SOW_12.01.15.docx

16-247-SOL-00013 Teleradiology Services, HHCC Pg. 10 Background:

The Hopi Health Care Center provides health care and community health services to approximately 16,000 American Indians/Alaska Natives in the area of Arizona and Utah. Services are provided primarily to members of the Hopi, Navajo and Kaibab Paiute Tribes. The Indian Health Service (IHS) continues to experience difficulties in recruiting and retaining radiologists who can provide radiology services within the IHS medical facilities. Given the current availability of teleradiology/telemedicine technology, the IHS is pursuing a contract to provide these services to Hopi Health Care Center in Polacca, Arizona.

C. Description/Specification:

The contractor shall perform teleradiology services and provide Medical Director Physician over-sight for operational issues for the Hopi Health Care Center located in Polacca, AZ.

1. Teleradiology Service:

a) The Contractor shall provide routine and emergency teleradiology interpreting and reporting services twenty-four hours/day, seven days/week (including holidays). These modalities include:

· Digital radiology (DR)/digital x-ray (DX)

· Sonograms

· Multi detector computed tomography (MDCT)

· Magnetic resonance imaging (MRI)

· Dual Energy X-ray Absorptiometry (DEXA)

b) Studies will be designated by the diagnostic imaging department as “Routine” or “Urgent”. Urgent studies will not exceed 20% of the total study volume.

c) Immediate feedback to the attending emergency room physician, or Clinical Director when examinations meet the criteria for critical results reporting, or in the event there is an unexpected, incidental finding that poses a significant clinical threat for the patient.

1. Criteria for Abnormal or Critical findings on “Urgent” exams include the following:

· Pneumothorax

· Positive pulmonary embolism

· Any unexpected mass

· Intracranial hemorrhage

· Pericardial effusions

2. Criteria for abnormal or critical findings on “Routine” exams include the following:

· Pneumothorax,

· Any new lung mass,

· Any routine out-patient exam with a fracture.

d) If the provider cannot be reached (during routine hours) the results will be called to the Imaging Supervisor at the Hopi Health Care Center or a member of the Imaging staff.

e) The contractor shall provide 24 hour/7 day availability to answer questions from providers concerning the clinical study interpretation, the Contractor will define the method for contacting the Radiologist.

f) The contractor shall provide teleradiology reception capability compatible with the Hopi Health Care Center’s teleradiology system. The Contractor is responsible for expenses outside of IHS network.

g) The contractor shall provide a point of contact for network and technical issues 24 hours a day, 7 days a week.

h) The contractor shall provide a point of contact for interpretation/clinical issues 24 hours a day, 7 days a week.

2. Operational Radiology Service:

The contractor shall:

a) Provide technical assistance and feedback to staff technologists regarding the quality of images.

b) Provide a designated Medical Director who works closely with the department supervisor to solve problems of an administrative nature and to ensure effective protocols are established.

c) Demonstrate an active involvement in the following departmental programs to assure compliance with The Joint Commission (TJC) requirements:

· Quality Management programs (X-ray, CT, MRI, DEXA, ultrasound and other services),

· Safety programs,

· Infection control programs,

· Health information management programs.

· Dose management

3. Training/certification (as required):

The contractor shall:

a) Provide Quarterly Continuing Medical Education (CME) in-service to medical staff.

b) Provide in-services and training to the radiology technical staff to improve or enhance their services when deemed necessary by the Radiology Manager. This training will take place at the contractor’s site or service unit to ensure continuity of practice, protocols and procedures.

4. Quality Management:

The contractor will:

a) Provide Radiologist/Medical Director to act as a subject matter expert in reviewing radiology policies and procedures, protocols, and standard of care relative to meeting all regulatory and compliance issues for Government or accrediting agencies.

b) Have a daily proactive monitoring system to ensure that contract interpretation benchmarks are met.

c) Have a designated coordinator for technical and medical staff issues.

d) Have a designated primary technical consultant for computer, network and software issues relative to this contract.

e) Develop or demonstrate a Quality Assurance (QA) program to monitor performance and submit monthly reports to Contracting Officer Representative (COR) or Radiology Manager.

5. Qualifications:

a) The contractor must meet all applicable criteria for credentialed and privileged attending physicians who will be providing these services, The contractor shall:

b) Provide a completed credentials file which shall include the following documentation:

· Radiology residency training

· Board certification radiology

· Medical school training

· Tort claims history and liability coverage

· Experience appropriate to the scope of service

· Licensure (active unrestricted U.S. medical license)

c) An on-line website must be available to the Radiology Manager to verify current renewal of credentialing of all interpreting radiologists.

d) Accreditation by The Joint Commission, in good standing, preferred.

6. Reports:

The contractor shall:

a) Provide a final, written interpretation on all routine studies within 24 hours after receipt of the study. Interpretations on studies sent after 5pm (Monday – Friday, including holidays) will be provided on the first following business day.

b) Provide a preliminary written interpretation on all Urgent studies (24/7) within one hour of receipt of the study. Final interpretations may be provided on the next business day. Urgent interpretation services will be available 24 hours per day, seven days per week.

c) Document the time critical results are called in and the individual receiving the results in the clinical report.

d) Include the dose limit product (DLP) radiation dose requirements for CT scans as required by the Joint Commission,

e) Ensure that all reporting services, including an HL-7 bi-directional interface for report reception utilizing software or other methods is deemed acceptable by government. Contractor is responsible for all expenses including, but not limited to, technical support, license fees, software, etc., to provide the interface and reporting services.

f) Provide a detailed monthly billing of all examinations sent for interpretation including the number of exams, by modality. If requested, a list of patients to include the medical record number, date of service, and procedure interpreted will be provided.

E. PRICING SCHEDULE:

The unit price paid to the Contractor shall be considered as payment in full for services provided under this award. In no way, unless directed by the IHS, shall any provider attempt to bill or collect from any IHS patient, or from any alternate resource for which the patient may be eligible, any monies for services provided under this award.

Item No.

1. Inspection and Acceptance

a) The contractor is responsible for management and quality control actions to meet the terms of the contract. The role of the government is quality assurance, to ensure the standards are achieved.

b) The contractor is required to develop a program of monitoring actions.

c) Surveillance to be done by established timelines, random and periodic government inspections.

d) Deficiencies in timeliness must be corrected in the following thirty (30 days).

e) Deficiencies in peer review standard must be corrected by the next calendar quarter.

Task–Based Matrix

99-100% of Urgent interpretations reported within 60 minutes.

The government will periodically conduct random sampling in order to assure compliance.

100% compliance with scope of services.

Peer Review done by Contractor on 100% of all selected films “Blind over-readings” by the end of the quarter.

The government will periodically conduct random sampling in order to assure compliance.

Radiology Reporting Requirements

The Government will periodically conduct surveillance of reports, review of data to determine compliance with necessary indicators, standards as identified in the scope of work and standards for specific specialty.

F. Period of Performance:

A base year of 12 months and four options years.

G. Contract Administration:

Contracting Officer Representative (COR) shall be responsible for:

1. Monitoring the Contractor’s technical progress, including surveillance and assessment of performance,

2. Interpreting scope of work,

3. Performing technical evaluations required,

4. Performing technical inspections and acceptances required by this contract,

5. Monitoring funds available for obligation under this contract,

6. Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.

In no event is the COR empowered to change any of the terms and conditions of the contract. Changes in the scope of work, contract price, quantity, and quality or delivery schedule shall be made only by the Contracting Officer by a properly executed modification to the contract. The designation of a COR does not authorize or provide a legal right to change any kind of contractual terms.

Special Contract Requirements:

Professional Credential Policy Contractor shall have their credentials available for review. Contractor shall be responsible for adherence to all policies and procedures of the Indian Health Service and the Service Unit credentialing program.

Information Technology Security Clearances All contractors that may have remote or direct access and/or interconnected to a federal Information Technology Systems (IT) shall be contractually subject to all Phoenix Area, Indian Health Service (PAIHS) and Federal IT security standards, policies, and reporting requirements. The contractor shall meet and comply with all IHS IT security policies and all applicable standards and guidelines, other Government‐wide laws and regulations for protection and security of all information technology.

Remote or Direct Access to Federal Information Systems This is not applicable. They do not access our system.

Prior to the contractor’s employees receiving access to the government’s IT systems, IT security awareness training is required. Information Systems Security Awareness http://www.ihs.gov/ISSA/

Interconnection only to Federal Information Systems:

Referenced are four documents in particular for interconnection, required to be completed:

The following documents are required to be completed and returned to the government before interconnection to the federal system is provided:

· Business Partner Interconnection Security Agreement - (Attachment, see section J – Applicable Document)

· Business Partner Interconnection Security Agreement Checklist

· Data Exchange Agreement (DEA) Template (Attachment, see section J – Applicable Document)

· IHS Rules of Behavior for Interconnection Security Agreements

Collection of Third Party Revenue:

a) The contractor shall provide necessary information for Indian Health Service (IHS) to bill and collect for any third party resources of its patients as a result of services rendered through performance of this contract.

b) Indian Health Service shall be responsible for processing collection of private insurance and/or patient eligible for Medicare and/or Medicaid benefits.

c) Indian Health Services shall have sole right to recover the reasonable costs of services from patient’s third party resources (also called alternate resources). All third-party billing and collection(s) opportunities derived from this service shall be revenue payable only to the Indian Health Service (IHS). Safeguarding this revenue stream and related assets is vital to IHS health care programs.

J: Attachments:

Exhibit A-SF1449 Exhibit B-Wage Determination Exhibit C-Tax Exemption Letter 2015 Exhibit D-Business Partner Interconnection Security Agreement

L. INSTRUCTION TO OFFERORS:

RFQ Submission Guidelines

TECHNICAL PROPOSAL PREPARATION:

Page Limit:

Limit to 26 pages including the cover page. Any pages in excess of 26 pages will not necessarily be evaluated.

Content:

a) Offerors must submit a technical narrative that describes a proven history of successfully providing 24/7 teleradiology services to a primary care health care center with emergency services within prescribed timeframes.

b) Offerors must submit a technical narrative that describes 24/7 radiologist availability for Medical Staff consultation in reference to performed studies and their interpretations.

c) Offerors must submit a technical narrative that established 24/7 process for network/technical issues.

d) Offerors must submit a technical narrative that describes proven ability to successfully integrate with I.H.S. RPMS-based informatics for the purposes of image transmission and receiving clinical interpretive reports.

e) Offerors must submit a technical narrative that describes all radiologists must meet all I.H.S. medical staff credentialing standards.

f) Offerors must submit a technical narrative that describes availability of interpreting radiologists board-certified (preferred) or experienced in multiple specialty areas (CT, MRI, Ultrasound).

g) Offerors must submit a technical narrative that describes defined system for reporting critical findings to primary care providers or Imaging Department staff.

h) Offerors must submit a technical narrative that describes defined plan for provision of CME to Medical Staff members that is current and relevant to Radiology practice.

i) Offerors must submit a technical narrative that describes proven ability to consistently meet 60 minute emergent and 24 hour routine turnaround times for finalized, electronic clinical reports.

j) Offerors must submit a technical narrative that describes proven success with bi-directional transcription interfaces.

k) Offerors must submit a technical narrative that describes established Quality Management program that includes report monitoring, peer reviews, and interpretation benchmarks which are shared with the customer.

l) Offerors must submit a technical narrative that describes proven experience and success with compliance activities related to accreditation (TJC), CMS and ACR.

Definitions:

· Experience reflects whether contractors have performed similar work before,

· Past performance describes how well contractors performed the work.

PAST PERFORMANCE:

Page Limit:

Limit to 15 pages including the cover page. Any pages in excess of 15 will not necessarily be evaluated.

Content:

Offerors must submit past performance that is current and relevant as defined below. Offerors may submit a maximum of 5 examples of their past performance with their offer. Past performance information should contain the following:

1. contract number and contract type

2. dollar value

3. contract award and completion dates

4. Description of the work and the relevancy, (include modalities managed)

5. Volume of cases read by modality

6. Report turnaround time

7. “Mis-reads” by peer review,

8. Contact name and number for reference site.

Definitions:

· Current is defined as having been completed within the last 24 months from solicitation close date.

· Relevant is defined as any contract or subcontract valued at similar magnitude or greater for the same type of service,

· Same type of service is defined as service for the clinical interpretation of multi-modality images,

· Experience reflects whether the contractors have performed similar work before,

· Past performance describes how well contractors performed the work.

COST PROPOSAL PREPARATION:

Format:

A SF1449 will be supplied with the solicitation. This shall be completely filled out with a price shown for teleradiology service for the base and option years.

Content:

The total price for the contract should be filled out completely with the total prices for the base and option years, identifying the price per services.

M. Evaluation Criteria:

Evaluation of offers received will be in accordance with provision 52.212-2 – Evaluation – Commercial Items as stated below:

Evaluation -- Commercial Items (Jan 1999)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

1. Technical :

· Capability to provide the technical narrative proposed under content of the Technical Proposal Preparation. (a-l)

2. Past Performance : (see FAR 15.304) Information must be submitted in accordance with 52.212-1 Instruction to Offerors – Commercial Items PPIRS and FAPIIS data will be pulled.

3. Price :

· Technical and past performance, when combined, are significantly greater when compared to price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.