36C26124Q0255 - Nephrology.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

36C26124Q0255 06-07-2024

Cynthia Diezel Contract Specialist 916-923-4567 07-09-2024

10:00 PDT

612MCP

Department of Veterans Affairs

Network Contracting Office (NCO) 21 3237 Peacekeeper Way, Bldg 200 Suite 204 McClellan Park CA 95652

X 100

X

621111

$16 Million

N/A

VA Sierra Nevada HealthCare System 815 Kirman Ave

Reno NV 89402

612MCP

Department of Veterans Affairs

Network Contracting Office (NCO) 21 3237 Peacekeeper Way, Bldg 200 Suite 204 McClellan CA 95652

Department of Veterans Affairs FMS VA-9(101) Financial Services Center

PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

Contractor shall provide a minimum of (2) Board Certified/ Board Eligible Nephrology Physicians and a minimum of (4) Advance Practice Provider to provide services in accordance with the Performance Work Statement.

Services to be completed at Sierra Nevada Healthcare System located at 975 Kirman Ave Reno, NV 89502

See Schedule at pages 6-10 See PWS at pages 11-31

Questions regarding this RFQ are due 06/18/2024 by 10:00 am PST by email to cynthia.diezel@va.gov

See CONTINUATION Page

X 1

Cynthia Diezel Contracting Officer

36C26124Q0255

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 SCHEDULE OF SERVICES

B.3 Performance Work Statement

B.1 IT CONTRACT SECURITY (Excerpt from VA Handbook 6500.6) EXCERPT

SECTION C - CONTRACT CLAUSES

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

AND COMMERCIAL SERVICES (NOV 2023)

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

C.3 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY (FEB

2023)

C.4 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (NOV 2021)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.7 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.8 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.9 VAAR 852.211-76 LIQUIDATED DAMAGES - REIMBURSEMENT FOR DATA

BREACH COSTS (FEB 2023)

C.10 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (OCT 2019)

C.11 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

C.12 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (NOV 2022) .. 61

C.13 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.14 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.15 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE (OCT

2019)

C.16 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019) .. 66

C.17 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.18 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.19 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.20 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (DEC 2023) (DEVIATION) (JAN 2024)

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)

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

SERVICES (NOV 2021)

E.3 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.4 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.6 52.216-1 TYPE OF CONTRACT (APR 1984)

E.7 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.8 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.9 VAAR 852.252-70 SOLICITATION PROVISIONS OR CLAUSES INCORPORATED BY

REFERENCE (JAN 2008)

E.10 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.11 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.12 VAAR 852.273-70 LATE OFFERS (NOV 2021)

E.13 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (NOV 2021)

E.14 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (NOV 2023)

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 36C261

Network Contracting Office (NCO) 21 5342 Dudley Blvd., Bldg. 209

c. ADMINISTRATION: Contract Specialist 36C261

Network Contracting Office (NCO) 21 5342 Dudley Blvd., Bldg. 209

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 in arrears

4. GOVERNMENT INVOICE ADDRESS: Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/ Tungsten direct vendor support number is 877- 489-6135 for VA contracts. The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA- FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. In order to successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your

Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support Phone: 1-877-489-6135

Website: http://www.tungsten-network.com/uk/en/ Department of Veterans Affairs Financial Service Center

Phone: 1-877-353-9791 Email: vafscched@va.gov

5. Post Award Conference Procedures The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by VA Acquisition Manual, Part M842.503-2.

6. Secure Fax – Please review VA Handbook 6500 that requires the following statement on all fax cover sheets be included:

This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above.

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

AMENDMENT NO DATE

B.2 SCHEDULE OF SERVICES

The Contractor shall furnish all key personnel to provide services necessary to perform onsite Nephrology Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center. The Contractor’s physician(s) and Advance Practice Provider (s) care shall cover the range of Nephrology 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 exceedingly currently recognized national standards. Care shall be compliant with all related VHA kidney health policies, including VHA Directive 1042.01: Veteran Dialysis Care and VHA Directive 1053: Chronic Kidney Disease Prevention, Early Recognition, and Management.

Care shall be generally consistent with published clinical practice guidelines including the VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease, those published by Kidney Disease:

Improving Global Outcomes (KDIGO: https://www.KDIGO.org) and by the National Kidney Foundation- Kidney Disease Outcomes Quality Initiative (NKF-KDIGO; https://www.kidney.org/professionals/ guidelines).

Place of Performance: Services shall be provided on site, VA Sierra Nevada Health Care System, 975 Kirman Avenue, Reno, NV 89502-0993

Pricing Instructions: The offeror is instructed to edit the number of sub-line-item number (SLIN) to correspond with the number of key personnel submitted for the line-item number (LIN). Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SLINs if adding or removing Key Personnel.

The Contractor shall propose a minimum of four (4) key personnel to be Board Certified/Board Eligible credentialed and be available for scheduling to meet the requirements of the contract.

The Contractor shall propose a minimum of two (2) key personnel to be credentialed and be available for scheduling to meet the requirements of the contract.

Period of Performance: BASE YEAR: November 1, 2024, to October 31, 2025

LIN SLIN Description Qty. Unit Unit Cost Total

Annual Cost

0001 None Board Certified /Board Eligible Nephrology Physician Services (1.5

FTE)

KEY PERSONNEL

None 0001a Board Certified /Board Eligible Nephrology Physician Services (1.5

FTE)

2000 Hours

None 0001b Night On-Call (over a 52- week period) 3730 Hours

None 0001c Weekend On-Call (over a 52-week period)

2496 Hours

None 0001d Holidays On-Call (over a 52-week period)

240 Hours

OPTION YEAR 1: November 1, 2025, to October 31, 2026

LIN

No.

SLIN Description Qty. Unit Unit Cost Total

Annual Cost

1001 None Board Certified /Board Eligible

None 1001a Board Certified /Board Eligible Physician(s)

2000 Hours

None 1001b Night On-Call (over a 52-week period) 3730 Hours

None 1001c Weekend On-Call (over a 52-week period)

2496 Hours

None 1001d Holidays On-Call (over a 52-week period)

240 Hours

TOTAL FOR Option Year 1 Hours

TOTAL FOR BASE Hours

Clin No.

Sub- Clin

Description Qty. Unit Unit Cost Total

Annual Cost

0002 None Advance Practice Provider (0.5 FTE) 1000 Hour

TOTAL FOR CLIN 0002

GRAND TOTAL FOR BASE YEAR

Clin No.

Sub- Clin

Description Qty. Unit Unit Cost Total

Annual Cost

1002 None Advance Practice Provider (0.5 FTE) 1000 Hour

TOTAL FOR CLIN 1002

GRAND TOTAL FOR OPTION YEAR ONE

OPTION YEAR 2: November 1, 2026, to October 31, 2027

LIN

No.

SLIN Description Qty. Unit Unit Cost Total

Annual Cost

2001 None Board Certified /Board Eligible

None 2001a Board Certified /Board Eligible Physician(s)

2000 Hour

None 2001b Night On-Call (over a 52-week period) 3730 Hour

None 2001c Weekend On-Call (over a 52-week period)

2496 Hour

None 2001d Holidays On-Call (over a 52-week period)

240 Hour

TOTAL FOR CLIN 2001 Hours

OPTION YEAR 3: November 1, 2027, to October 31, 2028

LIN

No.

SLIN Description Qty. Unit Unit Cost Total

Annual Cost

3001 None Board Certified /Board Eligible

None 3001a Board Certified /Board Eligible Physician(s)

2000 Hour

None 3001b Night On-Call (over a 52-week period) 3730 Hour

Clin No.

Sub- Clin

Description Qty. Unit Unit Cost Total

Annual Cost

2002 None Advance Practice Provider (0.5 FTE) 1000 Hour

TOTAL FOR CLIN 2002

GRAND TOTAL FOR OPTION YEAR TWO

None 3001c Weekend On-Call (over a 52-week period)

2496 Hour

None 3001d Holidays On-Call (over a 52-week period)

240 hour

TOTAL FOR CLIN 3001 Hours

OPTION YEAR 4: November 1, 2028, to October 31, 2029

LIN

No.

SLIN Description Qty. Unit Unit Cost Total

Annual Cost

4001 None Board Certified /Board Eligible

None 4001a Board Certified /Board Eligible Physician(s)

2000 Hour

None 4001b Night On-Call (over a 52-week period) 3730 Hour

None 4001c Weekend On-Call (over a 52-week period)

2496 Hour

None 4001d Holidays On-Call (over a 52-week period)

240 hour

TOTAL FOR CLIN 4001 Hours

Clin No.

Sub- Clin

Description Qty. Unit Unit Cost Total

Annual Cost

3002 None Advance Practice Provider (0.5 FTE) 1000 Hour

TOTAL FOR CLIN 3002

GRAND TOTAL FOR OPTION YEAR THREE

Clin No.

Sub- Clin

Description Qty. Unit Unit Cost Total

Annual Cost

4002 None Advance Practice Provider (0.5 FTE) 1000 Hour

TOTAL FOR CLIN 4002

BASE YEAR:

OPTION YEAR ONE:

OPTION YEAR TWO:

OPTION YEAR THREE:

OPTION YEAR FOUR:

Total for base performance period and all option years:

GRAND TOTAL FOR OPTION YEAR FOUR

B.3 Performance Work Statement

Onsite Nephrology Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Multiple Board Certified /Board Eligible Nephrology Physicians and multiple certified, licensed physician extenders (i.e., advanced practice registered nurses or physician assistants) on site in accordance with the specifications contained herein. Nephrology services include the full range of nephrology care for inpatient and outpatient VA Beneficiaries, including consultation, diagnosis, therapy and treatment, prognosis, and dialysis treatment of kidney disease patients of the Department of Veterans Affairs (VA) and the VA Sierra Nevada Health Care system (VASNHCS).

As Physician’s Physician Assistants are required to be monitored on FPPE/OPPE. The supervising Nephrology Physician will also sign off on Physician Assistant notes, and medications/labs ordered. APPs are brought in with a minimum of 6 months of experience therefore do not require oversight as trainees but, if trainees are brought on board, the supervising Physician will sign off on all notes, and orders.

The contractor nephrologist providers workload will include a minimum of eight half day physician telemedicine clinic if Veteran requests (performed on-site at VASNHCS); inpatient consultation and rounding; weekend rounding as needed per month; on call coverage 24-hours/day, 365-day/year. The contractor APP’s providers workload will include telemedicine clinic if Veteran requests (performed on-site at VASNHCS); inpatient consultation and rounding.

Clinic days include Monday through Thursday one (1) physician and one (1) Advance Practice Provider (APP) 0800-1700. Friday’s will require one (1) Physician 0800-1700. The Contractor will provide the following hours annually:

1.1.1 Normal hours: 3000 hours (2000 physicians and 1000 APP’s).

1.1.2 Physicians Night On-call hours: 3920 hours (over a 52- week period)

1.1.3 Physicians Weekend On-call hours: 2496 (over a 52-week period)

1.1.4 Physicians Holiday On-call hours: 240 hours (over a 52-week period)

1.2. Place of Performance: Contractor shall furnish services at the Sierra Nevada Healthcare System located at 975 Kirman Avenue, Reno, NV 89502-0993.

1.3. Authority: FAR Part 13.5, Simplified Procedures for Certain Commercial Products and Services Title 38 USC 8153, Health Care Resources (HCR) sharing Authority

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

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

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy

1.4.3. VHA Directive 1053: Chronic Kidney Disease Prevention, Early Recognition, and Management

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

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

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

1.4.7. VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.8. VHA Directive 1100.21: Privileging

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

1.4.10. VHA Directive 1605.01: Privacy and Release of Information

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

1.4.12. VHA VA Directive 1042.01 Veteran Dialysis Care

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

1.4.14. Privacy Act of 1974 (5 U.S.C. 552a) as amended:

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.4.15. VA/DoD Clinical Practice Guidelines for the Management of Chronic Kidney disease

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

1.5.1. ACGME: Accreditation Council for Graduate Medical Education

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. AOD: Admitting Officer of the Day

1.5.4. BLS: Basic Life Support

1.5.5. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.5.6. CDC: Centers for Disease Control and Prevention

1.5.7. CDR: Contract Discrepancy Report

1.5.8. CEU: Certified Education Unit

1.5.9. CME: Continuing Medical Education

1.5.10. CMS: Centers for Medicare and Medicaid Services

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

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

1.5.13. COS: Chief of Staff

1.5.14. CPARS: Contractor Performance Assessment Reporting System

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

1.5.16. DEA: Drug Enforcement Agency

1.5.17. ED: Emergency Department

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

1.5.19. FSMB: Federation of State Medical Boards

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

1.5.21. HHS: Department of Health and Human Services

1.5.22. HIPAA: Health Insurance Portability and Accountability Act

1.5.23. HR: Human Resources

1.5.24. ISO: Information Security Officer

1.5.25. 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.

1.5.26. MOD: Medical Officer of the Day

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

1.5.28. NKF – National Kidney Foundation

1.5.29. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

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

1.5.31. NP: Nurse Practitioner

1.5.32. NPPES: National Plan and Provider Enumeration System

1.5.33. OPPE/FPPE- Ongoing professional practice evaluation/ Focused professional practice evaluation

1.5.34. PA: Physician Assistant

1.5.35. PALS: Pediatric Advanced Life Support

1.5.36. POP: Period of Performance

1.5.37. PPD: Purified Protein Derivative

1.5.38. PWS: Performance Work Statement

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

1.5.40. QA/QI: Quality Assurance/Quality Improvement

1.5.41. QM/PI: Quality Management/Performance Improvement

1.5.42. QASP: Quality Assurance Surveillance Plan

1.5.43. VHA: Veterans’ Health Administration

1.5.44. VISN: Veterans Integrated Services Network

1.5.45. VistA Veterans Information Systems Technology Architecture

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

2. QUALIFICATIONS:

2.1. Staff/Facility

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

2.1.2. Board Certification: All contract Nephrology provider(s) shall be Board Certified /Board Eligible physicians by either the American Board of Internal Medicine in Nephrology http://www.abim.org/specialty/nephrology.aspx , or the American Osteopathic Board of Internal Medicine https://certification.osteopathic.org/internal-medicine/ . They must also be currently certified in either Basic Life Support (BLS) OR Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must always be kept up to date . Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor’s physician(s) prior to obtaining approval by the Facility Medical Executive Board and Medical Center Director.

2.1.3.1. If a Contractor’s physician(s) and/or other contract provider(s) are 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.

2.1.4. 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’s physicians shall have knowledge of professional care theories, principles, practices, and procedures to perform assignments of Nephrology patient/critically ill patient population. Contractor’s physician shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific to the critical care/nephrology population Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for 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.

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

Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. 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 credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

2.1.6. Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training (The following training is mandatory per VHACO for Contracted Physicians)

Frequency (once a year, etc.)

Annual Hours

ACLS/BLS Quarterly and on-site demonstration of ability to perform basic or advanced life support using VA’s technology-enabled manikins

1.0

VA Privacy and Information Security Awareness and Rules of Behavior

Annually 1.0

VHA Privacy and HIPAA Focused Training

Annually 1.0

Military Sexual Trauma for Medical providers

Annually 1.0

PACT Act 2022 Toxic Exposure Screening

Annually 1.0

Patient Abuse and Patient Right

Annually 1.0

Active Threat Training Annually 1.0

Blood Administration:

Complications

Annually 1.0

Blood Administration:

Administration (all contract employees who administer blood components)

Annually 1.0

Government Ethics Annually 1.0

Hospice and Palliative Care for VA Clinicians

Annually 1.0

Military Sexual Trauma (MST) for Medical Providers

Annually 1.0

Prevention of Workplace Harassment/No Fear Act

Annually 1.0

VHA MRI Safety Training Level 1 Training (all who enter MRI suites)

Annually 1.0

VA Core Values Training (ICARE Recommitment)

Annually 1.0

VA Privacy and Information Security Awareness and Rules of Behavior

Annually 1.0

VHA Privacy and HIPAA Focused Training

Annually 1.0

Patient Safety Annually 1.0

Patient Rights Annually 1.0

Patient Abuse Annually 1.0

Prevention/Management of Disruptive Behavior/Violence Prevention Level I

Annually 1.0

Suicide Prevention: Suicide Risk Management Training for Clinicians

Annually 1.0

SUX Infection Control and Blood Borne Pathogens

Annually 1.0

HER Annually 1.0

VISTA Imaging Annually 1.0

2.1.7. STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.):

Contractor shall provide proof of the following for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer.

Tests shall be current within the past year.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician(s) upon hire in accordance with CDC guidance. (This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.

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

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

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

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

2.1.7.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician(s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.7.7. The facility shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

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

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

2.1.10. 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 and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.11. Citizenship related Requirements:

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

2.1.11.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States.

Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

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

2.1.11.4. 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.

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

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

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

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

2.2. Clinical/Professional 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 Directive 1100.20 and VHA Directive 1100.21.

Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility COS and/or the Chief of the Service or his designee. The national OPPE/FPPE nephrology performance form shall be used to evaluate each contracted physician’s performance on a recurring basis. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

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

2.4. 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.

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

2.6. 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.

2.7. 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:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract provider(s).

When a Contractor or contract provider (s)has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The VA Full Time Equivalency (FTE) for the services required is 1.5 FTE.

2.9.2. The minimum number of Board Certified /Board Eligible Nephrology providers required to be on site daily is 1.0 FTE, Monday thru Friday as defined in paragraph Hour of Operations in the section.

2.9.3. The minimum number of Physician Extenders required to be on site daily is 0.5 FTE, on Friday as defined in paragraph Hour of Operations in the section.

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

2.9.5. 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.

2.9.5.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 30 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.

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

2.9.5.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility.

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

2.9.5.4. Contingency Plan: Because continuity of care is an essential part of the Facility’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.

3. VA HOURS OF OPERATION/SCHEDULING

3.1. VA Business Hours: The clinic operations of the Nephrology Section, Medical Service is Monday through Friday from 8:00am to 4:30pm. The VASNHCS Medical Specialty Clinic closed on all Federal Holidays.

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

3.1.2. Contractor’s physician(s) shall be available and present in clinic during normal facility clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are 8:00am to 4:30pm excluding weekends and Federal Holidays.

3.1.3. Physicians Off-hours Coverage: On-call coverage is required. The on-call schedule is on 24-hour/7 days a week basis, consisting of 16 hours per 24-hour day. Monday through Friday and 24 hours per day on weekends (Saturdays and Sundays) and all Federal holidays. When the Contractors provider is on-call, they shall remain with a thirty-minute arrival time to VASNHCS. All calls shall be responded to within fifteen minutes. On-call volume is estimated to be three to five calls per month and will be from the Administrator of the Day (AOD) at the VASNHCS.

3.1.3.1. On-call Contractor’s physician(s) must always be available for phone consultations with VA residents and physicians.

3.1.3.2. On-call providers must be available within 15 minutes by phone and on-site within 60 minutes.

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 to be a national holiday.

3.3. Cancellations

Referral to Community Care

4. CONTRACTOR RESPONSIBILITIES

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

4.1.1. 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.

4.2. Standards of Care:

The Contractor’s physician(s)’ care shall cover the range of Nephrology services as would be provided in a state-of-the-art civilian medical treatment facility and shall be of a quality that meets or exceeds community standards. All procedures, inpatient admissions, and consults shall be the responsibility of the attending contract Nephrology physician and the APP. Care shall be compliant with all related VHA kidney health policies, recognized TJC standards, and generally consistent with guidance available at :

4.2.1. The professional standards of the Joint Commission (TJC):

http://www.jointcommission.org/standards_information/standards.aspx

4.2.2. The standards of the American Hospital Association (AHA):

http://www.hpoe.org/resources?show=100&type=8

4.2.3. The National Kidney Foundation

(https://www.kidney.org/professionals/guidelines/guidelines_commentaries) ;

4.2.4. VA Directive 1042.01 Veteran Dialysis Care

4.2.5. VA Directive 1053 Prevention, Early Recognition and Management of Chronic Kidney Disease

4.2.6. VA/DoD Clinical Practice Guidelines for the Management of Chronic Kidney Disease

4.2.7. Kidney Disease: Improving Global Outcomes (KDIGO: https://www.KDIGO.org

4.2.8. National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDIGO;

https://www.kidney.org/professionals/ guidelines).

4.2.9. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractor’s physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C.

552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment of VA patients. Based on this exception, a BAA is not required for this contract. Health records generated by this contract or provided to the Contractors by the VA are covered by the VA Privacy Act system of records entitled ‘Patient Medical Records-VA’ (24VA10A7). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.4.4. 4.4.3.

4.3.3. Disclosure: Contractor’s physician(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract;…