Amendment 0001 - Solicitation Number 1605C3-21-R-00003.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

CAS

S-4307 200 Constitution Ave, NW Customer Acquisition Services US Department of Labor

CODE 16. ADMINISTERED BYCODE

X

X

621111

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED ORCAS

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

01/08/2021 1300 ES

12/31/2020

202-693-4576Jeremy Keator (No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBERa. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION 5. SOLICITATION NUMBER

1605C3-21-R-00003

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 149 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

Washington DC 20210

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Washington DC 20210 S-4307 200 Constitution Ave, NW Customer Acquisition Services

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$12.00

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

US Department of Labor

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

The Department of Labor (DOL) Office of Procurement Services, on behalf of the Office of Worker's Compensation Programs (OWCP) Division of Federal Employees Compensation (DFEC), has a requirement to procure medical second opinion services (SECOP) for claimants who reside within the area served by OWCP’s Philadelphia District Office (Delaware, Maryland, Pennsylvania and West Virginia), in accordance with this Request for Proposal (RFP).

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

JAMES M. JOHNSON

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT:

REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

This requirement will result in the award of a single indefinite delivery indefinite quantity

(IDIQ) contract. Period of performance: one

1)12-month Base Period with one(1)12-month Option

Period and one(1)4-month Option Period.

Period of Performance: 01/28/2021 to 06/27/2023

0001 BASE PERIOD

Medical Second Opinion and Examination Services for OWCP District Office - Philadelphia

Product/Service Code: Q999

Period of Performance: 01/28/2021 to 01/27/2022

1001 OPTION PERIOD ONE:

Medical Second Opinion and Examination Services for OWCP District Office - Philadelphia

(Option Line Item)

(Anticipated Option Exercise Date)01/01/2022

Product/Service Code: Q999

Period of Performance: 01/28/2022 to 06/27/2022

1002 OPTION PERIOD TWO:

Medical Second Opinion and Examination Services

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

149 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 149

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

1605C3-21-R-00003 for OWCP District Office - Philadelphia

(Option Line Item)

(Anticipated Option Exercise Date)06/01/2022

Product/Service Code: Q999

Period of Performance: 06/28/2022 to 12/27/2022

1003 OPTION PERIOD THREE:

Medical Second Opinion and Examination Services for OWCP District Office - Philadelphia

(Option Line Item)

(Anticipated Option Exercise Date)12/01/2022

Product/Service Code: Q999

Period of Performance: 12/28/2022 to 06/27/2023

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

Contents

SECTION A- SOLICITATION AND CONTRACT FORM………………………………… SEE SF-1449

SECTION B – SCHEDULE OF SUPPLIES/SERVICES AND PRICES/COSTS

SECTION C – PERFORMANCE WORK STATEMENT

SECTION D – PACKAGING AND MARKING

SECTION E – INSPECTION AND ACCEPTANCE………………………………………………

SECTION F – DELIVERIES OR PERFORMANCE

SECTION G – CONTRACT ADMINISTRATION DATA

SECTION H - SPECIAL CONTRACT REQUIREMENTS

SECTION I - CONTRACT CLAUSES

SECTION J – LIST OF ATTACHMENTS

SECTION K – OFFEROR REPRESENTATIONS AND CERTIFICATIONS AND

SOLICITATION PROVISIONS

SECTION L – INSTRUCTIONS TO OFFERORS

SECTION B – SCHEDULE OF SUPPLIES/SERVICES AND PRICES/COSTS

B.1. General

The contractor shall furnish Medical Second Opinion (SECOP) services and Medical Examination services for the U.S. Department of Labor, Office of Workers’ Compensation Programs (OWCP) covered claimants in accordance with the terms and conditions set forth in the solicitation document (including all amendments/modifications) and the resulting contract. The covered claimants reside within the United States, its Territories and Trust Territories in the specific locations identified in Part 2 “Region to be Served/Metropolitan Statistical Areas”.

B.2. Minimum/Maximum Requirements

The minimum guaranteed on this contract shall not exceed one (1) during any period of performance in which actual services are not ordered or required. In addition, the total amount estimated for the maximum quantities shall not exceed the “Total Not-To-Exceed Amount(s)” identified in the Schedule of Supplies/Services.

Note: Due to the fluctuating circumstances surrounding the need for these services and because each case is unique and does not always necessitate the government to schedule SECOP services that are required by this PWS, the Government estimates the guaranteed minimum for the base and each option period shall not exceed one (1) each for SECOP, Schedule Awards only, file review only, supplemental report and follow-up report services.

B.3 Payment for Necessary Supplemental Consultations, Diagnostic laboratory Tests and Diagnostic Procedures and other related services

The Contractor shall invoice/bill diagnostic testing and procedures using the appropriate CPT or HCPCS code. Any use of OWCP specific codes outside the requirements of this contract is strictly prohibited unless otherwise authorized by OWCP in writing for each incident. To reduce the chances of duplicate billing/invoicing, the contractor shall ensure no physician directly invoice/bill the government for these services.

Professional consultations, radiology procedures, diagnostic laboratory tests and other diagnostic procedures deemed necessary to complete a second opinion examination will be paid according to the OWCP fee schedule limitations provided under 20 CFR 10.805-813. Interpretive and transportation services require prior Government notification and approval (when possible) and supporting documentation (as applicable). Transportation will be reimbursed at the GSA Per Diem Rate.

All services shall be invoiced/billed and paid in accordance with the OWCP fee schedule limitations provided under 20 CFR 10.805-813 using the appropriate CPT or HCPCS code. DFEC will review all reports for accuracy and viability prior to the invoice/bill being submitted for payment.

B.4 Payment for Second Opinion Examinations, Impairment Rating Examinations, File Reviews, Supplemental Reports and Follow-Up Reports

When all medical examination and report requirements have been rendered and verified accurate, the Contractor shall submit one (1) invoice/bill for services along with a copy of the medical report to OWCP Program Office. Specific OWCP codes shall be supplied to the Contractor for invoicing/billing.

The use of OWCP specific codes shall be strictly prohibited outside the performance of this contract.

Once OWCP has reviewed the report for accuracy and viability, the invoice/bill charges shall be reviewed, verified and certified, and the invoice/bill shall be submitted for payment by the OWCP. The absence of the required report documentation shall result in the non-certification of the invoice/bill and non-payment. Payment for services shall not be initiated until the Contractor has met all the reporting requirements and OWCP has deemed the report viable. Once OWCP has deemed the report viable, the invoice/bill shall be submitted in accordance with Federal Acquisition Regulation (FAR) Clause 52.232- 25 Prompt Payment Act and OWCP invoicing/billing procedures. All related interpretive and transportation services require prior Government notification and approval (when possible) and supporting documentation (as applicable). All pre-approved travel cost (when applicable) will be reimbursed at the GSA Per Diem Rate.

B.5 Pricing and Estimated Quantities

The Contractor shall provide pricing for services in the format described in the SF-1449 “Solicitation/Contract/Order for Commercial Items”, Blocks 20-26 Schedule of Supplies/Services and Technical Exhibit 3 and services shall be provided at a firm fixed price per unit rate. The final negotiated price will be the sole rate of reimbursement for specified services and all other services will be reimbursed at the OWCP Fee Schedule Rate.

The prices per annum shall not exceed the maximum quantities and totals as identified in the Schedule of Supplies/Services “Maximum Estimated Amount” and “Total-Not-To-Exceed Amounts”. All terms and conditions of the initial contract shall remain unchanged, except where as expressly and formally modified by both parties, when applicable. The Firm Fixed prices are inclusive of any/all labor, indirect costs, materials, pick-up and delivery, ancillary costs and applicable fees.

B.6. Payment For “No Show/Canceled” Appointments

Government Cancellations (without notice): When the Government gives less than 24 hour notice in canceling a scheduled appointment and the physician/specialist bills for services in accordance with office policy for cancel/no show appointments, a fee up to $50 shall be paid by the Government as sole compensation for the cancelled appointment.

Claimant Cancellations (without notice): When a claimant gives less than 24 hour notice in canceling a scheduled appointment and the physician/specialist bills for services in accordance with office policy for canceled/no show appointments, a fee up to $50 shall be paid by the Government as sole compensation for the cancelled appointment.

No Show: When a claimant, without prior notice, fails to report for the scheduled appointment and the physician/specialist bills for services in accordance with office policy for canceled/no show appointments, a fee up to $50 shall be paid by the Government as sole compensation for the “no show” appointment.

NOTE: The Government will pay cancellation/no show fees directly to the SECOP contractor.

Specific OWCP codes shall be supplied to the SECOP Contractor for invoicing/billing of all services including cancellations, diagnostic testing and procedures, interpretive and transportation. The use of OWCP specific codes shall be strictly prohibited outside the performance of this contract. All canceled appointments shall require documentation to support the reason of cancellation and shall be submitted with the invoice/bill for the Government’s review. The absence of the required documentation (as applicable) shall result in the non-certification of the invoice/bill and non-payment. Interpretive and transportation services also require prior Government notification and approval (when possible) and supporting documentation (as applicable). Transportation will be reimbursed at the GSA Per Diem Rate.

Base Period: 01/28/2021 – 01/27/2022 Item# Number/CLIN

Description of Supplies/Services

Minimum Quantities

Maximum Quantities

Unit Unit Price

Total Estimated Price

0001 Medical Second Opinion and Examination Services

EA $ $

0002 Schedule Award/Impairment Ratings

EA $ $

0003 Supplemental Reports EA $ $ 0004 Follow Up Reports EA $ $ 0005 File Review Only EA $ $ 0006 Black Lung

Pulmonary Specialist (Optional Provider Services)

EA $ $

0007 DMA File Reviews (Optional Svc.)

EA $ $

0008 Black Lung File Review Services

EA $ $

Option Period 1: 01/28/2022 –6/27/2022 Item# Number/CLIN

Description of Supplies/Services

Minimum Quantities

Maximum Quantities

Unit Unit Price

Total Estimated Price

1001 Medical Second Opinion and Examination Services

EA $ $

1002 Schedule Award/Impairment Ratings

EA $ $

1003 Supplemental Reports EA $ $ 1004 Follow Up Reports EA $ $ 1005 File Review Only EA $ $ 1006 Black Lung

Pulmonary Specialist (Optional Provider Services)

EA $ $

1007 DMA File Reviews (Optional Svc.)

EA $ $

1008 Black Lung File Review Services

EA $ $

Option Period 2: 06/28/2022 – 12/27/2022 Item# Number/CLIN

Description of Supplies/Services

Minimum Quantities

Maximum Quantities

Unit Unit Price

Total Estimated Price

2001 Medical Second Opinion and Examination Services

EA $ $

2002 Schedule Award/Impairment Ratings

EA $ $

2003 Supplemental Reports EA $ $ 2004 Follow Up Reports EA $ $ 2005 File Review Only EA $ $ 2006 Black Lung

Pulmonary Specialist (Optional Provider Services)

EA $ $

2007 DMA File Reviews (Optional Svc.)

EA $ $

2008 Black Lung File Review Services

EA $ $

Option Period 3: 12/28/2022 – 06/27/2023 Item# Number/CLIN

Description of Supplies/Services

Minimum Quantities

Maximum Quantities

Unit Unit Price

Total Estimated Price

1001 Medical Second Opinion and Examination Services

EA $ $

1002 Schedule Award/Impairment Ratings

EA $ $

1003 Supplemental Reports EA $ $ 1004 Follow Up Reports EA $ $ 1005 File Review Only EA $ $ 1006 Black Lung

Pulmonary Specialist (Optional Provider Services)

EA $ $

1007 DMA File Reviews (Optional Svc.)

EA $ $

1008 Black Lung File Review Services

EA $ $

SECTION C – PERFORMANCE WORK STATEMENT

PART 1

PERFORMANCE WORK STATEMENT

C.1.1. Description of Services/Introduction

In accordance with Federal Acquisition Regulation 37.401, the services required are for non-personal services to manage and provide medical second opinion and examination services in accordance with the Performance Work Statement (PWS).

The Government will provide guidance within the general scope of the PWS and within contract, terms and conditions but the Government will not exercise any supervision (or control) over the contractor’s employees. Such contract employees shall remain under the contractor’s direct supervision (and control) at all times during the entire performance period. This also applies to the subcontracted service providers utilized in performance of these services.

The Government will evaluate the quality of professional and administrative services rendered but retains no control over the medical or professional aspects of those services (e.g. professional judgements, diagnosis for specific medical treatment etc.). Such service providers will be considered independent subcontractors responsible for performing medical second opinion and other related services. All subcontracted service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government to ensure services are managed and rendered in accordance with the general scope and within contract terms and conditions.

C.1.2. Background

The Office of Workers' Compensation Programs (OWCP) is responsible for administration of the Federal Employees' Compensation Act (FECA). The Act provides for medical benefits, wage-loss replacement, survivors' annuities, and other benefits to employees of the United States or their survivors when the employee is injured or dies in the course of employment. The OWCP, through the Division of Federal Employees' Compensation (DFEC), coordinates the activities of twelve Offices. These Offices have direct responsibility for processing claims. DFEC functional operations include: adjudicating incoming claims to determine eligibility for compensation payments; managing claims in which eligibility has been established; determining wage-loss compensation payments for covered disability or death; and processing payments for allowed medical and vocational rehabilitation services incurred in the treatment of injured workers covered under the Act.

Under the FECA, medical care and compensation for wage loss and for permanent physical impairment are provided to Federal employees who are injured in the performance of duty. The medical evaluation of workers who submit compensation claims is part of the adjudication and case management process.

A medical evaluation may be necessary: (1) to determine the causal relationship between work factors and the disease or injury; (2) to assess the extent and duration of the physical impairment or disability;

(3) to determine the appropriateness of therapy, including some surgical procedures; or (4) to determine when recovery has occurred and a return to work is feasible.

The BLACK LUNG program administers claims filed under the Black Lung Benefits Act, and provides compensation to coal miners who are totally disabled by pneumoconiosis arising out of coalmine employment. The program also provides eligible miners with medical coverage for the treatment of lung diseases related to pneumoconiosis. The BLACK LUNG beneficiary population is relatively small when compared with the FECA beneficiary population. More often than not, BLACK LUNG beneficiaries live in rural areas where they have limited access to medical practitioners, facilities, and other resources. Most BLACK LUNG beneficiaries are over the age of 50 years.

In certain instances, the OWCP must refer a claimant to a specialist in an appropriate field for a second medical opinion. The second opinion is based on and shall include a review of appropriate claim file material, a physical or psychiatric examination of the claimant, the performance of any clinical or laboratory tests deemed necessary in the diagnostic work-up and a narrative medical report responding to specific questions posed by a claims examiner. In addition to specific questions, the claims examiner provides a Statement of Accepted Fact (SOAF) which contains the information concerning events, working conditions and employment data accepted as factual by the OWCP. As such, the SOAF is the framework which the physician must use in answering the specific questions and in developing the evaluation report.

Second Opinion Examinations (also known as Independent Medical Examinations in the general insurance industry): Examine OWCP covered workers, review limited records from the worker’s file and on a Statement of Accepted Facts provided by OWCP, and provide independent medical opinion to questions posed.

Directed Medical Advisor (DMA) File Reviews: Conduct medical file reviews without patient examination (also known as Chart Reviews or Case File Reviews in the general insurance industry). File reviews may be needed to help address causation determinations, impairment, wage loss, diagnosis clarification, referee impairment reviews, referee file review, pharmacy utilization, and medical translation services.

Historical Data on Requested Services: During the period of October 1, 2018 through Sept 30, 2019, OWCP provided:

FECA

Attending Physicians: Medical services for 197,611 cases.

Directed Medical Services:

• Second Opinion Examinations: 13,360

• File Reviews: 13,940

• Referee Examinations: 1,804

BLACK LUNG

Attending Physicians: Medical services for 5,731 cases.

C.1.3. Objectives

The Government’s objective is to procure Medical Second Opinion (SECOP) and Examination services for covered claimants who reside within the area specified in Part 2: Region to be Served/Metropolitan Statistical Area.

The important elements of these services shall be the delivery of a quality, viable medical report(s), the verification and replication of impairment ratings by a reliable, certifiable and standardized process and the timeliness of scheduling medical reports. To be acceptable, the medical reports shall present comprehensive, unequivocal, unbiased and well-reasoned narrative opinions that are consistent with objective medical evidence or testing, physical or psychological findings that are consistent to the framework of the SOAF or provide a clear comprehensive, well-reasoned opinion disputing any of the medical conditions outlined in the SOAF that are unsubstantiated with any medical findings, and that address all questions posed by the claims examiner. The timely scheduling of appointments for examinations shall be maintained within the timeframes set forth in this solicitation and within the government’s acceptance of the number of physicians available by “required” specialty and within the designated Region to be Served/Metropolitan Statistical Area (MSA) to limit the inconvenience to OWCP claimants. The timely delivery of a quality, viable medical reports contributes to prompt and accurate adjudication of claims.

C.1.4. Scope

The contractor shall provide adequate and sufficient numbers of key personnel in order to manage and provide medical second opinion and examination services within the timeframes required and within the region to be served. (See Part 2 - Definitions/Acronyms for specific information regarding the region to be served)

The services required include medical second opinion and examination services, schedule awards, follow-up reports, supplemental reports, impairment ratings, file reviews and other diagnostic testing related services as prescribed in Part 5. Upon contract award, the successful contractor shall have the ability to:

1) Manage and provide sufficient numbers of qualified and appropriate medical specialists within the region to be served and within a reasonable commuting distance of each claimants residence;

2) Arrange timely scheduling of appointments for examinations and forward letters from the responsible claims examiners notifying claimants, their appointed representatives, and their employers of the claimants' responsibilities to appear and cooperate with scheduled medical exams;

3) Arrange for electronic receipt of referrals and associated documents via a OWCP designated SFTP location;

4) Provide a secure website (password protected [https protocol/SSL]) that is operational and available for the initiation of referrals and uploading of all pertinent imaged documents if OWCP has determined that electronic submission via SFTP is not available;

5) Assure timely pick-up and delivery of all pertinent documents to and from the Government, contractor and subcontractor (when applicable);

6) Assure the timely delivery of all medical reports within no more than 35 days;

7) Provide detailed quality assurance in order to ensure each medical second opinion report is comprehensive, unequivocal, unbiased, well-reasoned, consistent with the physical findings, responsive to all questions posed by the claims examiner and presented in a form and format specified by the

OWCP;

8) Assure timely electronic transmission to a OWCP designated SFTP location of all medical reports and related documents (including appointment letters and notifications) with an accompanying XML data file that provides indexing attributes for each document.

9) Assure timely return delivery (to the OWCP) of all Government Furnished Property (GFP) including completed medical second opinion reports and original claim file materials;

10) Assure compliance with applicable provisions of the Privacy Act of 1974 and the security and confidentiality of claimant medical records (and related materials) entrusted to the custody of the contractor or examining physician.

11) Provide clinical review of individual case documentation and medical advice on the processes and procedures involved in diagnosing and treating coal mine dust diseases (example: transplants, pharmaceuticals, home medical equipment and services, current processes and procedures from a medical perspective).

12) Provide pulmonology advice regarding program-wide medical policies and procedures for the Black Lung program. In all cases, the comments and/or opinions of the physician must be documented and explained so as to constitute a reasonable medical judgment.

13) Provide training and related activities when requested in writing by the Division of Coal Miners Workers' Compensation (DCMWC).

14) Attend conferences and meetings with program management and stakeholder groups (as needed).

Trainings and conference attendance would be on an as needed basis and only when requested in writing by DCMWC.

Incorporation of Contractor's Proposal

It is understood and agreed that the contractor shall meet all of the requirements identified within this contract when performing the work in accordance with the Performance Work Statement, all solicitation amendments/modifications, the contractor’s final proposal and the resulting contract. However, in the event the contractor’s proposal conflicts with any Government provision or clause or the Articles set forth herein are in conflict or inconsistent with any provisions of the contractor’s proposal, the provisions of the Articles of the resulting contract shall be controlling and shall supersede the provisions of the contractor’s proposal.

C.1.5. Period of Performance

The period of performance shall be for a twenty eight (28) month period as indicated below. The Period of Performances are as follows:

Philadelphia/Delaware, Maryland, Pennsylvania and West Virginia Performance Period: Base: 01/28/2021 – 01/27/2022 Option Period 1: 01/28/2022 –6/27/2022 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Transition-In Services:

Denver/Colorado, Montana, New Mexico, No. Dakota, So. Dakota, Utah, and Wyoming Performance Periods: Base: 02/01/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2022 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Kansas City/Arkansas, Iowa, Kansas, Missouri, and Nebraska; all employees of the Department of Labor, except Job Corps enrollees, and their relatives Performance Period: Base: 02/01/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2022 Option Period 2: 06/28/2023 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

New York/New Jersey, New York, Puerto Rico, and the Virgin Islands Performance Period: Base: 3/18/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2022 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Jacksonville/Alabama, Florida, Georgia, Kentucky, Mississippi, No. Carolina, So. Carolina, and Tennessee Performance Period: Base: 3/18/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2022 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 01/28/2022 – 06/27/2023

Washington, DC/District of Columbia, Virginia Performance Period: Base: 07/05/2021 – 01/27/2022 Option Period 1: 01/28/2022 - 06/27/2022 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Boston/Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont Performance Period: Base: 04/14/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2022 Option Period 2: 06/28/2022– 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Dallas/Louisiana, Oklahoma, and Texas Performance Period: Base: 08/06/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2022 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Seattle/Alaska, Idaho, Oregon, and Washington Performance Period: Base: 03/06/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2023 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Cleveland/Chicago/Indiana, Michigan, Ohio; All special claims and all areas outside the U.S., its possessions, territories and trust territories, Illinois, Minnesota, Wisconsin Performance Period: Base: 08/22/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2023 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

San Francisco/Arizona, California, Hawaii, and Nevada

Performance Period: Base: 03/29/2021 – 01/27/2022 Option Period 1: 01/28/2022 – 06/27/2023 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Optional Services - Black Lung Pulmonary Specialists Services Performance Period: Base: 01/28/2021 – 01/27/2022 Option Period 1: 01/28/2022 –06/27/2023 Option Period 2: 0628/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

Optional Services - Directed Medical Advisor File Review Services Performance Period: Base: 01/28/2021 – 01/27/2022 Option Period 1: 01/28/2022 –06/27/2023 Option Period 2: 06/28/2022 – 12/27/2022 Option Period 3: 12/28/2022 – 06/27/2023

The Government reserves the right to extend the term of this contract at the prices set forth in Section B in accordance with the terms and conditions contained in clause 52.217-8 Option to Extend Services and 52-217-9 Option to Extend the Term of the Contract and 52.237-3 Continuity of Services.

C.1.6. General Information

C.1.6.1. Quality Control

The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s quality control program is the means by which he assures himself that his work complies with the requirement of the contract. As a minimum, the contractor shall develop quality control procedures consistent with the PWS requirements and that address the areas identified in Technical Exhibit 1, “Performance Requirements Summary”. After the government’s review and acceptance of the quality control plan, the contractor shall be notified (in writing) by the contracting officer who will indicate any proposed change(s) to the Quality Control (QC) system (when applicable).

C.1.6.2. Quality Assurance

The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP) identified in Technical Exhibit 1 and Attachment J.3. The QASP is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

C.1.6.3. Government Remedies

The contractor shall have the opportunity to correct unsatisfactory services or deficiencies within five calendar days or another agreed upon timeframe but in no case will the Government pay for non-forming services. Failure to comply with the requirements of this PWS and may result in monetary penalties and administrative remedies as defined at FAR 42.15 “Contractor Performance Information, 52.212-4 “Contract Terms and Conditions-Commercial Items or 52.246-4 “Inspection of Services-Fixed Price, depending on the nature and impact of the deficiency.

C.1.6.4. Recognized Holidays

The contractor shall not schedule examination services on the following holidays:

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day

C.1.6.5. Hours of Operation/Place of Performance

The contractor is responsible for conducting business between the hours of 8:00am to 5:00pm EST or other time stated for the region to be served, Monday thru Friday (except Federal Holidays) or when the Government facility is closed due to local or national emergencies, administrative closings or similar Government directed facility closings as applicable for the Region to be served/MSA. The contractor must at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this performance work statement when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the work force are essential.

Telecommuting or “work at home” is not authorized unless under emergency situations as determined by the COR.

C.1.6.6. Type of Contract

The government anticipates award of a Firm Fixed Price, indefinite delivery, indefinite quantity (IDIQ) type contract for the services identified in the “Schedule of Services/Supplies”.

C.1.6.7. Security Requirements

All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated. The Contractor shall develop procedures covering key control that shall be included in the Draft Quality Control Plan. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas.

The Contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the Contracting Officer.

C.1.6.7.1. Physical Security When applicable, the contractor shall be responsible for safeguarding all Government Furnished Property identified and provided for contractor use (See Part 3 – Government Furnished Property). At the close of each work period, all government facilities, equipment, and materials shall be secured appropriately (when applicable).

C.1.6.7.2. Key Control When applicable, the Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons.

C.1.6.7.3. Lost Keys In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the Contracting Officer, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

C.1.6.7.4. Key Use When applicable, the Contractor shall prohibit the use of Government issued keys/key cards by any persons other than the Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the Contracting Officer.

C.1.6.7.5. Lock Combinations When applicable, the Contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The Contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the Contractor’s Quality Control Plan.

C.1.6.8 Conservation of Utilities The contractor shall instruct employees in utilities conservation practices. The contractor shall be responsible for operating under conditions that preclude the waste of utilities, which include turning off the water faucets or valves after using the required amount to accomplish cleaning vehicles and equipment.

C.1.6.9 Special Qualifications/Requirements: See Task 5.

C.1.6.9.1. Case Transfers and Loans

Transfers occur most often because the claimant or beneficiary has moved to another jurisdiction. Loans occur most often between the DOs and the National Office (NO). The NO may request cases for review by OWCP. Once a case is determined transferred or loaned, the Systems Manager or designee will transmit the electronic records, including ACPS records and Bill Processing System records through the Debt Management System (DMS). OWCP staff will notify all interested parties of the transfer; change the location code to reflect the transfer; and send the file by certified mail to the requesting office.

Cases pending at the end of contract performance may only be transferred from the existing contract to new contract if approved by DO COR. The incumbent must request written approval from the Designated Office COR and ensure reporting requirements and billing and invoicing DO NOT

DUPLICATE.

C.1.6.9.2. Conflict of Interest

The contractor shall not engage in scheduling or executing medical examination services at the request of an injured federal worker, another federal agency or any other entity that would give the appearance of a conflict of interest. Any referral request to perform medical examination services for a DFEC workers’ compensation case received from a source other than the Region to be served/Metropolitan Statistical Area may not be performed without the Contracting Officer’s approval.

The Contractor shall provide a plan to ensure physician and medical specialists are not engaged in providing workers’ compensation, disability or impairment rating medical examination services for other government agencies prior to the use of such physician or medical specialist. The Contractor shall ensure verification is conducted prior to the execution of the scheduled medical examination service.

The Contractor shall also ensure that a conflict of interest does not exist between the scheduled qualified physicians or medical specialist, the claimant, with the claimant’s treating physician, with any physician previously providing services to the claimant, or with any staff member employed by the scheduled qualified physician or medical specialist who may know or have knowledge of the claimant. A conflict of interest exists when the Contractor’s scheduled physician, medical specialist or their staff has either a direct familial or marital relationship, a past or current personal or professional relationship, with the claimant or the physicians providing medical care relating to the claimant’s workers’ compensation claim.

C.1.6.9.3. Freedom of Information Requests

The Government may receive requests for information under the requirements of the Freedom of Information Act (FOIA). Executive Order 12600, issued June 23, 1987, and Department of Labor Regulation §70.26, provide for pre-disclosure notification to submitters of records if confidential commercial information is contained in the records requested under the FOIA. A “submitter” means any person or entity who provides commercial or financial information to the government. “Confidential commercial information” is defined as records provided to the government by a submitter that arguably contain material exempt from release under Exemption 4 of the Freedom of Information Act, 5 U.S.C.

552(b)(4), because disclosure could reasonably be expected to cause substantial competitive harm.

In the event the Government receives a FOIA, a notification will afford the company (the submitter), or its designee, a reasonable period of time in which to object to the disclosure of any specific portion of the information contained in the records, and to state all grounds upon which disclosure is opposed under Exemption 4 of the FOIA. Any claim of competitive harm must be supported by facts explaining how release of this information could be used by competitors to disadvantage your company. The contractor will be provided 7 days from date of the Government’s notification to provide a written response by email, mail, fax, or both, of any objections the submitter may have to the release of specific information contained in your proposal which may be deemed to be confidential commercial or financial information under Exemption 4 of the FOIA. All statements should support and justify the claim(s), as they will be used in conjunction with other information to make a final determination as to its release.

Please note that failure to provide comments within 7 days will be considered a non-response and thus the submitter’s full consent to release the information in total, subject to FOIA exemptions or federal statutes prohibiting the release of such information. In addition, prior to the Government’s decision to release such records, the Government will notify the submitter of the Governments decision. Any additional comments received will be reviewed for their altering impact prior to the release of records.

C.1.6.9.4. Correspondence or Telephone Inquiries Related to Claims or Claimants

All correspondence or telephone inquiries involving specific OWCP claims or claimants should be documented and referred to the Program Office COR for appropriate action. At no time shall the contractor disclose the name(s) (either written/verbal) of Government Official(s) associated with the processing of OWCP claims without the consent of the Program Office COR.

C.1.6.9.5. Reports of Fraud

All OWCP contractors or providers are expected to report fraud or suspected abuse whenever suspected in the claims process. Whenever an OWCP contractor or provider is contacted by an individual, whether a private citizen or government official, with allegations or information regarding suspected fraud related to a claim, the individual will be referred immediately to the Program Office COR or Program Office Director for further action. Individuals may also call the Hotline at 1(800)347-3756.

C.1.6.9.6. Transportation Services

During the entire performance of these services, each contractor is expected to demonstrate and utilize maximum cost control measures in order to minimize the need for claimant travel beyond the 100 mile radius outside each urban MSA cluster.

When transportation services are required to obtain medical care and transportation is not furnished by the government, the employee may be reimbursed for travel expenses. Travel should be undertaken by the shortest route and by public conveyance such as bus or subway unless the employee's medical condition requires the use of a taxicab or specially equipped vehicle. An employee who uses his or her automobile will be reimbursed at the standard mileage rate for government travel.

All items will be reimbursed on the basis of actual expense; a per diem allowance is not payable. Wages and travel expenses of an attendant to accompany the employee may be approved if his or her condition is such that travel cannot be accomplished otherwise. Authorization for this expense should be obtained in advance of the travel, if possible. A letter requesting services must be sent to the Program Office COR. The letter should show the date of the request, the name of the employee, the case file number, provider and the scheduled appointment.

C.1.6.9.7. Privacy

Portions of information disclosed during the performance of this task are protected by the provisions of the Privacy Act of 1974; therefore, all personnel assigned to this Contract shall be required to take proper precautions to protect the information from disclosure. The Contractor shall ensure that any disclosure or breach of private, personal or medical information shall be immediately reported to the Contracting Officer and the National Office COR within one (1) hour. The Contractor shall have a process in the event of a breach or disclosure that also includes corrective action. The Contractor shall submit a privacy disclosure or breach of personal information plan to the government in their proposal.

C.1.6.10 Personal Information and Privacy

The contractor shall provide personal information and privacy support to ensure compliance to the Privacy Act and other Federal Privacy related policies including, but not limited to, OMB Memorandum M-06-16, Protection of Sensitive Agency Information, and M-07-16, Safeguarding Against and Responding to the Breach of Personally Identifiable Information. This support shall include the review and evaluation of the Privacy Impact Assessments (PIAs) for all systems containing DOL sensitive and PII information. The review shall ensure that the systems comply with the appropriate regulations pertaining to personally identifiable information (PII). The contractor shall evaluate the current PIA methodology and tracking system; and provide recommendations to make the processes and/or system more efficient and effective. The contractor shall evaluate their existing Departmental Privacy related policies and procedures to ensure they comply with federal Privacy related policies. Where the Contractor’s departmental policies and procedures do not comply, the Contractor shall perform the necessary updates/revisions to bring the documents and/or system into compliance as requested by the Contracting Officer or COR at no additional cost to the government. The contractor shall also ensure that all identified privacy vulnerabilities and areas of noncompliance have been documented and resolution tracked.

The Contractor shall ensure that its second opinion medical examination services solution maintains conformance to the most recent DOL implementation of Federal information security guidelines, currently defined as:

The Freedom of Information Act, as amended (5 USC 522), which provides for the disclosure of information maintained by Federal agencies to the public, while allowing limited protection for privacy.

The Privacy Act of 1974, as amended (5 USC 522a), including the Computer Matching and Privacy Act of 1988 (Public Law 100-503).

The Computer Security Act of 1987 (Public Law 100-235), which established minimum security practices for Federal computer systems.

The Federal Information Security Management Act of 2002, which established the requirement for all information systems operated by or on behalf of the United States Government to be certified and accredited as satisfying the minimum information security requirements established by statute, regulation, and National Institute of Standards and Technology (NIST) standards and guidance materials.

OMB Circular A-130, Management of Federal Information Resources, which provides instructions to Federal agencies on how to comply with the fair information practices and security requirements for operating automated information systems.

OMB Memorandum M-07-16, Safeguarding Against the Breach of Personally Identifiable Information, May 22, 2007.

OMB Memorandum M-06-19, Reporting Incidents Involving Personally Identifiable Information and Incorporating the Cost for Security in Agency Information Technology Investments, July 12, 2006.

OMB Memorandum M-06-16, Protection of Sensitive Agency Information, June 23, 2006.

OMB Memorandum M-06-15, Safeguarding Personally Identifiable Information, May 22, 2006.

FIPS PUB 199, Standards for Security Categorization of Federal Information and Information Systems.

http://csrc.nist.gov/publications/fips/fips199/FIPS-PUB-199-final.pdf

FIPS PUB 200, Minimum Security Requirements for Federal Information Systems.

http://csrc.nist.gov/publications/fips/fips200/FIPS-200-final-march.pdf

NIST Special Publication (SP) 800-53, Recommended Security Controls for Federal Information Systems.

http://csrc.nist.gov/publications/nistpubs/800-53-Rev2/sp800-53-rev2-final.pdf

US DOL Computer Security Handbook (DOL’s implementation of NIST SP 800-53). (Reference Attachment 25 - Computer Security Handbook 3.0)

DLMS – 9 – Chapter 1200, DOL Safeguarding Sensitive Data Including Personally Identifiable Information (Reference Attachment 26 - Department of Labor Manual Series (DLMS) 9 Chapter 1200)

C.1.6.10.1 Privacy Responsibilities

(a) The Contractor shall ensure that every employee completes all mandated Federal Security Training requirements prior to the employee’s first day of work under the second opinion medical examination services contract unless the Government provides a signed waiver agreement.

(b) The Contractor shall ensure that all information and reports generated under the terms of this contract are, and shall always remain, the property of the Government.

(c) The Contractor shall protect the Personally Identifiable Information (PII) of all claimants, providers, and Government employees from unauthorized disclosure.

(d) The Contractor shall use a Government-approved reporting mechanism, tool or form to notify the Government of all security incidents, disclosures, breaches, disasters involving Personally Identifiable Information (PII) within one (1) hour of becoming aware of the incident. This written notification shall describe the security incident, disclosure, breach or disaster in detail and state the measures taken to protect the confidentiality, integrity and availability of OWCP information. The contractor’s plan shall be included in the proposal and the Quality Assurance Plan.

(e) The Contractor shall take no action until the OWCP National Office and Contracting Officer is notified and provides direction.