) is named by the Secretary of Health and Human Services (HHS) as the official author of national operating rules that have since been incorporated into HIPAA law by the ACA. As of January 2013, all HIPAA-covered entities were required to adhere to CAQH CORE Phase I and Phase II HIPAA 270 Operating Rules. By obtaining and maintaining a CAQH CORE certification, VA is ensuring all vendors receiving and transmitting electronic PHI are complaint with federal law and adhere to the administrative simplification and standards set forth by HIPAA. Current contracting principles are to announce this offer under the SDVOSB set aside. If SDVOSB vendors are unable to meet the requirements of the PWS it may be reposted without the SDVOSB set aside requirement. Both EHNAC and CAQH CORE are required by all vendors at the time of contract award. Shall be a fully Accredited Healthcare Network (HNAP-EHN and ePAP-EHN accredited) by the Electronic Healthcare Network Accreditation Commission (EHNAC) (https://www.ehnac.org/) at the time of contract award and maintain accreditation for the duration of the Contract. Shall be certified by the Council for Affordable and Quality Healthcare (CAQH); per Section 104 of the Patient Protection and Affordable Care Act as following the  Phase I & II CAQH CORE Operating Rules for HIPAA  Eligibility & Claim Status  (270/271) at the time of contract award and maintain certification for the duration of the Contract. Potential Offeror Question (Q4): In what format do you desire attestation to all the required contract clauses listed in Section C of the Solicitation? Government Answer (A4): Attestation shall be completed by signing and returning the SF30 for this amendment. Potential Offeror Question (Q5): To ensure we complete the proposal, do you have a checklist of required items for the proposal? Government Answer (A5): The Instruction to Offerors inserted as a part of this amendment will detail the required items for this Request for Quotation. Potential Offeror Question (Q6): In Task 1 in paragraph 11 of the Performance Work Statement, a month is noted as the time to establish connections to 250 payers. In the PWS Appendix A under Section D, offerors are charged to demonstrate connectivity per Task 2 of the PWS on day one of contract award. These appear contradictory. Can you clarify the relationship of these two requirements? Government Answer (A6): A successful vendor will demonstrate day 1 connections with the payers listed in Section D, Appendix A as per Task 2. Task 2 specifically states The Contractor shall provide an appropriate transmission vehicle to ensure the delivery of HIPAA 270 inquiries from the Contractor's site to each responsible Payer or their contracted representative. VA shall provide the Contractor with a list of payers VA deems most important to access for initial implementation. The Contractor shall initiate a dialog with each responsible Payer to establish an understanding of the requirements associated with and to fulfill the obligation of relaying VA inquiries to and from Payers. A successful vendor will demonstrate connectivity to additional payers not listed in Appendix A within one month or less as per Task 1; with a highly successful vendor demonstrating connectivity to payers, including, but not limited to the following top payers: Colonial Penn, Cigna Behavioral Health, Bankers Life, and Independent Health. Potential Offeror Question (Q7): For Deliverable 3.2, can you define your expected resubmission policy and how the offeror is expected to perform to that policy? Government Answer (A7): A successful vendor will demonstrate their ability to design and negotiate with VA, upon contract award, a mutually agreeable re-submission policy that meets CAQH CORE standards. For example: A payer does not respond to a fully qualified HIPAA 270 within CORE standards, the clearinghouse will automatically re-submit the transaction on behalf of VA without prompting from VA systems. Potential Offeror Question (Q8): For Deliverable 6, are there any examples of reports that you definitively expect? Government Answer (A8): As per the PWS, Deliverable 6 which shall include, at a minimum those reports listed below. The reports outlined in this document should be itemized by payer and by VA Medical Center VA periodic and/or monthly reporting minimum for payer entities: Total number of inquiries processed by the Contractor Total number and percentage of inquiries accepted, rejected and timed-out by each payer Provide report(s) on inbound and outbound data exchanges to identify exceptions in timing and content Provide management reporting to support audit trail and reconciliation Other reports and technical documents may be developed as required throughout the project Potential Offeror Question (Q9): For Deliverable 8, can you provide information on the format of the required Unique Payer ID? Government Answer (A9): At this time, the Department of Health and Human Services, HIPAA, and CAQH CORE are silent on rules for payer/clearinghouse specific Unique Payer IDs used by trading partners in electronic transactions to uniquely identify the payer. VA systems are capable of handling up to a 30 character alpha-numeric Unique Payer ID until such time as HHS publishes rules and mandates use of standardized Health Plan Identifier(s) (HPID). Potential Offeror Question (Q10): For Deliverable 13, can you provide the policies under which this discovery is to be accomplished? Specifically, what security and privacy requirements are to be followed to ensure adherence to HIPAA, HITECH, and other security and privacy requirements? Government Answer (A10): A successful vendor will describe a technical approach to searching their systems for insurance policy information when VA does not already know the insurance policy information. As per PWS task 13, The contractor will receive Government furnished patient demographics in  HIPAA  standard formatting  to perform insurance coverage discovery activities with results being sent back to VA in HIPAA standard formatting. Government furnished patient demographics can include Patient Name, Patient DOB, Patient Address and Patient Social Security Number (SSN). VA will be seeking non-Medicare and non-Medicaid commercial policies through this process. All insurance coverage discovery transactions shall be conducted in HIPAA 270/271 formats and as such comply with HIPAA, HITECH and as well as all other security requirements as stipulated in the PWS Section C. Potential Offeror Question (Q11): Section E.4 details the Alternate Protest Procedure and starts on page 38 of the solicitation. The Evaluation Factors start on page 39 and appear to be part of that Section E.4 as the Evaluation Factors are followed by Section E.5.The Evaluation Factors start with a paragraph 3, Evaluation, and there does not appear to be paragraphs 1 or 2 associated with this. Is the Evaluation Section complete as it is included in the Solicitation? Is it part of Section E.4? Government Answer (A11): The Evaluation Section was specifically tailored for this requirement and manually inserted. Please note that the Evaluation Factors are complete. Potential Offeror Question (Q12): In paragraph 8 of the PWS, certain holidays are defined as days where no charges will be incurred.   How will transactions that are generated on these days be handled?   Government Answer (A12): Paragraph 8 is a standard PWS clause and a vendor should not expect to provide personal services, responses to emails, or other monitoring activities that can be billed to VA. Transactions that are automatically processed during Holidays shall be covered under a specific waiver authorized by VA Contracting Officer. The processing of transactions will be electronic and a 24 hour a day, 365 day a year process. This would only apply if we were using contractor personnel as part of a program support requirement. Potential Offeror Question (Q13): How does the date of March 19, 2018 defined in Section C.1 52.216-18 ORDERING (OCT 1995) relate to the Contract Award date of April 1, 2018? Government Answer (A13): VA anticipates contract award on March 19, 2018 but transaction processing would not be in effect until April 1, 2018. The time period between contract award and transaction processing start would be used to ensure communication systems between VA and Vendor are functioning as required for transaction processing. Potential Offeror Question (Q14): Under Evaluation Factors, paragraph 3. Evaluation (b) speaks to this proposal being a LPTA source selection with technical criteria being evaluated on a pass/fail basis. Paragraph 3, Evaluation (d) speaks to a Consensus Evaluation which includes significant strengths, strengths, weaknesses, significant weaknesses, deficiencies, and overall rating for the proposal or factor. If the overall rating is pass or fail, how will the significant strengths, strengths, weaknesses, significant weaknesses, deficiencies, and overall rating for the proposal or factor be used to select a vendor? A pass/fail grade would seem to render any further information of no consequence and ineligible for consideration. Government Answer (A14): The Evaluation Factors are modified to reflect that this is a LPTA requirement and there is no evaluation other than Pass/Fail. Potential Offeror Question (Q15): Please confirm that a Basis of Estimate is required or not for submission of a proposal. If a Basis of Estimate is required, is there a format preferred? Government Answer (A15): There is no requirement for submission of a Basis of Estimate. This was inserted when in the Request for Information and erroneously left in the Request for Quotation document. Potential Offeror Question (Q16): The turnaround time from submission of questions and obtaining answers is short. What are the procedures for asking for an extension in order to fully incorporate that additional information into a proposal? Government Answer (A16): There are no procedures for asking for an extension in order to fully incorporate the addition information into the proposal; as no extension will be granted. Potential Offeror Question (Q17): Reference: CLINS 1001AF and 1001AG. Based on our past history with programs of similar size and scope, the volume of transactions for Insurance Coverage Found and Non-Found transactions seem to be reversed. Did the government intend for CLIN 1001AF to be 36,000 while 1001AG to be 360,000? Will the government confirm the transaction volumes?   Government Answer (A17): Insurance Coverage Discovery processes have never been performed in this manner. CLIN 1001AG represents VA s estimate of transaction volume, based on available data of patient population that insurance policy information is likely to be found over the course of one year. CLIN 1001AG, there is no policy information available; this is based on an estimated. Potential Offeror Question (Q18): Reference: CLIN 0001AF. Based on past experience, we will be able to offer IOC for CLIN 0001AF in 30 days along with all other functionality. Would the government consider reducing the duration of the IOC and providing new base year CLINS (or early exercise of CLINS 1001AF and 1001AG) to take advantage of insurance coverage discovery transactions? Government Answer (A18): Current contract funding does not allow for early exercise of CLIN 1001AF and CLIN 1001AG. In addition, internal VA development efforts are scheduled to be completed no later than November 2018 to provide the ability to activate the insurance coverage discovery transactions nationally. Potential Offeror Question (Q19): Reference: General Requirements #5 and Sub-Factor 3 - General Technical Requirements of the PWS #c and #d. Requirements for HIPAA Eligibility & Claim Status (270/271) transactions to be compliant with Phase I & II CAQH CORE certification operating rules are clear throughout the solicitation.   Can the government clarify CAQH CORE certification requirements for the Health Insurance Portability and Accountability Act (HIPAA) Health Care Services Review Request for Review and Response (HIPAA X12N 278x217) and the Health Care Services Review Inquiry and Response (HIPAA X12N 278x215) transaction sets?   Government Answer (A19): At present; the Affordable Care Act (ACA) deadline for the effective date of implementation of national operating rules for Claims or Equivalent Encounter Information, Enrollment/Disenrollment in a Health Plan, Health Plan Premium Payments, Referral Certification and Authorization, and Claims Attachments was January 1, 2016. However, the Department of Health and Human Services (HHS) has not yet adopted operating rules or issued guidelines regarding compliance timeframes for these transactions. Therefore, until such time as HHS publishes guidelines and/or operating rules, general HIPAA mandates apply to these transactions. For more information on CAQH CORE please visit: https://www.caqh.org/core Potential Offeror Question (Q20): Reference: Task 3 Deliverable 3.1 Based on our experience with HIPAA 270 real-time inquiries, we have found response time for a majority of HIPAA 270 real-time inquiries to be less than one minute. For a small percentage (less than 1%) of transactions, we have noticed responses that can take one minute or more resulting from delays on the Payer systems. Will the government consider an average response of less than one minute for HIPAA 270 real-time inquiries acceptable in lieu of the requirement for a response time of less than one minute for each 270 real-time inquiry? Government Answer (A20): VA expects payers and clearinghouses to be fully HIPPA and CAQH CORE compliant, therefore real time responses not received within 60 seconds should trigger the clearinghouse s resubmission logic as per CAQH Phase II CORE 270: Connectivity Rule 4.3.6. Specific payer rules and/or systems may be taken into consideration on a case by case basis; but at no time should a real time response take longer than 15 minutes to return either with results or appropriate AAA message. Potential Offeror Question (Q21): Reference: Task 8. Can the government elaborate on the context and what is meant by Creation of a unique PAYERID for health care payers that shall eventually be converted to the national PAYERID ?   Government Answer (A21): At this time, the Department of Health and Human Services, HIPAA, and CAQH CORE are silent on rules for payer/clearinghouse specific Unique Payer IDs used by trading partners in electronic transactions to uniquely identify the payer. VA systems are capable of handling up to a 30 character alpha-numeric Unique Payer ID until such time as HHS publishes rules and mandates use of standardized Health Plan Identifier(s) (HPID). Potential Offeror Question (Q22): Reference: Task 12, Deliverable 12 regarding Special Projects - Does the government intend for this task to be included within the scope of 0001AD and 1001AD, Monthly Operational Support? Government Answer (A22): Yes. Potential Offeror Question (Q23): Reference: Optional Tasks 14-16 and B.3. There are no provisions or CLINS in the Price/Cost Schedules to address potential pricing for the optional tasks. Will tasks 14-16 be negotiated separately as described for Optional Task 17? Or will the government add Optional CLINS for Tasks 14-16 for the RFQ? Government Answer (A23): CLIN 1001AF and CLIN 1001AG separately priced and are assigned to optional Task 16. Task 16 will be priced in the contract and evaluated at the time of review, not negotiated afterwards. Optional Task 14, Optional Task 15, and Optional Task 17 are amended in the PWS as such; Optional Task 14: Access to HIPAA ASC X12N 278x217 & HIPAA ASC X12N 278x217 payers. In the event the contractor is requested to perform tasks not included in the Performance Work Statement, the amount of each task shall be negotiated and a task order issued. Optional Task 15: Provide Real-Time data exchange services for HIPAA ASC X12N 278x217 & HIPAA ASC X12N payers. In the event the contractor is requested to perform tasks not included in the Performance Work Statement, the amount of each task shall be negotiated and a task order issued. Optional Task 17: Perform Additional Tasks. The contractor will be asked to perform additional tasks related to healthcare EDI and its associated emerging technologies. In the event the contractor is requested to perform tasks not included in the Performance Work Statement, the amount of each task shall be negotiated and a task order issued. Potential Offeror Question (Q24): Will the Contracting Officer grant certain limited exception to the 50% provision in 125.6? 125.6 What are the prime contractor s limitations? (1) In the case of a contract for services (except construction), it will not pay more than 50% of the amount paid by the government to it to firms that are not similarly situated. Any work that a similarly situated subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded. (2) In paragraph (g) Request to change applicable limitations on subcontracting. SBA may use different percentage. Government Answer (A24): VA will not seek an SBA waiver for this contract as per 13 CFR 125.6. VA requires all vendors performing electronic healthcare transactions to carry both EHNAC accreditation and CAQH CORE certificates. As per Department of Veterans Affairs, Deputy Assistant Secretary for Information Security memo dated September 2, 2016; EHNAC provides a valuable service through accreditation programs that promote the standards, best practices, administrative simplification, open competition and protection of information exchange regarding security, privacy, and confidentiality in the [healthcare] marketplace HIPPA covered entities are bound by the provisions found in the HIPAA Privacy and Security rules (45 CFR Parts 160 & 164, Subparts A & C Security Standards for the Protection of Electronic Protected Health Information; Standards for Privacy of Individually Identifiable Health Information; HITECH Act 2009; and the Affordable Care Act (ACA). These mandates specifically reference the NIST SP 800-53, NIST SP 800-66 and include penalties for failure to comply and for breaches. Vendors who carry EHNAC accreditation(s) do not have to seek separate privacy and security accreditation from the Department of Veterans Affairs, Office of Information Technology (OIT), which can be a lengthy process. An EHNAC accreditation also ensures a respected industry leader and non-governmental agency has thoroughly and independently verified vendor(s) meet the requirements for privacy, security and performance of electronic health networks as stipulated by HIPAA. In addition, both the State of Maryland (http://mhcc.maryland.gov/mhcc/pages/hit/hit_ehn/hit_ehn_application_process.aspx) and the State of New Jersey (http://www.state.nj.us/dobi/proposed/ad060605.pdf) require EHNAC accreditation to conduct electronic transaction business in their states, and several VA Medical Centers operate in these states. Coalition for Affordable Quality Healthcare  (CAQH) Committee on Operating Rules for Information Exchange (CORE) is named by the Secretary of Health and Human Services (HHS) as the official author of national operating rules that have since been incorporated into HIPAA law by the ACA. As of January 2013, all HIPAA-covered entities were required to adhere to CAQH CORE Phase I and Phase II HIPAA 270 Operating Rules. By obtaining and maintaining a CAQH CORE certification, VA is ensuring all vendors receiving and transmitting electronic PHI are complaint with federal law and adhere to the administrative simplification and standards set forth by HIPAA. Current contracting principles are to announce this offer under the SDVOSB set aside. If SDVOSB vendors are unable to meet the requirements of the PWS it may be reposted without the SDVOSB set aside requirement. Both EHNAC and CAQH CORE are required by all vendors at the time of contract award. Shall be a fully Accredited Healthcare Network (HNAP-EHN and ePAP-EHN accredited) by the Electronic Healthcare Network Accreditation Commission (EHNAC) (https://www.ehnac.org/) at the time of contract award and maintain accreditation for the duration of the Contract. Shall be certified by the Council for Affordable and Quality Healthcare (CAQH); per Section 104 of the Patient Protection and Affordable Care Act as following the  Phase I & II CAQH CORE Operating Rules for HIPAA  Eligibility & Claim Status  (270/271) at the time of contract award and maintain certification for the duration of the Contract. Potential Offeror Question (Q25): In section B. SCHEDULEFOR DELIVERABLES: (Page 10) Deliverable 13.1, does the payer list where insurance coverage may be searched mirror the payer list supplied on pages 33 36 of this RFQ? Government Answer (A25): A successful vendor will provide an insurance coverage discovery payer list that contains payers listed in Appendix A and/or inclusion of the industry s largest and most popular payers. Potential Offeror Question (Q26): In section B. SCHEDULEFOR DELIVERABLES: a. (Page 11) Please provide additional information on the description of Deliverable #1 as compared to Deliverable #2 the Items are both named Payer List & Payer List. b. (Page 12) Deliverable #6, Delivery Date: Within 1 month of contract. The contractor ability to meet that time requirement depends on a Payer s response time to the contractor which is out of the control of the contractor. Some payers may take 45 days to respond to the provider s request. In most cases the contractor will either already have connectivity with the payer or the payer is responsive but the payer may not be responsive. Question: Will the Contracting Officer hold the contractor responsible for failure of the payer to meet the 1 month requirement if the payer does not respond to request timely? Government Answer (A26): A successful vendor will demonstrate day 1 connections with the payers listed in Section D, Appendix A as per Task 2. Task 2 specifically states The Contractor shall provide an appropriate transmission vehicle to ensure the delivery of HIPAA 270 inquiries from the Contractor's site to each responsible Payer or their contracted representative. VA shall provide the Contractor with a list of payers VA deems most important to access for initial implementation. The Contractor shall initiate a dialog with each responsible Payer to establish an understanding of the requirements associated with and to fulfill the obligation of relaying VA inquiries to and from Payers. A successful vendor will demonstrate connectivity to additional payers not listed in Appendix A within one month or less as per Task 1; with a highly successful vendor demonstrating connectivity to payers, including, but not limited to the following top payers: Colonial Penn, Cigna Behavioral Health, Bankers Life, and Independent Health. Potential Offeror Question (Q27): In section B.3, PRICE/COST SCHEDULE; pgs. 17 & 18 of 60 in the RFQ Please define or illustrate the difference between the following: DESCRIPTION OF SUPPLIES/SERVICES. Can you explain the rational why each of these transactions needs to be identified and separated for pricing? 0001AA Participating Payer Transaction volume. 0001AB Standard payer s transaction volume. 0001AC Non-participating payer s transaction volume. Government Answer (A27): During market research, VA determined a tiered pricing structure is common in the industry and expects contract pricing to reflect discounts given to participating payer transactions over standard payer transactions and discounts given to standard payer transactions over non-participating payer transactions. A.1 52.212-1 INSTRUCTIONS TO OFFERORS COMMERCIAL ITEMS (JAN 2017) (a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code and small business size standard for this acquisition appear in Block 10 of the solicitation cover sheet (SF 1449). However, the small business size standard for a concern which submits an offer in its own name, but which proposes to furnish an item which it did not itself manufacture, is 500 employees. (b) Submission of offers. Submit signed and dated offers to the office specified in this solicitation at or before the exact time specified in this solicitation. Offers may be submitted on the SF 1449, letterhead stationery, or as otherwise specified in the solicitation. As a minimum, offers must show (1) The solicitation number; (2) The time specified in the solicitation for receipt of offers; (3) The name, address, and telephone number of the offeror; (4) A technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary; (5) Terms of any express warranty; (6) Price and any discount terms; (7) "Remit to" address, if different than mailing address; (8) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically); (9) Acknowledgment of Solicitation Amendments; (10) Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information); and (11) If the offer is not submitted on the SF 1449, include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration. (c) Period for acceptance of offers. The offeror agrees to hold the prices in its offer firm for 30 calendar days from the date specified for receipt of offers, unless another time period is specified in an addendum to the solicitation. (d) Product samples. When required by the solicitation, product samples shall be submitted at or prior to the time specified for receipt of offers. Unless otherwise specified in this solicitation, these samples shall be submitted at no expense to the Government, and returned at the sender's request and expense, unless they are destroyed during preaward testing. (e) Multiple offers. Offerors are encouraged to submit multiple offers presenting alternative terms and conditions, including alternative line items (provided that the alternative line items are consistent with subpart 4.10 of the Federal Acquisition Regulation), or alternative commercial items for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately. (f) Late submissions, modifications, revisions, and withdrawals of offers. (1) Offerors are responsible for submitting offers, and any modifications, revisions, or withdrawals, so as to reach the Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that offers or revisions are due. (2)(i) Any offer, modification, revision, or withdrawal of an offer received at the Government office designated in the solicitation after the exact time specified for receipt of offers is "late" and will not be considered unless it is received before award is made, the Contracting Officer determines that accepting the late offer would not unduly delay the acquisition; and (A) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of offers; or (B) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of offers and was under the Government's control prior to the time set for receipt of offers; or (C) If this solicitation is a request for proposals, it was the only proposal received. (ii) However, a late modification of an otherwise successful offer, that makes its terms more favorable to the Government, will be considered at any time it is received and may be accepted. (3) Acceptable evidence to establish the time of receipt at the Government installation includes the time/date stamp of that installation on the offer wrapper, other documentary evidence of receipt maintained by the installation, or oral testimony or statements of Government personnel. (4) If an emergency or unanticipated event interrupts normal Government processes so that offers cannot be received at the Government office designated for receipt of offers by the exact time specified in the solicitation, and urgent Government requirements preclude amendment of the solicitation or other notice of an extension of the closing date, the time specified for receipt of offers will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume. (5) Offers may be withdrawn by written notice received at any time before the exact time set for receipt of offers. Oral offers in response to oral solicitations may be withdrawn orally. If the solicitation authorizes facsimile offers, offers may be withdrawn via facsimile received at any time before the exact time set for receipt of offers, subject to the conditions specified in the solicitation concerning facsimile offers. An offer may be withdrawn in person by an offeror or its authorized representative if, before the exact time set for receipt of offers, the identity of the person requesting withdrawal is established and the person signs a receipt for the offer. (g) Contract award (not applicable to Invitation for Bids). The Government intends to evaluate offers and award a contract without discussions with offerors. Therefore, the offeror's initial offer should contain the offeror's best terms from a price and technical standpoint. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received. (h) Multiple awards. The Government may accept any item or group of items of an offer, unless the offeror qualifies the offer by specific limitations. Unless otherwise provided in the Schedule, offers may not be submitted for quantities less than those specified. The Government reserves the right to make an award on any item for a quantity less than the quantity offered, at the unit prices offered, unless the offeror specifies otherwise in the offer. (i) Availability of requirements documents cited in the solicitation. (1)(i) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to GSA Federal Supply Service Specifications Section Suite 8100 470 East L'Enfant Plaza, SW Washington, DC 20407 Telephone (202) 619-8925 Facsimile (202) 619-8978. (ii) If the General Services Administration, Department of Agriculture, or Department of Veterans Affairs issued this solicitation, a single copy of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained free of charge by submitting a request to the addressee in paragraph (i)(1)(i) of this provision. Additional copies will be issued for a fee. (2) Most unclassified Defense specifications and standards may be downloaded from the following ASSIST websites: (i) ASSIST (https://assist.dla.mil/online/start/); (ii) Quick Search (http://quicksearch.dla.mil/); (iii) ASSISTdocs.com (http://assistdocs.com). (3) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point (DoDSSP) by? (i) Using the ASSIST Shopping Wizard (https://assist.dla.mil/wizard/index.cfm); (ii) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or (iii) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone (215) 697-2667/2179, Facsimile (215) 697-1462. (4) Nongovernment (voluntary) standards must be obtained from the organization responsible for their preparation, publication, or maintenance. (j) Unique entity identifier. (Applies to all offers exceeding $3,500, and offers of $3,500 or less if the solicitation requires the Contractor to be registered in the System for Award Management (SAM) database.) The Offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation Unique Entity Identifier followed by the unique entity identifier that identifies the Offeror s name and address. The Offeror also shall enter its Electronic Funds Transfer (EFT) indicator, if applicable. The EFT indicator is a four-character suffix to the unique entity identifier. The suffix is assigned at the discretion of the Offeror to establish additional SAM records for identifying alternative EFT accounts (see subpart 32.11) for the same entity. If the Offeror does not have a unique entity identifier, it should contact the entity designated at www.sam.gov for unique entity identifier establishment directly to obtain one. The Offeror should indicate that it is an offeror for a Government contract when contacting the entity designated at www.sam.gov for establishing the unique entity identifier. (k) System for Award Management. Unless exempted by an addendum to this solicitation, by submission of an offer, the offeror acknowledges the requirement that a prospective awardee shall be registered in the SAM database prior to award, during performance and through final payment of any contract resulting from this solicitation. If the Offeror does not become registered in the SAM database in the time prescribed by the Contracting Officer, the Contracting Officer will proceed to award to the next otherwise successful registered Offeror. Offerors may obtain information on registration and annual confirmation requirements via the SAM database accessed through https://www.acquisition.gov. (l) Debriefing. If a post-award debriefing is given to requesting offerors, the Government shall disclose the following information, if applicable: (1) The agency's evaluation of the significant weak or deficient factors in the debriefed offeror's offer. (2) The overall evaluated cost or price and technical rating of the successful and the debriefed offeror and past performance information on the debriefed offeror. (3) The overall ranking of all offerors, when any ranking was developed by the agency during source selection. (4) A summary of the rationale for award; (5) For acquisitions of commercial items, the make and model of the item to be delivered by the successful offeror. (6) Reasonable responses to relevant questions posed by the debriefed offeror as to whether source-selection procedures set forth in the solicitation, applicable regulations, and other applicable authorities were followed by the agency. (End of Provision)
 

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File Name: 36C77718Q0012 00001 36C77718Q0012 00001_1.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=4087392&FileName=36C77718Q0012-00001000.docx)

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