36C24925Q0458 Sources Sought RFI Teleradiology TVHS.docx

SUBJECT*

Other - VISN 9 Tele-Radiology Contract - VISN Replacement base+4 requirement

GENERAL INFORMATION

SET-ASIDE

Network Contracting Office 9 (90C)

NCO 9

1639 Medical Center Parkway, Suite 204 Murfreesboro TN 37129

POINT OF CONTACT*

Contract Specialist Ramona Bonness Ramona.Bonness@va.gov

PLACE OF PERFORMANCE

as listed in description

POSTAL CODE

COUNTRY

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

DESCRIPTION

TELERADIOLOGY PHYSICIAN SERVICES

Veterans Integrated Services Network (VISN) 9 Radiology Departments

THIS IS NOT A SOLICITATION. This is a Request for Information (RFI)/ Sources Sought Notice only and is issued in accordance with Federal Acquisition Regulation (FAR) 10 Market Research, in order to conduct market research. Responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. This RFI is issued solely for information and planning purposes and does not constitute a solicitation or a guarantee to issue a solicitation in the future. This RFI does not commit the Government to contract for any supply or service. All information submitted in response to this announcement is voluntary; the Government will not pay for information requested nor will it compensate any respondent for any cost incurred in developing information provided to the Government. Not responding to this RFI does not preclude participation in any future solicitation, if issued. This announcement is based on the best information available at this time and is subject to future modification.

The Department of Veterans Affairs (VA) and Veterans Integrated Services Network (VISN) 9 is seeking a contractor that can meet/exceed the government’s objectives for the following requirement VISN-wide TeleRadiology Physician Services. The Contractor shall provide Board Certified Teleradiology Physician Services in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and Veterans Integrated Services Network (VISN) 9. The VA Radiology Services are accredited by The Joint Commission and follow the standards & guidelines set forth by American College of Radiology (ACR). A contractor providing Teleradiology services shall provide services consistent with The Joint Commission (TJC) and that meets or exceeds VA and the American College of Radiology Guidelines as defined in this document.

Contractor shall furnish services for the following Veterans Integrated Services Network (VISN) 9 Medical Centers:

Lexington VA Medical Center (Station: 00596) 2250 Leestown Road Lexington, KY 40502-2235 Robley Rex VA Medical Center (Station: 00603*) 800 Zorn Avenue Louisville, KY 40206-1433

Memphis VA Medical Center (Station: 00614) 1030 Jefferson Avenue Memphis, TN 38104-2127 James H. Quillen VAMC (Station: 00621*) Corner of Lamont and Veterans Way P.O. Box 4000 Mountain Home, TN 37684-4000

Tennessee Valley Healthcare System (Station: 00626) 1310 24th Avenue South Nashville, TN 37212-2637

Sources Sought Notice Sources Sought Notice

Sources Sought Notice

B.3 PERFORMANCE WORK STATEMENT FOR TELERADIOLOGY PHYSICIAN SERVICES **DRAFT**

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified Teleradiology Physician Services in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and Veterans Integrated Services Network (VISN) 9. The VA Radiology Services are accredited by The Joint Commission and follow the standards & guidelines set forth by American College of Radiology (ACR). A contractor providing Teleradiology services shall provide services consistent with The Joint Commission (TJC) and that meets or exceeds VA and the American College of Radiology Guidelines as defined in this document.

1.2. Place of Performance - Contractor shall furnish services for the following Veterans Integrated Services Network (VISN) 9 Medical Centers; see Table B.3.1 for name of the Medical Center and address.

Table B.3.1 – Veterans Integrated Services Network (VISN) 9 Medical Centers Lexington VA Medical Center (Station: 00596) 2250 Leestown Road Lexington, KY 40502-2235 Robley Rex VA Medical Center (Station: 00603* 800 Zorn Avenue Louisville, KY 40206-1433

Memphis VA Medical Center (Station: 00614) 1030 Jefferson Avenue Memphis, TN 38104-2127 James H. Quillen VAMC (Station: 00621*) Corner of Lamont and Veterans Way P.O. Box 4000 Mountain Home, Tn 37684-4000

Tennessee Valley Healthcare System (Station: 00626) 1310 24th Avenue South Nashville, TN 37212-2637

Note: (*) Station 00603 and 00621 are currently participating in the Veterans Health Administration (VHA) National Teleradiology Program (NTP); to ensure non-interrupted healthcare services to these medical centers they are included in this procurement if the VHA NTP cannot provide adequate Teleradiology services.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.

1.4. Policy/Handbooks - the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.4.1. VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347

1.4.2. VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1.4.3. VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.4. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.5. VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.4.6. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

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

1.4.8. National Institute of Standards and Technology: Federal Information Processing Standards (FIPS) http://scrc.nist.gov/publications/fips/index.html

1.4.9. National Institute of Standards and Technology Special Publications 800 Series http://csrc.nist.gov/publications/nistpubs/index.html

1.4.10. VA Handbook 6500.6 Contract Security (if additional VA Security references are necessary the VISN 9 Information Security Officer will provide to the contractor within five (5) business days from the date of request) http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=471&FType=2

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 in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. ACEP: American College of Emergency Physicians

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACO: Administrative Contracting Officer – A Contracting Officer engaged in administering contracts

1.5.4. AIS: Automated Information Security

1.5.5. AOD: Admitting Officer of the Day

1.5.6. BAA: Business Associate Agreement – A contract between VHA and a business associate, entered into before releasing PHI to the business associate, in order for the business associate to perform a covered activity for VHA.

1.5.7. BLS: Basic Life Support

1.5.8. BPE: Business Partner Extranet connection are data communication pathways form VA facilities to non-VA business partners that cannot pass through on One-VA Internet gateways must be fully documented and must have OI&T Chief/CIO and ISO approvals. These connections must be managed and coordinated with and by the VA NSOC. Source: VA Handbook 6500.

1.5.9. CBO: VA Central Billing Office

1.5.10. CDC: Centers for Disease Control and Prevention

1.5.11. CDR: Contract Discrepancy Report

1.5.12. CEU: Certified Education Unit

1.5.13. CME: Continuing Medical Education

1.5.14. Confidentiality: Preserving authorized restrictions on access and disclosure, including means for protecting personal privacy and proprietary information. Source: 38 U.S.C. §5727.

1.5.15. Continuity of Operations Plan (COOP): A COOP provides guidance on the system restoration for emergencies, disasters, mobilization, and to maintain a state of readiness to provide the necessary level of information processing support commensurate with the mission requirements/priorities identified by the respective functional proponent. The Federal Government and its supporting agencies traditionally use this term to describe activities otherwise known as disaster recovery, business continuity, business resumption, or contingency planning. Source: VA Handbook 6500.8.

1.5.16. CMS: Centers for Medicare and Medicaid Services

1.5.17. 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.

1.5.18. 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.

1.5.19. COS: Chief of Staff

1.5.20. CPARS: Contractor Performance Assessment Reporting System

1.5.21. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.5.22. Covered Entity: A covered entity subject to the HIPAA Privacy and Security Rules is (a) a health care provider who transmits any health information in electronic form in connection with a transaction covered by the Rules; (b) a health care clearinghouse; or (c) a health insurance plan. Source: 45 C.F.R. §160.103.

1.5.23. CPT: Current Procedural Terminology

1.5.24. 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.

1.5.25. CSS: Customer Satisfaction Survey will be conducted periodically by the Network and/or representative to measure government users’ satisfaction with the contractor’s performance across the Network. The assigned COR will provide a copy of the CSS results within 10 business days from the date they have been published. The contractor will have 10 business days to provide feedback to the COR, if corrective action plan is necessary, it shall be provided within 10 business days from the date the CSS results was provided to the contractor. At a minimum, the contractor shall provide facts from its prospective for any marginal and/or unsatisfactory responses within the CSS report and the corrective actions it has and/or will implement to improve customer satisfaction.

1.5.26. CV: Curriculum Vitae

1.5.27. Data Breach: The loss, theft, or other unauthorized access, other than those incidental to the scope of employment, to data containing SPI, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Source: 38 U.S.C. §5727.

May or may not be a breach under the HIPAA Privacy and Security Rules, which define “Breach” as the unauthorized acquisition, access, use, or disclosure of PHI in violation of the HIPAA Privacy Rule which compromises the security or privacy of such information, except where an unauthorized person to show such information is disclosed would not reasonably have been able to retain such information. Under these Rules, breach of PHI excludes:

a. Any unintentional acquisition, access, or use of PHI by an employee or individual acting under the authority of a covered entity or business associate if such acquisition, access, or use was made in good faith and within the course and scope of the employment or other professional relationship with the covered entity or business associate and does not result in further use or disclosure.

b. Any inadvertent disclosure from an individual who is otherwise authorized to access PHI at a facility operated by a covered entity or business associated with another similarly situated individual at some facility.

c. Any such information received because of such disclosure is not further acquired, accessed, used, or disclosed without authorization by any person. Source: 45 C.F.R. §164.402.

1.5.28. DEA: Drug Enforcement Agency

1.5.29. DICOM: Digital Image and Communication in Medicine

1.5.30. DIGMA: Drop In Group Medical Appointment

1.5.31. DSS: Decision Support Group

1.5.32. EPRP: External Peer Review Program

1.5.33. FDA: Food and Drug Administration

1.5.34. FIPS: Federal Information Processing Standards

1.5.35. FISMA: The Federal Information Security Management Act was passed by Congress and signed into law by the President as part of the E-Government Act of 2002 (Public Law Number 107-347). The goals of FISMA include development of a comprehensive framework to protect government information, operations, and assets.

1.5.36. FSMB: Federation of State Medical Boards

1.5.37. Health Information: Health Information is any information, whether oral or recorded in any form or medium, created or received by a health care provider, health plan, public health authority, employer, life insurers, school or university, or health care clearinghouse or health plan that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual. This encompasses information pertaining to examination, medical history, diagnosis, and findings or treatment, including laboratory examinations, X-rays, microscopic slides, photographs, and prescriptions, Source: 45 C.F.C. §160.103

1.5.38. HHS: Department of Health and Human Services

1.5.39. HIMS: Health Information Management System

1.5.40. HL7: Health Level Seven

1.5.41. HIPAA: Health Insurance Portability and Accountability Act

1.5.42. HR: Human Resources

1.5.43. Incident: An occurrence that actually or potentially jeopardizes the confidentiality, integrity, or availability of an information system or the information the system processes, stores, or transmits or that constitutes a violation or imminent threat of violation of security policies, security procedures, or acceptable use policies. Source: FIPS 200; NIST SP 800-53.

The term incident means security incident as defined in 38 U.S.C. §5727.

1.5.44. Individually Identifiable Health Information: Information, including demographic data, that (a) relates to an individual’s past, present or future physical or mental health or condition, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual, and (b) identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual. Source: 45 C.F.R. §160.103.

1.5.45. ISO: Information Security Officer is an individual working with the senior agency ISO, AO, or Information System Owner to help ensure the appropriate operational security posture is maintained for an information system or program. Source: CNSSI-4009; VA Adapted.

1.5.46. Information Security Requirements: Information security requirements promulgated in accordance with law, or directed by the Secretary of Commerce, NIST, and OMB, and, as to national security systems, the President. Source: 38 U.S.C. §5727.

1.5.47. Local Area Network (LAN): A Datacom system allowing a number of independent devices to communicate directly with each other, within a moderately sized geographic area over a physical communications channel of moderate rates. Source: FIPS 191

1.5.48. MOD: Medical Officer of the Day

1.5.49. 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).

1.5.50. NIST: National Institute of Standards and Technology

1.5.51. NPPES: National Plan and Provider Enumeration System

1.5.52. OA&L: Office of Acquisition and Logistics

1.5.53. OSHA: Occupational Safety and Health Administration

1.5.54. PACS: Picture Archiving and Communications System

1.5.55. PACT: Patient Aligned Care Team Background and Introduction: VA Has implemented a PCMH model at all VA Primary Care sites which is referred to as PACT. This initiative supports VHA’s Universal Health Care Services Plan to redesign VHA healthcare delivery through increasing access, coordination, communication, and continuity of care. PACT provides accessible, coordinated, comprehensive, patient-centered care, in team-based environment including the active involvement of other clinical and non-clinical staff. PACT allows patients to have a more active role in their health care and is associated with increased quality improvement, patient satisfaction, and a decrease in hospital costs due to fewer hospital visits and readmissions.

1.5.56. POP: Period of Performance

1.5.57. PPD: Purified Protein Derivative

1.5.58. PWS: Performance Work Statement

1.5.59. Personally Identifiable Information (PII): Any information which can be used to distinguish or trace an individual’s identity, such as their name, social security number, biometric records, etc., alone, or when combined with other personal or identifying information which is linked or linkable to a specific individual, such as date and place of birth, mother’s maiden name, etc. Information does not have to be retrieved by any specific individual or unique identifier (i.e., covered by the Privacy Act) to be PII. (See Sensitive Personal Information, below). Source: OMB M-07-16

1.5.60. Privacy Event: A Privacy Event is a confirmed instance in which information protected by HIPAA; the Privacy Act of 1974; or other confidentiality statues such as 38 U.S.C. §§ 5701, 5705, or 7332 may have been improperly disclosed, and includes the loss, theft, or any other unauthorized access, or any other access than that which is incidental to the scope of employment, to data containing SPI in electronic, printed, or any other format, and results in the potential compromise of the confidentially or integrity of the data regardless of the manner in which the breach might have occurred. Source: VA Directive 6509.

1.5.61. Privacy Officer (PO): The PO is responsible for taking proactive measures to help ensure that PII collected by VA is limited to that which is legally authorized and necessary; and is maintained in a manner that precludes unwarranted intrusions upon individual privacy; thereby minimizing privacy events. Additionally, it is the defensive duty of a PO to assist in mitigating damage when PII is compromised. Source: VA Directive 6509.

1.5.62. 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.

1.5.63. Protected Health Information (PHI): Individually identifiable health information held by a covered entity or by a business associated acting on its behalf. PHI excludes education records covered by the Family Educational Rights and Privacy Act, as amended, 20 U.S.C. §1232g, records described at 20 U.S.C. §§1232(g)(a)(4)(B)(iv), and employment records held by a covered entity in its role as employer. Within VA, VHA is the only covered entity. Certain other VA components, such as OI&T, are business associates of VHA. Source: 45 C.F.R. §160.103; VA Directive 6066.

1.5.64. QAPI: Quality Assessment and Performance Improvement

1.5.65. QASP: Quality Assurance Surveillance Plan

1.5.66. Remote Access: Access by users (or information systems) communicating externally to an information system security perimeter. Source: NIST SP 800-18 Remote access uses telecommunications to enable authorized access to non-public VA computing services that would otherwise be inaccessible from work location outside a VA LAN or VA-controlled wide area network (WAN) computing environment. Remote Access includes access to non-public VA Information Systems and data that are exposed to the public Internet (e.g., web access to electronic mail (email) by the home user or business traveler) as well as modem, dial-up and/or Virtual Private Network (VPN) access to internal VA IT servers and desktop workstations.

1.5.67. Security Controls: The management, operational, and technical controls (i.e., safeguards or countermeasures) prescribed for an information system to protect the confidentiality, integrity, and availability of the system and its information. Source: NIST SP 800-53; NIST SP 800-37; NIST SP 800-53A; NIST SP 800-60; FIPS 200; FIPS 199; CNSSI-4009.

1.5.68. Sensitive Personal Information (SPI): The term, with respect to an individual, means any information about the individual maintained by VA, including the following: (i) education, financial transactions, medical history, and criminal or employment history; (ii) information that can be used to distinguish or trace the individual’s identity, including name, social security number, date and place of birth, mother’s maiden name, or biometric records. Source: 38 U.S.C. §5727.

1.5.69. SOP (Clinical): Scope of Practice

1.5.70. TJC: The Joint Commission

1.5.71. Technical Controls: The security controls (i.e., safeguards or countermeasures) for an information system that are primarily implemented and executed by the information system through mechanisms contained in the hardware, software, or firmware components of the systems. Source: NIST SP 800-53; NIST SP 800-53A; NIST SP 800-37; FIPS 200.

1.5.72. Threat: Any circumstance or event with the potential to adversely impact organizational operations (including mission, functions, image, or reputation), organizational assets, individuals, other organizations, or the Nation through an information system via unauthorized access, destruction, disclosure, modification of information, and/or DoS. Source: NIST SP 800-53; NIST SP 800-53A; NIST SP 800-27A; SP 800-60; NIST SP 800-37; CNSSI-4009.

1.5.73. Training: A learning experience in which an individual is taught to execute a specific information security procedure or understand the information security common body of knowledge. Source: 38 U.S.C. §5727.

1.5.74. User: Individual or (system) process acting on behalf of an individual and authorized to access an information system. Source: NIST SP 800-53, NIST SP 800-18; CNSSI-4009 At VA, users are Department personnel, employees, contractors working under an approved contract, business associates working under approved business associate agreements, and any other individuals providing services or performing functions for, to or on behalf of VA who have been authorized by VA to access VA information or information systems. To access VA information or VA information systems, these individuals must complete VA-approved security and privacy awareness training, sign the VA National Rules of Behavior (ROB) or Contractor ROB, and complete appropriate background screening before such access may be granted.

1.5.75. VA: Veterans Administration

1.5.76. VA Contractor Rules of Behavior: A set of Department of rules that describes the responsibilities and expected behavior of contractors using VA information systems or VA sensitive information. Source: 38 U.S.C. §5727

1.5.77. VA Information/Data: Information collected or maintained by or on behalf of VA. Generally, includes information collected or maintained by a VA contractor in the performance of services under a VA contract but excludes information received from VA by entities over which VA has no statutory or operational authority, such as other Federal agencies. Source: FISMA

1.5.78. VA National Rules of Behavior: A set of Department rules that describes the responsibilities and expected behavior of users of VA information systems or VA information. Source: 38 U.S.C. §5727

1.5.79. VA Sensitive Information/Data: All Department Information and/or data on any storage media or in any form or format, which requires protection due to the risk of harm that could result from inadvertent or deliberate disclosure, alteration, or destruction of the information. The term includes not only information that identifies an individual but also other information whose improper use or disclosure could adversely affect the ability of an agency to accomplish its mission, proprietary information, and records about individuals requiring protection under applicable confidentiality provisions. Source: 38 U.S.C. §5727

1.5.80. 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.

1.5.81. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in Michigan and Indiana.

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

1.5.83. 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 all Medical Centers within VISN 9 Medical Center.

1.5.84. 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.

1.5.85. Virtual Private Network (VPN): A virtual network built on top of existing networks that can provide a secure communications mechanism for data and Internet protocol (IP) information transmitted between networks. Source: NIST SP 800-113.

1.5.86. Vulnerability: Weakness in an information system, system security procedures, internal controls, or implementation that could be exploited by a threat source. Source: NIST SP 800-53; NIST SP 800-53A; NIST SP 800-37; NIST SP 800-60; NIST SP 800-115; FIPS 200

1.5.87. Wide Area Network (WAN): VA’s WAN is a telecommunication network that covers a broad area (i.e., any network that links across metropolitan, regional, or national boundaries) and may be comprised of one or more LANs connected to each other. Source: VA Adapted

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License - Contract physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Information on state licensing in teleradiology may be found at this site: http://www.acr.org/Advocacy/State-Local-Relations/Legislative-Issues/Teleradiology/Teleradiology-Licensing-Requirements-by-State. Contract 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.

2.1.2. Board Certification - All contract physician(s) shall be board certified in diagnostic radiology and/or nuclear medicine. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging – Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible for ensuring that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract physician(s) prior to obtaining approval by the Credentialing Committee Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1. If a contract 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 as it should impact the mission by causing delays in service.

2.1.3.2. When telemedicine services are being provided by contract physician (s) who direct, diagnose or otherwise provide clinical treatment to a patient via a telemedicine link, the contract physician (s) must be appointed, credentialed, and privileged by the designated VISN 9 MOU which receive the telemedicine services (patient site), as well as at the site providing the services. The following requirements apply:

2.1.3.2.1. Contract licensed independent practitioners must be credentialed and privileged through the VA facility’s Medical Staff Office in accordance with VHA Handbook 1100.19, Credentialing and Privileging.

2.1.3.2.2. Separately delineated privileges for telemedicine services must be requested and assigned in this process.

2.1.3.2.3. In general, the credentialing process should be started at least 120 days in advance of estimated entry on duty. The time required for this process may be expedited when patient care needs are urgent.

2.1.3.2.4. The VA’s Medical Staff Office or Human Resources Management Service will provide an instruction packet containing forms and a detailed listing of required documentation, including curriculum vitae, current references, signed release of information from the candidate, and statement that the candidate does not have any physical or mental health condition that would adversely affect his/her ability to carry out the assigned duties, and additional credentialing forms. The candidate will also be required to make application through the VetPro internet-based process. The candidate will need to be enrolled in VetPro by the Credentialing Coordinator at the VA or by the Human Resources Management Service designee. The website address is: http://fep.vetpro.org/. It is the Contractor’s responsibility to contact the COR to request a package and instructions.

2.1.3.2.5. When contract physician (s) provide only teleconsultation by offering advice that supports care provided by VA’s on site licensed independent providers, the Contractor must furnish VA with a copy of the contract physician (s) credentials, verification of credentials, and current clinical privileges. The contract physician (s) providing teleconsultation services do not have to be separately privileged at the VA facility.

2.1.3.2.6. The Contractor must furnish a copy of its policy and procedures for credentialing and privileging to the Contracting Officer and COR for review to ensure these meet the VA’s requirements for establishment of competence through these mechanisms.

2.1.4. Technical Proficiency - Contract physician(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract physician(s) and contract physician (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws ( Lexington, Louisville Memphis, Mt. Home, TVHS, Huntington) rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.5. 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. Contract 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).

2.1.6. Standard Personnel Testing/Infection Control (if applicable) – Contractor shall provide statement that all required infection control testing is current and that the contractor is compliant with OSHA regulations concerning occupational exposure to blood borne pathogens. The Contractor shall also notify the VA of any significant communicable disease exposures and the VA will also notify the contractor of the same, 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. Tests shall be current within the past year.

2.1.7. 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.

2.1.8. DEA; Will not be required for the tele-radiologist as they will not be required to prescribe medications for VA beneficiaries.

2.1.9. Conflict of Interest: The Contractor and all contract 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. http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=3152

2.1.10. Citizenship related Requirements:

2.1.10.1.1. 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;

2.1.10.1.2. 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.

2.1.10.1.3. 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.

2.1.10.1.4. 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.

2.1.10.1.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.11. 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.

2.1.11.1. 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 contract 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.

2.1.11.2. 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.

2.2. Clinical/Professional Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. 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.

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

2.4. Inherent Government Functions: Contractor and Contract 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.

2.5. No Employee status: The Contractor shall be responsible for protecting Contract 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:

2.5.1. Workers’ compensation

2.5.2. Professional liability insurance

2.5.3. Health examinations

2.5.4. Income tax withholding, and

2.5.5. Social security payments.

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s). When a Contractor or contract 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.

2.7. 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 during loss of data telecommunication circuits and if the contract physician(s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

2.7.1. Contractor shall submit a listing of proposed key personnel performing technical delivery of services in the following format:

Provider Name:

Title:

2.7.2. Curriculum Vitae and qualification documents of each key personnel shall be submitted with the proposal.

2.7.3. Data Telecommunications contingency planning will ensure continuity of teleradiology services supporting the VA during the temporary and long-term loss of data communication connectivity with the VA.

2.8. Emergency 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 15 calendar days 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 15 calendar days prior to making any permanent substitutions.

2.8.1. 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 15 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.

2.8.2. 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.

3. HOURS OF OPERATION

3.1. Business Hours: The VISN 9 VAMCs normal hours of operations are Monday through Friday, 8:00 AM till 4:30 PM (local time) except for Federal Holidays identified in paragraph 4. (Note VISN 9 geographical area covers two (2) time zones: Eastern Time and Central Time). VISN 9 VAMCs provide primary healthcare, urgent/emergency care, and mental healthcare 24-hours a day, 7 days a week, 52 weeks a year.

3.2. Contractor shall be available to the VAMCs for consultation and interpretation 24 hours a day, 7 days a week, 52 weeks a year for all stat, urgent, and routine exams.

4. 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

· Juneteenth

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared by the President of the United States to be a national holiday.

5. Continuity of services under contact:

5.1. Unless a state of emergency has been declared or services are otherwise cancelled by the VAMC, the Contractor shall be responsible for providing services.

5.2. Contractor is responsible for providing qualified personnel to read films. Contractor is responsible to provide back-up staff if scheduled staff becomes unavailable due to illness or emergency.

5.3. The contractor shall maintain open and professional communication with members of the VISN and Facility Diagnostic Imaging staff. The contractor shall provide up-to-date points of contact to facilitate communication on clinical, technical and administrative issues. Clinical staff will be available by phone and pager 24/7. The Contractor will provide a schedule of radiologists with telephone numbers and email address for consultation by VA technologists and referring physicians. Any changes of contact of information will be provided to the VA within 24 hours of the applicable change.

5.4. The Contractor shall provide phone numbers and email addresses for initial communication between the interpreting radiologist and the referring provider or their representatives should be readily and bidirectionally available and consistent with the ACR Practice Guideline for Communication of Diagnostic Imaging Findings. Pathway of easy and prompt communication should be well established, agreed upon, and facilitated by both parties. Although various delivery formats are available, including a landline telephone, smart phone, electronic medical record, e-mail, and voicemail, the delivery method should be the choice of the referring VA provider.

5.4.1. American College of Radiology, ACR practice guideline for communication of diagnostic imaging findings. http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/General-Diagnostic

5.4.2. The Contractor’s teleradiologist/Telehealth provider shall escalate their efforts to communicate when a provider cannot be reached immediately when results require synchronous (usually via telephone) physician-to-physician communications.

5.4.3. The contractor shall provide a single phone number, which is staffed 24 hours a day, seven days per week 365 days per year to resolve issues and/or expedite communications between ordering physicians and assigned tele-radiologist providing the evaluation.

5.4.4. The contractor shall provide an update schedule of tele-radiologist supporting this contract to the assigned Contracting Officer Representative (COR) and/or designee (alternate CORs) within 24 hours of any changes. This will include contact information for each Tele-radiologist such as landline telephone number, smart phone, and e-mail address.

5.4.5. The contractor’s interpreting Teleradiologist shall be available for consultation with the ordering physician/clinician and with other VA radiologists.

5.5. Tele-Communications

5.5.1. The contractor shall plan and be prepared to receive radiographic order and images and then communicate the results during the loss of data telecommunications services. The alternative means of communication will ensure protection of personal health information of each study. (Examples may include registered mail, FEDEX, UPS, fax, diverse-path telecommunications, etc.)

5.5.2. The contractor shall make provisions for the proper maintenance and functioning of all imaging, teleradiology and associated equipment, facilities and fixtures as may reasonably be required by Contract Physicians to perform services hereunder.

6. CONTRACTOR RESPONSIBILITIES

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

6.2. Management and Supervision:

6.2.1. The Contractor shall be responsible for supervising the daily services provided under this contract by the Contractor’s staff.

6.2.2. The Contractor shall have written policies and procedures regarding staff credentials and privileging.

6.2.3. The contractor will provide a FIPS (Federal Information Processing Standards) web-based means for the electronic transmission of radiographic orders.

6.2.4. The VAMC will provide to the Contractor policies, procedures, and processes necessary to allow cooperative functioning between the agency and VAMC. Updates and refreshers will be provided to the Contractor upon request and when policy procedures or process changes.

6.2.5. The Contractor shall complete background investigations to ensure that…