36C25525Q0561 Solicitation Final.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C25525Q0561 03/25/2026

Condiff, Jason 913-946-1113 04/27/2026

1700 CST

36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048 x 100 x

621399

$10 Million

N/A

X

VA St. Louis Healthcare System John Cochran Division 915 N. Grand

ST. Louis, MO 63106

36C255

Department of Veterans Affairs Network Contracting Office (NCO) 15

36C255

Financial Services Center http://www.fsc.va.gov/einvoice.asp

Austin TX

877-353-9791 512-460-5429

See CONTINUATION Page

Contractor to provide qualified Intraoperative Neurophysiologic Monitoring (IONM) Services and and instrumentation for ST. Louis Healthcare System John Cochran Division 915 N. Grand, St. Louis, MO 63106.

All services to be provided IAW the Performance Work Statement.

Section B.2 Schedule of Services begins on page 4.

Reports and Deliverables begins on page 33.

Instructions to Offerors begins on page 72, addendum page 74.

See CONTINUATION Page

X ONE

Condiff, Jason

36C25525Q0561

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS-COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023) (DEVIATION OCT 2025)

C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.8 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.9 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.10 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS. (DEVIATION NOV

2025)

C.11 852.204-72 PERSONNEL VETTING AND CREDENTIALING (MARCH 2026)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS-COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023) (DEVIATION OCT 2025)

E.2 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021) (DEVIATION OCT 2025)

E.3 52.216-1 TYPE OF CONTRACT (APR 1984) (DEVIATION NOV 2025)

E.4 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006) (DEVIATION NOV 2025)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C255

Network Contracting Office (NCO) 15

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

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] MONTHLY

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

Vendors are advised that VA reorganization may necessitate adding additional locations to this contract in the future. Any such additions will be completed by bilateral modification.

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

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

CLIN DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT

PRICE AMOUNT

0001 Complete Intraoperative Neuromonitoring (IONM) Services in accordance with the Performance Work Statement (PWS). Base Year: Period of Performance (POP) 11/15/2026 – 11/14/2027

0001A Base Year – During Normal Business Hours 450.00 HR

0001B Base Year – Outside Normal Business Hours 12.00 HR

BASE YEAR TOTAL

1001 Complete Intraoperative Neuromonitoring (IONM) Services in accordance with the Performance Work Statement (PWS). Option Year 1: POP 11/15/2027 – 11/14/2028

1001A Option Year 1 – During Normal Business Hours 450.00 HR

1001B Option Year 1 – Outside Normal Business Hours 12.00 HR

Option Year 1 Total

2001 Complete Intraoperative Neuromonitoring (IONM) Services in accordance with the Performance Work Statement (PWS). Option Year 2: POP 11/15/2028 – 11/14/2029

2001A Option Year 2 – During Normal Business Hours 450.00 HR

2001B Option Year 2 – Outside Normal Business Hours 12.00 HR

Option Year 2 Total

3001 Complete Intraoperative Neuromonitoring (IONM) Services in accordance with the Performance Work Statement (PWS). Option Year 3: POP 11/15/2029 – 11/14/2030

3001A Option Year 3 – During Normal Business Hours 450.00 HR

3001B Option Year 3 – Outside Normal Business Hours 12.00 HR

Option Year 3 Total

Complete Intraoperative Neuromonitoring (IONM) Services in accordance with the Performance Work Statement (PWS). Option Year 4: POP 11/15/2030 – 11/14/2031

4001A Option Year 4 – During Normal Business Hours 450.00 HR

4001B Option Year 4 – Outside Normal Business Hours 12.00 HR

Option Year 4 Total

Grand Total

B.3 PERFORMANCE WORK STATEMENT

1.0 GENERAL:

1.1. Services Provided: The Contractor shall provide Intraoperative Neurophysiologic Monitoring (IONM) services that meet the standards of the Department of Veterans Affairs (VA) and The Joint Commission. Services shall be delivered in accordance with the specifications outlined in this Performance Work Statement (PWS) to beneficiaries of the VA St. Louis Health Care System (VASTLHCS), John Cochran Division.

1.1.1. Place of Performance: Contractor shall furnish services at the VA St. Louis Healthcare

System; John Cochran Division 915 N. Grand, St. Louis, MO 63106

1.2. Scope: The Contractor shall provide comprehensive Intraoperative Neurophysiologic

Monitoring (IONM) services for patients undergoing surgical procedures at the VA St.

Louis Health Care System. The Contractor shall furnish all required personnel, equipment, software, network infrastructure, materials, and supervision necessary to deliver these services. Services shall include on-site technologists and remote neurologist oversight with real-time interpretation.

Coverage shall be available 24 hours a day, 7 days a week, 365 days a year for scheduled and emergency cases. The Contractor shall respond promptly to all requests, including elective and urgent/emergent cases, ensuring that an on-site technologist and a remote neurologist are available within 60 minutes of notification for emergencies. For elective cases, the Contractor shall ensure availability to provide services within two (2) business days of request. Services shall be conducted in the operating room on a per-case basis as determined by VA Surgical Service. The Contractor shall promptly communicate any changes to scheduled monitoring, including date, time, or type of monitoring, to the VA.

The Contractor shall provide pre-operative, intraoperative, and post-operative monitoring using contractor-owned telemedicine technology for secure, real-time communication.

Included modalities encompass auditory evoked potentials, electroencephalogram (EEG), electromyography (EMG), nerve conduction studies, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), visual evoked potentials (VEP), blink reflex testing, neuromuscular junction testing, and continuous intraoperative neurophysiology monitoring both on-site and remotely.

1.3. Authority: Federal Acquisition Register Part 12 - Acquisition of Commercial Products and

Commercial Services.

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. VHA Handbook 1100.17: National Practitioner Data Bank Reports, dated December

28, 2009.https://ba.va.gov/policy/viewer/paKMfE00000011JpWAI

1.4.2. VHA Directive 1100.18 Reporting and Responding to State Licensing Boards, dated

January 21, 2021.https://ba.va.gov/policy/viewer/paKMOE00000009094AA

1.4.3. VHA Directive 1100.20(2), Credentialing of Health Care Providers, dated September

15, 2021.https://ba.va.gov/policy/viewer/paKMOE0000000K8F4AU

1.4.4. VHA Directive 1003.04, VHA Patient Advocacy, dated November 09, 2023,https://ba.va.gov/policy/viewer/paKMOE0000000EBD4A2

1.4.5. VHA Directive 1088(1), Communicating Test Results to Providers and Patients, dated

July 11, 2023.https://ba.va.gov/policy/viewer/paKMOE0000000IlU4AU

1.4.6. VHA Directive 1192.01, Seasonal Influenza Prevention Program, dated August 10, 2020.https://ba.va.gov/policy/viewer/paKMOE00000009Cg4AI

1.4.7. VA Directive 1663, Health Care Resources Contracting –Buying Title 38 U.S.C. 8153, Dated May 10, 2018.https://ba.va.gov/policy/viewer/paKMOE00000009FF4AY

1.4.8. VHA Directive 1907.01(1) VHA Health Information Management and Health Records, dated April 05, 2021.https://ba.va.gov/policy/viewer/paKMOE0000000Ebz4AE

1.4.9. Privacy Act of 1974 (5 U.S.C. 552a) as

amendedhttps://www.justice.gov/archives/oip/blog/foia-update-freedom-information-act-5-usc-sect-552-amended-public-law-no-104-231-110-stat

1.4.10. VA Handbook 6510, VA Identity, Credential and Access Management, dated

September 27, 2024.https://ba.va.gov/policy/viewer/paKMOE0000000KL44AM

1.4.11. VHA Directive 0710(1), VHA Personnel Security and Suitability Program, dated

October 31, 2023.https://ba.va.gov/policy/viewer/paKMOE0000000Hak4AE https://ba.va.gov/policy/viewer/paKMfE00000011JpWAI https://ba.va.gov/policy/viewer/paKMOE00000009094AA https://ba.va.gov/policy/viewer/paKMOE0000000K8F4AU https://ba.va.gov/policy/viewer/paKMOE0000000EBD4A2 https://ba.va.gov/policy/viewer/paKMOE0000000IlU4AU https://ba.va.gov/policy/viewer/paKMOE00000009Cg4AI https://ba.va.gov/policy/viewer/paKMOE00000009FF4AY https://ba.va.gov/policy/viewer/paKMOE0000000Ebz4AE https://www.justice.gov/archives/oip/blog/foia-update-freedom-information-act-5-usc-sect-552-amended-public-law-no-104-231-110-stat https://www.justice.gov/archives/oip/blog/foia-update-freedom-information-act-5-usc-sect-552-amended-public-law-no-104-231-110-stat https://ba.va.gov/policy/viewer/paKMOE0000000KL44AM https://ba.va.gov/policy/viewer/paKMOE0000000Hak4AE

1.4.12. The Freedom of Information Act 5 U.S.C. § 552, As Amended By Public Law No. 104- 231, 110 Stat. 3048.https://www.justice.gov/archives/oip/blog/foia-update-freedom-information-act-5-usc-sect-552-amended-public-law-no-104-231-110-stat

1.4.13. VA Handbook 6500.6, Contract Security, dated March 12, 2010.https://ba.va.gov/policy/viewer/paKMOE00000009Cz4AI

1.4.14. VHA Directive 1660.03, Conflict of Interest for Sharing of Health Care Resources, dated September 13,2021.https://ba.va.gov/policy/viewer/paKMOE00000009Is4AI

1.4.15. VHA Directive 1080(1), Access to Personally Identifiable Information in Information

Technology System, dated September 28, 2023.https://ba.va.gov/policy/viewer/paKMOE0000000GXk4AM

1.4.16. VHA Directive 1605, VHA Privacy Program, dated September 01, 2017.https://ba.va.gov/policy/viewer/paKMOE000000098J4AQ

1.4.17. VHA Directive 1605.03(3), Privacy Compliance Accountability Program, dated

September 19, 2019.https://ba.va.gov/policy/viewer/paKMOE0000000Ei24AE

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.

ABRET: American Board of Registration of Electroencephalographic and Evoked

Potential Technologists ACOS: Associate Chief of Staff. Unless identified by another service, for the purposes of this contract the ACOS refers to the Associate Chief of Staff for Surgical Service, at VA St. Louis Health Care System.

CDC: Centers for Disease Control and Prevention CEU: Certified Education Unit

CME: Continuing Medical Education

CNIM: Certified Neurophysiologic Intraoperative Monitoring (CNIM) Technologist.

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.

Contracting Officer’s Representative (COR): –A person appointed by the CO to https://www.justice.gov/archives/oip/blog/foia-update-freedom-information-act-5-usc-sect-552-amended-public-law-no-104-231-110-stat https://www.justice.gov/archives/oip/blog/foia-update-freedom-information-act-5-usc-sect-552-amended-public-law-no-104-231-110-stat https://ba.va.gov/policy/viewer/paKMOE00000009Cz4AI https://ba.va.gov/policy/viewer/paKMOE00000009Is4AI https://ba.va.gov/policy/viewer/paKMOE0000000GXk4AM https://ba.va.gov/policy/viewer/paKMOE000000098J4AQ https://ba.va.gov/policy/viewer/paKMOE0000000Ei24AE 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.

COS: Chief of Staff

CPARS: Contractor Performance Assessment Reporting System

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

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.

DNEPs: Descending neurogenic evoked potential

EEG (intraoperative): Electroencephalogram

FSMB: Federation of State Medical Boards

HHS: Department of Health and Human Services

HIPAA: Health Insurance Portability and Accountability Act

IOM: Intraoperative Monitor

IONM: Intraoperative Neurophysiologic Monitoring (IONM) refers to the continuous assessment of nervous system function during surgery using a variety of specialized neurophysiologic tests and measures. The purpose of IONM is to provide the surgical team with information about impending adverse changes in nervous system function, so that timely corrective action can be taken to reduce the risk of lasting injury.

ISO: Information Security Officer

Medical Emergency: A sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

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).

Non-Contract Provider: any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

NPPES: National Plan and Provider Enumeration System

NMEP: Neurogenic motor evoked potential

OFFER: Quotation (to include documentation in support of the evaluation criteria) submitted in response to the Government’s Request for Quotation (RFQ).

OFFEROR: Contractor that submits a response (i.e. Quotation) to the Government’s Request for Quotation (RFQ).

OR: Operating Room

POP: Period of Performance

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.

Provider of Care: Any providers or servicing individuals who enter the VA under the contract, including onsite Technologists.

PWS: Performance Work Statement

OR: Operating Room

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

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

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

VISTA (Veterans Integrated Systems Technology Architecture): APC 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.

Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean the VA St. Louis Health Care System, John Cochran Division, 915 N. Grand Boulevard, St. Louis, Missouri, 63106.

2.0 QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: Neurologists assigned by the Contractor to perform services under this contract must hold a current, valid, and unrestricted license to practice medicine in a State, Territory, or Commonwealth of the United States, or the District of Columbia.

2.1.1.1. All licenses held by personnel working on this contract must be full and unrestricted. Contractor’s Neurologists who have current, full, and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily surrendered pending action, or denied upon application will not be considered for this contract.

2.1.2. Board Certification: All Contractor-provided Neurologists must be Board Certified or

Board Eligible by the American Board of Psychiatry and Neurology (ABPN).

Documentation verifying current certification must be submitted to the VA Contracting Officer’s Representative (COR) annually throughout the contract period. All continuing education requirements necessary to maintain certification must remain current at all times.

2.1.2.1. All Contractor-provided Electro Neurophysiologic Technologists performing on-site IONM services must have a Certification Neurophysiologic Intraoperative Monitoring (CNIM), through the American Board of Registered Electroencephalographic and Evoked Potential Technologists (ABRET) (http://www.abret.org). This certification is intended for Technologists who work under supervision by a Neurophysiologist or Neurologist. All continuing education requirements necessary to maintain certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA Contracting Officer’s Representative (COR) within thirty

(30) days of contract award and annually thereafter for each year of contract performance

2.1.2.2. All on-site Contractor personnel must maintain current Basic Life Support (BLS) certification. All continuing education requirements necessary to maintain certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the Contractor to the VA Contracting Officer’s Representative (COR) within thirty (30) days of contract award and annually thereafter for each year of contract performance.

2.1.2.3. Credentialing and Privileging: Credentialing and privileging shall be conducted in accordance with VHA Directive 1100.19, VHA Handbook 1100.19, and all applicable VA policies. The Contractor is responsible for ensuring that all proposed personnel meet credentialing requirements prior to performing any services.

2.1.2.4. On-Site Contract Technologists: All Electro Neurophysiologic Technologists performing services on VA premises must complete VA credentialing requirements through VetPro, the VA’s credentialing system. No services shall be provided until credentialing has been approved by the VAVASTLHCS Medical Center Director.

The Contractor shall ensure timely submission of all required documentation into VetPro, including verification of education and training, current unrestricted licensure or certification, background checks, and health requirements. The Contractor shall maintain compliance with VA re-credentialing schedules and promptly report any changes in status. The VAMC has determined that Flash/PIV is required for on-site IONM Technologist.

2.1.2.5. Off-Site Contract Neurologists: VA privileging is not required for off-site Neurologists, as their work is technical in nature, does not involve clinical decision-making, and does not include direct patient care. Remote Neurologists shall be board-certified with unrestricted licenses and credentialed and privileged through the Contractor or its affiliate location. The Contractor shall provide written verification that each Neurologist is licensed, credentialed, and privileged in accordance with applicable standards. All services shall comply with HIPAA, HITECH, and VA privacy and security requirements. VA reserves the right to audit credentialing documentation at any time. The VAMC has determined that Flash/PIV is NOT required for off-site Neurologists.

2.1.2.6. Documentation: The Contractor shall provide documents upon request of the COR to verify current and ongoing competency. The Contractor shall provide verifiable evidence of all educational and training experiences, including explanations for any gaps in educational history, for all Electro Neurophysiologic Technologists.

Technologists shall comply with the Facility’s Medical Staff By-Laws, rules, and regulations referenced herein that govern staff behavior.

2.1.3. Compliance and Substitution: All providers of care must be properly credentialed as required in Section 2.1.2.3, and the scope of practice must be current in accordance with VHA guidelines for working with IONM processes in the Operating Room.

2.1.3.1. Neurologist Substitution: If a Contractor’s Neurologist is not credentialed as required in Section 2.1.2.3, or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the Government.

2.1.3.2. Technologist Substitution: If a Contractor’s Electro Neurophysiologic Technologist is not credentialed as required in Section 2.1.2.3, or has credentials suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the Government within 30 calendar days.

2.1.4. Technical Proficiency: The Contractor must be capable of providing real-time data and shall utilize the most recent technology and hardware. The Contractor will work closely with surgeons, nursing staff, schedulers, Clinical Engineering, and Sterilization and Processing Service to support surgical procedures. All equipment provided must function with the current electrical power supply at VASTLHCS. Remote Neurologists will provide real-time monitoring via HIPAA- and HITECH-compliant telemedicine platforms. The Contractor shall provide scheduled services throughout the contract period and ensure qualified replacement personnel at no additional cost to the Government in the event of absence. All replacement personnel must meet VA credentialing and technical requirements prior to performing services The Contractor shall implement a comprehensive Quality Assurance (QA) program that monitors and tracks performance, successes, and complications. QA reports shall be submitted to the COR no later than the 10th day of the month following the end of each quarter

2.1.4.1. Intraoperative Neurophysiologic Monitoring (IONM): The Contractor shall provide qualified Electro Neurophysiologic Technologists to perform on-site intraoperative neurophysiologic monitoring (IONM) services. Monitoring shall include, but is not limited to, somatosensory evoked potentials (SSEPs), transcranial motor evoked potentials (TcMEPs), spontaneous and triggered electromyography (S-EMG, T- EMG), spinal cord mapping including D-waves, DNEPs, and NMEPs, cortical, motor, sensory, and language mapping, white matter tract and brainstem nuclei mapping, brainstem auditory evoked responses, visual evoked potentials, cranial nerve monitoring, and intraoperative EEG. All monitoring shall be performed in real time with continuous communication to the surgical team.

2.1.4.2. Technical Skills and Responsibilities: Electro Neurophysiologic Technologists 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. Technologists shall be responsible for testing equipment prior to use, making necessary adjustments, selecting appropriate electrode combinations, obtaining standard recordings, and reporting the ongoing status of the patient’s nervous system to the surgeon during the procedure. They shall remove electrodes post-procedure and ensure proper handling and return of equipment to designated VASTLHCS locations or removal of contractor-supplied equipment from the operating room upon completion of each procedure.

2.1.4.3. Data Integrity and Communication: Technologists shall recognize artifacts in the data, differentiate them from evoked potential patterns, and take appropriate steps to eliminate them. They shall translate test results from computer files into hard copy reports for interpretation by the Neurologist and immediately notify the attending surgeon if there is any indication that possible damage may occur to the patient.

2.1.5. Continuing Medical Education (CME) / Certified Education Unit (CEU) Requirements:

Contracted Neurologists shall provide the COR copies of current CME documentation as required or requested by VASTLHCS. Neurologists registered or certified by national medical associations shall continue to meet the minimum CME standards to remain current. The Contractor shall report CME hours to the credentialing office for tracking. These documents are required for both privileging and re-privileging. Failure to provide CME documentation shall result in loss of privileges for Contractor’s Neurologists.

2.1.6. Training (BLS, EHR and VA MANDATORY): The Contractor shall meet all VA educational and mandatory training requirements defined herein. All training must be completed by the Contractor’s Neurophysiologic Technologists as required by VA.

Additional training may become required; VA will communicate any changes to the Contractor:

Training Frequency Annual Hours

VA Privacy and Information Security Awareness and Rules of Behavior

Yearly 1 hour

VHA Privacy and HIPAA Focused Training

Yearly 1 hour

VA Cybersecurity Awareness Yearly 1 hour

Infection Control Yearly 1 hour

OSHA Bloodborne Pathogens Yearly 1 hour

Basic Life Support Every two years 3 hours

*Additional training may be required during the contract period. VA will communicate any changes to the Contractor. Completion of all mandatory training is required prior to performing services and must be documented for compliance.

2.1.7. Standard Personnel Testing (PPD, etc.): The Contractor shall provide proof of the following tests for on-site providers of care entering the facility within five (5) calendar days after contract award and prior to the first duty shift. Documentation shall be submitted to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Proof of a negative reaction to PPD testing or an

Interferon-Gamma Release Assay (IGRA) blood test is required for all on-site contractor providers of care. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive results. The TB screening shall be repeated annually.

2.1.7.2. RUBELLA TESTING: Proof of immunization for measles, mumps, and rubella or a rubella titer of 1.8 or greater is required. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.7.3. VARICELLA: Proof of immunity for varicella is required for all on-site Contractors.

2.1.7.4. ACELLULAR PERTUSSIS: Proof of one dose of Tdap vaccination is required for all on-site Contractors.

2.1.7.5. INFLUENZA: Proof of annual influenza vaccination is required unless contraindicated. Contractors with medical contraindications shall wear a mask during influenza season

2.1.7.6. COVID-19: On-site contractor providers of care shall comply with all current VHA infection control policies and any supplemental requirements related to COVID-19 or other communicable diseases, as communicated by VASTLHCS. This may include vaccination, masking, or testing during periods of elevated risk or as directed by VA policy.

2.1.7.7. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: The Contractor shall provide generic self-study training for all contractor providers of care; offer the Hepatitis B vaccination series at no cost to VA if elected; maintain an exposure determination and control plan;

maintain required records; and ensure proper follow-up evaluation is provided following any exposure incident.

2.1.7.8. VAVASTLHCS shall notify the Contractor of any significant communicable disease exposures as appropriate. The Contractor shall adhere to the current CDC/HICPAC Guidelines for Infection Control in Health Care Personnel (updated 2023) for disease control. The Contractor shall provide follow-up documentation of clearance to return to the workplace prior to resuming duties.

2.1.8. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. This requirement applies to contracted Neurologists providing services. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual health care practitioners and organizational entities. The Contractor shall have an appropriate NPI and, if applicable, the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES). NPIs must be provided to the Contracting Officer with the quote.

2.1.9. Conflict of Interest: The Contractor and all contractor providers of care are responsible for identifying and communicating to the CO and COR any conflicts of interest at the time of quote and throughout the contract performance period. At the time of quote, the Contractor shall provide a statement describing 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 will provide services. The Contractor must also provide relevant facts demonstrating how its organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall comply with VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and be fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.10. Citizenship related Requirements:

2.1.10.1. The Contractor certifies compliance with all legal provisions contained in the

Immigration and Nationality Act of 1952, as amended, and related laws and regulations enforced by the Department of 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.

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

2.1.10.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or applicable agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain legal status or otherwise failed to comply with applicable laws shall be prohibited from working at any location where the Contractor provides services to VA patients. Such failure shall constitute grounds for termination of this contract for breach.

2.1.10.4. 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.

2.1.10.5. The Contractor agrees to obtain a similar certification from its subcontractors.

The certification shall be included as part of the Contractor’s response to the RFQ 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) maintains a list of parties and entities excluded from Federal health care programs. Excluded individuals or entities may not receive Federal health care program payments due to fraud and/or abuse of Medicare or Medicaid programs.

2.1.11.1. The Contractor shall review the HHS OIG List of Excluded Individuals/Entities at http://oig.hhs.gov/exclusions/index.aspto ensure that proposed providers of care are not listed. 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 Civil Monetary Penalties (CMP) and treble damages.

CMPs may also be imposed against contractors that employ or contract with excluded individuals.

http://oig.hhs.gov/exclusions/index.asp

2.1.11.2. By submitting a quote, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that neither the Contractor nor its proposed personnel are listed as of the date the offer was signed.

2.2. Clinical/Professional Performance: The qualifications of contractor personnel are subject to review by the VA Medical Center Chief of Staff (COS) or designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical performance monitoring and review will be conducted by VASTLHCSCOS and/or the Chief of Service or designee. A COR will be appointed; however, only the CO is authorized to approve contract modifications.

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

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

2.5. Prohibition Against Self-Referral: Personnel are prohibited from referring VA patients to their own practice(s) or the Contractor’s practice.

2.6. Inherent Government Functions: Contractor and contractor’s providers of care 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.

2.7. No Employee status: The contractor shall be responsible for protecting the contractor’s providers of care furnishing services. To carry out this responsibility, the contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

• Workers’ compensation

• Professional liability insurance

• Health examinations

• Income tax withholding, and

• Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover the contractor’s providers of care. When a contractor or contractor’s contracted personnel have 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 contractor’s Neurologists or Electro Neurophysiologic Technologist) action or non-action shall be the responsibility of the contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. Clinical Personnel – Neurologists: The Contractor shall provide contracted

Neurologists who are competent, qualified per this Performance Work Statement, and adequately trained to perform assigned duties. Two (2) Neurologists shall be available daily as defined in the Hours of Operation section.

2.9.2. Clinical Personnel – Technologists: The minimum number of Board Certified/Board Eligible Electro Neurophysiologic Technologists required to be available daily shall be two (2) as defined in the Hours of Operation section.

2.9.3. Staff-to-Patient Ratio: At all times during procedures in the operating room, the ratio of contracted staff to patient shall be at a minimum of 1:1.

2.9.4. Personnel Substitutions: During the first ninety (90) calendar days of performance, the

Contractor shall make no substitutions of key personnel unless necessitated by illness, death, or termination of employment. The Contractor shall notify the CO in writing within three (3) calendar days after such occurrence and provide the required information. After 90 days, the Contractor shall submit substitution requests to the CO at least 30 calendar days prior to making any permanent substitutions.

2.9.4.1. Permanent Substitutions: The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitution, 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 ten (10) 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.

2.9.4.2. Temporary Substitutions: For temporary substitutions where the key person shall not be reporting to work for three consecutive workdays or more, the Contractor shall provide a qualified replacement with comparable qualifications. Any period exceeding two weeks will require the procedure outlined above for permanent substitutions.

2.9.4.3. Government Right to Refuse Personnel: 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, drug use, theft, patient abuse, negligence, or other conduct resulting in formal complaints. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee document clinical problems or continual unprofessional behavior/actions with any Contractor personnel, immediate replacement may be requested without cause. The CO and COR shall address issues raised concerning Contractor personnel conduct. The CO is the final arbiter on questions of acceptability.

2.9.4.4. Contingency Plan: Because continuity of care is essential, the Contractor shall have a contingency plan in place to ensure uninterrupted services if any Contractor Neurologist(s) or Technologist(s) leaves employment or is unable to continue performance under the contract.

3. HOURS OF OPERATION

3.1. VA Business Hours: Normal hours of operations are 7:30 am –7:30 pm, Monday through

Friday. The operating room is open 24 hours/day and a contractor shall be available for procedures 365 days/year, 24/7.

3.1.1. Contractor’s services shall be available and present for all hours of possible scheduled operations, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently normal operating room hours are 7:30 am – 5:00 pm, Monday through Friday.

3.1.1.1. During normal business hours of operation, contracted staff shall be onsite and ready to perform services 45 minutes prior to the start of surgery. Equipment and Technologist shall be cleared through biomed and SPS 45 minutes prior to surgical procedure.

3.1.2. Contracted personnel shall be available for procedures outside of normal hours of operations, including evenings, weekends and holidays.

3.1.2.1. Outside of normal business hours, contracted staff should report to the operating room within 60 minutes of being called for surgery.

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

Affairs:

New Year’s Day President’s Day Martin Luther King’s Birthday Memorial Day 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.

3.3 Cancellations: Contractor will not cancel service for any reason.

3.3.1. Unless a state of emergency has been declared or clinics are otherwise cancelled by the VASTLHCS, the contractor shall be responsible for providing services.

4. CONTRACTOR RESPONSIBILITIES

4.1. The Contractor shall furnish all supplies, accessories, equipment, consumables, transportation, delivery, training, and services necessary to perform Intraoperative Neurophysiologic Monitoring (IONM) services.

4.2. The Contractor shall provide comprehensive case coverage and scheduling twenty-four

(24) hours a day, seven (7) days a week, three hundred sixty-five (365) days per year by Key Personnel listed on the approved roster.

4.3. Routine requests for service shall be scheduled within two (2) days of request, while urgent and emergent cases shall be supported immediately, ensuring that an on-site Technologist and remote Neurologist are available within sixty (60) minutes of notification.

4.4. All neurophysiologic studies are conducted on-site by the Electro Neurophysiologic

Technologist under the direction of the OR Surgeon. Remote Neurologists provide technical interpretation and monitoring via secure telemedicine platforms in real time;

they do not engage in direct patient care or clinical decision-making.

4.5. Contractors must comply with appropriate and applicable policies, procedures and regulations of the VASTLHCS as well as with Centers for Medicare & Medicaid Services (CMS) requirements and complete medical record deficiencies within policy guidelines. Services must meet The Joint Commission (TJC) clinical quality standards for intraoperative monitoring and be FIPS compliant. Quality reports required for quality assurance must comply with The Joint Commission standard.

4.6. The contractor shall provide, transport, install, participate in the simulations, be available in live surgical cases and test the medical equipment prior to utilization.

4.7. Intraoperative Neuromonitoring (neurophysiology) services: The Contractor shall provide on-site intraoperative neurophysiologic monitoring (IONM) performed by qualified Electro Neurophysiologic Technologists under the direction of the OR Surgeon, with remote Contractor Neurologists providing real-time technical interpretation via secure telemedicine. Continuous communication with the surgical team is required throughout the procedure.

4.8. Monitoring Modalities: IONM shall include auditory evoked potentials, electroencephalogram (EEG), electromyography (EMG), nerve conduction studies, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), visual evoked potentials (VEP), blink reflex testing, neuromuscular junction testing, and continuous intraoperative neurophysiology monitoring both on-site and remotely.

Advanced techniques may be provided as clinically indicated to support complex surgical cases.

4.9. Interpretation and Technical Accuracy: The Contractor shall ensure that intraoperative monitoring recordings are interpreted accurately and that technical recommendations regarding neurophysiologic data trends are communicated promptly to the attending Neurosurgeon. The Technologist shall identify and eliminate artifacts in the data, differentiate them from true evoked potential patterns, and maintain accurate monitoring throughout the procedure. When requested, the Technologist shall obtain relevant patient medical information and prepare a hard copy report from computer-generated test results for review.

The Contractor must demonstrate the capability to identify monitored waveforms and detect any variations from established baseline values. Additionally, the Contractor shall ensure that personnel possess a thorough understanding of anesthetic techniques and physiologic changes that may influence waveform integrity.

4.10. Communication Protocols: The Contractor Technologist will establish communication protocols with the surgical team and remote Contractor Neurologist to report monitoring activity. The neuromonitoring team shall provide all resources required to ensure seamless integration with surgical workflows.

4.11. Technologist Responsibilities: The Contractor Technologist shall work under the direction of the VA OR Surgeon and perform multiple‑modality intraoperative neurophysiologic monitoring at VASTLHCS. Responsibilities include setting up all required equipment and supplies; accurately placing recording and stimulating electrodes at predetermined positions; testing equipment prior to use and making necessary adjustments; selecting appropriate electrode combinations (including non‑standard assortments as needed); obtaining standard recordings; and continuously reporting the patient’s nervous system status to the surgeon during the procedure. The Technologist shall recognize artifacts, differentiate them from true evoked potential patterns, and take corrective steps to eliminate them; obtain patient medical information when requested; and translate computer‑generated test results into hard‑copy reports for Neurologist interpretation. Data shall be transmitted for remote interpretation using secure, HIPAA‑compliant methods consistent with HITECH, VA Handbook 6500.6, and FIPS 140‑2 encryption requirements. Post‑procedure duties include removing electrodes and returning equipment to specified VASTLHCS locations or removing contractor‑supplied equipment from the operating room upon completion. Technologists performing services shall meet ABRET/CNIM certification and VA credentialing requirements as referenced in Section 2.1.3.