R--Medical Claims

Agency: Department of Veterans Affairs
State: Virginia
Type of Government: Federal
FSC Category:
  • R - Professional, Administrative and Management Support Services
NAICS Category:
  • 524292 - Third Party Administration of Insurance and Pension Funds
Set Aside: Service-Disabled Veteran-Owned Small Business
Posted Date: Sep 27, 2019
Due Date: Oct 4, 2019
Solicitation No: 36C10G19R0018
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Opportunity History
Solicitation Number :
36C10G19R0018
Notice Type :
Combined Synopsis/Solicitation
Synopsis :
Added: Aug 16, 2019 11:35 am
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
Please consult the list of document viewers if you cannot open a file.
Attachment
Type:
Other (Draft RFPs/RFIs, Responses to Questions, etc..)
Label:
Attachment
Posted Date:
August 16, 2019
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111784&FileName=36C10G19R0018-001.docx
Description: 36C10G19R0018 36C10G19R0018_1.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111786&FileName=36C10G19R0018-002.docx
Description: 36C10G19R0018 Attachment A Schedule Med Claims (JT) FINAL.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111787&FileName=36C10G19R0018-003.docx
Description: 36C10G19R0018 Attachment B Contract Administration (JT) Final.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111789&FileName=36C10G19R0018-004.docx
Description: 36C10G19R0018 Attachment C Clauses (JT) Final.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111791&FileName=36C10G19R0018-005.docx
Description: 36C10G19R0018 Attachment D Performance Work Statement Final, (JT).docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111792&FileName=36C10G19R0018-006.docx
Description: 36C10G19R0018 Attachment E Solicitation Provisions Final (JT).docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111794&FileName=36C10G19R0018-007.docx
Description: 36C10G19R0018 Attachment F Past Performance Final (JT) Final.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5111796&FileName=36C10G19R0018-008.docx
Description: 36C10G19R0018 Attachment G Quality Assurance Surveillance Plan (JT) Final.docx
Amendment 1
Type:
Mod/Amendment
Posted Date:
September 11, 2019
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5150364&FileName=36C10G19R0018-A00001000.docx
Description: 36C10G19R0018 A00001 36C10G19R0018 A00001.docx
Amendment 2
Type:
Mod/Amendment
Posted Date:
September 20, 2019
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164307&FileName=36C10G19R0018-A0002000.docx
Description: 36C10G19R0018 A0002 36C10G19R0018 A0002.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164308&FileName=36C10G19R0018-A0002001.docx
Description: 36C10G19R0018 A0002 36C10G19R0018 QA A-0002.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164309&FileName=36C10G19R0018-A0002002.docx
Description: 36C10G19R0018 A0002 SF 1449 36C10G19R0018 A-0002.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164310&FileName=36C10G19R0018-A0002003.docx
Description: 36C10G19R0018 A0002 Attachment A Schedule Med Claims A-0002.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164311&FileName=36C10G19R0018-A0002004.docx
Description: 36C10G19R0018 A0002 Attachment D Performance Work Statement A-0002.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164312&FileName=36C10G19R0018-A0002005.docx
Description: 36C10G19R0018 A0002 Attachment E Solicitation Provisions Final A-0002.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164313&FileName=36C10G19R0018-A0002006.pdf
Description: 36C10G19R0018 A0002 2015-5215 Austin WD.pdf
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164314&FileName=36C10G19R0018-A0002007.pdf
Description: 36C10G19R0018 A0002 2015-5261 Waco WD.pdf
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5164315&FileName=36C10G19R0018-A0002008.xlsx
Description: 36C10G19R0018 A0002 EXAMPLE Medical Claims Pricing Sheets EXAMPLE A-0002.xlsx
Amendment 3
Type:
Mod/Amendment
Posted Date:
September 27, 2019
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5171841&FileName=36C10G19R0018-A0003000.docx
Description: 36C10G19R0018 A0003 36C10G19R0018 A0003.docx
https://www.vendorportal.ecms.va.gov/FBODocumentServ...
https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=5171842&FileName=36C10G19R0018-A0003001.docx
Description: 36C10G19R0018 A0003 36C10G19R0018 QA A-0003.docx
Contracting Office Address :
U.S. Department of Veterans Affairs;OPAL | Strategic Acquisition Center;10300 Spotsylvania Ave | STE 400;Fredericksburg VA 22408-2697
Point of Contact(s) :
Glenn Burton; Glenn.Burtonjr@va.gov
Sharon Redman; Sharon.Redman@va.gov

Glenn.BurtonJr@va.gov
All Files
Attachment
Aug 16, 2019
36C10G19R0018 36C10G...
36C10G19R0018 36C10G19R0018_1.docx
36C10G19R0018 Attach...
36C10G19R0018 Attachment A Schedule Med Claims (JT) FINAL.docx
36C10G19R0018 Attach...
36C10G19R0018 Attachment B Contract Administration (JT) Final.docx
36C10G19R0018 Attach...
36C10G19R0018 Attachment C Clauses (JT) Final.docx
36C10G19R0018 Attach...
36C10G19R0018 Attachment D Performance Work Statement Final, (JT).docx
36C10G19R0018 Attach...
36C10G19R0018 Attachment E Solicitation Provisions Final (JT).docx
36C10G19R0018 Attach...
36C10G19R0018 Attachment F Past Performance Final (JT) Final.docx
36C10G19R0018 Attach...
36C10G19R0018 Attachment G Quality Assurance Surveillance Plan (JT) Final.docx
Amendment 1
Sep 11, 2019
36C10G19R0018 A00001...
36C10G19R0018 A00001 36C10G19R0018 A00001.docx
Amendment 2
Sep 20, 2019
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 36C10G19R0018 A0002.docx
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 36C10G19R0018 QA A-0002.docx
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 SF 1449 36C10G19R0018 A-0002.docx
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 Attachment A Schedule Med Claims A-0002.docx
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 Attachment D Performance Work Statement A-0002.docx
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 Attachment E Solicitation Provisions Final A-0002.docx
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 2015-5215 Austin WD.pdf
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 2015-5261 Waco WD.pdf
36C10G19R0018 A0002 ...
36C10G19R0018 A0002 EXAMPLE Medical Claims Pricing Sheets EXAMPLE A-0002.xlsx
Amendment 3
Sep 27, 2019
36C10G19R0018 A0003 ...
36C10G19R0018 A0003 36C10G19R0018 A0003.docx
36C10G19R0018 A0003 ...
36C10G19R0018 A0003 36C10G19R0018 QA A-0003.docx
General Information
Notice Type:
Combined Synopsis/Solicitation
Original Posted Date:
August 16, 2019
Posted Date:
September 27, 2019
Response Date:
October 4, 2019
Original Response Date:
September 13, 2019
Archiving Policy:
Automatic, on specified date
Original Archive Date:
December 12, 2019
Archive Date:
December 12, 2019
Original Set Aside:
Service-Disabled Veteran-Owned Small Business
Set Aside:
Service-Disabled Veteran-Owned Small Business
Classification Code:
R -- Professional, administrative, and management support services
NAICS Code:
524 -- Insurance Carriers and Related Activities/524292 -- Third Party Administration of Insurance and Pension Funds

Related Document

Feb 26, 2019[Presolicitation] R--Medical Claims
Aug 16, 2019[Combined Synopsis/Solicitation] R--Medical Claims
Sep 11, 2019[Combined Synopsis/Solicitation] R--Medical Claims
Sep 20, 2019[Combined Synopsis/Solicitation] R--Medical Claims

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