Washington,_DC_QASP_-_2019.docx

QUALITY ASSURANCE SURVEILLANCE PLAN

Version – October 2019

For: Healthcare “Medical” Services Contract Number: < TBD> Contract Description: Medical Second Opinion and Examination Services for the Office of Workers’ Compensation Programs Washington, DC District Office Contractor’s name: TBD (hereafter referred to as the contractor).

1. PURPOSE.

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

· What will be monitored?

· How monitoring will take place?

· Who will conduct the monitoring?

· How monitoring efforts and results will be documented?

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance. In addition, the QASP should recognize that unforeseen and uncontrollable situations may occur.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Updates shall ensure that the QASP remains a valid, useful, and enforceable document. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

The following FAR clauses may apply depending on contract type:

52.246-4 Inspection of Services – Fixed-Price,

2. GOVERNMENT ROLES AND RESPONSIBILITIES.

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: TBD Organization or Agency: OASAM/BOC/Office of Procurement Services Telephone: TBD Email: TBD

b. Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. At the conclusion of the contract or when requested by the CO, the COR shall provide documentation to the CO. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf. The contractor shall refer any changes they deem may affect contract price, terms, or conditions to the CO for action.

Assigned COR: Tammi Turner, District Office Office of Workers’ Compensation Programs Telephone: 202-513-6950 Email: turner.tammi@dol.gov

Assigned COR: Bryan McLain, National Office Office of Workers’ Compensation Programs Telephone: 202-354-9699 Email: mclain.bryan@dol.gov

c. Other Key Government Personnel

Name: Phyllis J. Barnes Title: Administrative Contracting Officer Office of Workers’ Compensation Programs Telephone: 202-354-9697 Email: barnes.phyllis@dol.gov

Name: Michelle Wood Title: Lead, Division of Administrative Operations Office of Workers’ Compensation Programs Telephone: 202-343-5836 Email: barnes.phyllis@dol.gov

3. CONTRACTOR REPRESENTATIVES:

The following employees of the contractor serve as the contractor’s Contract Manager and Task Manager for this contract.

a. Contract Manager - <TBD> Telephone: <enter number> Email: <enter address>

b. Task Manager - <TBD> Telephone: <enter number> Email: <enter address>

c. Other Contractor Personnel - <TBD > Title: <enter title> Telephone: <enter number> Email: <enter address>

4. PERFORMANCE STANDARDS.

Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets or does not meet these standards.

The Performance Requirements Summary Matrix, Technical Exhibit 1 pages 55-57 in the Performance Work Statement (and included below) includes performance standards. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

TECHNICAL EXHIBIT 1

Performance Requirements Summary

The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Performance Objective

Method of Surveillance

PRS # 1.

The contractor shall ensure an adequate number of “required” physicians and medical specialists are active, current, and available that meet the criteria set forth in paragraph Part 5 (other sections as applicable) in order to provide necessary medical examinations.

The contractor is required to have five (5) “required” physician specialty and ability to arrange examinations with specialties outside the 8 must haves.

The maximum acceptable level is no more than 30% of referred cases can be examined by one particular orthopedic surgeon, one neurologist, one neuro-surgeon, or one physical medicine and rehabilitation specialist or no more that 33% for on otolaryngologist, one psychiatrist, one pulmonologist, or one dermatologist per annum.

Weekly, monthly and quarterly reports validated by COR.

Periodic Inspection and 100% inspection

PRS # 2

The contractor shall meet all scheduling requirements in Part 5 (other sections as applicable) once a referral is received

1. Date of examination must allow the claimant 14 days advance notice

2. DFEC notified of appointment details within 6 days

3. Rescheduling examinations shall not exceed 28 days from the first referral notice.

4. DFEC notified of claimant’s request for rescheduling appointment within 4 days.

5. Notify DFEC within 7 days of the scheduled appointment date when the claimant failed to report or cooperate with examination.

The maximum acceptable level is no more than 5% of referred cases fall outside each of the scheduling requirements

Weekly, monthly and quarterly reports validated by COR.

PRS # 3

The contractor shall ensure timely pickup and delivery of claim file material, SOAF and Examiner’s Questions set forth in Part 5 (other sections as applicable).

All related materials, along with copies of all medical reports from the case record will be prepared for delivery to the medical specialist.

The minimal acceptable delivery of all related materials to the medical specialist is 48 hours before the scheduled examination

Physician, validated DFEC Office complaint, or medical report documenting the absence of related materials

PRS #4

The contractor shall ensure all reports noted in Task 5.4 (or other sections as applicable) are viable complete, responsive and delivered in the proper format within thirty-five (35) days from date of referral.

All reports must contain a complete history, description of physical or psychiatric findings, diagnosis related to physical and diagnostic findings, provide an unequivocal, well rationalized opinion that answers all questions. ensure appropriate forms are completed and submitted, proper adherence and application of the AMA Guidelines of the 6th Edition (or newer), how the level of impairment was calculated, the contractor’s verification of the physician’s calculations, and when needed, medically warranted restrictions or limitations on work-related activities that includes objective findings and supported by medical rationale for each restriction or limitation.

The maximum acceptable level is no more than 5% of all medical examinations result in the need for clarification, correction, completion, or re-performance.

Periodic evaluation of reports, weekly, monthly, and quarterly reports, and complaints* received from DFEC District Office COR.

* Only complaints validated by the National Office will be considered in determining performance

OWCP/DFEC Bills/Invoice validation process.

5. INCENTIVES.

Incentives are not applicable to this requirement.

6. METHODS OF QA SURVEILLANCE.

Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

· DIRECT OBSERVATION. 100% surveillance of month compliance with all PWS deliverables.

· PERIODIC INSPECTION. Monthly compliance with all PWS deliverables, in accordance with the performance standards.

· VALIDATED USER/CUSTOMER COMPLAINTS. (Relies on the user of the service to identify deficiencies. Complaints are then investigated and validated. Highly applicable to services provided in quantity and where quality is highly subjective.) In accordance with the performance standards.

· 100% INSPECTION. Compliance with all PWS deliverables.

· RANDOM MONITORING. Performed by the COR or their designated inspector.

· Analysis of contractor's progress reports. (Evaluate cost, schedule, etc.) In accordance with the performance standards.

Surveillance results may be used as the basis for actions (to include payment deductions) against the contractor. In such cases, the Inspection of Services clause in the Contract becomes the basis for the CO’s actions.

7. RATINGS.

Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used:

The evaluation ratings are as follows:

Exceptional – Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the task and sub-task being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good - Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the task and sub-task being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory - Performance meets contractual requirements. The contractual performance of the task and sub-task contain some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal - Performance does not meet contractual requirements. The contractual performance of the task and sub-task being assessed reflect a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory - Performance does not meet contractual requirements. The contractual performance of the task and sub-task contain some minor problems for which corrective actions taken by the contractor appear or were unsatisfactory

8. DOCUMENTING PERFORMANCE.

a. ACCEPTABLE PERFORMANCE.

The Government shall document positive performance. A report template is attached. Any report may become a part of the supporting documentation for fixed fee payments, award fee payments, or other actions.

b. UNACCEPTABLE PERFORMANCE.

When unacceptable performance occurs, the COR shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in the COR file.

When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the contractor's task manager or on-site representative. A CDR template is attached to this QASP.

The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the COR. The Government shall review the contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for contract payment deductions, fixed fee deductions, award fee nonpayment, or other actions deemed necessary by the CO.

9. FREQUENCY OF MEASUREMENT.

a. Frequency of Measurement.

During contract/order performance, the COR shall take periodic measurements, monthly as specified in the AQL column of the Performance Standards Summary Matrix, and shall analyze whether the negotiated frequency of measurement is appropriate for the work being performed.

b. Frequency of Performance Assessment Meetings.

The CO and/or COR shall conduct a performance assessment at the end of the five-month performance period to assess performance and shall provide a written assessment.

The Government for this procurement will address the Quality of Service; Schedule; Business relations, Management of Key Personnel, and technical. As this information may affect future source selections throughout DOL, the annual assessment will be used appropriately as a complementary performance oversight and communication tool with the QASP.

Prepared by: TBD

Signature – Contracting Officer’s Representative

PERFORMANCE REPORT

1. CONTRACT NUMBER: <TBD>

2. Prepared by: (Name of COR) < >

3. Date and time of observation:

4. Observation:

At the end of each month, the COR or PM will prepare a written report for the CO summarizing the overall results of the quality assurance surveillance of the contractor’s performance. This written report, which includes the contractor’s submitted monthly report and the completed quality assurance monitoring forms, will become part of the QA documentation. It will enable the government to demonstrate whether the contractor is meeting the stated objectives and/or performance standards, including cost/technical/scheduling objectives.

Prepared by: Bryan McLain

CONTRACT DISCREPANCY REPORT (CDR)

1. Contract Number: <TBD>

2. TO: (Contractor Task Manager or on-site representative) <insert name>

3. FROM: (Name of COR) <insert name>

4. Date and time observed discrepancy:

5. DISCREPANCY OR PROBLEM:

<Describe in detail. Identify any attachments.>

5. Corrective action plan:

A written corrective action plan < is / is not > required.

< If a written corrective action plan is required include the following. > The written Corrective Action Plan will be provided to the undersigned not later than < # days after receipt of this

CDR. >

Prepared by: <Enter COR’s name>

Received by:

< The COR may initiate a CDR at any time, including whenever the number of monthly recorded defects for a performance standard exceeds the allowable number of defects; anytime unacceptable performance is determined critical in nature and requires formal corrective action; and whenever an unfavorable trend is detected in contractor performance.>