Draft_PWS_-_SECOP_Washington_DC_-_Solicitation_1605DC-17-R-00029.pdf

DRAFT PERFORMANCE WORK STATEMENT

For

Medical Second Opinion and Medical Examination Services (SECOP)

Washington, DC District Office

Department of Labor (DOL) Office of Workers’ Compensation Programs (OWCP)

Division of Federal Employees’ Compensation (DFEC)

PART 1

C.1.1 Purpose

This is a non-personal services contract to provide: Medical Second Opinion and Medical Examination Services (SECOP) for the

Office of Workers’ Compensation, Division of Federal Employees’ Compensation (DFEC). The Contractor’s employees shall remain under the Contractor’s direct supervision at all times. Although the Government will coordinate directions within the scope of the contract, detailed instruction for the Contractor’s employees and supervision shall remain the responsibility of the Contractor. The

Government also shall not exercise any supervision or control over the contract service providers performing the services herein.

Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

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 DFEC, coordinates the activities of twelve District Offices. These District Offices have direct responsibility for processing claims. The District Office 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.

In certain instances, the DFEC 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 Facts (SOAF) which contains the information concerning events, working conditions and employment data accepted as factual by the DFEC. As such, the SOAF is the framework which the physician must use in answering the specific questions and in developing the evaluation report.

The important elements of this service contract 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 Metropolitan Statistical Area (MSA) to limit the inconvenience to FECA claimants. The timely delivery of a quality, viable medical reports contributes to prompt and accurate adjudication of outstanding medical and compensation issues.

C.1.3 Objective

The objective of this requirement shall enable the Government to procure Medical Second Opinion (SECOP) and Medical

Examinations, Schedule Awards, Supplemental Reports, Follow-up Reports, File Reviews and related services for affected claimants who reside within the area serviced by the OWCP Washington, DC District Office.

C.1.4 Scope

The Contractor shall provide Medical Second Opinion Services for no more than 700 FECA claimants per annum with additional services to include schedule award examination services, follow-up reports, file reviews and supplemental reports for no more than the estimated maximum quantities identified in Section B – “Schedule of Supplies/Services and Prices/Costs” per annum. Services required by this PWS require the use of the OWCP Fee Schedule.

The affected claimants reside within the Metropolitan Statistical Areas identified below but the Contractor shall have the ability to schedule medical examination services in areas outside the Metropolitan Statistical Areas below. Claim files may be under the jurisdiction of the Washington, DC District Office, but the claimant may reside in another state other than the states listed.

District of Columbia and Virginia

(Please Note: All claim files are in the custody of the District Office indicated above and therefore, the District Office will provide the Contractor with all necessary information pertaining to covered claimants.)

The Governments best estimates of the types of physicians or medical specialists needed for services are listed in Task 5.3 “Qualified and Appropriate Medical Specialists”. In addition, are the *eight (8) most “required specialties” listed below that must be included in the offerors proposal. The estimates are provided for informational purposes only and do not commit the Government to any particular mix of specialties under the resulting contract.

*orthopedic surgery, otolaryngology, neurology, neuro-surgery, psychiatry, dermatology and physical medicine and rehabilitation (PMR)

C.1.5 Type of Contract

The Government anticipates the award of a single Firm Fixed Price (FFP), Indefinite Delivery / Indefinite Quantity (IDIQ) Contract.

C.1.6 Contract Term

The Government anticipates that the period of performance for the contract will consist of one (1) twelve (12) month Base Year, and one (1) six (6) month Option Period.

All Option Periods will be exercised at the unilateral discretion of the Government. The effective date will begin from date of contract award.

C.1.7 Recognized Holidays

The Contractor shall not schedule examination services and no direct medical examinations may take place on the following recognized Federal 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.1.8 Hours of Operation:

The Contractor shall at all times maintain an adequate workforce for the uninterrupted performance (with the exception of recognized

Federal Holidays) of SECOP services and all tasks defined within this PWS Monday through Friday, *8:00 am to 5:00 pm local time.

(*Based on required operating hours of the associated District Office, time may be subject to change.)

C.1.9 “No Show” Appointments

(a) Government (with adequate notice): When the Government cancels a scheduled appointment with at least 24 hour notice to the Contractor or to the examining physician, no payment shall be made and no liability is incurred by the Government.

(b) Government (without notice): When the Government gives less than 24 hour notice in canceling a scheduled appointment, a fee of no more than (See Section B.5) shall be paid to the Contractor as sole compensation for the cancelled appointment.

(c) Claimant (with notice): When a claimant cancels a scheduled appointment with at least 24 hour notice to the Contractor or to the examining physician, no payment shall be made and no liability is incurred by the Government.

(d) Claimant (without notice): When a claimant gives less than 24 hour notice in canceling a scheduled appointment, a fee of no more than (See Section B.5) shall be paid to the Contractor as sole compensation for the cancelled appointment.

(e) Claimant (No Show): When a claimant, without prior notice, fails to report for the scheduled appointment, the Contractor shall notify the District Office Contracting Officer Representative (COR) within 24 hours of a missed appointment and a fee of no more than (See Section B.5) shall be paid to the Contractor as sole compensation for the cancelled appointment.

Note: Specific OWCP codes will be supplied to the Contractor for invoicing/billing. The use of OWCP specific codes outside the performance of this contract shall be strictly prohibited. See “Section B Schedule of Supplies/Services and Prices/Costs” for specific invoicing/billing requirements.

C.1.10 Performance Work Statement

The DFEC Washington, DC District Office services include providing the services identified throughout the solicitation, PWS, Task

5, Technical Exhibits I and II the resulting contract. All days referred to in this Section and elsewhere are calendar days, unless otherwise specified.

A. Summary/Overview. The Contractor shall perform all related supervisory and project management/control activities to provide services required by the PWS and Task Areas 1 through 6 (See Part 5 for specific tasks).

o Task Area 1 – Contract-Level and Task Order Management o Task Area 2 – Operational Support Services for OWCP/DFEC District Office.

o Task Area 3 – Qualified and Appropriate Medical Specialists.

o Task Area 4 – SECOP Reports to include Follow-up Reports and Supplemental reports.

o Task Area 5 – Scheduling of Appointments for Examinations.

o Task Area 6 – Additional Support Services for DFEC District Office.

C.1.11 Second Opinion Examinations, Impairment Rating Examinations, File Reviews, Supplemental Reports and Follow-Up

Reports.

The Contractor shall provide sufficient and adequate numbers of specialists/physicians in order to provide second opinion examinations, impairment rating examinations, file reviews, supplemental reports and follow up reports in accordance with the PWS and Task 5. The DFEC Washington, DC District office will review all reports for accuracy and viability prior to the invoice/bill being submitted for payment. Please see Section B “Schedule of Supplies/Services and Prices/Costs” for specific invoicing/billing requirements.

C.1.12 Necessary Supplemental Consultations, Diagnostic Laboratory Tests and Diagnostic Procedures

The Contractor shall provide sufficient and adequate numbers of specialists/physicians in order to provide professional consultations, diagnostic laboratory tests and other diagnostic procedures deemed necessary to complete a second opinion examination obtain objective medical evidence for the physician to render a comprehensive, unequivocal, unbiased and well-reasoned narrative opinion that is consistent with objective medical evidence or testing; physical or psychological findings that are consistent to the framework of the SOAF; 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 in accordance with the

PWS and Task 5.6 “Additional Support Services for DFEC District Office”.

C.1.13 Performance/Delivery Schedule: The Contractor shall perform all elements of the second opinion services within the time frames described below, Task 5 and Technical Exhibit 2.

The following is the schedule for performance of the contract and delivery of receivables by the Contractor. All days referred to in this solicitation are calendar days, unless otherwise specified. The purpose of the following schedule shall help assure quality and viable medical reports are delivered timely. In this context, except where otherwise specified, timely means within thirty-five (35) days from the date of initial referral or date of first notice that medical services are needed.

A. Scheduled Appointments. The Government is only obligated to pay for services under the contract when the DFEC District

Office initiates a medical examination service referral. The DFEC referral notification will be considered initiated when the

Contractor receives a request for medical examination services via the telephone, written notice, email or the Contractor’s secure website. Upon notice from DFEC (by phone, e-mail, FAX or other written means) of the need for a second opinion by a medical specialist shall initiate the referral process and be equal to the date of first notice in which the delivery schedule requirements shall begin.

Upon telephone, written notice or website notification from DFEC of the need for a second opinion by a medical specialist, the Contractor shall do the following:

(1) Make an appointment for the claimant in question with a physician in the appropriate field of medical specialty and forward notice of the appointment to the claimant, the claimant's appointed representative and the employing agency, using a format specified by DFEC. The date of the examination must allow the claimant to receive at least fourteen (14) days advance notice of the appointment date.

(2) Within six (6) days from first notice, notify DFEC in writing via email of the specialist's name, address and phone number, and the date and time of the scheduled appointment.

(3) Reschedule an appointment only once to suit the convenience of an examining physician. The date of the rescheduled examination shall be not more than twenty-eight (28) days from the first notice from DFEC. In the event of a rescheduling to suit the convenience of an examining physician, the completed report shall be delivered to DFEC within thirty-five (35) days from first notice from DFEC. If additional requests for rescheduling the appointment are received from the examining physician/specialist, the Contractor shall schedule an appointment for examination with another physician/specialist.

(4) Notify DFEC within four (4) days of a claimant's request for rescheduling. If a request for rescheduling is received from the claimant, the Contractor or examining physician may not reschedule the appointment without DFEC permission. Rather, the Contractor must notify DFEC so the responsible claims examiner may decide the issue.

(5) Contact the examining physician/specialist within four (4) days after the scheduled appointment date to determine whether the claimant reported and cooperated with the exam. If claimant did not report or did not cooperate, Contractor shall so notify DFEC within seven (7) days of the scheduled appointment date.

B. Delivery of Second Opinion Reports to DFEC. The physician/specialist's second opinion report shall be complete, responsive to all questions posed by the claims examiner, supported by medical rationale and submitted in the form and format specified by

OWCP. All shall be in accordance with the OWCP form and format specified, the PWS and Task 5.4 “SECOP Reports to include

Follow-Up Reports and Supplemental Reports”.

The Contractor shall arrange for receipt of completed medical second opinion reports to the District Office within thirty-five (35) days from the date referral was originated.

C. Delivery of Claim File Materials, SOAF and Examiner's Questions. Before requesting a second opinion, the responsible claims examiner shall prepare a statement of accepted facts (SOAF), a list of questions to the examining physician which are specific to the issue at hand, a letter notifying the claimant to appear for the scheduled medical examination, and if needed a travel voucher. These materials, along with copies of all appropriate medical reports from the case record and any DFEC reporting forms which are appropriate to the medical issue and the information sought, shall be prepared for delivery to the second opinion specialist. The Contractor shall deliver these materials to the appointed consultants at least twenty-four (24) hours before the scheduled examination.

D. Initiation and Completion of Diagnostic Tests. OWCP authorizes all non-invasive diagnostic procedures that are substantively related to the condition or issue which gave rise to the second opinion referral, and which the examining physician feels are necessary to render a reasoned opinion and full report. Upon notification from the examining physician that such a diagnostic procedure is needed, the Contractor shall schedule the procedure(s) so that the claimant shall have at least fourteen (14) days advance notice of the appointment. The full report, based on the diagnostic procedure(s), shall be delivered to OWCP within twenty-one (21) days of notification by the examining physician that such a diagnostic procedure was needed. The Contractor shall ensure that the examining physician includes the diagnostic results in his medical report and provides a reasoned opinion of the findings and the relatedness to the medical condition. The Contractor shall demonstrate the capability to schedule diagnostic procedures to ensure a timely medical report is submitted.

E. Delivery of Second Opinion Reports, Including Schedule Award Reports, to DFEC. The Contractor shall arrange for delivery of a complete, quality and viable medical report to the District Office within thirty-five (35) days after the examinations and diagnostic procedures are completed.

F. Delivery of Supplemental and Follow-up Reports to DFEC. The Contractor shall arrange for delivery of a complete, quality and viable Supplemental and/or Follow-up Reports to the DFEC Office that originated the request within twenty-one (21) days after first notice from DFEC.

G. Delivery of Addendum Reports to DFEC. When a correction or re-performance in the form of an addendum report is identified by the District Office COR, the Contractor shall deliver the completed addendum within twenty-one (21) days of first notice from

DFEC of need for such a correction or re-performance. The Contractor shall ensure that no additional cost to the Government is incurred for the correction or re-performance of an addendum report.

H. Delivery of File Review Reports to DFEC. The Contractor shall arrange for delivery of a complete, quality, and viable report to the DFEC Office which originated the request for file review within thirty-five (35) days after first notice from DFEC.

I. Delivery of Claim File Material, SOAF and Examiner's Questions. Before requesting a second opinion, the responsible claims examiner shall prepare a statement of accepted facts (SOAF), a list of pertinent questions to the examining physician which are specific to the issue at hand, a letter notifying the claimant to appear for the scheduled medical examination, and a travel voucher. These materials, along with copies of all appropriate medical reports from the case record and any DFEC reporting forms which are appropriate to the medical issue and the information sought, will be prepared for delivery to the second opinion specialist. To ensure timely delivery of necessary materials to service providers, the Contractor shall arrange for regular pickup of the materials from the District Office in Washington, DC, and for their delivery to the appointed consultants at least twenty-four (24) hours before the scheduled examination.

J. Reporting Requirements: The Contractor shall ensure all reports are delivered in a timely manner as specified above and in Task 5.6 “Additional Support Services for DFEC

District Office” and Technical Exhibit 2

C.1.14 Claimants Covered and Work to be Performed.

The estimates provided herein and in “Section B - Schedule of Supplies/Services and Prices/Costs” are subject to fluctuation due to the number of claims filed, claims requiring medical opinions and impairment ratings, the number of file reviews or legislation. This estimates identified in Section B – Schedule of Supplies/Services and Prices/Costs” does not constitute a guarantee, as the minimum number of services shall be equal to one (1) per service. The maximum quantities identified in Section B – Schedule of

Supplies/Services and Prices/Costs are estimates of the number of medical second opinion file reviews, schedule awards, follow-up reports and supplemental reports that may be required.

Medical Second Opinion Services (SECOP) The Contractor shall be capable of providing medical examinations to FECA claimants

(See estimated maximum quantities identified in Section B – Schedule of Supplies/Services and Prices/Costs”) per annum of whom reside within the states handled by the Washington, DC District Office.

The Contractor shall exhibit a sufficient network of physicians and shall have the ability to schedule medical second opinion examination services second opinion examinations in the states handled by the Washington, DC District Office and within the MSA provided. The referring DFEC Office shall provide to the Contractor all necessary information pertaining to covered claimants.

Supplemental and Follow-Up Reports. When an acceptable second opinion report raises new issues not previously considered in the adjudication of a claim, a supplemental report may be required in accordance with the procedures in the PWS and Task 5.4

“SECOP Reports to include Follow-up Reports and Supplemental Reports”. For each supplemental report, the Contractor shall submit one invoice/bill for no more than the maximum quantities specified in Schedule B.

Schedule Award Examinations and Reports. The Contractor shall arrange for a schedule award examination with an appropriate physician in accordance with the PWS, Task 5.3 “Qualified and Appropriate Medical Specialists” and Task 5.5 “Scheduling of

Appointments for Examinations”.

Reports for schedule awards shall be submitted to OWCP in accordance with the instructions in the PWS and Task 5.4 “SECOP

Reports to include Follow-up Reports and Supplemental Reports”. For each schedule award report, the Contractor shall submit one invoice/bill for no more than the maximum quantities specified in Schedule B.

File Review Only. The Contractor shall arrange for a file review only with an appropriate physician in accordance with the PWS and

Task 5.

Reports for file review only shall be submitted to OWCP in accordance with the instructions in the PWS and Task 5.4 “SECOP

Reports to include Follow-up Reports and Supplemental Reports”. For each schedule award report, the Contractor shall submit one invoice/bill for no more than the maximum quantities specified in Schedule B.

C.1.15 Contractor Records Retention. Contractor shall retain a copy of each referral package for ninety (90) days after submitting a completed report in case of need for a supplemental or follow-up report or for re-performance under the terms of Section L, below.

Contractor shall retain a copy of each completed report for twelve (12) months after the date submitted to OWCP.

C.1.16 Correction or Re-performance under the Warranty of Services Clause, (FAR 52.246-20). Should any delivered report require clarification, correction, completion, or re-performance under Clause 52.246-20 Warranty of Services, such will take the form of an addendum report. The Contractor shall submit an acceptable addendum report within twenty-one (21) days and without additional charge, except for such additional diagnostic procedures as may be required.

A. If there are 5 or more addendum requests per quarter to the same physician, the Contractor is required to perform an internal quality review as specified by DFEC. If the physician is unable to correct his/her deficiencies, the physician will be removed from use.

C.1.17 Security, Confidentiality and Care of Claimant Medical Records and DFEC Files. DFEC files, claimant medical records and related materials remain the property of the U.S. Department of Labor, and no property right in them is conferred on the physician or medical facility providing service. All DFEC files and related materials, as well as, the reports which are generated in fulfillment of this contract must be treated in a confidential manner and may be made available only to persons who have a need for them in order to provide services under this agreement. The Contractor shall:

(1) assure that no excerpts are taken from any compensation file except as necessary to accomplish the purposes of this contract;

(2) assure that no medical case history be used for publication of any paper or book or in lectures without written permission of the Director of the Office;

(3) assure that, when not in actual use, all DFEC files and related material in the Contractor's possession be kept in locked storage, accessible only to those individuals who have a need for them;

(4) assure that no DFEC files, related materials, medical second opinion reports, or facsimiles thereof, are released to any claimant, attorney, employing agency or other party at interest without express written permission of the

Contracting Officer; and

(5) assure that all DFEC files and related materials supplied to the Contractor are returned to DFEC at the same address and according to the same schedule indicated in Section C.1.12 and C.1.15(G) for return of Reports.

(6) assure that copies of DFEC files or related materials which may have been retained by the Contractor, and copies of reports retained under the requirement at Section C.1.15.K, are destroyed by burning, shredding or another technique that will preserve claimant confidentiality and privacy.

C.1.18 Training for Participating Physician/Specialists. In coordination with the COR, the Contractor shall ensure all participating physicians/specialists are familiar with the requirements of the PWS and Task 5 (as applicable). Also, see Task 5 Area 6.

C.1.19 Training for OWCP District Office Staff. In coordination with the District Office COR, the Contractor shall prepare all training materials and provide training to District Office Staff. See Task 5 Area 6.

C.1.20 Quality Control: The Contractor shall develop and maintain an effective quality control program to ensure medical examination services and reports are performed in accordance with this PWS. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of any defective service or report. The Contractor shall ensure that all reports conform to the DFEC requirements to meet a viable report and that all impairment ratings are verified using a standardized, unbiased and certifiable method. The Contractor’s quality control program shall be the means by which assurance that work complies with the requirement of the contract. The Quality Control Plan shall be delivered with the Contractors’ proposal. The Contractor shall submit final QCP for the Government’s acceptance 10 days after contract award. After acceptance of the quality control plan the

Contractor shall receive the contracting officer’s acceptance in writing of any proposed change to his QC system.

C.1.21 Quality Assurance: The Government shall evaluate the Contractor’s performance under this contract. This oversight is primarily focused on what the Government shall do to ensure that the Contractor has performed in accordance with the performance standards. It defines how the performance standards shall be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

C.1.22 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.1.23 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) http://csrc.nist.gov/publications/fips/fips199/FIPS-PUB-199-final.pdf http://csrc.nist.gov/publications/fips/fips200/FIPS-200-final-march.pdf http://csrc.nist.gov/publications/nistpubs/800-53-Rev2/sp800-53-rev2-final.pdf

C.1.24 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. The Government will provide annual security training to all on-site Contractors required for these services.

(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.

The District Office COR is not authorized to respond or act on behalf of the OWCP National Office on security incidents, disclosures, breaches or disasters involving PII.

(e) The Government shall approve the Contractors resolution to the incident.

(f) The Contractor shall be responsible for any liability resulting for the security incident, disclosure or breach involving a claimant’s

PII, including financial harm to the Government.

C.1.25 Ownership

All products and deliverables developed under this PWS and contract shall be the property of the U.S. Government and Department of

Labor, Office of Workers’ Compensation Programs.

C.1.26 Commitment To Protect Sensitive Information

The Contractor shall not release, publish, or disclose sensitive information to unauthorized personnel, and shall protect such information in accordance with provisions of the following laws and any other pertinent laws and regulations governing the confidentiality of sensitive information: 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records). The Contractor shall not use or disclose any case information for study, research or any other circumstance without the express written approval of the

Contracting Officer.

C.1.27 Contracting Officer Representative (COR):

The resulting contract will be monitored by the following individual COR’s: (Note: TBD at time of award)

District Office COR

National Office COR – N/A

(Note: When N/A is indicated for National Office COR, the Contracting Officer reserves the right to retain and execute such COR duties until otherwise designated and authorized in writing.)

The District Office and National Office COR shall be identified by separate letter. Each COR monitors all technical aspects of the contract and assists in contract administration. Both CORs is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract: perform the oversight necessary in connection with contract performance:

maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies. A letter of designation issued to both the District Office COR and the National Office COR will be issued stating their responsibilities and limitations. A copy will also be forwarded to the Contractor outlining those responsibilities and limitations, especially with regard to changes in cost or price, estimates or changes in delivery dates. The District Office or National Office CORs are NOT authorized to make changes to any of the terms and conditions of the resulting contract. Changes shall only be made by the

Contracting Officer.

C.1.28 Contractor Personnel and Medical Specialists: The Contractor shall provide sufficient personnel, and Medical Specialists both in numbers and qualifications to perform all work associated with the PWS and Task 5. The Contractor’s employees shall remain under the Contractor’s direct supervision at all times and each contract service provider (medical specialists) shall be accountable solely to the Contractor who, in turn is responsible to the Government for ensuring all services are provided in accordance with the contracts terms and conditions.

C.1.29 Employee/Physician/Specialists Conduct

Contractor employees and Subcontractors shall at ALL times conduct themselves in a professional manner and shall not reflect discredit upon the United States Government, the Department of Labor and the Office of Workers’ Compensation Programs.

C.1.30 Removal or disapproval of Employees, Physicians and Specialists for Misconduct or Security Reasons. The Government shall, at its sole discretion, remove or disapprove any Contractor employee physician or specialists from performing a U.S.

Department of Labor contract requirement including but not limited to, inability to perform a thorough examination and/or report, misconduct, bias, appearance of conflict of interest, or safety/security reasons. Removal or disapproval does not relieve the Contractor of the responsibility to continue providing the services required by the contract. The Contracting Officer shall provide the Contractor with a written explanation to support any request to remove an employee or service provider.

C.1.31 Disapproval of Physicians/Specialists. The Government shall, at its sole discretion, disapprove a Physician or Specialists from performing a U.S. Department of Labor contract requirement including but not limited to, inability to perform a thorough examination and/or report, misconduct, bias, appearance of conflict of interest, or safety/security reasons. Disapproval does not relieve the Contractor of the responsibility to continue providing the services required by the contract. The Contracting Officer shall provide the Contractor with a written explanation to support its decision.

PART 2

DEFINITIONS & ACRONYMS

2.1 Acronyms

CO – Contracting Officer

COR - Contracting Officer’s Representative: A representative from the requiring activity assigned by the Contracting Officer to perform surveillance and to act as liaison to the Contractor

DOL - Department of Labor

EFT – Electronic Funds Transfer

FAR – Federal Acquisition Regulation

IDIQ –Indefinite Delivery Indefinite Quantity

IT – Information Technology

OASAM – Office of the Assistant Secretary for Administration and Management

OMB - Office of Management and Budget

PWS – Performance Work Statement

POP – Period of Performance

Quality Control - Those actions taken by a Contractor to control the performance of services so that they meet the requirements of the

PWS.

Quality Assurance - Those actions taken by the Government to assure services meet the requirements of the Performance Work

Statement. See Technical Exhibit 1 “Performance Requirements Summary”

SOW – Statement of Work

OFFICE OF WORKERS’ COMPENSATION PROGRAMS ACCEPTED

DEFINITIONS & ACRONYMS

DFEC – Division of Federal Employees’ Compensation

Fee Schedule – An OWCP specific five digit code used for billing and reporting medical second opinion and examination services and procedures performed by physicians.

Geographic Location - The states served by the District Office which include several population centers described by the

*Metropolitan Statistical Area.

*MSA – Metropolitan Statistical Areas - The Population centers served within the United States.

*District of Columbia and Virginia

OWCP - Office of Workers’ Compensation Programs

Provider – individual, group or facility providing medical second opinion examinations and services.

“Required” categories: The Governments best estimate of the types of physicians or medical specialties required for performance of medical second opinion and examination services within the MSA.

*Orthopedic surgery, psychiatry, otolaryngology, neuro-surgery, dermatology, pulmonology and physical medicine and rehabilitation (PMR)

SECOP - Medical Second Opinion and Examination Services

WCMBP – Workers Compensation Medical Bill Processing

Types of Causal Relationship:

Under the FECA, an injury or disease may be considered as employment-related in any one of several ways. The FECA contains no provision for apportionment, and the Office will pay for all medical and compensation expenses due to impairments which result from an employment injury.

A. Direct Causation. This type of relationship exists when the injury or factors of employment result in the claimed condition through a natural and unbroken sequence. Acute trauma such as from a fall exemplifies this type of causal relationship.

Direct causation may be identified in both traumatic injuries and occupational diseases. However, the amount and sophistication of the medical documentation necessary to establish this relationship in claims for occupational diseases are usually greater because of the multifactorial etiologies and clinical complexities of some of these diseases.

B. Aggravation. This type of relationship exists when a preexisting condition (not necessarily employment-related) is intensified or exacerbated by an employment-related injury or factor. If this type of causality is identified by the consultant, it is imperative that it be categorized as temporary or permanent.

(1) Temporary aggravation involves an exacerbation of a pre-existing condition which will last for a finite period of time, after which the employee returns to his or her baseline physical status. For instance, an acute asthmatic attack is triggered in an employee known to have asthma by the exposure to formaldehyde fumes in the work place. In such a case, compensation is payable only for the period of exacerbation established by the medical evidence and not for any disability caused by the underlying disease.

(2) Permanent aggravation constitutes an exacerbation of an underlying condition which persists indefinitely or produces irreversible anatomical and/or physiologic changes so that the employee does not return to his or her previous status.

Identification of this type of causality requires thoughtful evaluation of the medical documentation in the case file. The physician should describe the way in which the underlying condition has been irreversibly affected by the work aggravation.

C. Acceleration. Acceleration is said to occur when an employment-related injury or work factor hastens the clinical manifestation of a latent condition in a manner which cannot be explained by the natural history of the disease. In the context of the FECA, this type of causality carries the same weight as direct causation; compensation and medical benefits are reimbursed on an indefinite basis.

D. Precipitation. Precipitation involves the clinical manifestation of a quiescent condition which is prompted or caused by factors related to employment. It is different from acceleration in that the work factor or injury is actually necessary for the development of the condition, whereas acceleration refers only to the clinical appearance of a disease sooner than expected.

E. Consequential Injury. This is an injury which occurs because of weakness or impairment caused by a work-related injury. It may affect the same part of the body as the original injury or a different area altogether. For instance, a claimant with an accepted knee injury may fall at home because the weakened knee has buckled; this incident will constitute a consequential injury whether the affected part of the body is the knee or some other area, such as the back or arm. Or, a claimant with an injured eye may compensate for loss of functioning by overuse of the other eye, which may result in a consequential injury. The consultant may be asked to give an opinion concerning the causal relationship of the second injury to the first. Unsuccessful surgery or complications arising from medical care authorized by the Office may also serve as the basis for a claim for consequential injury.

F. Intervening Injury. Such an injury is said to occur when the same part of the body originally injured is re-injured outside the performance of duty and compensation is claimed subsequent to the second injury. It must be determined whether the disability is attributable to the second injury alone, or whether the effects of the first injury still contribute to the disability. Unless the second injury by itself accounts for the disability, it will be considered related to the original incident.

G. Recurrence. A recurrence is said to be a spontaneous material change, demonstrated by objective findings in the medical condition, resulting from the previous injury or occupational illness (without an intervening injury or new exposure to factors causing the illness).

H. Reasonable Commuting Distance: For claimants who reside in urban areas, no examination shall require a claimant to travel more than thirty (30) miles or forty five (45) minutes driving time (whichever is shorter) from the claimant’s residence without express permission of the COR. Claimants who reside in rural areas shall not have to travel more than sixty (60) miles or one and a half hours

(1 hr. 30 min) driving time (whichever is shorter) from the claimant’s residence without express permission of the COR.

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3.0 GOVERNMENT FURNISHED ITEMS AND SERVICES:

The Government (DFEC District Office) will provide to the Contractor all necessary information pertaining to covered claimants. The claim files are in the custody of the District Office.

The Contractor shall protect form unauthorized disclosure any materials or information made available by the Government, or that the

Contractor has access to by virtue of the provisions of this contract, that are not intended for public disclosure.

The material and information made available to the Contractor by the Government, or that the Contractor comes into contact with in completing this contract, are the exclusive property of the Government. Any information or materials developed by the Contractor in performance of this contract are also the exclusive property of the Government. Upon completion or termination of this contract, the

Contractor shall turn over to the Government all materials (copies included) that were furnished to the Contractor by the Government and all materials that were developed by the Contractor in the performance of this contract.

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4.0 CONTRACTOR FURNISHED ITEMS AND SERVICES:

The Contractor shall provide all items and services as required by the Performance Work Statement, Task 5 and the contract.

PART 5

SPECIFIC TASKS

5. Specific Tasks:

The Contractor shall provide sufficient personnel, both in numbers and qualifications, to perform all work associated with the following tasks and associated performance work statement.

Failure to comply with these requirements may result in monetary penalties depending on the nature and

Impact of the deficiency. The Contractor shall have the opportunity to correct such deficiencies within five days or other agreed upon timeframe. In no case will the Government pay for services associated with failure to comply. Following are a list of associated Tasks:

Task 1 – Contract-Level and Task Order Management

Task 2 – Operational Support Services for the OWCP, DFEC

Task 3 – Qualified and Appropriate Medical Specialists

Task 4 – SECOP Reports to include Follow-up Reports and Supplemental Reports

Task 5 – Scheduling of Appointments for Examinations

Task 6 – Additional Support Services

Task 1 – Contract Level and Task Order Management

5.1.1 Contract Level Program Management

The Contractor will provide the technical and functional activities at the Contract Level needed to manage the tasks of this Performance Work Statement. All work described under the Performance Work

Statement shall be under taken by the Contractor after consultation with the District Office Contracting

Officer Representative (COR) identified in Technical Exhibit 1. DOL expects the Contractor to develop an initial management plan detailing personnel and other resources it expects to deploy to successfully complete the work described.

5.1.2 Key Personnel

The Contractor shall provide sufficient personnel both in numbers and qualifications to perform all work associated with the PWS and

Task 5.1. The Contractor is allowed to substitute (for contract personnel only):

1 year work experience for successfully, completed education (30 credit hours).

Supervisory and Project…