1605DC-19-R-00025.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

OWCP DC DFEC SHIP CODE 16. ADMINISTERED BYCODE

X

X

621111

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

05/06/2019 1000 ES

03/28/2019

202-693-7197Myla Bundy (No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

1605DC-19-R-00025

5. SOLICITATION NUMBER

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

1 116 1638-DAO-19-NAT-0113OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

WASHINGTON DC 20210

ROOM S3229

200 CONSTITUTION AVE, NW

US DEPARTMENT OF LABOR

15. DELIVER TO

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$11.00

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)

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 Washington D.C.

District Office (Washington D.C. and Virginia),in accordance with this Request for Proposal (RFP).

This requirement will result in the award of a (Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

Kim L. Carr

. 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.

single indefinite delivery indefinite quantity

(IDIQ) contract.

Period of performance: one (1) 12-month base period with one (1) 6-month option period.

Clarifying questions regarding this RFP must be submitted (in writing only) to the Contract

Specialist, Myla G. Bundy, Bundy.Myla@dol.gov and to the Contracting Officer, Kim L. Carr, at

Carr.Kim.L@dol.gov by 10:00 am ET on 04/11/2019.

Questions must be submitted in accordance with the attachment “Questions and Comments Template”.

Responses to questions submitted will be responded as an amendment to the RFP on the

Federal Business Opportunities website. No questions posed via telephone will be accepted.

Proposals shall be submitted via email to the

Contract Specialist, Myla G. Bundy and to the

Contracting Officer, Kim L. Carr by the time and date specified in Block 8 of this form.

Delivery: 1 Days After Award

Period of Performance: 07/05/2019 to 01/04/2021

0001 Medical Second Opinion and Examination Services

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

116 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 116

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

1605DC-19-R-00025

for OWCP Washington D.C. District Office

Product/Service Code: Q999

Period of Performance: 07/05/2019 to 07/04/2020

1001 Medical Second Opinion and Examination Services for OWCP Washington D.C. District Office

(Option Line Item)

(Anticipated Option Exercise Date)05/01/2020

Product/Service Code: Q999

Period of Performance: 07/05/2020 to 01/04/2021

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

Sponsored by GSA

FAR (48 CFR) 53.110

Department of Labor Solicitation: 1605DC-19-R-00025 Medical Second Opinion Services – Washington D.C. 4

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), Division of Federal Compensation (DFEC) Washington, DC District Office in accordance with the terms and conditions set forth in the solicitation document (including all amendments/modifications), and the resulting contract.

B.2 Contract Type

The Government anticipates awarding a firm-fixed price, indefinite delivery, indefinite quantity (IDIQ) type contract for services required by this PWS. See Section B.8 - Schedule of Supplies/Services for “estimated quantities”.

B.3 Period of Performance

This contract shall be in effect for a one (1) year base period and one (1) six-month option period.

Base Period: 07/05/2019 - 07/04/2020 Option Year 1: 07/05/2020 - 01/04/2021

B.4. Minimum/Maximum Requirements

The minimum guaranteed services on this contract shall not exceed a total of one (1) during the entire period of performance in which actual services are acquired under the contract. In addition, the total estimated maximum quantities for services shall not exceed the “Total Not-To-Exceed Amount(s)” identified in the B.8 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 as indicated above. .

B.5. Payment for “No Show” Appointments

Government Cancellations (without notice): When the Government gives less than 24 hour notice in canceling a scheduled appointment, a fee of no more than $50 shall be paid to the Contractor 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, a fee of no more than $50 shall be paid to the Contractor as sole compensation for the cancelled appointment.

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

Medical Second Opinion Services – Washington D.C. 5 appointment and a of no more than $50 shall be paid to the contractor as sole compensation for the cancelled appointment.

Note: All payment for “no shows” will be paid directly to the SECOP contractor using OWCP codes. Any use of OWCP codes outside the performance of this contract is strictly prohibited. All invoices/bills shall be submitted with appropriate documentation and any absence of such documentation may result in non-payment. Examples of documentation include; date of notification, reason for no show, the person notified etc.

B.6 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 DFEC 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. The DFEC District office will review all reports for accuracy and viability prior to the invoice/bill being submitted for payment.

B. 7 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 the Washington, DC District 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 the DFEC District office 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 District Office. 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 DFEC has deemed the report viable. Once DFEC 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.8 Pricing and Estimated Quantities

The Contractor shall provide the SECOP and medical examination services, as specified elsewhere in the Schedule, at the firm fixed price per unit specified herein. All terms and conditions of the initial contract shall remain unchanged, except as where expressly and formally modified by both parties, when applicable. The

Medical Second Opinion Services – Washington D.C. 6 following prices indicate the sole rate of reimbursement under this contract. The price is inclusive of any/all labor, indirect costs, materials, pick-up and delivery, ancillary costs and applicable fees. In addition, the total amount estimated for the maximum quantities below shall not exceed the “Total Not To Exceed Amounts” indicated below (excluding services indicated in Sections B.5 and B.6).

Base Period: 07/05/2019-07/04/2020

Item Number

Description of Supplies/Services

Minimum Quantity

Maximum Quantities

Unit Unit Price

Amount

0001 Medical Second Opinion Services

1 700 Each $ $

0002 Schedule Awards 1 300 Each $ $ 0003 Supplemental Reports 1 100 Each $ $ 0004 Follow-Up Reports 1 100 Each $ $ 0005 File Review Only 1 100 Each $ $

Total Not to Exceed Amount $

Option Period One: 07/05/2020-01/04/2021 Item Number

Description of Supplies/Services

Minimum Quantity

Maximum Quantities

Unit Unit Price Amount

1001 Medical Second Opinion Services

1 350 Each $ $

1002 Schedule Awards 1 150 Each $ $ 1003 Supplemental Reports 1 50 Each $ $ 1004 Follow-Up Reports 1 50 Each $ $ 1005 File Review Only 1 50 Each $ $

Total Not to Exceed Amount $

Medical Second Opinion Services – Washington D.C. 7

SECTION C – PERFORMANCE WORK

STATEMENT

PART 1

PERFORMANCE WORK STATEMENT

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.

Medical Second Opinion Services – Washington D.C. 8

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 750 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.8 – “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 offeror’s 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, neuro-surgery, neurology, psychiatry, dermatology, pulmonary, otolaryngology and physical medicine and rehabilitation (pmr)

Medical Second Opinion Services – Washington D.C. 9

C.1.5 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.1.6 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.1.7 “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.

Medical Second Opinion Services – Washington D.C. 10

C.1.8 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.1.9 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.1.10 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.1.11 Performance/Delivery Schedule: The contractor shall perform all elements of the second opinion services within the time frames described below, Task 5 and Section F.5 - Technical Exhibit 2 “Performance Deliverables Schedule”.

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.

Medical Second Opinion Services – Washington D.C. 11

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

Medical Second Opinion Services – Washington D.C. 12 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.

Medical Second Opinion Services – Washington D.C. 13

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 Section F.5 Technical Exhibit 2 Performance Deliverables Schedule)

C.1.12 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.

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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.

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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).

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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.1.24 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, 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

Medical Second Opinion Services – Washington D.C. 17 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 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.1.28 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.1.29 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.