36C24620R0047-001.docx

36C24620R0047

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1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C24620R0047 03-04-2020 Wyona Davis 757-728-7013 03-13-2020

4:30PM EDST

Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 X 621111 $12 Million N/A X Salem Department of Veterans Affairs 1970 Roanoke Blvd.

Salem VA 24153-6404 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin TX 78714-9971 See CONTINUATION Page Contract to provide On-Site Ophthalmic Plastic Surgeon Physician (Oculoplastic) staffing Services for Salem VAMC.

Please see Schedule of Services on page 5 for additional details.

See CONTINUATION Page X Mario L. Santiago Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1. CONTRACT ADMINISTRATION DATA

1. CONTRACT ADMINISTRATION: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C246 Mario Santiago Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests. Payment request shall be submitted Electronically To:

Department of Veterans Affairs Financial Services Center

PO BOX 149971

Austin TX 78714-9971

ACKNOWLEDGMENT OF AMENDMENTS: The Offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 SCHEDULE OF SERVICES

The Contractor shall furnish personnel to provide services necessary to perform onsite Ophthalmology Physician Services to eligible beneficiaries of the Salem Department of Veterans Affairs Medical Center (hereinafter referred to as VAMC). The contractor’s physician(s)’ care shall cover the range of Ophthalmology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by the American Academy of Ophthalmology (AAO) https://www.aao.org/about-preferred-practice-patterns

Place of Performance: Services shall be provided on site at the Salem VAMC, 1970 Roanoke Boulevard, Salem, Virginia 24153-6404.

Pricing Instructions:

1. All invoices will include the following statement. “The contractor is certifying that the hours billed are the exact hours worked by the said contracted staff”.

2. The parties acknowledge and agree that 48 hours of Ophthalmic Plastic Surgeon Physician Services shall be provided by the contractor for the first six-month base period, then 96 hours per year for each option year (executed solely at the Government’s discretion). The contract is effective from date of award through 30 September 2020 with four one-year option periods thru 30 September 2025. The contract is subject to availability of VAMC appropriations. The contractor shall perform no services after September 30th each year until the Contracting Officer (CO) authorizes such services in writing. The Ophthalmic Plastic Surgeon Physician shall provide services at the Salem VAMC in accordance with the schedule determined by the Service Chief assigned by VAMC. The Contractor shall propose one (1) appropriately qualified and credentialed Ophthalmic Plastic Surgeon Physician be available for scheduling to meet the requirements of the contract, one (1) additional candidate will need to be prescreened.

Total Contract Cost

B.3. PERFORMANCE WORK STATEMENT

Performance Work Statement for Onsite Ophthalmology Physician Services

1. GENERAL:

1.1. Services Provided: The Department of Veteran Affairs Medical Center (VAMC) Salem, VA has a need for the provision of services of an Ophthalmic Plastic Surgeon Physician staffing (Oculoplastic) services to provide monthly coverage for attending clinical services to eligible beneficiaries of the Salem, Virginia Veterans Affairs Medical Center (Salem VAMC). Contractor shall provide the services of an Ophthalmic Plastic Surgeon (Oculoplastic) physician, who is Board Certified in Ophthalmology, with a minimum one (1) year Fellowship in Ophthalmic Plastic Surgery. Services are to provide surgical attending coverage for ophthalmic plastic surgery in the Operating Room at the Salem VAMC. The Ophthalmic Plastic Surgeon must be credentialed and privileged with a local hospital and shall submit documents to obtain staff privileges at Salem VAMC.

The services to be provided for the Ophthalmic Plastic Surgeon Physician staffing (Oculoplastic) services is for eight (8) hours per day one (1) day per month for a total of 96 total hours of physician work for twelve (12) months per year. The contracted ophthalmologist physician staff shall be assigned to the Eye Clinic in the Surgical Care Service Line. This position requires independent judgment and actions, flexibility, organizational skills, and the ability to utilize an interdisciplinary approach in the provision of care. Salem VAMC shall provide one (1) Resident, one (1) Ophthalmology Technician, and administrative staff to support the services of the contracted ophthalmologist physician. Ophthalmology patients shall be monitored by the Salem VAMC.

Contractors will be working with:

· In-patient and outpatient setting

· Geriatric patient population

· Various behavioral groups who may be disoriented, disabled, or reduced physical function

· Clinically complex group of chronic/mentally ill patients

The Contractor shall be paid for actual performance, not for standing by or being on-call. Payment for any leave, including sick leave or vacation time, holiday pay, shift differential, and overtime is the responsibility of the Contractor. The VA reserves the right to refuse to accept any Ophthalmic Plastic Surgeon Physician(s) who do not meet the requirements set forth, who fails to perform in accordance with the contract requirements, or who fails to adapt to the VA Salem Health Care System.

1.4 POLICY/HANDBOOKS: The contractor shall be subject to the following policies, including any subsequent updates during the period of performance in accordance with VA policy and certifying bodies:

1.4.4 VHA Handbook 1121.01: Eye Care https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2394

1.4.5 VHA Directive 1192: Seasonal Influenza Prevention Program https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=5472

1.4.6 VHA Directive 1220: Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8365

1.4.7 VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8579

1.4.8 VA Directive 1663: Health Care Resources Contracting - Buying https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.9 VHA Handbook 1907.01: Health Information Management and Health Records https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

1.4.10 Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5 DEFINITIONS/ACRONYMS: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict, the language in this section shall govern.

1.

2.1.

2.2.

2.3.

2.4.

2.5.

1.5.1. AAO: American Academy of Ophthalmology http://www.aao.org/

1.5.2. ABO: American Board of Ophthalmology http://abop.org/board-certification/

1.5.3. ACGME: Accreditation Council for Graduate Medical Education

1.5.4. ACLS: Advanced Cardiac Life Support

1.5.5. BLS: Basic Life Support

1.5.6. CDC: Centers for Disease Control and Prevention

1.5.7. CDR: Contract Discrepancy Report

1.5.8. CEU: Certified Education Unit

1.5.9. CME: Continuing Medical Education

1.5.10. CMS: Centers for Medicare and Medicaid Services

1.5.11. Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.12. Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.13. COS: Chief of Staff

1.5.14. CPARS: Contractor Performance Assessment Reporting System

1.5.15. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.16. DEA: Drug Enforcement Agency

1.5.17. EHR: Electronic Health Record - electronic health record system used by the VA

1.5.18. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.19. HHS: Department of Health and Human Services

1.5.20. HIPAA: Health Insurance Portability and Accountability Act

1.5.21. ISO: Information Security Officer

1.5.22. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.23. NPPES: National Plan and Provider Enumeration System

1.5.24. POP: Period of Performance

1.5.25. PPD: Purified Protein Derivative

1.5.26. PWS: Performance Work Statement

1.5.27. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.5.28. QA/QI: Quality Assurance/Quality Improvement

1.5.29. QM/PI: Quality Management/Performance Improvement

1.5.30. QASP: Quality Assurance Surveillance Plan

1.5.31. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.32. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

1.5.33. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.5.34. VetPro: a federal web-based credentialing program for healthcare providers.

1.5.35. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Salem Veterans Affairs Medical Center.

2. KEY PERSONNEL REQUIREMENTS:

2.1. Contractor shall provide the services of an Ophthalmic Plastic Surgeon (Oculoplastic) physician, who is Board Certified in Ophthalmology, with a minimum one (1) year Fellowship in Ophthalmic Plastic Surgery. Services are to provide surgical attending coverage for ophthalmic plastic surgery in the Operating Room at the Salem VAMC. The Ophthalmic Plastic Surgeon must be credentialed and privileged with a local hospital and shall submit documents to obtain staff privileges at Salem VAMC.

2.2. The minimum number of Board Certified /Board Eligible Ophthalmology physicians required to be on site on a monthly basis is 1 (one) physician to be on site 1 (one) day per month for 8 (eight) hours.

2.2.1. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required. In the event a scheduled physician is unable to complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) at the Salem VAMC immediately of the schedule change.

2.2.2. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 14 calendar day(s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 14 calendar days prior to making any permanent substitutions.

2.2.2.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 14 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.2.2.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.2.2.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s physician(s), s/he may request, without cause, immediate replacement of said Contractor’s physician(s). The CO and COR shall deal with issues raised concerning Contractor’s physician(s) conduct. The final arbiter on questions of acceptability is the CO.

2.2.2.4. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor’s physician(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. The vendor shall have a post award transition plan to maintain continuity of care.

3. PATIENT SAFETY:

3.1 Contractor is responsible for quality of care and patient safety.

3.2 Patient incidents must be reported using Patient Safety Reports immediately or within 24 hours of occurrence.

4. QUALIFICATIONS:

1.1 2.1 3.1

4.1 License – The Contractor’s physician (s) assigned by the Contractor to perform the services covered by this contract shall have a current unencumbered license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

If a contractor’s physician(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

4.7 Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor’s physician(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the Credentials Office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

4.8 Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall complete all mandatory required training. Talent Management System (TMS) – Privacy and HIPAA Training (#10203) and VA Privacy and Information Security Awareness and Rules of Behavior (#10176). Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

4.9 Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

4.10 TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician(s) {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

4.11 MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

4.12 VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

4.13 ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.

4.14 INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season . {This is applicable to all health care workers}.

4.15 OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician(s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

4.16 National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

4.17 DEA (as required) - Contractor shall provide copy of current DEA certificate.

4.18 Conflict of Interest: The Contractor and all contractor’s physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

4.19 Citizenship related Requirements:

4.19.1 The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals.

4.19.2 While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

4.19.3 If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

4.19.4 This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

4.20 Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

4.20.1 Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

4.20.1.1 By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

4.21 Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center Chief of Staff (COS) or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

4.22 Non-Personal Healthcare Services: The parties agree that the Contractor and all contractor’s physician(s) shall not be considered VA employees for any purpose.

4.23 Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.

4.24 Prohibition against Self-Referral: Contractor’s physicians are prohibited from referring VA patients to contractor’s or their own practice(s).

4.25 Inherent Government Functions: Contractor and Contractor’s physician(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

4.26 No Employee status: The Contractor shall be responsible for protecting Contractor’s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

· Workers’ compensation

· Professional liability insurance

· Health examinations

· Income tax withholding

· Social security payments

4.27 Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contractor’s physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s [or contract physician(s)] action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

5. CLINICAL RESPONSIBILITIES:

requisite education and training, and, when required, will be licensed and/or certified.

6.2 Contractor is aware of all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPPA and complies with all standards.

renewed.

6.6 Contractor shall provide current Curriculum Vitae, copies of Certification(s), License(s), documentation of experience, and documentation of education and training with the proposal.

7. VA HOURS OF OPERATION/SCHEDULING:

7.1. WORK SCHEDULE: The services to be provided for the Ophthalmic Plastic Surgeon Physician is for eight (8) hours per day one (1) day per month for a total of 96 total hours of physician work for twelve (12) months per year.

7.1.1. Clinic: The contracted ophthalmologist physician staff shall be assigned to the Eye Clinic in the Surgical Care Service Line at the Salem VAMC.

7.1.2. Patients must be seen by a contractor’s physician(s) on-site at the Salem VAMC in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

7.1.3. Contractor’s physician(s) shall be available and present in clinic during normal (Facility) clinic hours, (Facility) which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Normal working hours are on Wednesdays one day per month, 8:00 am - 4:30 pm with a 30-minute unpaid lunch break.

7.1.4. This position does not require overtime.

7.1.5. No on-call or weekend coverage required.

7.2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

· New Year’s Day

· President’s Day

· Martin Luther King’s Birthday

· Memorial Day

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared to be a national holiday.

Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.

8. INVOICING AND BILLING

8.1. Supporting documentation and invoice must be submitted within 30 days of the end of the month services were provided, the vendor shall provide itemized invoicing showing the number of monthly hours services were provided. Billing is based on actual hours worked using the agreed upon daily rate. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

· Name and Address of Contractor

· Invoice Date and Invoice Number

· Contract Number and Purchase/Task Order Number

· Date of Service

· Contractor’s physician(s) (Name of Contractor’s employee)

· Hourly Rate

· Quantity of hours worked

· Total price

8.2. Billing is based on actual hours worked using the agreed upon daily rate.

8.3. Vendor Electronic Invoice Submission Methods: Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/. Tungsten direct vendor support number is 877-489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Taxpayer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact: Tungsten Support Phone: 1-877-489-6135Website: http://www.tungsten-network.com/uk/en/ Department of Veterans Affairs Financial Service Center Phone: 1-877-353-9791 Email: vafscched@va.gov.

8.4. Payment Adjustments: Invoices will be prorated for partial days/hours worked. The contractor shall be paid only for actual work performed onsite. In the event that the Contract provider works a portion of an hour, the government may adjust payments by 15-minute increments. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed.

8.5. Payments in full/no billing VA beneficiaries: The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services. This provision shall survive the termination or ending of the contract.

8.6. To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a charge for such service and that the VA will not be responsible for payment.

8.7. The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract. It shall be considered fraudulent for the Contractor to bill other third-party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract.

9. CONTRACTOR RESPONSIBILITIES:

9.1 Clinical Personnel Required: The Contractor shall provide contractor’s physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

1.1.1. RECORD KEEPING:

1.1.1.1. Contractor’s employee(s) shall report to the COR or Administrative Officer, Medicine Service, upon arrival at the VAMC. VAMC personnel shall brief Contractor employee(s) on VAMC policies and procedures on the first scheduled duty day.

1.1.1.2. The VAMC, Medicine Service, shall establish and maintain a record keeping system that will record the services performed by the Contractor’s employee(s). This recordkeeping system shall consist of time and attendance reports to ensure that required services have been received by the VA Medical Center. Any incidents of Contractor non-compliance as evidenced by the monitoring procedure shall be forwarded immediately to the Contracting officer.

1.1.1.3. Documentation of services performed shall be reviewed prior to certifying payment. Contractor shall be present at the VAMC and shall be performing the required services as specified in the contract in order to receive reimbursement. The VAMC shall pay for services performed and in strict accordance with Section B, Schedule of Supplies/Services above. Contract monitoring and record keeping procedures shall be sufficient to ensure proper payment and allow audit verification that services were provided.

1.1.1.4. Should the VAMC, in case of emergency, require services to be performed by the Contractor during non-work hours or on a federal holiday as described above, the VAMC shall be responsible for payment to the Contractor in accordance with the prices outlined in the Schedule.

1.1.2. Contractor’s physician(s)shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

9.2 Standards of Care: The contractor’s physician(s)’ care shall cover the range of Ophthalmology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:

9.2.1 American Academy of Ophthalmology(AAO) Guidelines and Preferred Practice Patterns: http://one.aao.org/guidelines-browse.

9.2.2 VHA Handbook 1121.01 “Eye Care” - www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2394

9.2.3 The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

9.2.4 The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

9.2.5 The requirements contained in this PWS

9.3 Resident Supervision and Teaching: The contractor will instruct VAMC Residents on ophthalmic procedures.

9.3.1 Resident Supervision/Teaching: According to the guidelines dictated by the Residency Review Committee of ACGME, the contractor’s physician(s) performing the services shall be responsible for residents. Contractor’s physician(s) shall be responsible for:

9.3.1.1 Academic environment: Provide for an academic environment conducive to the training and professional development for residents rotating through the Ophthalmology Service.

9.3.1.2 Resident patient care documentation: Contractor’s physician(s)shall be responsible for complying with the Residency review documentation and ensuring that all notes and encounters are completed and shall appropriately document medical records in accordance with VA standards, equivalent to TJC compliance guidelines, standard commercial practice and guidelines established by Salem VAMC. The Contractor shall also perform any administrative duties relative to documentation of resident training, as required and directed by the VA COS or designated representative.

9.3.1.3 Clinical Direction and Oversight: Contractor’s physician(s) shall provide clinical direction to and oversight of residents/fellows consistent with current accreditation guidelines, clinical research, protocol development, data management of protocols, quality assurance conferences and meetings, and affiliate/VA staff meetings. Ensure on-site resident supervision in accordance with the national VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents, dated November 07, 2019. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8579

9.3.2 Attending Physician: Clinics/Ophthalmology procedures shall not be conducted by residents in the absence of an attending physician. All procedures, inpatient admissions and consults shall be the responsibility of an attending physician.

9.4 Medical Records

9.4.1 Authorities: Contractor’s physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA). The Contractor is a VA contractor and shall assist in the provision of health care to patients seeking such care from or through VA. As such, the Contractor is considered as being part of the Department health care activity. Contractor is a VA contractor for purposes of the Privacy Act, Title 5 U.S.C. 552a. Further, for VA records access and patient confidentiality, Contractor is a VA contractor for the following provisions: Title 38 U.S.C. 5701, 5705, and 7362.