36C24926Q0165.docx

SUBJECT*

36C249-26-AP-1085 Radiology and Nuclear Medicine Physician Services

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 George Cochran george.cochran@va.gov 615-225-5631

PLACE OF PERFORMANCE

1101 Veterans Dr

Lexington KY

COUNTRY

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

DESCRIPTION

This is a Sources Sought Notice for market research purposes. This is NOT a solicitation for proposals, proposal abstracts, or quotations. The purpose of this notice is to obtain information regarding the availability and capability of all qualified sources to perform a potential requirement.

Services Required: The Department of Veterans Affairs (VA), Veterans Health Administration (VHA) Lexington VA Medical Center (Lexington VAMC) requires a full range of Radiology and Nuclear Medicine Physician Services to be provided in a private hospital, office, or clinic environment to Veterans.

There is currently a contract in place for these services. It is anticipated that it will take 6 (six) months to award a new contract.

Purpose and Objectives: Your responses to the information requested will assist the Government in determining the appropriate acquisition methodology. Interested parties should complete the attached questionnaire and return it with their capability statement.

NAICS Code: 621111 and sized standard is $16 Million.

NOTE: Respondent claiming SDVOSB and VOSB status must be registered and verified through the Small Business Administration at https://search.certifications.sba.gov/. Additionally, all Offerors responding to a solicitation must have an active registration in the System for Award Management (SAM) at the time of proposal submission.

Project requirements: Contractor will provide Radiology and Nuclear Medicine Physician Services at the Lexington VAMC in Lexington, Kentucky. The contractor shall provide various path and lab staff for including daytime coverage, evening coverage, weekend coverage, and coverage on federal holidays. Services include, but are not limited to:

The Contractor shall provide Board Certified/Board Eligible Abdominal/GU, Breast Imaging, Cardiovascular, General, Interventional, Muscoskeletal, Neuroradiology, Nuclear Medicine and PET/CT Physician Services in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Lexington VA Health Care System. The VA Radiology Services follow the standards & guidelines set forth by American College of Radiology (ACR).

Performance Work Statement: See attached for a DRAFT Performance Work Statement.

Anticipated Period of Performance: Period of performance is projected to be for a base period of one (a) year with an additional four (9) one-year options periods but is subject to change.

SOURCES SOUGHT QUESTIONNAIRE

Company Name ___________________________________________

POC ___________________________________________

Phone Number ___________________________________________

Email Address ___________________________________________

UEI ___________________________________________

1. Is your firm considered a Small Business? The North American Industry Classification System (NAICS) code is tentatively 621111; the small business size standard for this NAICS code is $16 Million.

A size standard, which is usually stated in number of employees or average annual receipts, represents the largest size that a business (including its subsidiaries and affiliates) may be to remain classified as a small business for Small Business Administration and federal contracting programs. The definition of "small" varies by industry. Is your business considered any of the following?

[ ] yes [ ] no Service Disabled Veteran Owned Small Business (SDVOSB)**

[ ] yes [ ] no Veteran Owned Small Business (VOSB)**

[ ] yes [ ] no Historic Underutilized Business Zone (HUBZONE)

[ ] yes [ ] no Small Disadvantaged Business (SDB)

[ ] yes [ ] no Woman Owned Small Business (WOSB)

[ ] yes [ ] no Small Business (SB)

**If you responded ‘yes’ to SDVOSB or VOSB, submit a copy of your current SBA Vendor Certification.

2. Does your firm have an active registration in the System for Award Management (SAM)?

[ ] yes [ ] no

3. Have you provided Outpatient Clinic Services under NAICS 621111 to a Federal Agency in the past? If so, please list experience.

4. In your opinion, what are the risks associated with this effort? Comment on any current or potential technical, cost, schedule, or performance risks that you would like to make the Government aware of that concern Radiology and Nuclear Medicine Physician Services and/or this requirement.

5. Provide any additional feedback that you feel is relevant (i.e., problems or any other issues experienced with similar contracts).

Note: Do not include proprietary, classified, confidential, or sensitive information in responses.

Please e-mail your questionnaire response with the above information to Robert Pritchard (george.cochran@va.gov) with the subject line " Radiology and Nuclear Medicine Physician Services” by 11:00am CT on March 31, 2026.

Sources Sought Notice Sources Sought Notice Disclaimer and Important Notes. This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization’s qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. After a review of the responses received, a pre-solicitation synopsis and solicitation may be published to the System for Award Management. However, responses to this notice will not be considered adequate responses to a solicitation.

Confidentiality. No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).

Sources Sought Notice

PERFORMANCE WORK STATEMENT

DIAGNOSTIC, INTERVENTIONAL, AND NUCLEAR MEDICINE PHYSICIAN SERVICES

1. GENERAL

1.1. SERVICES REQUIRED: The Contractor shall provide Board Certified/Board Eligible Abdominal/GU, Breast Imaging, Cardiovascular, General, Interventional, Muscoskeletal, Neuroradiology, Nuclear Medicine and PET/CT Physician Services in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Lexington VA Health Care System. The VA Radiology Services follow the standards & guidelines set forth by American College of Radiology (ACR). A contractor providing Abdominal/GU, Cardiovascular, General, Interventional, Muscoskeletal, Neuroradiology radiologist services shall provide services that meet or exceed the American College of Radiology Guidelines https://www.acr.org/-/media/ACR/Files/Practice-Parameters/IRClin-Prac-Mgmt.pdf.pdf

1.2. PLACE OF PERFORMANCE: Contractor shall furnish services at the Lexington VA Health Care System, 1101 Veterans Dr. Lexington KY, 40502

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

1.4. Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications

1.4.1. VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C. 8153

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy

1.4.3. VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice

1.4.4. VHA Directive 1088(1): Communicating Test Results to Providers and Patients

1.4.5. VHA Directive 1100.18: Reporting and Responding to State Licensing Boards

1.4.6. VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.7. VHA Directive 1100.21: Privileging

1.4.8. VHA Directive 1192.01: Seasonal Influenza Vaccination Program for VHA Health Care Personnel

1.4.9. VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting

1.4.10. VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents:

1.4.11. VHA Directive 1605.01: Privacy and Release of Information

1.4.12. VHA Directive 1907.01: VHA Health Information Management and Health Records

1.4.13. VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports

1.4.14. VHA Handbook 1400.04: Supervision of Associated Health Trainees:

1.4.15. VHA Directive 1414 Stereotactic Body Radiotherapy

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

1.4.17. US Nuclear Regulatory Commission for management and use of radioactive materials for medical use and radiation safety requirements, to include (but not limited to) 10 CFR Parts 19, 20, 30, 33, 35, and 71: http://www.nrc.gov/reading-rm.html

1.4.18. VHA Directive 1105.05: Magnetic Resonance Safety

1.4.19. VHA Directive 1105.04: Fluoroscopy Safety

1.4.20. VHA Directive 1417: Lung Cancer Screening

1.5. ACRONYMS/DEFINITIONS:

1.5.1. AAPM: American Association of Physics in Medicine

1.5.2. ABR: American Board of Radiology

1.5.3. ACGME: Accreditation Council for Graduate Medical Education

1.5.4. ACO: Administrative Contracting Officer

1.5.5. ACR: American College of Radiology

1.5.6. ALARA: As Low as Reasonably Achievable (least & lowest radiation exposure possible)

1.5.7. AOA: American Osteopathic Association

1.5.8. ARRT(T): American Registry of Radiologic Technologists (T) in Radiation Therapy

1.5.9. ASTRO/APEx: American Society for Radiation Oncology/Accreditation Program for Excellence ® (https://www.astro.org/Daily-Practice/Accreditation)

1.5.10. BAA: Business Associate Agreement

1.5.11. CAMPEP: Commission on Accreditation of Medical Physics Educational Programs (http://www.campep.org/default.asp)

1.5.12. CDC: Centers for Disease Control and Prevention

1.5.13. CEU: Certified Education Unit

1.5.14. Clinical Privileging: Clinical 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, and within available resources.

1.5.15. CMD: Certified Medical Dosimetrist

1.5.16. CME: Continuing Medical Education

1.5.17. CMS: Centers for Medicare and Medicaid Services

1.5.18. CO: Contracting Officer

1.5.19. COR: Contracting Officer’s Representative

1.5.20. COS: Chief of Staff

1.5.21. CPARS: Contractor Performance Assessment Reporting System

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

1.5.23. Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience, or other qualifications.

1.5.24. DEA: Drug Enforcement Agency

1.5.25. EHR: Electronic Health Record – electronic health record system used by the VA.

1.5.26. FSMB: Federation of State Medical Boards

1.5.27. FTE: Full Time Equivalent VA’s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year. However, providers may propose using their standard FTE definition.

1.5.28. HHS: Department of Health and Human Services

1.5.29. HICPAC: Healthcare Infection Control Practices Advisory Committee- a federal advisory committee made up of 14 external infection control experts who provide advice and guidance to the CDC and the Secretary of HHS regarding the practice of health care infection control, strategies for surveillance and prevention and control of health care associated infections in United States health care facilities.

1.5.30. HIPAA: Health Insurance Portability and Accountability Act

1.5.31. IGRT: Image Guided Radiation

Therapy is the process of frequent two and three-dimensional imaging, during a course of radiation treatment, used to direct radiation therapy utilizing the imaging coordinates of the actual radiation treatment plan.

1.5.32. IMRT: Intensity Modulated Radiation Therapy is the process of delivering highly conformal radiotherapy to the tumor while sparing the surrounding normal tissues by varying radiation intensity across treatment portals.

1.5.33. IROC: Imaging and Radiation Oncology Core

1.5.34. ISO: Information Security Officer

1.5.35. Key Personnel: The individuals specified in this contract who are essential to work performance.

1.5.36. MU: Monitor Unit is a measure of machine output of a linear accelerator in radiation therapy.

1.5.37. NHPP: National Health Physics Program- NHPP provides regulatory oversight for the Nuclear Regulatory Commission master materials license issued to VHA to include permitting for use of materials, on-site inspections, and investigations of allegations, medical events, and incidents. In addition, we provide oversight for machine sources of ionizing radiation used for radiation therapy. Finally, we provide assistance and technical information for uses of ionizing radiation for healthcare diagnosis and treatment and non-human biomedical research. (http://www.patientcare.va.gov/NHPP.asp)

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

1.5.39. NROP: National Radiation Oncology Program

1.5.40. NRSC: National Radiation Safety Committee

1.5.41. POP: Period of Performance

1.5.42. PPD: Purified Protein Derivative

1.5.43. PWS: Performance Work Statement

1.5.44. QASP: Quality Assurance Surveillance Plan

1.5.45. QMP: Quality Management Program

1.5.46. SPE: Senior Procurement Executive

1.5.47. SRS: Stereotactic Radio Surgery: a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinated system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation, radiosurgery (SRS) etc.

1.5.48. SBRT: Stereotactic Body Radiotherapy

1.5.49. TJC: The Joint Commission

1.5.50. TLD: Thermoluminescent Dosimeter- a device that measures radiation dose

1.5.51. TMP: Therapeutic Medical Physicist

1.5.52. TRT: Therapeutic Radiologic Technologist (Interchangeable Names: Radiologic Therapy Technologist, Radiation Therapist)

1.5.53. VA: Department of Veterans Affairs

1.5.54. VetPro: Is VHA’s mandatory credentialing software platform to document the credentialing of VHA health care providers. This system facilitates completion of a uniform, accurate, and complete credentials file.

1.5.55. VHA: Veterans Health Administration

1.5.56. VISN: Veterans Integrated Services Network

1.5.57. VistA: Veterans Information Systems Technology Architecture

2.1. QUALIFICATIONS: 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 key 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.

2.2. Board Certification: All contract physician(s) shall be board certified/board eligible. Please note that board eligible physicians must be supervised by a Board Certified per the American Board of Radiology. 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.

2.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 referenced above. The Contractor is responsible to ensure 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 Facility Medical Executive Board and Medical Center Director.

2.3.1. In accordance with VHA Directive 1100.20, all health care professionals who claim licensure, certification, or registration, as applicable to the position (this applies to all who are appointed or utilized on a full-time, part-time, intermittent, consultant, without compensation, on-station fee-basis, on-station contract, or on-station sharing agreement basis) and who are not currently privileged in accordance with VHA Directive 1100.21, must be credentialed in accordance with this directive.

2.3.2. If a contract physician(s) and/or other contract provider(s) are not credentialed and privileged or have credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.3.3. Technical Proficiency: Contract physician(s) and other contract provider (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’s physicians and other contract provider (s) shall have knowledge of professional care theories, principles, practices, and procedures to serve imaging patient population. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract physician(s) and other contract provider (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.4. Continuing CME Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractors registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. CME hours shall be reported to the credential’s office for tracking. These documents are required for initial and renewal privileging. Failure to provide shall result in loss of privileges.

2.5. Training (BLS (Physicians & radiation therapy technologists only), EHR and VA MANDATORY): 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.

2.6. STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.): Contractor shall provide proof of the following 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.

2.6.1. 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) upon hire in accordance with CDC guidance. (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.

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

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

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

2.6.5. 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}.

2.6.6. 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 facility 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.

2.7. 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.

2.8. DEA: Contractor shall provide copy of current DEA certificate.

2.9. Conflict of Interest: The Contractor and all contract physician(s) and other contract provider (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 - and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.10. Citizenship related Requirements:

2.10.1. 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;

2.10.2. 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.

2.10.3. 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.

2.10.4. 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.

2.10.5. 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.

2.11. 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.

2.11.1. 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) is 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.

2.11.2. 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.

2.12. 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 Directive 1100.20 and VHA Directive 1100.21. Clinical/Professional direction of all clinical personnel covered by this contract will be provided by the facility 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.

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

2.14. Inherent Government Functions: Contractor and Contract physician(s) and other contract provider (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.

2.15. No Employee Status: The Contractor shall be responsible for protecting Contract physician(s) and other contract provider (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:

2.15.1. Workers’ compensation

2.15.2. Professional liability insurance

2.15.3. Health examinations

2.15.4. Income tax withholding, and

2.15.5. Social security payments.

2.16. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract physician(s) and other contract provider (s). When a Contractor or contract physician(s) and/or other contract provider (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) or other contract provider (s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.17. Key Personnel: Contractor shall provide the number of qualified staff as is necessary to perform the services required under this contract, at the staffing level determined to be professionally acceptable by the Facility Chief of Staff and in accordance with national radiology practice staffing guidelines.

2.17.1. The VA Full Time Equivalency (FTE): FTE for the services required is not applicable.

2.17.2. The minimum number of Board-Certified/Board-Eligible Imaging physicians required to be on site daily is 1 as defined in paragraph Hours of Operation in this section.

2.17.3. The Contractor shall assign to this contract the following key personnel: Lead Radiologist to be the Contractor Representative (CR).

2.17.4. 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 1 hour and notify the Contracting Office Representative (COR) immediately of the schedule change.

2.18. 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.

2.18.1. 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.

2.18.2. 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.

2.18.3. 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 contract physician(s), s/he may request, without cause, immediate replacement of said contract physician(s).

2.18.4. The CO and COR shall deal with issues raised concerning Contract physician(s) conduct. The final arbiter on questions of acceptability is the CO.

2.19. Contingency Plan: Continuity of care and uninterrupted operations of a Diagnostic Imaging Service are essential components of this contract and will be primary factors in Contractor’s assignment of staff and frequency of substitutions. The Contractor shall have a contingency plan in place to be utilized if the contract physician(s) and other contract provider (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: Normal business hours for the Lexington VA HCS Imaging Service are Monday – Friday, 7:30am – 5:00pm. Interventional Radiology and Fluoroscopy patients must be seen by a contractor’s physician(s) on-site at the facility in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult/order completion. The contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.2. Work Schedule: Hours per provider will be determined by the contractor based on the needs of the service.

3.2.1. Patients must be seen by a contract physician(s) on-site at the Facility 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.

3.2.2. Contract Physicians shall be available during normal Facility clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are Monday through Friday, 7:30 a.m. to 5:00 p.m.

3.2.3. Off-hours Coverage: Contracted Providers will be available 24 hours per day and 7 days per week for Stat and Urgent reporting needs.

3.2.3.1. On-call contract physicians must always be available for phone consultations with VA residents and physicians.

3.2.4. 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 to be a national holiday.

3.2.5. Cancellation/Rescheduling: Unless clinics are cancelled by the VAHCS, the Contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

4.1. SERVICES REQUIRED: The Contractor shall provide the necessary manpower to cover the reporting needs of the Lexington VA Health Care System. While the bulk of this work is routine in nature, Stat/Urgent reports are based on the needs of the Veteran.

4.1.1. Lexington VA HCS provides a broad range of Diagnostic Imaging, Interventional and Therapeutic services. These services include but are not limited to: Radiography, Fluoroscopy, Computed Tomography, Magnetic Resonance Imaging, Special Procedures, Ultrasound, Nuclear Medicine, PET/CT, and Interventional Radiology.

4.2. Standards of Practice: The contract physician(s)’ care shall cover the range of Radiology and Nuclear Medicine 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:

4.2.1. The American College of Radiology Guidelines for Radiology Practice by subspecialty:

4.2.2. https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards.

4.2.3. The American College of Radiology Guidelines for Radiology Practice by Organ or Body System:

4.2.4. https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards.

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

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

4.2.7. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contract physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (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).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Health records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA10A7). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4.

4.3.3. Disclosure: Contract physician(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract; however, Contractor shall obtain permission from the VA before disclosing any patient information outside VA. VA authorizes the Contractor to discuss patient health information for coordination of care within community health care providers in compliance with VA regulations, HIPAA, and VHA Directive 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Directive 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 and all guidelines provided by the facility.

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility were assigned.

4.3.6. Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series.

4.3.7. Security requirements for unclassified information technology resources

4.3.7.1. The contractor, their personnel, and their subcontractors shall be subject to the Federal laws, regulations, standards, and VA Directives and Handbooks regarding information and information system security as delineated in this contract.

4.4. Direct Patient Care: estimated 95% of the time involved in direct patient care. The contract shall be responsible for:

4.4.1. Scope of Care: Contractor’s physician(s) shall be responsible for providing Nuclear Medicine, Diagnostic, and Interventional Radiology procedures, including, but not limited:

4.4.1.1. General Radiology

4.4.1.2. Fluoroscopy

4.4.1.3. Computed Tomography

4.4.1.4. Magnetic Resonance Imaging

4.4.1.5. Ultrasound

4.4.1.6. Interventional Radiology

4.4.1.7. Nuclear Medicine (Diagnostic and Theragnostic)

4.4.1.8. PET/CT

4.4.2. Contractor’s physician(s) shall be present on time for any scheduled clinics as documented by physical presence in the clinic at the scheduled start time and be available as needed.

4.4.3. Communication of Test Results: Mechanisms must be in-place to provide notification of test results for patients receiving care in accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients.

4.4.4. Consultation Responsibilities: Contractor physician(s) shall provide consultation with instruction to referring physicians regarding appropriate indications for radiologic procedures so that the most expeditious and clinically appropriate work-up can be done. Contractor physician(s) shall determine the appropriate course of treatment and communicate in person or by phone with the referring clinicians. This consultation could be in the form of an electronic consult response in the electronic medical record.

4.4.5. Contractor physician(s) shall provide review of consults/orders when necessary

4.4.6. Contractor physician(s) shall provide post-procedure evaluation and follow-up and clinical consultation regarding complications of interventional radiologic procedures.

4.4.7. Medications: Contractor physician(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.

4.4.8. Discharge education: Provide discharge education and follow up instructions that are coordinated with the next care setting for all interventional radiology patients.

4.4.8.1. Documentation Requirements: All patient care documentation including, but not limited to consultations, encounters, progress notes, treatment discharge notes, follow-up notes, and other required documentation, shall be recorded in CPRS in accordance with VA Rules and Regulations.

4.4.8.2. COMMUNICATING TEST RESULTS TO PROVIDERS AND PATIENTS: In accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients, all test results requiring action must be communicated by the ordering provider, or designee, to patients no later than 7 calendar days from the date on which the results are available. For test results that require no action, results must be communicated by the ordering provider, or designee, to patients no later than 14 calendar days from the date on which the results are available. The contractor shall determine a plan to fulfill critical test result procedures, per VA policy. Critical results must be reported to the clinician by the radiologist by telephone. Documentation of this notification, “who, when” must appear in the radiology report. See policy SOP #33 “COMMUNICATION OF IMAGING RESULTS“ in section D for additional requirements regarding communication of test results. Mechanisms must be in-place to provide notification of test results for patients receiving care in accordance with VHA Directive 1088, Communicating Test Results to Providers and Patients.

4.6 ADMINISTRATIVE: 5% of time not involved in direct patient care.

4.6.1 Quality Improvement Meetings: The Contractor’s physician(s) shall participate in continuous quality improvement activities and meetings with committee participation as required by the facility Chief of Service, Chief of Staff, or designee.

4.6.2 Staff Meetings: Contractor’s staff shall attend service staff meetings as required by the Facility COS, or designee. Contractor to communicate with COR on this requirement and report any conflicts that may interfere with compliance with this requirement.

4.6.3 Contractor is responsible for assisting in a protected peer review program in compliance with The Joint Commission and practice standards promulgated by ACR, ASTRO, and AAPM and to maintain documentation of appropriate peer review statistics as needed for quality management and credentialing.

4.6.4 Unrestricted Authorized User: At least one contractor’s physician(s) must be a current 10CFR 35.300 level AU that includes 35.390, 35.392, 35.394 and 35.396 or equivalent Agreement State Requirements. This is the administration of I-131 sodium iodide >30uCi, any therapeutic dosage of unsealed byproduct material and the parenteral administration of other unsealed radionuclides. Documentation must be provided to support this.

4.6.5 Patient Safety Compliance and Reporting:

4.6.5.1 Contractor’s physician(s) shall follow all established patient safety and infection control standards of care. Contractor’s physician(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be documented in the medical record of those impacted and disclosed to the patient or surrogate. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit an entry in the Patient Safety Reporting System, following up with COR as required or requested.

4.6.5.2 Adverse events will be reported to the VA Quality & Patient Safety Office to the Patient Safety Manager or Patient Safety Coordinator and entered into the Patient Safety Reporting System, as outlined in the National Center for Patient Safety Handbook (http://www.va.gov/ncps/Pubs/NCPShb.doc). Adverse events will be scored utilizing the Safety Assessment Code for determination of the need for conducting a Root Cause Analysis (RCA). Report adverse events to Lead Patient Safety Manager at (859) 233-4511 ext. 4364

4.6.5.3 The Contractors shall report all incidents involving radioactive material to the NHPP and NRC in accordance with National Radiation Safety Committee SOP #5: “National Health Physics Program (NHPP) Incident Response Procedure” and NRC Reporting Requirements (10 CFR 20, 21, 30, 35).

4.6.5.4 Adverse drug reactions, allergies, and adverse drug events should be appropriately and promptly entered into CPRS. http://nhpp.med.va.gov/NHPP_Procedures.asp

4.7 PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI): The Government may evaluate the quality of professional and administrative services provided in accordance with the standards (practice guidelines and standards promulgated by ACR, ASTRO, and AAPM) as outlined in this document, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment), in accordance with Federal Acquisition Regulation (FAR) 37.401(b).