BPA.docx

RFQ-20-Q-0013

BPA TERMS AND CONDITIONS

Pursuant to the Federal Acquisition Regulation (FAR) 13.303, Blanket Purchase Agreements (BPAs), the Contractor agrees to the following terms of a BPA exclusively with Claremore Indian Hospital and Lawton Indian Hospital:

SEE ATTACHED SCHEDULE B PRICE LISTING (ATTACHMENT 2)

Any subsequent pricing changes must be agreed upon by both parties.

All orders placed against this BPA are subject to the terms and conditions, as noted.

(2)The government is obligated only to the extent of authorized purchases actually made under this BPA.

(3) The dollar limitation for each individual purchase under this BPA shall not exceed the simplified acquisition threshold ($250,000.00).

1. Contractor Name, Address, Phone Number, billing contact name and e-mail address

1. BPA Number

1. Date of Purchase

1. Date of Delivery or Shipment

1. Unique invoice number

1. Itemized list of supplies or services furnished

1. Quantity, Unit Price, and Extension of each item, Less applicable discounts

1. Contractor Name, Address, Phone Number, billing contact name and e-mail address

1. BPA Number

1. Invoice Date

1. Unique invoice number

1. Tax Identification Number (TIN)

1. Call Number or Order Number (if applicable) as shown on the award document

1. Discount Terms (if applicable)

1. Banking information: Bank Routing Transit Number (nine digits) and last 4 digits of bank account number (for verification)

1. Specific description of Work relating to invoice, including service period dates (if applicable)

1. Invoice Amount The Vendor shall submit their original invoice to Oklahoma City Area Office, 701 Market Drive, Oklahoma City, Oklahoma 73114.

(12) The terms and conditions included in this BPA apply to all purchases made pursuant to it. In the event of an inconsistency between the provisions of this BPA and the Contractor's invoice, the provisions of this BPA will take precedence.

(1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(2) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115-91).

(3) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (Nov 2015)

(4) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).

(5) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Public Laws 108-77, 108-78 (19 U.S.C. 3805 note)).

(6) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004) (Public Laws 108- 77 and 108-78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the contracting officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

|_| (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 4704 and 10 U.S.C. 2402).

|_| (2) 52.203-13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

|_| (3) 52.203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (Jun 2010) (Section 1553 of Pub L. 111-5) (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009).

|_| (4) 52.204-10, Reporting Executive compensation and First-Tier Subcontract Awards (Oct 2016) (Pub. L. 109-282) (31 U.S.C. 6101 note).

|_| (5) [Reserved] |_| (6) 52.204-14, Service Contract Reporting Requirements (Oct 2016) (Pub. L. 111-117, section 743 of Div. C).

|_| (7) 52.204-15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (Oct 2016) (Pub. L. 111-117, section 743 of Div. C).

|_| (8) 52.209-6, Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Oct 2015) (31 U.S.C. 6101 note).

|_| (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Jul 2018) (41 U.S.C. 2313).

|_| (10) [Reserved] |_| (11) (i) 52.219-3, Notice of HUBZone Set-Aside or Sole-Source Award (Nov 2011) (15 U.S.C. 657a).

|_| (ii) Alternate I (Nov 2011) of 52.219-3.

|_| (12) (i) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Oct 2014) (if the offeror elects to waive the preference, it shall so indicate in its offer)(15 U.S.C. 657a).

|_| (ii) Alternate I (Jan 2011) of 52.219-4.

|_| (13) [Reserved] |_| (14) (i) 52.219-6, Notice of Total Small Business Aside (Nov 2011) (15 U.S.C. 644).

|_| (ii) Alternate I (Nov 2011).

|_| (iii) Alternate II (Nov 2011).

|_| (15) (i) 52.219-7, Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644).

|_| (ii) Alternate I (Oct 1995) of 52.219-7.

|_| (iii) Alternate II (Mar 2004) of 52.219-7.

|_| (16) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (15 U.S.C. 637(d)(2) and (3)).

|_| (17) (i) 52.219-9, Small Business Subcontracting Plan (Aug 2018) (15 U.S.C. 637 (d)(4)).

|_| (ii) Alternate I (Nov 2016) of 52.219-9.

|_| (iii) Alternate II (Nov 2016) of 52.219-9.

|_| (iv) Alternate III (Nov 2016) of 52.219-9.

|_| (v) Alternate IV (Aug 2018) of 52.219-9.

|_| (18) 52.219-13, Notice of Set-Aside of Orders (Nov 2011) (15 U.S.C. 644(r)).

|_| (19) 52.219-14, Limitations on Subcontracting (Jan 2017) (15 U.S.C. 637(a)(14)).

|_| (20) 52.219-16, Liquidated Damages—Subcontracting Plan (Jan 1999) (15 U.S.C. 637(d)(4)(F)(i)).

|_| (21) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (Nov 2011) (15 U.S.C. 657f).

|_| (22) 52.219-28, Post Award Small Business Program Rerepresentation (Jul 2013) (15 U.S.C. 632(a)(2)).

|_| (23) 52.219-29, Notice of Set-Aside for, or Sole Source Award to, Economically Disadvantaged Women-Owned Small Business Concerns (Dec 2015) (15 U.S.C. 637(m)).

|_| (24) 52.219-30, Notice of Set-Aside for, or Sole Source Award to, Women-Owned Small Business Concerns Eligible Under the Women-Owned Small Business Program (Dec 2015) (15 U.S.C. 637(m)).

|_| (25) 52.222-3, Convict Labor (June 2003) (E.O. 11755).

|_| (26) 52.222-19, Child Labor—Cooperation with Authorities and Remedies (Jan 2018) (E.O. 13126).

|_| (27) 52.222-21, Prohibition of Segregated Facilities (Apr 2015).

|_| (28) (i) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246).

|_| (ii) Alternate I (Feb 1999) of 52.222-26.

|_| (29) (i) 52.222-35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212).

|_| (ii) Alternate I (July 2014) of 52.222-35.

|_| (30) (i) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793).

|_| (ii) Alternate I (July 2014) of 52.222-36.

|_| (31) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212).

|_| (32) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496).

|_| (33) (i) 52.222-50, Combating Trafficking in Persons (Jan 2019) (22 U.S.C. chapter 78 and E.O. 13627).

|_| (ii) Alternate I (Mar 2015) of 52.222-50, (22 U.S.C. chapter 78 and E.O. 13627).

|_| (34) 52.222-54, Employment Eligibility Verification (Oct 2015). (Executive Order 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.)

|_| (35) (i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C. 6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

|_| (ii) Alternate I (May 2008) of 52.223-9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

|_| (36) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (Jun 2016) (E.O.13693).

|_| (37) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (Jun 2016) (E.O. 13693).

|_| (38) (i) 52.223-13, Acquisition of EPEAT® -Registered Imaging Equipment (Jun 2014) (E.O.s 13423 and 13514 |_| (ii) Alternate I (Oct 2015) of 52.223-13.

|_| (39) (i) 52.223-14, Acquisition of EPEAT® -Registered Television (Jun 2014) (E.O.s 13423 and 13514).

|_| (ii) Alternate I (Jun 2014) of 52.223-14.

|_| (40) 52.223-15, Energy Efficiency in Energy-Consuming Products (Dec 2007) (42 U.S.C. 8259b).

|_| (41) (i) 52.223-16, Acquisition of EPEAT® -Registered Personal Computer Products (Oct 2015) (E.O.s 13423 and 13514).

|_| (ii) Alternate I (Jun 2014) of 52.223-16.

|_| (42) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging while Driving (Aug 2011) (E.O. 13513).

|_| (43) 52.223-20, Aerosols (Jun 2016) (E.O. 13693).

|_| (44) 52.223-21, Foams (Jun 2016) (E.O. 13696).

|_| (45) (i) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

|_| (ii) Alternate I (Jan 2017) of 52.224-3.

|_| (46) 52.225-1, Buy American--Supplies (May 2014) (41 U.S.C. chapter 83).

|_| (47) (i) 52.225-3, Buy American--Free Trade Agreements--Israeli Trade Act (May 2014) (41 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41, 112-42, and 112-43).

|_| (ii) Alternate I (May 2014) of 52.225-3.

|_| (iii) Alternate II (May 2014) of 52.225-3.

|_| (iv) Alternate III (May 2014) of 52.225-3.

|_| (48) 52.225-5, Trade Agreements (Aug 2018) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note).

|_| (49) 52.225-13, Restrictions on Certain Foreign Purchases (June 2008) (E.O.’s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).

|_| (50) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).

|_| (51) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150).

|_| (52) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150).

|_| (53) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 4505), 10 U.S.C. 2307(f)).

|_| (54) 52.232-30, Installment Payments for Commercial Items (Jan 2017) (41 U.S.C. 4505, 10 U.S.C. 2307(f)).

|_| (55) 52.232-33, Payment by Electronic Funds Transfer— System for Award Management (Jul 2013) (31 U.S.C. 3332).

|_| (56) 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management (Jul 2013) (31 U.S.C. 3332).

|_| (57) 52.232-36, Payment by Third Party (May 2014) (31 U.S.C. 3332).

|_| (58) 52.239-1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a).

|_| (59) 52.242-5, Payments to Small Business Subcontractors (Jan 2017) (15 U.S.C. 637(d)(12)).

|_| (60) (i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631).

|_| (ii) Alternate I (Apr 2003) of 52.247-64.

|_| (iii) Alternate II (Feb 2006) of 52.247-64.

(c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or executive orders applicable to acquisitions of commercial items:

|_| (1) 52.222-17, Nondisplacement of Qualified Workers (May 2014) (E.O. 13495) |_| (2) 52.222-41, Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67.).

|_| (3) 52.222-42, Statement of Equivalent Rates for Federal Hires (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

|_| (4) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (Multiple Year and Option Contracts) (Aug 2018) (29 U.S.C.206 and 41 U.S.C. chapter 67).

|_| (5) 52.222-44, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (May 2018) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

|_| (6) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67).

|_| (7) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67).

|_| (8) 52.222-55, Minimum Wages Under Executive Order 13658 (Dec 2015) (E.O. 13658).

|_| (9) 52.222-62, Paid Sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706).

|_| (10) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792).

(d) Comptroller General Examination of Record The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records -- Negotiation.

(1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor’s directly pertinent records involving transactions related to this contract.

(2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved.

(3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law.

(e)

(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c) and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause—

(i) 52.203-13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

(ii) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(iii) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115-91).

(iv) 52.219-8, Utilization of Small Business Concerns (Oct 2018) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $700,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities.

(v) 52.222-17, Nondisplacement of Qualified Workers (May 2014) (E.O. 13495). Flow down required in accordance with paragraph (1) of FAR clause 52.222-17.

(vi) 52.222-21, Prohibition of Segregated Facilities (Apr 2015).

(vii) 52.222-26, Equal Opportunity (Sep 2015) (E.O. 11246).

(viii) 52.222-35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212).

(ix) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793).

(x) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212).

(xi) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222-40.

(xii) 52.222-41, Service Contract Labor Standards (Aug 2018), (41 U.S.C. chapter 67).

(xiii) (A) 52.222-50, Combating Trafficking in Persons (Mar 2015) (22 U.S.C. chapter 78 and E.O. 13627).

(B) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 E.O. 13627).

(xiv) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67.)

(xv) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67)

(xvi) 52.222-54, Employment Eligibility Verification (Oct 2015) (E. O. 12989).

(xvii) 52.222-55, Minimum Wages Under Executive Order 13658 (Dec 2015).

(xviii) 52.222-62, Paid sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706).

(xix) (A) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

(B) Alternate I (Jan 2017) of 52.224-3.

(xx) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).

(xxi) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6.

(xxii) 52.247-64, Preference for Privately-Owned U.S. Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64.

(2) While not required, the Contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.

(End of Clause)

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): http://farsite.hill.af.mil

DOCUMENTS, EXHIBITS AND ATTACHMENTS

END OF SECTION

Attachment 1 Statement of Work for Quality Indicator Project (CMS), and ORYX (TJC) Claremore & Lawton Indian Hospital

A. Purpose of Contract:

The primary purpose is to meet mandatory requirements by Center of Medicare/Medicaid Systems (CMS) for the Quality Indicator Program and The Joint Commission (TJC) for ORYX.

CMS requires data collection and submission for the purpose of public reporting and to receive the facility’s full IPPS annual payment update (APU). If the hospital fails to report the inpatient and outpatient quality initiatives as outlined by CMS, the APU percentage is reduced. Annually, Claremore and Lawton will each identify the available measures for reporting based on the vendor’s fee schedule and individual hospital needs to ensure compliance and participation of CMS and TJC requirements for quality initiatives.

B. Statement of Work for Quality Indicator Program (Chart Abstracted Measures & eCQM Measures) for CMS and TJC

1. Compliance with CMS and TJC Criteria: The vendor will meet current criteria that are included on TJC's list of acceptable systems. The vendor should be committed to meeting future criteria established by CMS & TJC, which includes the maintenance and expansion of Chart Abstracted Measures & eCQM Measures according to predetermined specifications within the timeframes established by CMS & TJC.

2. The following timelines will be followed:

*timelines will vary based on CMS required due dates

3. Quarterly reporting structure will remain the same throughout the option years. Vendor submission dates will change each option year and vendor should adhere to CMS reporting deadlines.

4. Data Submission by Facility: The vendor shall supply Facility with the necessary Data Abstraction Tools, instructions, and training for submission of data to the vendor.

5. The facility will collect specified private healthcare data from medical records and electronically submit that data to the vendor. The vendor will electronically submit the data via the QualityNet website for CMS. TJC data will not require submission but should be available for the facility to export & submit to TJC as needed.

6. Data Reliability: The vendor will perform audits including those required by the TJC and CMS to determine that the data is accurate, complete and that the measures consistently identifies the events they were designed to identify.

7. Reports/Services Provided by the vendor: The vendor shall provide

a) Quarterly reports representing up to a minimum of three years of data for each chart abstracted measures as identified by the individual facility

b) Facility specific tabular reports and control charts with trended data for each measure the Facility submits

c) Comparative graphic and tabular reports, including year-to-date information, for each measure the Facility submits

C. Websites CMS: http://www.qualitynet.org TJC: http://www.jointcommission.org

D. General Provisions

1. This contract shall include 5-year option with base year beginning January 1, 2020. Option years to include 2021, 2022, 2023, and 2024 unless earlier terminated in accordance with the provisions contained herein.

2. This contract may be terminated by either party, without cause or for good cause upon thirty days written notice or upon termination of the contract.

E. Period of Performance The period of performance January 1, 2020 through December 31, 2020 unless Period is changed by written modification.

F. Extent of Obligation The United States Government is obligated only for the authorization services listed in Item A, “Purpose of Contract”. Any modification to this contract will require prior approval by both parties before any additional obligations of the Government is incurred.

G. Negotiated Authority An appropriate contract authority is 41 USC 25.

H. Deliverables:

Attachment 2

Quality Indicators Program Facility Data Submission Deadlines

Annual Data Submission Deadline (Web Tool Lockdown Dates):

First Quarter 2020 (January – March): ______________

Second Quarter 2020 (April – June): ______________

Third Quarter 2020 (July – September): ______________

Fourth Quarter 2020 (October – December): ______________

Quality Indicators Program - 2020 Fee Schedule Chart Abstracted Measures & Participation BASE Fee ($___________) Includes all PPS Requirements for IQR & OQR. Please check Reporting Preferences below:

· Inpatient:

· Outpatient:

eCQM Participation BASE Fee ($ ) - includes all eCQM Reporting Requirements for 2020:

· 4 eCQMs for IQR/E.H.R. to CMS for 2nd Quarter 2020

· 4 eCQMs to TJC* (if selected) for 2nd Quarter 2020

TJC FEE

ePC-01 Elective Delivery

$______TJC

ePC-02 Cesarean Birth (New for 2020)

$______TJC

Electronic Import Fee – Electronic import of data files to web tools.

*TJC Fee ($___________) Hospitals are required to provide permission under the hospital’s DDS platform for chart abstracted and eCQM data submission (if eCQM submission is requested).

· Chart Abstracted – Includes submission of monthly aggregate data on a quarterly basis for calendar year 2020 using TJC’s Direct Data Submission (DDS) Platform.

· Up to a maximum of 4 Chart Abstracted Measures (HCOs with >300 live births per year)

OR

· Up to a maximum of 1 Chart Abstracted Measure (HCOs with <300 live births per year)

· eCQMs - Includes submission of 4 eCQMs for 2nd Quarter 2020 using TJC’s Direct Data Submission (DDS) Platform.

Optional Chart Abstracted Measures - Please check optional Chart Abstracted Measures below ($___________ each measure)

Optional Measure Sets ($_____________ each measure set)

Non-Core Measure Set – fee includes any/all measures selected under non-core measures below.

Provider Quality Measure Set – fee includes any/all measures selected below:

Perioperative Temperature Management

Discharged on Antithrombotic Therapy for Stroke

Hemoglobin A1c Poor Control

Screening or Therapy for Osteoporosis in Women 65 and Older

Pharmacologic Therapy for Osteoporosis for People 50 and Older

Pneumonia Vaccination Status for Older Adults

Lipid Profile Lab Testing for Adult Kidney Disease

Blood Pressure Management for Adult Kidney Disease

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis

Eye Exam Due to Diabetes

Venous Thromboembolism Prophylaxis

ICU VTE Prophylaxis

VTE Patients with Anticoagulation Overlap Therapy

Non-Core Measures

Hospital Program - Select optional measures below:

Group B Streptococci