17-245-SOL-00015_Chinle_MRI_Services.pdf

Chinle On‐Site Mobile MRI Services Solicitation Number: 17‐245‐SOL‐00015

ISSUE DATE: August 3, 2017 DUE DATE: September 1, 2017

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. The Navajo Area Indian Health Service, Chinle Comprehensive Health Care Facility is Requesting for Proposals from interested Offerors to provide On‐site Mobile Magnetic Resonance Imaging (MRI) Services. It is requested that you review the enclosed RFP proposal instructions and provide this office with a proposal, utilizing the information contained therein. The Government contemplates award of a requirements type firm fixed price contract resulting from this solicitation.

COMPLETION OF SOLICITATION REQUIREMENTS

Ensure all forms and additional information are completed in their entirety. Verify calculations before signing the proposal.

1. Standard Form 1449‐Solicitation/Contract/Order or Commercial Items

2. Section B.2: Fee Schedule/Pricing

3. Section B.9: Qualifications

4. Section B.10: Equipment Specifications

5. Section B.17: Contractor’s Point of Contact

6. Section E.2: 52.212‐2 Evaluations‐Commercial Items (OCT 2014)

7. Section E.3: 52.212‐3 Offeror Representation & Certifications ‐ Commercial Items (JAN

2017)

8. Completed set of Section E: Solicitations Provisions E.1‐E.6

9. Prospective Offerors are required to complete registration in the System for Award

Management (SAM) database in accordance with FAR 4.1102.

Offerors’ proposal shall be prepared and submitted in accordance with Paragraph E.1 52.212‐1 Instructions to Offeror Commercial Items. This paragraph shall stipulate the submission of all required documents, certifications, etc., to determine your responsibility of providing the required services. All proposals must be received in the Department of Acquisitions and Contracts by the due date listed above.

Chinle Comprehensive Health Care Facility Attn: Tanya Begay, Contracting Officer Off Highway 191 & Hospital Drive PO Drawer “PH” Chinle, AZ 86503

MARK YOUR ENVELOPE: “CHINLE ON‐SITE MOBILE MRI SERVICES”

This requirement is a 100% Small Business Set‐Aside.

The anticipated period of performance will be for one (1) basic contract year with two (2) one (1) year option years.

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TABLE OF CONTENTS

Page No.

SECTION A STANDARD FORM 1449/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1

SECTION B CONTINUATION OF SF‐1449 2

B.1 General/Purpose of Contract 4

B.2 Fee Schedule/Pricing 4‐5

B.3 Definitions 5‐6

B.4 Performance Work Statement 6‐8

B.5 Billing 8

B.6 Films 8

B.7 Government Furnished Property/Information/Materials 8

B.8 MRI Unit Maintenance 8‐9

B.9 Qualifications 9‐10

B.10 Equipment Specifications 10‐11

B.11 Quality Control and Performance Requirements 11‐12

B.12 Reporting Requirements 12‐13

B.13 Task Orders 13

B.14 Invoice Submission 13

B.15 Contracting Officer’s Responsibility 13‐14

B.16 Contracting Officer’s Representative (COR) 14

B.17 Contractor’s Point of Contact 14

B.18 Client Background 14

B.19 Non‐Discrimination in Services, Benefits and Facilities 14

B.20 Quality of Patient Care 14‐15

B.21 Health Insurance Portability and Accountability Act (HIPAA) 15

SECTION C CONTRACT CLAUSES 16

C.1 52.252‐2 Clauses Incorporated by Reference (FEB 1998) 16

C.2 52.212‐4 Contract Terms & Conditions‐Commercial Items (JAN 2017) 16‐21

C.3 52.212‐5 Contract Terms & Conditions Required to Implement Statues or Executive Orders—Commercial Items (JAN 2017)

21‐27

C.4 52.216‐18 Ordering (OCT 1995) 28

C.5 52.216‐19 Order Limitations (OCT 1995) 28

C.6 52.216‐21 Requirements (OCT 1995) 28‐29

C.7 52.217‐9 Option to Extend the Term of the Contract (MAR 2000) 29

C.8 52.232‐18 Availability of Funds (APR 1984) 30

C.9 52.237‐2 Protection of Government Buildings, Equipment and Vegetation (APR 1984)

C.10 52.237‐7 Indemnification and Medical Liability Insurance (JAN 1997) 30‐31

C.11 Department of Health and Human Services Acquisition Regulation (HHSAR) (48 CFR Chapter 3) Clauses

31‐33

SECTION D CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS 34

SECTION E SOLICITATION PROVISIONS 35‐59

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SECTION B – CONTINUATION OF SF1449

B.1 General/Purpose of Contract:

The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal healthcare services to American Indians and Alaska Natives. The provision of healthcare services to members of federally‐recognized tribes grew out of the special government‐to‐government relationship between the federal government and Indian tribes. The Indian

Health Service (IHS) is the principal federal health care provider and health advocate for Indian people and its goal is to raise their health status to the highest possible level. The IHS provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 564 federally recognized tribes in 35 states. The Chinle Comprehensive Health Care Facility

(CCHCF) is a Navajo Area IHS facility.

CCHCF currently lacks Magnetic Resonance Imaging (MRI) service, prompting frequent referrals outside the service unit. For emergent indications, such as suspected stroke or spinal compression, the lack of

MRI necessitates referrals via air transportation (fly outs). Over the last several years, MRI has become more accessible to rural and community hospitals utilizing on‐site mobile MRI services. Providers are historically reluctant to refer for MRI service due to concerns over travel burden for patients and the cost to the service unit. Despite these concerns, last year, we referred out 406 MRI studies. Rather than referring out, CCHCF will be able to offer on‐site mobile MRI services.

This Nonpersonal Service Contract is for a contractor to provide on‐site MRI services provided in a

Contractor‐owned mobile unit. The mobile unit shall be brought on‐site to CCHCF in Chinle, AZ for services

(2 days/week) for the term of the contract.

B.2 Fee Schedule/Pricing:

The Contractor shall be compensated at an all‐inclusive fixed monthly amount to provide on‐site Mobile

MRI Services, Part Time Mobile Service 2 days/week in accordance to Performance Work Statement

(PWS). On‐site Mobile MRI services shall be provided for one (1) basic contract year with two (2) one (1) year option period. If the Contractor is unable to fulfill 100% of the services, then the Contractor shall be assessed a penalty fee based on a percentage of the monthly rate to be determined prior to contract award.

2.1 Base Year: October 1, 2017 through September 30, 2018

Service Description Quantity

Unit Price/Month

Total Price

2.1.1

On‐site Mobile MRI Services, Mobile Service 2 days/week, average volume 10 studies/day. Services shall include breast coils for breast MRI scans.

12 months $ $

TOTAL = $

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2.2 First Year Option: October 1, 2018 through September 30, 2019

Price/Month

Total Price

2.2.1

On‐site Mobile MRI Services, Mobile Service 2 days/week, average volume 10 studies/day. Services shall include breast coils for breast MRI scans.

2.3 Second Year Option: October 1, 2019 through September 30, 2020

Price/Month

Total Price

2.3.1

On‐site Mobile MRI Services, Mobile Service 2 days/week, average volume 10 studies/day. Services shall include breast coils for breast MRI scans.

B.3 Definitions

1. Acceptance: An authorized representative of the Government has inspected and agreed that the work meets all requirements of this contract, to include documentation requirements.

2. Acquisition term for MRI Scans: The process of measuring and storing image data.

3. Approval: The Government has reviewed submittals, deliverables, or administrative documents

(e.g., insurance certificates, installation schedules, planned utility interruptions, etc.) and has determined the documents conform to contract or contract requirements. Government

Approval shall not relieve the Contractor from responsibility for complying with contract requirements.

4. Authorized Ordering Official: A Government employee with the authority to order/issue and sign individual task orders for MRI services for the CSU medical facility.

5. Contracting Officer (CO): A Government employee with warranted delegated authority to enter into, administer, and/or terminate contracts.

6. Contracting Officer’s Representative (COR): A Government individual responsible for administration of this contract. The COR closely monitors the contract for contractor compliance and provides feed back to the Contracting Officer.

7. Contractor: The individual or firm awarded a legal binding contract to provide supplies and/or services.

8. Customer Input: A criticism against the Contractor submitted to the Contracting Officer. This is one of the criteria used to monitor the Contractor’s performance.

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9. Cultural Awareness: The realization and respect for American Indian and Alaskan Native practices.

10. DICOM: Acronym for Diagnostic Imaging Communication in Medicine

11. Enhancement Studies: The use of contrast media to improve the visibility of internal body structures in magnetic resonance imaging (MRI).

12. Federal Acquisition Regulations (FAR): The FAR is the primary set of regulations for use by all

Federal Executive agencies in their acquisition of supplies and services with appropriated funds.

13. Holiday: A day marked by the government for general suspension of work in commemoration of an event.

14. MRI Scan: Magnetic resonance imaging (MRI) is a technique that uses a magnetic field and radio waves to create detailed images of the organs and tissues within a body.

15. Ordering Activity: An authorized user of IHS that may issue a task or delivery order to obtain required services under this contract.

16. Past Performance Information: Relevant information regarding a contractor’s actions under previously awarded contracts. It includes the contractor’s record of conforming to specifications and to standards of good workmanship; the contractor’s record of containing and forecasting costs on any previously performed cost reimbursable contracts; the contractor’s adherence to contract schedules, including the administrative aspects of performance; the contractor’s history for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the contractor’s business‐ like concern for the interest of the customer.

17. Quality Assurance Surveillance Plan (QASP): An organized written document prepared and used by the Government for Quality Assurance surveillance of the contractor’s performance.

18. Root Cause: A situation where performance does not meet expectations. Cause suggests responsibility or a factor to blame for a problem.

19. Task Order: An order issued by the government in accordance with the terms of the contract that details an ordering activity’s specific requirements. An authorized ordering official’s written order to obtain service, at a minimum will include the following where applicable: description of services, skill categories, hours, price period of performance, contract number, and the ordering activity’s task order number.

20. Service Unit (SU): A facility that houses Service Unit administrative staff and is responsible for the administration, coordination, and implementation of the Indian Health program/s in a designated geographic portion of the Area. The Navajo Area IHS covers approximately 25,000 square miles across North Arizona, Southern Utah, Western New Mexico and Colorado. The IHS medical facilities range from small ambulatory care clinics (health centers) to full service hospitals. Most of the medical facilities are located on Indian reservations.

B.4 Performance Work Statement

1. The Contractor shall provide all supervision, personnel, labor, parts, materials, tools, supplies, equipment, and free standing unit necessary to provide On‐site Mobile Magnetic Resonance

Imaging (MRI) services to include qualified technical staff to operate the MRI scanners and equipment 2 days per week. CCHCF will be responsible for providing adequate site for placement, including the requisite power and data connections per the mobile MRI units’ specifications. The

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Contractor shall be responsible for performing a variety of MRI examinations for IHS beneficiaries seeking care at CCHCF or who have been referred to CCHCF.

2. The Contractor shall obtain and maintain all required Federal, State, and Local licenses associated with the operation/transportation of the equipment and performance of the services being requested. The Contractor shall maintain all Federal and State licenses required for possession and operation of equipment for the term of the contract.

3. The Contractor shall provide on‐site mobile MRI services two (2) days per week for eight (8) hours per days contractor is on site, excluding federally recognized holidays. The on‐site MRI services shall be provided as identified on the individual task orders.

4. The Contractor shall maintain a patient exam register which includes the patient’s chart number, type of exam, date of birth and length of time for each exam.

5. The Contractor shall provide on‐site diagnostic MRI services in both inpatient and outpatient settings as follows:

a. Outpatient: Patient scheduled for MRI scan services will report to the mobile unit. For emergency scans, CCHCF medical staff will escort the patient to the mobile unit for MRI scans.

b. Inpatient: The patient will be escorted to the mobile unit by a member of the CCHCF nursing or medical staff. CCHCF will be responsible for determining which patients need to be monitored. The MRI technician shall immediately notify the covering radiologist of any emergency or changes in a previously stable patient. CCHCF will be responsible for managing all patient related emergencies.

6. MRI services will not be available for emergency purposes, except on the days when the mobile

MRI unit is scheduled to be on‐site.

7. The Contractor shall assume liability of all I.H.S. patients while in the MRI mobile unit.

8. The Contractor shall store all records of MRI studies on a magnetic disc or equivalent device.

CCHCF will provide the storage media and storage space.

9. The Contractor shall maintain a documented quality control program which will be reviewed on an annual basis by the COR.

10. The MRI technologist shall be responsible for ensuring completion of MRI safety screening forms, which will be provided by CCHCF prior to each patient’s exam.

11. Services shall conform with and, if applicable, certified by:

a. The Accreditation Association for Ambulatory Health Care (AAAHC)

b. Health Insurance Portability and Accountability Act (HIPPA)

c. Infection Control, National Fire Protection Association (NFPA)

d. Health Service Inspection (HSI)

e. Centers for Medicaid and Medicare Services (CMS)

f. The Joint Commission (TJC)

g. Indian Health Service (IHS) Standards

h. The American College of Radiology (ACR)

12. The Contractor shall be solely responsible for all driver‐staffing issues related to set‐up and operation of the systems.

a. The Contractor shall perform arrival, set‐up, take‐down, and departure of mobile systems in a manner that causes limited or no disruption to normal CCHCF operations. The

Contractor shall perform arrival and departure such that the MRI unit operates full days

Page | 8 on days schedule. Appropriate arrival and departure schedules shall be developed such that the MRI unit is fairly accommodated regarding its operation.

b. The Contractor shall be responsible for cleaning of mobile units and for disposal of trash in a responsible manner.

B.5 Billing

CCHCF reserves the right to bill for and collect all applicable reimbursement monies associated with the contracted service from all third party resources. The Contractor shall provide CCHCF with the National

Practitioner Identification (NPI) number of the contracted providers. The Contractor shall be responsible to ensure their MRI technologist meet the qualifications to obtain and maintain credentials and privileges.

B.6 Films

The Contractor shall store all exams on Optical Compact Disc (CD) discs, which will be provided by

CCHCF. The discs will be stored in the Radiology Department at CCHCF.

B.7 Government Furnished Property/Information/Materials

1. CCHCF will be responsible for scheduling patients.

2. CCHCF will provide the necessary space for the weekly set‐up of the Contractor’s mobile unit.

CCHCF will provide electrical power, data line connectivity, and a telephone line accessible to

CCHCF to meet code requirements.

3. CCHCF radiology department will provide all direct patient care medical supplies. These include contrast materials, syringes, IV tubing, oxygen mask and tubing, needles, emesis basins, gown, and other similar direct patient care items. The Contractor’s personnel shall submit a request to

CCHCF radiology department for dispensing of contrast media.

4. CCHCF staff can be contacted as necessary to provide linguistic services when interpretation is necessary for non‐English speaking IHS patients.

5. CCHCF staff radiologist will provide interpretations for all MRI studies. CCHCF radiology will have the final responsibility for all aspects of the study including but not limited to: reviewing all indications for the scan, specifying the pulse sequences to be performed, specifying the use and dosage of the contract agents, interpreting the images and generating reports.

B.8 MRI Unit Maintenance

Contractor shall perform Preventative Maintenance (PM) as recommended by the original equipment manufacturer (OEM) and repairs for both the MRI System and the Mobile Unit. The Mobile Unit includes, but is not limited to, generator, MRI contrast injector, air conditioning/heating systems, and patient lift.

The service contract shall be maintained by an OEM and be comprehensive. Records of all maintenance activities shall be maintained for the life of the MRI equipment and these records shall be available to COR for review. Any unscheduled repairs and maintenance shall be done in a prompt fashion and to the extent possible, during hours when service is not scheduled in order to minimize the amount of time the mobile unit is unavailable for service.

1. The Contractor shall provide a service point of contact and phone number for hospital/clinic employees to call in the event of equipment failures.

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2. Contractor shall have phone response within 1 hour and onsite service within 24 hours for the

MRI System and 24 hours for Mobile Unit.

3. Contractor shall perform initial set‐up and annual Physicist review as required per TJC and the

ACR and provide copies of the review to the Government including, but not limited to:

a. Image uniformity for all coils

b. Signal‐to‐noise for all coils

c. Slice thickness accuracy

d. Slice position accuracy

e. Alignment light accuracy

f. High‐contrast resolution. Contrast‐to‐noise ratio

g. Geometric accuracy

h. Magnetic field homogeneity,

i. Artifact evaluation.

j. Proper function/performance of display monitors (luminance max/min, uniformity, resolution and spatial accuracy.) Service should be maintained by an OEM and comprehensive.

B.9 Qualifications

1. The Contractor shall maintain appropriate certification for each MRI technologist and qualified medical physicist providing services throughout the term of this contract and provide the documentation to the COR.

2. The Contractor shall be solely responsible for all technologist staffing responsibilities, except patient scheduling related to operation of the mobile systems.

3. Each MRI technologist shall:

a. Be certified by the American Registry of Radiologic Technologist (ARRT) as an MRI technologist.

OR

b. Be certified by ARRT and/or have appropriate and current state license plus six (6) months of supervised clinical MRI scanning experience or American Registry of Magnetic Resonance

Imaging Technologist (ARMRIT).

c. Be licensed in the State in which the MRI technologist practices.

d. All MRI Technologists shall be Basic Life Support (BLS) certified and remain current in BLS training. Copies of certifications hall be kept on file.

e. Have current CPR certification.

f. Have training and experience in administering IV injections.

g. The Contractor shall comply with the provision of Public Law 101‐630:

Occupational/Classification – Indian Children Protection and Family Violence Protection Act.

h. Read, understand, speak, and write English fluently.

4. The Qualified Medical Physicist shall be appropriately certified with the American Board of

Radiology (ACR).

5. The Contractor’s mobile unit shall be appropriately State licensed and/or possess all necessary permits/accreditation, OSHA standards and meet National Life Safety Standard Codes.

6. The Contractor shall possess medical liability insurance in accordance with FAR 52.237‐7:

Indemnification and Medical Liability Insurance. The Contractor shall maintain medical liability

Page | 10 insurance throughout the term of the contract and provide updated copies to the Contracting

Officer’s Representative upon renewal/s.

7. The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest.

8. The Contractor shall maintain all immunizations required of practicing medical professionals, and work in a professional manner at all times. Before start of work health care workers shall provide proof of immunizations for the following disease according the CDC guidelines: Hepatitis B, measles, mumps, rubella, varicella, and influenza. The Contractor shall also provide proof of a negative TB skin test within 12 months (if positive, proof of negative chest X‐ray within 12 months) prior to start of work.

9. The Contractor personnel shall present a clean, neat appearance and be easily recognized as contractor employees.

B.10 Equipment Specifications

Mobile MRI scanner shall include a ramp and/or a lifting device for non‐walking patients. The unit should be set up for 3 phase, 480volt/200 amperes service. The trailer shall have a separate area included within the trailer for a patient changing area.

Equipment shall include, but not be limited to, a fully equipped MRI per minimum equipment requirements below. The system will be Joint Commissioned certified. The scanner shall be no more than two (2) years old:

Minimum equipment requirements:

1. GE 1.5 HDxt – with Excite 8‐Channel Software with 16 level software (or equal)

2. WideOpen Short Bore Magnet with Dual Flared Enclosures

3. 10.3 Wide patient opening – 60 cm.

4. Patient Bore is (LxWxH) 70 cm x 60 cm x 60 cm

5. Patient table accommodates patient weight to a maximum 350 lbs.

6. High performance Gradient Subsystem

7. Gradient strength is 33 mT/m

8. Slew rate is 120 T/M/s

9. Variable FOV from 2 cm to 48 cm

10. Dicom 3.0 Compliant

11. 2D Spin Echo (SE), 2D Inversion Recovery (IR), Double IR, Triple IR, 2D and 3D Gradient Echo (GRE), Fast Recovery Fast Spin Echo (FRFSE), Single Shot Fast Spin Echo (SSFSE), 3D Fast Recovery Fast

Spin Echo (3DFRFSE), 2D/3D Spoiled Gradient Recalled (SPGR), 2D/3D Fast Spin Echo, Fast Spin

Echo XL, 2D/3D Fast Gradient Echo (FGRE), 2D/3D Fast spoiled Gradient Echo (FSPGR), Cine, Fast

Flair, EPI, IVI, 3D Surface Rendering and ClairView, T1 Flair, T2 Flair

12. 2D/3D Time of Flight Angiography (TOF)

13. 2D/3D Phase Contrast MR Angiography

14. MRCP – SSFSE, Single Shot Fast Spin Echo Cholangiopancreatography

15. MRCP3 – Spin Echo Cholangiopancreatography

16. SmartPrep

17. Fluoro‐triggered MRA

18. Single Shot Diffusion Weighted Imaging ‐ EchoPlus

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19. Perfusion Analysis (Imaging)

20. The following additional equipment should be included:

a) MRI pads and restraints

b) MRI compatible nonferrous wheelchair and stretcher with IV pole (gurney)

c) Nonferrous oxygen cylinder

d) Capability to provide patient exam on CD

e) MRI license for PACS

f) Interface between MRI scanner and PACS, Dicom print, store and worklist

g) Optical disk archival device compatible with PACS

h) Code kit and code call button

i) MRI compatible 02 saturation monitor

j) Contrast media and warmer

k) MRI compatible power injector

l) Coils including: 8 Channel Body Array. 8 Channel CTL Array, 8 Channel Head Array, Channel

Neurovascular Array, 4 Channel Extremity Coil, 4 Channel Shoulder Array Coil, Dual Array

Package and Breast imaging coils.

m) Vibrant Software for breast imaging or equal.

B.11 Quality Control and Performance Requirements

1. The Contractor shall have documented proof of the following Quality Control tests as listed below:

a) The following Quality Control tests shall be performed quarterly:

1) Measurement of central frequency.

2) Measurement of system signal‐to‐noise ratio on a standard head or body coil.

3) Assessment of image quality and image artifacts.

b) The following Quality Control tests shall be performed and documented semi‐annually and after any major change on equipment by a qualified physicist.

1) Review of daily quality control testing records.

2) Measurement of image uniformity; spatial linearity, and high contrast spatial resolution.

3) Measurement of slice thickness, location, and separation.

c) All Quality Control testing shall be carried out in accordance with written procedures and methods. Preventive maintenance shall be scheduled, performed, and documented by a qualified service engineer on a regular basis. Service performed to correct system deficiencies shall also be documented and service records shall be maintained by the MRI contractor and available for the COR.

Additionally:

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.

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Performance

Objective

(The Service required usually a shall statement)

Performance Standard Performance

Threshold

(This is the maximum error rate. It could possibly be "Zero deviation from standard")

Quality Assurance Incentives

PRS #1. The Contractor shall provide on‐site MRI scanner and technical support to provide services 2 days per week.

The contractor provided on site MRI scanner and technologists to provide the scans.

The scanner and technologist will be available for services

100% of the time

Monthly stats. % uptime is number of clinical hours performed divided by scheduled

Clinical hours in the month.

Payment of contract price for satisfactory service.

No payment for incomplete work.

Contractor performance will be evaluated using the Contractor Performance Assessment Report

(CPAR).

The evaluation will be considered when future IHS contract selections are made.

PRS #2. The Contractor shall provide quality customer service

Validated customer complaints

No more than one validated customer complaint per 6 month time period

*Validated customer complaints from providers and patients.

PRS #3. The Contractor shall provide quality MRI images and exams

All MRI study/exams shall be high quality excluding factors not under technical control i.e.

patient was noncompliant

No more than one validated low quality study/exam per month

**Validated complaint from

Radiologist or orthopedic surgeon.

PRS #4. Adhere to

HIPPA requirements

Within acceptable standards

Zero deviation from standard

Subject to contract termination

PRS #5. Complete scheduled scans daily

Daily Complete scheduled daily scans at a rate > 100%

Monitored by COR

* Validated Customer Complaint: Complaints must be validated. Complaints are validated if found to be reasonable and true after an administrative investigation.

**Validated complaint from Radiologist or orthopedic surgeon: Complaints are validated if found to be reasonable and true after an administrative investigation. Defective or low quality MRI scans are limited to image quality issues under the technologists control such as proper sequencing protocols, positioning and demonstration of attempts to resolve poor quality studies. Complaints are validated if found to be reasonable and true after an administrative investigation.

B.12 Reporting Requirements

Report No.

Description No. of Copies Recipient Due Date

1 Quality Control 1 COR Quarterly

2 Equipment Maintenance 1 COR Quarterly

3 Required Accreditations 1 COR Annually

4 Liability Insurance 1 COR Annually

5 Patient Exam Log 1 Technical Rep Each Visit

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6 Image of PACS 1 Technical Rep Each Visit

B.13 Task Orders

1. Individual Task Orders under this contract will be issued by utilizing SF‐1449:

Solicitation/Contract/Order for Commercial Items. Each Task Order will establish an estimated patient workload and set forth the actual work performance dates.

2. The Acquisition staff at CSU are authorized to place task orders against this contract.

B.14 Invoice Submission

1. The Contractor shall submit an original invoice and three copies to the address designated in the contract to receive invoices. An invoice must include the following:

a) Name and address of the Contractor;

b) Invoice date and number;

c) Contract number, line item number and, if applicable, the order number;

d) Description, quantity, unit of measure, unit price and extended price of the items delivered;

e) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

f) Terms of any discount for prompt payment offered;

g) Name and address of official to whom payment is to be sent;

h) Name, title, and phone number of person to notify in event of defective invoice; and

i) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

j) Electronic funds transfer (EFT) banking information.

2. Payment: Payment will be made in accordance with the Prompt Payment procedures outlined in the 5 U.S.C CFR Part 13‐15.

3. Target Date For Payment: The target date for payment under this contract is thirty (30) calendar days after the date of receipt in the office designated herein of a correct and properly documented invoice.

B.15 Contracting Officer’s Responsibility

Authority to negotiate changes in terms, conditions, or amounts cited in this contract is reserved to the

Contracting Officer.

B.16 Contracting Officer’s Representative (COR)

The Contracting Officer's Representative (COR): Georgina Nez, Health System Specialist, who shall be responsible for:

1. Monitoring the Contractor's technical progress on individual task orders, including surveillance and assessment of performance and issuing technical changes to individual task orders;

2. Interpreting the Scope of Work on Individual Task Orders, with the assistance of the SU medical staff;

3. Technical inspections and acceptance required by this contract; and

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4. Assisting the Contractor in the resolution of technical and administrative problems encountered during the performance of this contract.

B.17 Contractor’s Point of Contact

Designated Contractor’s Point of Contact, whom we may contact for prompt Contract Administration:

Name & Title:

Address:

Telephone No.:

Email Address:

The Contractor shall provide updated Point of Contact information within 30 days of newly appointed

Point/s of Contact for the term of this contract.

B.18 Client Background

Many of the IHS patients receiving services under this contract may only speak a native language and/or reside on a federally recognized Indian reservation. The Contractor shall demonstrate sensitivity to cross‐ cultural and language difference and have the ability to work through interpreters as necessary for non‐

English speaking patients. Formal interpretation will be provided by CSU staff as necessary.

B.19 Non‐Discrimination in Services, Benefits and Facilities

1. The Contractor shall make no distinction among patients under this contract on the basis of race, color, creed, or national origin, including, but not limited to the following: denying a patient any service or benefit or availability of a facility; providing any service or benefit to a patient which is different, or is provided in a different manner or at a different time from that provided to other patients under this contract; subjecting a patient to segregation or separate treatment in any manner related to his/her receipt of any service, restricting a patient in any way in the enjoyment of any advantage or privilege enjoyed by others in determining whether he/she satisfies any admission, enrollment quota, eligibility, membership or other requirement or condition, which an individual must meet in order to be provided any service or benefits; and the assignment of times or places for the provisions of services on the basis of the race, color, creed, or national origin of the patients served.

2. The Government reserves the right to terminate this contract in whole or in part whenever the

Contractor fails to comply with the requirements of this clause.

B.20 Quality of Patient Care

As appropriate, the Contractor shall provide IHS patients under the terms of this contract, proper and adequate general health care services, which are the same or equal to those provided to non‐IHS patients.

1. Proper and adequate general health care shall include compliance with The Joint Commission

Standards or Medicare Certification. All patients hospitalized shall be in the facilities utilization and review program. Reason(s) for admission and length of stay determinations shall be

Page | 15 documented and reviewed by appropriate members of the hospital's utilization review committee or local designated Peer Review Organization (PRO).

2. MRI Scan services shall be provided within accepted professional standards.

3. The government may evaluate the quality of professional and administrative services provided, but retain no control over the medical, professional and administrative services rendered (e.g., professional judgments, diagnosis for specific medical treatment).

B.21 Health Insurance Portability and Accountability Act (HIPAA)

The Indian Health Service (IHS) is required to comply with HIPAA in the provision of health care to IHS patients. HIPAA was implemented by the U.S. Department of Health and Human Services, Office of Civil Rights, under the Code of Federal Regulations, Part 160 and 164. Accordingly, all health care providers, including contracted health care providers are required to comply with HIPAA requirements (Full text will be furnished upon request).

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SECTION C – CONTRACT CLAUSES

C.1 52.252‐2 Clauses Incorporated by Reference (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browsefar

FAR NUMBER TITLE DATE

52.224‐1 Privacy Act Notification Apr 1984 52.224‐2 Privacy Act Apr 1984 52.232‐40 Providing Accelerated Payments to Small Dec 2013 Business Sub‐Contractors 52.243‐1 Changes‐Fixed Price (Alternate 1) Aug 1987

C.2 52.212‐4 Contract Terms & Conditions‐Commercial Items (JAN 2017)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post‐acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any

Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the

Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at

FAR 52.233‐1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202‐1, Definitions, is incorporated herein by reference.

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(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the

Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232‐33, Payment by Electronic Funds

Transfer—System for Award Management, or 52.232‐34, Payment by Electronic Funds Transfer—Other

Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

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(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment

Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR Part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212‐5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the

Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C.

7109 , which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six‐month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the

Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the

Contracting Officer (see 32.607‐2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

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(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or

(C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor.

(vii) The interest charge made under this clause may be reduced under the procedures prescribed in 32.608‐2 of the Federal Acquisition Regulation in effect on the date of this contract.

(j) Risk of loss. Unless the contract specifically provides otherwise, risk of loss or damage to the supplies provided under this contract shall remain with the Contractor until, and shall pass to the Government upon:

(1) Delivery of the supplies to a carrier, if transportation is f.o.b. origin; or

(2) Delivery of the supplies to the Government at the destination specified in the contract, if transportation is f.o.b. destination.

(k) Taxes. The contract price includes all applicable Federal, State, and local taxes and duties.

(l) Termination for the Government’s convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges the Contractor can demonstrate to the satisfaction of the

Government using its standard record keeping system, have resulted from the termination. The

Contractor shall not be required to comply with the cost accounting standards or contract cost principles for this purpose. This paragraph does not give the Government any right to audit the Contractor’s records.

The Contractor shall not be paid for any work performed or costs incurred which reasonably could have been avoided.

(m) Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the Contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance. In the event of termination for cause, the Government shall not be liable to the Contractor for any amount for supplies or services not accepted, and the Contractor shall be liable to the Government for any and all rights and remedies provided by law. If it is determined that the Government improperly terminated this contract for default, such termination shall be deemed a termination for convenience.

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(n) Title. Unless specified elsewhere in this contract, title to items furnished under this contract shall pass to the Government upon acceptance, regardless of when or where the Government takes physical possession.

(o) Warranty. The Contractor warrants and implies that the items delivered hereunder are merchantable and fit for use for the particular purpose described in this contract.

(p) Limitation of liability. Except as otherwise provided by an express warranty, the Contractor will not be liable to the Government for consequential damages resulting from any defect or deficiencies in accepted items.

(q) Other compliances. The Contractor shall comply with all applicable Federal, State and local laws, executive orders, rules and regulations applicable to its performance under this contract.

(r) Compliance with laws unique to Government contracts. The Contractor agrees to comply with 31

U.S.C. 1352 relating to limitations on the use of appropriated funds to influence certain Federal contracts;

18 U.S.C. 431 relating to officials not to benefit; 40 U.S.C. chapter 37, Contract Work Hours and Safety

Standards; 41 U.S.C. chapter 87, Kickbacks; 41 U.S.C. 4712 and 10 U.S.C. 2409 relating to whistleblower protections; 49 U.S.C. 40118, Fly American; and 41 U.S.C. chapter 21 relating to procurement integrity.

(s) Order of precedence. Any inconsistencies in this solicitation or contract shall be resolved by giving precedence in the following order:

(1) The schedule of supplies/services.

(2) The Assignments, Disputes, Payments, Invoice, Other Compliances, Compliance with Laws Unique to Government Contracts, and Unauthorized Obligations paragraphs of this clause;

(3) The clause at 52.212‐5.

(4) Addenda to this solicitation or contract, including any license agreements for computer software.

(5) Solicitation provisions if this is a solicitation.

(6) Other paragraphs of this clause.

(7) The Standard Form 1449.

(8) Other documents, exhibits, and attachments.

(9) The specification.

(t) System for Award Management (SAM).

(1) Unless exempted by an addendum to this contract, the Contractor is responsible during performance and through final payment of any contract for the accuracy and completeness of the data within the SAM database, and for any liability resulting from the Government’s reliance on inaccurate or incomplete data. To remain registered in the SAM database after the initial registration, the Contractor is required to review and update on an annual basis from the date of initial registration or subsequent updates its information in the SAM database to ensure it is current, accurate and complete. Updating information in the SAM does not alter the terms and conditions of this contract and is not a substitute for a properly executed contractual document.

(2)(i) If a Contractor has legally changed its business name, “doing business as” name, or division name (whichever is shown on the contract), or has transferred the assets used in performing the contract, but has not completed the necessary requirements regarding novation and change‐of‐name agreements in FAR subpart 42.12, the Contractor shall provide the responsible Contracting Officer a minimum of

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(B) comply with the requirements of subpart 42.12; and (C) agree in writing to the timeline and procedures specified by the responsible Contracting Officer.