MOD | Q | Compensation and Pension Exams Sources Sought Amendment

FBO DAILY ISSUE OF APRIL 13, 2011 FBO #3427
MODIFICATION

Q -- Compensation and Pension Exams Sources Sought Amendment

Notice Date: 4/11/2011
Notice Type: Modification/Amendment
NAICS: 621111 — Offices of Physicians (except Mental Health Specialists)
Contracting Office: Department of Veterans Affairs;VISN 9 ASC (90C);1639 Medical Center Parkway, Suite 400;Murfreesboro TN 37129
ZIP Code: 37129
Solicitation Number: VA24911RP0144
Response Due: 4/14/2011
Archive Date: 6/13/2011
Point of Contact: Christina (Tina) B Smith
Small Business Set-Aside: N/A
Description: This is an amendment to the Sources Sought notice released 4/2/11. The DUE DATE IS CHANGED to 4/14/11, as the month due was inadvertently listed as May. The Department of Veterans Affairs, VISN 9, Network Contracting Activity (NCA) VISN 9 Central Region, Murfreesboro, Tennessee proposes to award a short-term indefinite delivery, indefinite quantity contract to provide examinations to support claims processing for Veterans at the VA MidSouth Healthcare Network facilities who have filed a claim for disability compensation or pension (C&P) benefits. The short term contract will have a six month performance period with a six month option to extend services. This requirement is to provide compensation and pension examinations for patients at VISN 9 facilities. VISN 9 currently receives approximately 4200-4500 exam requests a month from VBA. Service area includes six medical centers and two outpatient clinics in the VA MidSouth Healthcare Network. Contractor shall have the capability within 45 days of contract award and shall be mobilized to perform examinations for the VA MidSouth Healthcare Network (VISN 9). STATEMENT OF WORK DISABILITY EXAMINATION SERVICES FOR COMPENSATION & PENSION A. GENERAL INFORMATION A.1Scope of Work Under the authority of 38 USC 1703(a)(8) and FAR Parts 12 and 15, Contractor shall provide Health Care Resources in accordance with the terms and conditions stated herein, to be furnished to the VA MidSouth Healthcare Network (VISN 9). VISN 9 is comprised of six medical centers in Huntington, West Virginia; Lexington, Kentucky; Louisville, Kentucky; Memphis, Tennessee; Mountain Home/Johnson City, Tennessee; and Nashville/Murfreesboro, Tennessee. The Contractor shall provide all resources necessary to accomplish the requirements described in the Statement of Work (SOW), except as may otherwise be specified. The Contractor is expected to perform required examinations and ancillary procedures with medical staff trained to perform Disability Examinations to the Department of Veterans Affairs (VA) standards. The Contractor shall perform a comprehensive examination, document all clinical findings, adhere to VA approved templates and shall provide completed reports to the VA through secure procedures. The contractor shall additionally perform all administrative procedures to include contacting veterans and/or service members to schedule examinations. Contractor shall have the capability within 45 days of contract award and shall be mobilized to perform examinations for the VA MidSouth Healthcare Network (VISN 9) in the following counties: Cabell, WV (Huntington); Fayette, KY (Lexington); Jefferson, KY (Louisville); Shelby, TN (Memphis); Washington, TN (Johnson City); Knox, TN (Knoxville); Davidson, TN (Nashville); Rutherford, TN (Murfreesboro); and Hamilton, TN (Chattanooga). A.2Background The Department of Veterans Affairs (VA) Disability Compensation and Pension (C&P) Program provides monthly payments to veterans in recognition of the effects of disabilities, diseases, or injuries incurred or aggravated during active military service. A disability may be determined by VA to be service-connected on a direct basis, a secondary basis, a presumptive basis, or on the basis of aggravation. Compensation may also be paid for the worsening of a non-service connected condition aggravated by a service-connected condition. The VA Pension Program provides monthly payments, as specified by law, to needy wartime veterans who are permanently and totally disabled as a result of disability not related to military service. About 3 million veterans and their dependents receive VA disability C&P benefits. VA conducts medical examinations and produces medical evidence reports based on those examinations. VA Rating Specialists uses the Disability Examination reports and other available medical evidence from the claim to determine the rating of the compensable disability. Disability examinations are critical pieces of evidence for determining the extent of permanent impairment, and thus the percent of disability that defines the benefits a veteran is awarded. Because it is so critical, the examination report must be of highest quality, providing valid, essential information to support each disability diagnosed, impairment statement and causality opinion. It is not enough to simply state a diagnosis and impairment statement and opinion if necessary. The examination report must provide detailed information sufficient for Veterans Benefits Administration (VBA) to arrive at a determination that is able to withstand the scrutiny of appellate review. A.3Place of Performance Contractor and subcontractor locations and military installations as required. B.STATEMENT OF WORK B.1 “ General Requirements B.1.1The contractor will be required to perform disability examination services to support claims processing for veterans and or service members who have filed a claim for disability compensation or pension benefits. The contractor shall provide the full range of medical Disability Examinations for the following areas; musculoskeletal; organs of sense; infectious, immune, and nutritional deficiencies; respiratory; cardiovascular; digestive; genitourinary; gynecological and breast; hemic and lymphatic; skin; endocrine; neurologic; mental disorders; and dental and oral examinations. Based on specific VA request, special purpose examinations shall be provided including: cold injury protocol, and aid and attendance or housebound status examinations. Audiology, dental, ophthalmology, and psychiatric examinations must be conducted by specialists in those fields. Traumatic Brain Injury (TBI) examinations may be performed by certified general medical physicians combined with cognitive screening performed by qualified providers. B.1.2Examinations for the following categories remain within the VA system except for special exception cases agreed upon in advance by VA and the contractor: Original Gulf War Environmental Claims for undiagnosed illnesses; U.S. Court of Veterans Appeals cases; examinations for Aid and Attendance/Housebound benefits; examinations requiring hospitalization or surgical evaluation, such as sleep apnea or endometriosis needing laparoscopy; former Prisoners of War; 38 USC 1151 initial determinations; veterans residing in VA domiciliaries/nursing homes; and incarcerated veterans. In addition, no requests for review of records in the determination of Death Indemnity Compensation (DIC) are sent to the contractor. B.1.3The Contractor shall furnish all required services, facilities, and equipment required to perform the contract in accordance with the terms, conditions, and specifications and at the established firm fixed price rates. B.1.4The Contractor shall ensure that all staff performing Disability Examinations receive VA-approved training for all required disability examination modules and general VA disability examination training. B.1.5The Contractor is expected to incorporate the accepted VA toolsets for performing examinations: CAPRI. The VA information technology (IT) system, Compensation And Pension Records Interchange (CAPRI) provides a graphical user interface to access the Veterans Health Information Systems and Technology Architecture (VistA). It is used to communicate Disability Examination requests and reports between VBA and VHA. When VHA providers perform Disability Examinations they use CAPRI where they access a template framework that allows practitioners to use approved templates to perform VA Disability Examinations and the resulting examination results are then submitted through CAPRI. B.1.6The Contractor may use their own information system for receiving examination requests, performing examinations, and returning completed examination reports. Support of effective communication mechanisms of the exam request and completed reports from and to CAPRI is required. B.1.7If the Contractor elects to use their own information system, the Contractor shall provide VA access to its secure Management Information System for real-time status information such as Veteran examination requests. Contractor shall provide information technology capability to receive on-line examination requests, messages from VA, maintain status information accessible by VA, maintain completed examination reports accessible in a database for a period of not less than 18 months, and return completed examination reports to VA staff. B.1.8The contractor shall resolve any erroneous bills received by veterans and issue appropriate documentation to the veteran that the issue has been resolved. B.1.9The Contractor will have 45 days from contract award to have trained, qualified staff available and fully operational to perform disability examinations in at least 50% of the covered geographic area and 90 days to establish 100% coverage. New geographic areas tasked after contract award will also use this start up approach and timeline. B.2 “ Scheduling B.2.1The VA authorized ordering entities will issue a form 2507 to denote the types of Disability Examinations to be performed. For Disability Examination requests that might require further clarification, the Contractor shall contact the requesting VAMC. B.2.2 The VA requires the contractor to schedule Disability Examinations for the veterans and/or service members. The contractor shall make a minimum of one attempt to contact Veteran or Service Member Point of Contact (POC) via telephone to schedule appointments. The contractor shall notify the veteran of the scheduled appointment date, time and location at least five days prior to the scheduled appointment by mail, telephone and/or e-mail, and works with the physician ™s office to assure that the veteran is seen within one hour of the scheduled appointment time. B.2.3Every attempt is made to schedule examinations as close to the veteran's home of record as feasible. The VA will be consulted when travel distance exceeds fifty (50) miles for non-specialist examination and one hundred (100) miles for specialist examinations. The VA may allow for greater distances for remote geographical areas. B.2.4 Contractor shall limit rescheduling of a cancelled appointment to one (1) unless otherwise requested by VA. B.2.5The contractor also provides toll-free access for veterans to call with questions regarding their scheduled appointments from 8 am to 8 pm Eastern Standard Time. B.3 “ Medical Records B.3.1Review of medical records, or Claims File (C-File), by the examiner is required for some Disability Examinations and will be denoted on the exam request. Medical records/C-Files will not be sent to the Contractor for every examination request. VA will make available applicable veteran ™s/service member ™s medical records prior to the examination in a secure manner either with the exam request or within 2 business days of submitting the exam request. The VA may provide the entire C-File or only the pertinent records for the exam request in either an electronic or hardcopy form. B.3.2If hardcopy records are sent, the contractor may scan the contents of the claims file to be transmitted to the physician(s) electronically. Contractor shall return the Veterans ™ claims folders to their originating source in the same order in which they were received not later than five workdays after completion of the requested examination in the same condition in which they were sent; e.g., stapled items must be re-stapled together in the same manner, order, etc. The Contractor shall ensure that the records are returned via a secure, traceable mailing method. Upon completion of the examination, the contractor shall also make the scanned electronic copy available for VA to obtain and upload into its Virtual VA system. B.3.3Contractor shall provide physician(s) with a copy of the veteran ™s medical records, if applicable or required by VA, prior to the examination in a secure manner. B.3.4The contractor will maintain records that comply with applicable state and federal patient standards for privacy policy and the Privacy Act (i.e. HIPAA). All records must be typewritten, accurate, complete and in compliance with professional standards. B.4 “ Exam Requirements B.4.1 All examinations shall be conducted in accordance with VA-issued examination worksheets specified in the examination request. The C&P Worksheets, which can be found at: http://www.vba.va.gov/bln/21/Benefits/exams/index.htm. The examination worksheets provide detailed examination requirements based upon legislative and court mandated criteria for VA disability entitlement determinations. Changes may be made periodically to the examination worksheets to reflect changing regulatory or medical requirements. VA will notify the Contractor in writing when changes occur. Contractor shall accommodate all technical changes without revision of the price schedule unless the change results in the provision of a new service for which pricing had not already been established. B.4.2All test and procedures the examination worksheets require shall be conducted unless not medically advisable or declined by the individual examined. The examination report must detail and document any reason for not performing a requested test or study. Waivers for declined tests must be attached to the exams upon submission to VA. VA will not be providing a specific waiver form. Tests listed in the examination worksheets represent guidelines. Additional standard tests may be used to establish a diagnosis or severity of disability. Any additional tests necessary to establish a diagnosis or to determine severity of disease or injury shall also be conducted. No invasive procedure shall be performed without the prior approval of the requesting office, the individual to be examined, and the VAMC. B.4.3If recent test results are documented in the record and available to the examining physician for review, those tests need not be repeated unless specifically requested by the VAMC or there is indication of recent changes in the condition examined. Unless otherwise specified in the examination worksheets, any tests conducted within a twelve-month period prior to the current examination shall be considered recent and sufficient, unless there is an indication of recent changes in condition being examined. B.4.4All claimed conditions identified on the examination request MUST be examined. All questions included in the examination worksheet must be answered. If the answer is either yes or no, a clear statement must be included explaining why a definitive answer could not be provided and specifying the probability of a positive response with a statement of the evidentiary basis for that assumption. A diagnosis must be provided or a statement included that the claimed condition was not found, for each condition specified in the examination request. If a diagnosis cannot be established nor ruled out, the facts must be documented with a clear statement of why a diagnosis could not be established. B.4.5A statement that a diagnosis could not be established because additional tests are required will not be an acceptable reason for returning an examination without establishing a diagnosis or providing a statement that the claimed condition was not found. Unless the required tests were not medically advisable or are declined by the individual examined, incomplete reports that include a statement of this nature will be deemed unacceptable. B.4.6 Contractor shall segregate and bill appropriately between Expert Medical Opinions and Medical Record Reviews according to the Price Schedule. Expert Medical Opinions are in response to specific questions explicitly requested by the VAROs and contained in the exam order and are examiner-produced professional opinions required beyond the normal scope of an examination. A Medical Record Review, however, is the time spent by an examiner in reviewing a veteran ™s or service member ™s record and history in preparation for the examination. Medical Record Reviews are to be billed in accordance with the volume (in inches) of the information in the record that requires review. B.4.7Evaluation of musculo-skeletal conditions for functional loss of movement requires addressing the DeLuca requirement. At this time, this requirement can be met by three repetitive range of motions of the structure being tested, and documentation of any change in range of motion. B.4.8Use of Goldmann Bowl Perimeter Testing or similarly approved VA devices is required for visual field tests. B.4.9Comprehensive General Medical Examinations must document a complete review of each system. B.4.10Audiology exams must take place in a location that meets or exceeds all of the technical requirements as outlined in the work audiology examination work sheet/rating schedule. B.4.11At the Veteran ™s request, family members, caregivers, and significant others are permitted to accompany the Veteran during an examination but may not participate in and/or interfere with the examination. Only service animals are permitted. B.4.12Completed examination reports shall include an indication of the examiner ™s credentials (e.g. œMD if performed by Medical Doctor) and signature. The person signing the examination shall have been the person who conducted the examination and the VA will accept electronic signatures. B.4.13The Contractor shall alert the Veteran or service member of any abnormal finding during the examination which the Veteran or service member should follow-up with their primary physician. B.4.14The Contractor shall ensure that examination reports are adequate and in compliance with the examination request worksheets with review of test results by examiners documented, and any discrepancies resolved. B.4.15The VA is in the process of developing Disability Benefits Questionnaires (DBQs). DBQs are disease (condition) specific, and are designed to be easy for clinicians to use while succinctly providing the precise medical evidence needed by VBA Rating Veterans Service Representatives to make decisions on Veterans ™ disability benefits claims. DBQs are designed to ensure adequate reports by including all ratings criteria for each condition. Individual DBQs are expected to be released incrementally in the coming months when further direction will be provided since the intent is to replace the corresponding C&P Worksheet. Currently there are three DBQs available and included in the Price Schedule. The DBQs are available at the following URL: http://www.vba.va.gov/disabilityexams/. If the DBQ is to be used in the Disability Examination it will be indicated in the form 2507 exam request information. B.5 “ Examiner Qualifications B.5.1The Contractor shall ensure all examiners have all licenses, permits, accreditation, and certificates required by law, and provide them to the COTR upon request. The contractor shall ensure that the medical examinations are conducted by a graduate of an accredited medical school or other appropriately recognized professional school for non-physician providers. Prohibited from participation are individuals who are excluded, suspended, or otherwise barred from participation in the Medicare or Medicaid programs, or any other Federal or Federally-assisted program; whose license to provide health care services is currently revoked or suspended by a State licensing authority pursuant to adequate due process procedures for reasons bearing on professional competence, professional conduct, or financial integrity; or who, until a final determination is made, has surrendered such a license while formal disciplinary proceedings involving professional conduct are pending. All of the examiners ™ licenses must be clear and unrestricted while performing examinations under this contract. Examiners are not required to be licensed in the state where the examination will occur in order to provide flexibility in using licensed, trained, experienced examiners at all locations. This supports the use of traveling providers, especially in support of the VA/DoD joint initiative programs, and aids in site start up. B.5.2Physicians must be compliant with OSHA and the American Disabilities Act. B.5.3The contractor shall ensure that examiners have current medical malpractice liability insurance coverage. For States that maintain lower levels of medical malpractice liability insurance requirements for examiners/dentists, the VA will accept those State levels for the purposes of this contract. B.5.4The contractor shall maintain documentation of their credentialing review on file and make that information available to the VA for review upon request. The contractor shall check the status of its examiners on a semi-annual basis to ensure that licensing has not been revoked or disciplinary proceedings involving professional conduct are not pending. B.5.5The Contractor shall provide examiners and appropriately licensed facilities to conduct required laboratory testing, for the following areas, including, but not limited to: musculoskeletal; organs of sense, infectious, immune, and nutritional deficiencies; respiratory; cardiovascular; digestive; genitourinary; gynecological and breast; hemic and lymphatic; skin; endocrine; traumatic brain injury (TBI); neurologic; mental disorders; dental and oral examinations. B.5.6Licensed psychologists with a doctoral degree in psychology, i.e. PhD or PsyD, from a graduate program in psychology accredited by the American Psychological Association (APA) or Psychiatrist must perform all mental examinations including those for initial and review cases of Post-Traumatic Stress disorder. B.5.7Traumatic Brain Injury (TBI) examinations may be supported by a general medical practitioner that will conduct the consultative requirements and a psychologist will conduct the cognitive screening. If additional Neuropsychiatric Testing is required based on the exam, the contractor will schedule and perform the diagnostic. B.5.8The contractor shall ensure that state licensed audiologists who use the Maryland CNC hearing test conduct examinations for audiology. B.5.9Ophthalmologists or licensed optometrists must be used for eye examinations. B.5.10Contractor must meet individual facility credential and privileges requirements prior to performance of examinations in Government medical facilities at military installations, if applicable. B.5.11The contractor shall provide orientation and instructions to the examiners for conducting examinations for VA purposes based on the requirements provided in the C&P examination worksheets. In addition, the contractor shall prepare and implement a training program for all examiners to provide: ï‚§A basic overview of VA programs ï‚§Available sources of veteran assistance ï‚§An understanding of the core claims adjudication process (what the veteran may expect after the examination, who makes the decision, and whom to contact for more information) ï‚§Information concerning referral to the VA's health care system is also provided ï‚§Examiners shall meet with Veterans within one hour of the scheduled appointment time ï‚§Orientation and instructions to the examiners for conducting examinations for VA purposes based on the requirements provided in the C&P examination worksheets In addition, the contractor provides training to the examiners to: ï‚§Explain the differences between a VA disability examination protocol versus the examination protocol for treatment purposes ï‚§Ensure an appropriate attitude towards veterans and their unique circumstances ï‚§Ensure that examiners understand the VA's principle of reasonable doubt ("as least as likely as not") in the application of disabilities ï‚§Explain the concept of presumptive diagnoses in view of unique circumstances of military service ï‚§Ensure that examiners understand how to assess and document pain B.5.12The Contractor shall ensure that all practitioners performing Disability Examinations have received VA certification to perform Disability Examinations. The CPEP General Certification Course is included for all examiners and others are completed based on their support of specialty exams. Providers will be CPEP certified using VA Employee Education System (https://www.ees-learning.net) which provides easy access for non VA employees. This includes certification for the Traumatic Brain Injury (TBI) examinations. Cyber Security and Privacy Training are mandatory for all examiners and will use training materials from the VA. B.6 “ Privacy/Security B.6.1The contractor's staff will have access to sensitive veterans'/service members ™ records. The contractor shall prevent the unauthorized release of information obtained by employees in the performance of work required by this contract. The contractor shall ensure that employees are aware of and receive training, as necessary, on all regulations and laws, such as the Privacy Act, that restrict the release of information. Veteran ™s claims files and all examination reports and testing results are the property of the VA and the information contained therein is protected under the Privacy Act. All veteran claims folders forwarded for copying/scanning must be maintained in locked files while under the care of the contractor. B.6.2The contractor may have access to patient medical records, including patient treatment records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. The contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent that explicit disclosure authority from VA has been received. B.6.3 The level of background investigation for this effort is NACI/Low Risk and applies to individuals who have direct access to VA local area network (LAN) systems. They shall be the subject of a background investigation and must receive a favorable adjudication from the VA Security and Investigations Center (SIC). Once the contractor ™s background investigation has been initiated, contract performance may commence. If the security clearance investigation is not completed prior to the start date of the contract, the contract employee may work on the contract with an initiated status while the security clearance is being processed. B.6.4Training. All Contractor and subcontractor personnel requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and networks: i.Sign and acknowledge understanding of and responsibilities for compliance with the National Rules of Behavior related to access to VA information and information systems ii.Successfully complete VA Cybersecurity Awareness training and annual refresher training as required iii.Successfully complete VA General Privacy training and annual refresher training as required iv.Successfully complete any additional cybersecurity or privacy training as required for VA personnel with equivalent information system access The Contractor shall provide to the COTR a copy of the training certificates for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required. B.6.5The contractor shall ensure adequate LAN/Internet, data, information, and system security in accordance with VA standard operating procedures and standard contract language, conditions laws, and regulations. The contractor ™s firewall and web server shall meet or exceed the government minimum requirements for security. All government data shall be protected behind an approved firewall. Any security violations or attempted violations shall be reported to the VA project manager as soon as possible. The contractor shall follow all applicable VA policies and procedures governing information security. B.6.6Contractor shall have the capability to send and receive encrypted e-mail in accordance with VA standards. The Contractor shall provide email addresses to the COTR for distribution to the VAMCs. B.7 “ Quality Assurance Program B.7.1Determination of adequacy of Disability Examinations will be based on the professional judgment of the COTR or quality review board in each case. Compensation and Pension Examinations records are considered the property of the VA. B.7.2The Contractor, upon receipt of an insufficient examination, shall return the corrected insufficient examination reports to the VA within 14 calendar days without additional charge to VA. Insufficient examination reports are those that do not meet the examination worksheets requirements (i.e. no diagnosis, no testing performed, etc.) The only exception will be for charges incurred due to additional tests authorized by VA. Examination reports returned for clarification, correction, or completion will be amended and returned without additional charge. B.7.3The contractor shall demonstrate a quality assurance program to ensure that examination reports comply with the VA requirements before submission to the VA. The Contractor shall ensure that examination reports are adequate and in compliance with the examination request worksheets with review of test results by examiners documented, and any discrepancies resolved. B.7.4Not greater than 2% of examinations shall be deemed insufficient due to provider ™s action or lack of action. VA will evaluate examinations using the examination worksheets as a baseline for requirements. Quality will be determined based on completed examinations with all questions completely addressed and answered from the C&P examination worksheets; proper worksheets utilized; proper tests, procedures, laboratory work, and x-rays utilized; and correct billing codes and CLINS for examinations, tests, procedures, laboratory work, and x-rays utilized. B.8 “ Reporting B.8.1The Contractor shall forward to VA completed Disability Examination reports within an average of 20 days for C&P exams from receipt of the examination request. Time begins on the date the contractor receives the examination request and ends on the date the report is delivered to the VA. Photographs shall be delivered within 24 hours of the report delivery date. B.8.2The contractor shall provide completed Disability Examination reports in an electronic Word and a PDF format signed by the examiner. The Contractor may use their own information system for returning completed examination reports and support of effective communication mechanism of completed reports to CAPRI is required. B.8.3The Contractor shall provide the Contracting Officer ™s Technical Representative (COTR) a consolidated monthly status report of examination requests sorted by site not later than the 15th of each month for the previous month. These monthly status reports shall include overall and site-specific data for the following: 1.Number of C&P Exam Worksheets requested the previous month (showing distribution by site and by the type of worksheet) 2.Number of C&P Exam Worksheets completed the previous month (showing distribution by site and by the type of worksheet) 3.Number of examinees (i.e. Veterans or Service Members) requested to be seen for examination the previous month (showing distribution by site) 4.Number of examinees (i.e. Veterans or Service Members) for whom examinations were completed the previous month (showing distribution by site) 5.Number of examination reports pending with a list of the pending examination requests (to include claim number, name, and date of request) 6.Average time from receipt of examination request to delivery of completed examination reports 7.Lists of rescheduled examinations, examinations cancelled for failure to report, and refusal to report 8.Up-to-date status of all examiners with statement verifying that individual licenses and/or credentials have not been revoked and that disciplinary proceedings involving professional conduct are not pending within 26 calendar days of being offered an agreement by contractor. 9.List any problems that arose and a statement explaining how the problem(s) was resolved or why have not yet been resolved B.9 “ Invoice and Billing B.9.1Invoices will be transmitted to the ordering facility using a CMS 1500 health care billing form for each Veteran or Service Member. The CMS 1500 claim form will contain all of the ancillary procedures performed and will identify the disability examination using the Current Procedural Terminology (CPT) Code 99456 with the applicable Contract Line Item Pricing (for Disability Examination) and will identify the type of examination in the modifier section. Contractors will invoice monthly based on the actual examinations performed. Standard red and white CMS 1500 forms should be used. Black and white forms will not be accepted by VA. Electronic Data Interchange (EDI) can also be used, via Emdeon, to submit claims (http://www.nonvacare.va.gov/edi.asp ). B.9.2The œunit prices for tests, laboratory work, procedures, and x-rays is the agreed upon percentage outlined in the Price Schedules. At the time of invoice, the agreed upon percentage will be applied to the current National Medicare baseline using the applicable Current Procedural Terminology (CPT) code to determine the œunit price at the time of invoice. Current National Medicare baseline is defined as the National Medicare baseline at the time the test, lab, procedure or x-ray was performed where the National Medicare Baseline is the nationally uniform relative value of the service for physician work. The formula used to determine the billable amount is as follows: (Work RVU + Practice RVU)*Conversion Factor = reimbursement rate (Reimbursement rate) x (proposed percentage in price schedule) = billable amount In cases where a CPT code lacks a "Work RVU", then whatever formula is being used to compute the CPT price should have the Mal-Practice RVU component removed from the formula, and follow through with the adjusted formula to determine the new œreimbursement . This œreimbursement is then multiplied by the percentage found in the price schedule to determine the billable amount. The current National Medicare baseline is published annually on the following web site: http://www.cms.gov/. A comprehensive list of CPT codes can be found at http://www.ama-assn.org/. END OF STATEMENT OF WORK The determination of acquisition strategy for this acquisition lies solely with the Government. Interested parties should submit a capabilities package demonstrating the ability to perform work listed in the attached Statement of Work. Packages should include the following information: (1) NAICS code; (2) Business name, address and small business type, (3) a positive statement of your intention to submit an offer for this requirement as a prime contractor, and (4) demonstration of the firm's experience within the past five years, by listing the actual projects completed. Provide the following: a brief description of the work performed to include project title and a customer contact name and phone number for a customer knowledgeable of the work completed. Responders are solely responsible for all expenses associated with responding to this Sources Sought Announcement. All interested businesses are encouraged to respond to this announcement no later than April 9, 2011, 5:00 PM EST, by submitting all requested documentation listed above via e-mail to Christina Smith at christina.smith7@va.gov and on the Subject Line insert "Comp and Pension Exams - Sources Sought Response “ (Company Name)". Telephone responses will not be accepted. Please be reminded that no solicitation document is available at this time; this notice is NOT a solicitation announcement, it is to gain information only. Qualified vendors will be required to respond to a separate solicitation announcement. In accordance with Federal Acquisition Regulation Policy, prospective vendors must be registered in Central Contractor Registration prior to award of contract. If you are a VOSB or a SDVOSB, please take note of VAAR Part 84.1102.
Web Link: FBO.gov Permalink
(https://www.fbo.gov/spg/VA/NaVAMC/VAMCCO80220/VA24911RP0144/listing.html)
Place of Performance: Address: VISN 9 Network Contract Activity;Tennessee Valley Healthcare System;1639 Medical Center Parkway, Suite 400;Murfreesboro, TN; Zip Code: 37129
Record: SN02421861-W 20110413/110411234536-0fbbcdb5bbd7c0d8671087f5167755d4 (fbodaily.com)
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Q -- Compensation and Pension Exams Sources Sought Amendment