36C26118Q0019-008.docx

36C26118Q0019

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.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

654-18-3-070-0011 36C26118Q0019 12-7-2017 Nandini Johnson 916-923-4575 1-05-2018 12:00

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609 X 621111 $27.5 Million X N/A X Department of Veterans Affairs VA Sierra Nevada Health Care System 975 Kirman Ave Reno NV 89502

612MCP

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 3230 Peacekeeper Way, Bldg. 209 McClellan CA 95652-1012

Department of Veterans Affairs FMS VA-9(101) Financial Services Center PO Box 149971 Austin TX 78714-9971 Contractor shall provide On-Site Cardiac Electrophysiology Physician Services for the VA Sierra Nevada Health Care System in accordance with the Performance Work Statement contained herein.

Reference Price/Cost Schedule Please carefully read FAR 52.212-1 Instructions to Offerors and VAAR 852.273-73 Evaluation – Health-Care Resources in order to respond to this RFQ. Failure to do so may eliminate your response from being considered for award.

X X Nandini Johnson Contracting Officer

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261 Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Northern California HealthCare System 5342 Dudley Blvd, Bldg 209 McClellan CA 95652-2609

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

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly in arrears

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests. Invoices shall be in accordance with the requirements of The Department of Veterans Affairs (VA) Financial Services Center (VAFSC). The latest information shall be used for invoicing and payments and may be changed during the Period of Performance of this acquisition. Current invoicing information is located at https://www.fsc.va.gov/einvoice.asp Vendor e-Invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

· Tungsten e-Invoice Setup Information: 1-877-489-6135

· Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

· FSC e-Invoice Contact Information: 1-877-353-9791

· FSC e-invoice email: vafsccshd@va.gov

B.2 NOTIFICATION TO OFFERORS

1. Authority: Cardiac Electrophysiology Physician Services are being procured in accordance with FAR Part 13.

2. Offerors MUST complete and return all information designated in the enclosed Federal Acquisition Regulation (FAR) clause 52.212-1, Instructions to Offerors – Commercial Items, paragraph b, prior to the time specified in block 8 of SF1449 in order to be considered for award. Offerors should also reference enclosed amendment to FAR 52.212-1 and VAAR Provision 852.273-73 Evaluation - Health-Care Resources, for further information of requirements for the submission of proposals. Failure to do so may preclude the Offeror from further consideration.

3. Offerors should thoroughly review the specifications and be familiar with the requirements of the solicitation prior to submitting proposals in order to be fully aware of the scope of services required. Failure to do so will not relieve the successful Offeror from performing in accordance with the strict intent and meaning of the specifications without additional cost to the Government.

4. TECHNICAL INQUIRES: Direct all technical inquiries via email to the Administrative Contracting Officer, Nandini Johnson, at Nandini.johnson@va.gov not later than December 28, 2017.

5. DUNS NUMBER: Provide the Dun and Bradstreet Number assigned to your firm in the space provided below: (refer to Provision 52.212-1, Instructions to Offerors – Commercial Items):

6. The Government may use two separate and individual online databases for proposal evaluations:

a. The Federal Awardee Performance and Integrity Information System (FAPIIS) found at https://fapiis.ppirs.gov/ , a subcomponent of the Contractor Performance Assessment Reporting System (CPARS) found at https://www.cpars.gov/. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (DVA) evaluates Contractor past performance on all contracts that exceed $100,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the Contractor is provided an opportunity to comment on past performance evaluations prior to each report closing. The CPARS database, which is available to all Federal agencies, is used to capture this information. Further, your registered representative data, as well as any other information in your registration data, must be kept current. Performance evaluations entered into CPARS by the Contracting Officer will be assigned to the Contractor’s registered representative for comment. Failure to comment and reassign the report back to the Contracting Officer, or to maintain current registration, will result in the Government’s evaluation being entered in the database with a statement that you have failed to respond.

b. The System for Award Management (SAM) for the provision of basic information relative to contract awards found at https://www.sam.gov/ . After initial registration, the Contractor is required to update registration data as changes occur and must re-register annually to ensure all data remains current. Noncompliance with this requirement will preclude the exercising of any option periods that may be included herein and will be cause for termination of the contract at such time noncompliance is discovered. Refer to FAR Clause 52.212-4, para (t) for more details.

c. IT IS IMPERATIVE THAT ALL OFFERORS COMPLETE THESE REGISTRATIONS IN ORDER TO BE CONSIDERED FOR CONTRACT AWARD. Award cannot be made to a Contractor without current registration in each of these database systems.

d. PAYMENT: Upon award, the successful Offeror will be required to establish payment by electronic funds transfer (EFT). For implementing EFT payments, please contact your financial institution for assistance in completion of the Payment Information Form – SF 3881 and submit to the VA Finance Center in Austin, Texas. SF 3881 is NOT to be returned with the proposal. It must be submitted by the SUCCESSFUL Offeror directly to the VA Finance Center in Austin, Texas.

B.3 SUBCONTRACTING COMMITMENTS--MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors, and VAAR 852.215-71, Evaluation Factor Commitments. Accordingly, any contract resulting from this solicitation will include these clauses. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) to assist in assessing contractor compliance with the subcontracting commitments incorporated into the contract. To that end, the support contractor(s) may require access to the contractor's business records or other proprietary data to review such business records regarding contract compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor compliance with the subcontracting commitments.

B.4 SCHEDULE OF SERVICES

Contractor shall furnish all personnel to provide services necessary to perform onsite Electrophysiology Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Reno, Nevada (hereinafter referred to as VAMC). The Contractor’s physician(s) care shall cover the range of Electrophysiology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by The American College of Cardiology (ACC): http://www.cardiosource.org/Science-And-Quality/Practice-Guidelines-and-Quality-Standards.aspx .

Place of Performance: Services shall be provided on site, VAMC 975 Kirman Ave, Reno, NV 89502.

Pricing Instructions: The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the contract line item number (CLIN).

The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments.

The Contractor shall propose a minimum of ONE key personnel to be credentialed and be available for scheduling to meet the requirements of the contract.

Period of Performance: BASE YEAR: April 01, 2018_ to March 31, 2019

Annual Cost

KEY PERSONNEL

NAME:___________

TITLE/LEVEL OF EXPERIENCE:___________

(One 8 hr shift per week: 8 hrs x 52 weeks = 416 hrs)

TOTAL FOR BASE

OPTION YEAR 1: April 01, 2019_ to March 31, 2020

Annual Cost

NAME:____________

TITLE/LEVEL OF EXPERIENCE:____________

(One 8 hr shift per week: 8 hrs x 52 weeks = 416 hrs)

TOTAL FOR OPTION YEAR 1

OPTION YEAR 2: April 01, 2020_ to March 31, 2021

Annual Cost

NAME:____________

TITLE/LEVEL OF EXPERIENCE:____________

(One 8 hr shift per week: 8 hrs x 52 weeks = 416 hrs)

TOTAL FOR OPTION YEAR 2

OPTION YEAR 3: April 01, 2021_ to March 31, 2022

Annual Cost

NAME:____________

TITLE/LEVEL OF EXPERIENCE:____________

(One 8 hr shift per week: 8 hrs x 52 weeks = 416 hrs)

TOTAL FOR OPTION YEAR 3

OPTION YEAR 4: April 01, 2022_ to March 31, 2023

Annual Cost

Cardiac Electrophysiologist Physician Services

NAME:____________

TITLE/LEVEL OF EXPERIENCE:____________

(One 8 hr shift per week: 8 hrs x 52 weeks = 416 hrs)

TOTAL FOR OPTION YEAR 4

Total for base performance period and all option years: $_________________________

PERFORMANCE WORK STATEMENT

FOR

ELECTROPHYSIOLOGY INPATIENT AND OUTPATIENT SERVICES

1. GENERAL:

0. Services Provided: The Contractor shall provide Board Certified /Board Eligible Physician Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the VA Sierra Nevada Health Care System.

0. Place of Performance: Contractor shall furnish services at the VASNHCS 975 Kirman Ave, Reno, NV 89502.

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

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

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

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

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

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

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

3. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791

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

0. 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.

4. ACGME: Accreditation Council for Graduate Medical Education

4. AICD: Automated Implantable Cardiac Defibrillators

4. CDC: Centers for Disease Control and Prevention

4. CEU: Certified Education Unit

4. CME: Continuing Medical Education

4. 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.

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

4. COS: Chief of Staff

4. CPARS: Contractor Performance Assessment Reporting System

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

4. 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.

4. DEA: Drug Enforcement Agency

4. EP: Electrophysiology

4. FSMB: Federation of State Medical Boards

4. HHS: Department of Health and Human Services

4. HIPAA: Health Insurance Portability and Accountability Act

4. ISO: Information Security Officer

4. POP: Period of Performance

4. PPD: Purified Protein Derivative

4. PWS: Performance Work Statement

4. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for 8independent 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.

4. QA/QI: Quality Assurance/Quality Improvement

4. QM/PI: Quality Management/Performance Improvement

4. QASP: Quality Assurance Surveillance Plan

4. 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).

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

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

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

4. VETPro: a federal web-based credentialing program for healthcare providers.

4. 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 Sierra Nevada Health Care Systems Medical Center.

1. QUALIFICATIONS:

1. Staff/Facility

0. License: The Contractor’s 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) when services are performed onsite on VA property.

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

0. Board Certification: All Contractor’s physician(s) shall be Board Certified /Board Eligible by the American Board of Internal Medicine in Clinical Cardiac Electrophysiology http://www.abim.org/ , and be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency. 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.

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

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

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

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

0. Training (ACLS, BLS 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.

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

6. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all Contractor’s physician(s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

6. RUBELLA TESTING: Contractor shall provide proof of immunization for all contract physicians (s) for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all Contractor’s physician(s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf ) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

0. 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.

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

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

0. Citizenship related Requirements:

10. 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;

10. 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.

10. 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.

10. 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.

10. 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.

1.0.11. 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.

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

11. 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.

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

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

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

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

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

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

6. Workers’ compensation

6. Professional liability insurance

6. Health examinations

6. Income tax withholding, and

6. Social security payments.

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

1. Key Personnel:

8. The VA Full Time Equivalency (FTE) for the services required is .20 FTE. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

8. The minimum number of Board Certified /Board Eligible Cardiac Electrophysiology Physicians required to be on site on a daily basis is 1 as defined in paragraph Hours of Operation in this section.

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

8. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions.

3. 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.

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

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

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

1. HOURS OF OPERATION

2. VA Business Hours: Monday through Friday 08:00 am - 4:30 pm Clinic or OR Schedule: Procedures to be completed Thursday mornings and regularly scheduled new and follow-up clinics on Thursdays from 1:00 pm – 4:30 pm, excluding holidays or other designated days off.

Patients must be seen by a Contractor’s physician(s) on-site at VASNHCS 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.

0. Contractor’s physician(s) shall be available and present in clinic during normal VASNHCS clinic hours, VASNHCS which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are Thursdays, 1:00 pm – 4:30pm.

0. Off-hours Coverage: Contractor must make the Contractor’s physician(s) available on-call during all hours when the VASNHCS clinic is closed, including evenings, weekends and holidays.

1. On-call contractor’s physician(s) must be available at all times for phone consultations with VA residents and physicians.

1. Patients must be seen within 30 minutes of the page when medically indicated.

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

1. New Year’s Day

1. President’s Day

1. Martin Luther King’s Birthday

1. Memorial Day

1. Independence Day

1. Labor Day

1. Columbus Day

1. Veterans Day

1. Thanksgiving

1. Christmas

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

1. Cancellations: Any procedure or clinic cancellations shall be completed at a minimum of 90 days in advance of the requested cancellation date and any patients scheduled shall be seen prior to the date of cancellation whenever possible.

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

1. CONTRACTOR RESPONSIBILITIES

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

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

3. Standards of Care: The Contractor’s physician(s)’ care shall cover the range of Cardiac Electrophysiology 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:

1. The American College of Internal Medicine (ABIM): https://www.abim.org/~/media/ABIM%20Public/Files/pdf/publications/certification-guides/policies-and-procedures.pdf .

1. The American College of Cardiology (ACC): http://www.acc.org/guidelines#doctype=Guidelines

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

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

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

1. The requirements contained in this PWS

3. MEDICAL RECORDS

2. Authorities: Contractor’s physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

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. Treatment and administrative patient 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’ (24VA19). 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 are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

2. Disclosure: Contractor’s physician(s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 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.

2. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791 and all guidelines provided by the VAMC.

2. 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. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual’s Records, to process “Release of Information Requests.” In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA’s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient’s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address:

Robert T. Smith 975 Kirman Avenue Reno, NV 89502 Phone: (775) 328-1245 Email: Robert.Smith36@va.gov

3. Direct Patient Care: 90% of the time involved in direct patient care. Contractor shall be responsible for all clinical documentation in patient medical records.

3. Scope of Care: The Contractor shall provide Board Certified or Board eligible staff in Internal Medicine and the subspecialty of cardiovascular disease and fellowship trained in cardiac electrophysiology to the VASNHCS, Reno, Nevada. Services include a full range of electrophysiology services for both inpatient and outpatient care. Contractor shall provide comprehensive cardiac electrophysiology consultative care for our veteran population including evaluation and treatment of patients for potential arrhythmias, disorders of the cardiac conduction system, syncope, evaluation of patients for permanent cardiac pacemaker placement or revision, and need for, implantation and monitoring of automated implantable cardiac defibrillators (AICD). Assignments can be changed based on the needs of Medical Service and/or at the discretion of the Service Chief.

3. Clinic Responsibilities: Contractor’s physician(s) shall be present and on time for scheduled procedures and clinic start times as documented by physical…