SOLICITATION NOTICE
R -- REFERRAL & SURGERY REVIEW COORDINATOR - FAR provision 52.212-3
- Notice Date
- 6/9/2010
- Notice Type
- Combined Synopsis/Solicitation
- NAICS
- 541611
— Administrative Management and General Management Consulting Services
- Contracting Office
- Department of Health and Human Services, Indian Health Service, Billings Area Office, 2900 4th Avenue North, PO Box 36600, Billings, Montana, 59107
- ZIP Code
- 59107
- Solicitation Number
- RFQ-10-10-039-REL
- Archive Date
- 7/10/2010
- Point of Contact
- Rita E Langager, Phone: 406.247.7293
- E-Mail Address
-
rita.langager@ihs.gov
(rita.langager@ihs.gov)
- Small Business Set-Aside
- N/A
- Description
- Federal Acquisition Regulation (FAR) 52.212-3, Offeror Representations and Certifications - Commercial Items (AUG 2009) that must be completed and submitted with the offer. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This procurement is being conducted under Simplified Acquisition Procedures pursuant to the authority of FAR Subpart 13.5, Test Program for Certain Commercial Items (10 U.S.C. 2304(g) and 2305 and 41 U.S.C. 253(g) and 253a and 253b); FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994 (Public Law 103-355)); and FAR 37.104, Personal Services Contracts (Public Law 103-332, Department of the Interior and Related Agencies Appropriation Act, Title II, September 30, 1994, 108 Stat. 2530 as implemented by 25 U.S.C. 3109). This announcement constitutes the only solicitation; therefore, a written solicitation will not be issued. The Billings Area Indian Health Service (IHS) intends to award a fixed-price commercial item contract in response to Request for Quotation (RFQ)-10-10-039-REL. The solicitation is issued on an unrestricted basis. The solicitation documents and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-41. The associated North American Industry Classification System code is 541611 and the small business size standard is $7.0 million. Potential contractors shall propose an all inclusive hourly rate for the base year and each option year. PRICE SCHEDULE - REFERRAL & SURGERY REVIEW COORDINATOR: BASE YEAR: 2080 HOURS @ $____________________ per HR = $_________________________; OPTION YEAR ONE: 2080 HOURS @ $____________________ per HR = $_________________________; OPTION YEAR TWO: 2080 HOURS @ $____________________ per HR = $_________________________; OPTION YEAR THREE: 2080 HOURS @ $____________________ per HR = $_________________________; OPTION YEAR FOUR: 2080 HOURS @ $____________________ per HR = $_________________________;GRAND TOTAL: $_________________________. PURPOSE OF THE CONTRACT: The purpose of this acquisition is to acquire a Referral & Surgery Review Coordinator for the Flathead Tribal Health and Human Services, P.O. Box 880, Mission Drive, St. Ignatius, Montana 59865. STATEMENT OF WORK: The Referral & Surgery Review Coordinator is a professional position that coordinates referral and surgical reviews for health care services purchased from external providers through Contract Health Services (CHS) for Tribal Health or Indian Health. Specific duties include, but are not limited to: (A) Oversees the review of referrals for services including specialty referrals and diagnostic services. Approves routine requests and denies requests that are not covered by Contract Health Services (CHS). Accommodates the approval of emergent referrals through consultation with the Health System Specialist according to Indian Health Service (IHS) guidelines. Prepares notifications to referring providers and other applicable entities informing them of referral approvals and denials. Prepares notifications to beneficiaries of referrals and denials and ensures that patients receive notification of the appeal process and what action they are required to take to initiate an appeal. (B) Oversees the review of requests for surgeries. Prepares surgery requests for review by the Medical Advisor and/or Reviewing Committee. Establishes Contract Health Service and/or Direct Care Service eligibility of beneficiary, declared Primary Care Provider, and demographic information. Approves routine requests and denies requests that are not covered by CHS. Accommodates the approval of emergent surgeries through consultation with Medical Advisor and/or Health System Specialist according to IHS guidelines. Prepares notifications to beneficiaries, referring providers and other applicable entities informing them of approval or denial of requests as directed. Ensures that patients receive notification of the appeal process and action they are required to take to initiate an appeal. (C) Reviews all referrals submitted by the Primary Care Physicians to Specialists or for diagnostic services to ensure necessary information is submitted. Maintains documentation of reviews, approvals, and denials. (D) Authorizes additional provider visits when Contract Health Services has determined that the number of allowable monthly outpatient visit limits has been reached. (E) Ensures appropriate and consistent communication of practices and procedures with IHS staff, Tribal Health and Human Services (THHS) staff, the beneficiary population, outside providers, and the general public as required. (F) Works closely with CHS claims processing, Beneficiary Alternate Resource Specialists, and other IHS or THHS staff as required to facilitate accurate and consistent communication about policies, procedures, and services relating to referral and surgical review coordination. (G) Works closely with the Health System Specialist and Case Management Committee to identify and review cases that have a potential of becoming high cost. Refers cases that may have an alternate resource to the Beneficiary Alternate Resource Staff. Provides referrals to the appropriate Community Health Team for follow-up and monitoring when case management is needed to curtail and prevent unnecessary costs. (H) Develops, implements, and evaluates practices and procedures for the review and disposition of requests for CHS beneficiaries. Reviews surgery requests to determine if requests are emergent or elective and route to the Medical Review Committee and/or Medical Advisor to apply priority rating, as appropriate. (I) Refers patients to the Community Health Teams for appropriate THHS direct care services as deemed appropriate. (J) Interacts daily with contract providers/nurses, THHS Direct Providers/Nurses and hospital staff to ensure the proper processing of patient referrals/requests. Interaction may be by phone, facsimile, or occasionally in person. (K) Responsible for the development and updating of standards to be followed by primary care providers and THHS direct care services staff. Research current medical practices and obtain review and comment from the THHS Medical Advisor and Billings Area Medical Officer. (L) Recommends categories for non-emergent (elective) surgery procedures and identifies and implements cost-saving approaches if appropriate or available. (M) Participates in CHS management and administrative meetings and committees as assigned. (N) Performs other duties as assigned. WORK SCHEDULE: The tour of duty is eight (8) hours per day, Monday through Friday. The work schedule will be coordinated between the Contractor and the Supervisor. The Contractor does not earn or accrue annual leave or sick leave and is not entitled to any health or life insurance, retirement or other benefits or deductions inherent to permanent federal employees. As a contract employee, the Government does not withhold Federal or State taxes. It is the Contractor's responsibility to have taxes withheld and to pay for all taxes during the term of the contract. PERIOD OF PERFORMANCE: The performance of this contract shall be for one year with four 12-month options. GOVERNMENT FURNISHED PROPERTY: The IHS shall provide the Contractor with the following: (1) Office space including a telephone; (2) access to standard and specialized equipment including a computer, copy machines, and facsimile machines. The CHS Office will be responsible for getting the Contractor access and clearance to all pertinent computer services necessary to carry out his/her duties; and (3) office supplies. COMPUTER SECURITY: Pursuant to the Federal Information Security Management Act of 2002 (FISMA), the contractor will be required to complete a course in Computer Security Awareness Training (CSAT). This training must be completed annually by all employees including all contractors. The Contractor will be required to comply with the Federal Information Processing Standards Publication (FIPS PUB) Number 201, 'Personal Identity Verification of Federal Employees and Contractors,' and the associated Office of Management and Budget (OMB) implementation guidance for personal identity verification for all affected contractor and subcontractor personnel. REPORTING REQUIREMENTS: The Contractor shall provide the Contracting Officer with evidence that payment of employment taxes has been made 15 days after each quarter. CONTRACTING OFFICER AUTHORITY: Authority to negotiate changes in the terms, conditions or amounts cited in this contract is reserved for the Contracting Officer. PROJECT OFFICER: The project officer shall be responsible for: (1) Monitoring the Contractors technical progress, including surveillance and assessment of performance and recommending technical changes; (2) Interpreting the Statement of Work; (3) Technical evaluation as required; (4) Technical inspections and acceptance; and (5) Assisting the Contractor in the resolution of technical problems encountered during performance of this contract. INVOICE SUBMISSION AND PAYMENT: The Contractor shall submit its invoice to the Supervisor. The Contractor agrees to include the following information on each invoice: (1) Contractor's name and address; (2) Contract Number; (3) Invoice number and date; (4) Dates of Service including the number of hours worked and total amount due; and (5) Remit to address. Payment shall be made by the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107. PRO-CHILDREN ACT OF 1994: The Contractor certifies that it will comply with the provisions of Public Law 103-227, Pro-Children Act of 1994, which imposes restrictions on smoking where federally funded children's services are provided. CHILD CARE NATIONAL AGENCY CHECK AND INVESTIGATION (CNACI). A CNACI must be completed for all Indian Health Service (IHS) contractor personnel within the Billings Area. Public Law (P.L.) 101-630, Indian Child Protection and Family Violence Prevention Act and P.L. 101-647, Crime Control Act of 1990, require the IHS to conduct a character and criminal history background investigation on all contractors performing services in IHS facilities. The character and background investigations will be conducted by the Billings Area IHS Office. PROVISIONS AND CLAUSES: The following provisions and clauses apply to this acquisition. The FAR provision 52.212-1 Instructions to Offerors Commercial Items; and 52.212-3 Offeror Representations and Certifications Commercial Items are incorporated by reference. The provision at 52.212-2 applies to this acquisition and is provided in full text. FAR 52.212-2 EVALUATION COMMERCIAL ITEMS (JAN 1999): (a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. THE CONTRACTOR SHALL PROVIDE EVIDENCE OF, OR SUBMIT A WRITTEN RESPONSE TO, THE FOLLOWING TECHNICAL EVALUATION FACTORS. The following factors shall be used to evaluate offers: (1) KNOWLEDGE OF IHS CONTRACT HEALTH SERVICE PROGRAM = 50 POINTS; and (2) PAST EXPERIENCE WITH GOVERNMENT CONTRACT HEALTH SERVICE PROGRAM, POLICIES, AND PROCEDURES (The offeror must demonstrate its record of successful performance in past contracts and/or jobs, Government and/or commercial. Each offeror will be evaluated on its performance under existing and prior contracts/jobs. The offeror must list at least two contracts/jobs and include the following information. (1) Name of Government agency/Company; (2) Contract number, if applicable; (3) Dates of Service/Employment; (4) Total contract value/Hourly wage; (5) Description of contract work/Job duties; (6) Contracting Officer/Company Manager and telephone number; (7) Program Manager and telephone number, if applicable; and (8) Administrative Contracting Officer and telephone number, if applicable = 50 POINTS. Technical and past performance, when combined, are approximately equal to cost or price. (b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. The following FAR and Health and Human Services Acquisition Regulation (HHSAR) clauses are applicable: 52.204-4, 52.204-9, 52.212-4, 52.212-5, 52.215-5, 52.217-8, 52.217-9, 52.223-5, 52.223-6, 52.224-1, 52.224-2, 52.227-14, 52.227-17, 52.229-3, 52.232-3, 52.232-18, 52.237-2, 52.237-3, 52.242-15, 52.242-17, 52.245-1, 52.249-12, 352.201-70, 352.202-1, 352.203-70, 352-215-1, 352.215-70, 352.222-70, 352.223-70, 352.224-70, 352.227-70, 352.231-71, 352.237-70, 352.237-71, 352.237-72, 352.239-73, 352.242-71, 352.242-72, 352.242-73, 352.270-2, and 352.270-3. The following FAR clauses cited in 52.212-5 are applicable to the acquisition: 52.203-6 with Alternate I, 52.219-8, 52.219-28, 52.222-3, 52.222-21, 52.222-26, 52.222-35, 52.222-36, 52.222-37, 52.222-39, 52.225-13 and 52.232-33. Upon request, the Contracting Officer will provide full text copies of the FAR and HHSAR provisions and clauses. The provisions and clauses may also be accessed electronically at https://www.acquisition.gov/ and http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=3524d214210697effd2fd5c77848a806&rgn=div5&view=text&node=48:4.0.1.8.33&idno=48. CONTRACTORS INTENDING TO CONDUCT BUSINESS WITH THE FEDERAL GOVERNMENT MUST REGISTER WITH THE DEPARTMENT OF DEFENSES CENTRAL CONTRACTOR REGISTRATION (CCR) DATABASE. THE CCR IS THE PRIMARY GOVERNMENT REPOSITORY, WHICH RETAINS INFORMATION ON GOVERNMENT CONTRACTORS. YOU MAY REGISTER VIA THE INTERNET AT HTTPS://WWW.BPN.GOV/CCR/DEFAULT.ASPX OR BY CALLING (888) 227-2423. PROPOSAL SUBMISSION INSTRUCTIONS: The Contractor shall provide evidence of, or submit a written response to, the technical evaluation factors in FAR 52.212-2. In addition, the Contractor shall submit a completed copy of FAR 52.212-3 with its offer. All responsible offerors may submit a proposal, which shall be considered by the Agency. Offers shall be submitted to the Billings Area Indian Health Service, 2900 Fourth Avenue North, Room 304, Billings, Montana 59101, no later than 2:00 p.m., on June 25, 2010. The offer must be submitted in a sealed envelope, addressed to this office, showing the time specified for receipt, the solicitation number, and your name and address. Offers will also be accepted by e-mail at Rita.Langager@ihs.gov or by fax at (406) 247-7108. ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least 90 days from the date of receipt by the Government.
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