47QFWA22R0008 Solicitation Sections B-J 12.29.2021.pdf

DoDMERB

47QFWA22R0008

General Services Administration Federal Acquisition Service (FAS)

Greater Southwest Region

Department of Defense Medical Examination Review

Board (DoDMERB) Medical Services Contract

Solicitation 47QFWA22R0008

December 29, 2021

TABLE OF CONTENTS

Section Title Page

PART I – THE SCHEDULE

A SECTION A: SOLICITATION/CONTRACT FORM 3

B SECTION B: SUPPLIES OR SERVICES AND PRICES/COSTS 4

C SECTION C: DESCRIPTION / SPECIFICATIONS/

STATEMENT OF WORK

D SECTION D: PACKAGING AND MARKING 23

E SECTION E: INSPECTION AND ACCEPTANCE 24

F SECTION F: DELIVERIES OR PERFORMANCE 25

G SECTION G: CONTRACT ADMINISTRATION DATA 40

H SECTION H: SPECIAL CONTRACT REQUIREMENTS 44

PART II – CONTRACT CLAUSES

I SECTION I: CONTRACT CLAUSES 48

PART III – LIST OF DOCUMENTS, EXHIBITS, AND OTHER

ATTACHMENTS

J SECTION J: LIST OF ATTACHMENTS 57

Sections marked “RESERVED” contain no data.

PART I – THE SCHEDULE

– SECTION A –

SOLICITATION/CONTRACT FORM

– SECTION B –

SUPPLIES OR SERVICES AND PRICES/COSTS

B. 1 In an effort to receive the highest quality solution at the lowest possible price, the Government requests all available discounts on all services offered by the Contractor for this requirement.

B.2 The Contractor will provide prompt payment terms in their proposal.

B.3 The Contractor will provide pricing details for each period of performance, i.e., unit price per Contract Line Item Number (CLIN), total for each CLIN and a total for each performance period. The Contractor will also provide a summary of the total of all performance periods for a base plus options total.

B.4 This is a non-personal health care services contract under which the Contractor is an independent contractor. The Government may evaluate the quality of professional and administrative services provided, but retains no control over the medical, professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment). This commercial, performance based, Firm Fixed Unit Price (FFUP) contract is issued in accordance with Federal Acquisition Regulation (FAR) Parts 12 (Acquisition of Commercial Items), 15 (Contracting by Negotiation) and 37 (Service Contracting).

B.5 Contractors must use the tables in Appendix M when submitting their price proposals. The pricing tables in Appendix M represent the reasonable total estimated quantities; the CPT Codes listed in Appendix M are not an inclusive list, but rather a sample of the most commonly requested examinations.

This estimate is not a representation that the estimated quantity will be required or ordered, or that conditions affecting requirements will be stable or normal. The Contractor shall only invoice for actual services rendered. The Government is NOT obligated to fully expend all dollars/buy all quantities listed on this contract, and the Government reserves the right to require additional services at the Firm Fixed Price (FFP) awarded rates (for each line item) based on demand increases. This contract will be to provide on demand services, which will fluctuate based on the Government’s need. AT NO TIME shall the Contractor be authorized to provide services in excess of the funded amount of this contract.

B.6 OTHER DIRECT COSTS (ODCS): There are no ODCs anticipated for this contract.

B.7 TRAVEL: Travel is not anticipated for this contract.

– SECTION C –

DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C.1 BACKGROUND

The mission of DoDMERB involves the medical evaluation of applicants to various Department of Defense (DoD) accession and DoD commissioning programs. Contracting services are required to provide a subcontracted network of medical providers and connectivity between DoDMERB, Applicants, the Prime Contractor and the various Medical Network Providers.

The Initial Medical Examinations (IME) and the Additional Medical Services (AMS) accomplished under the provisions of this contract are for the purpose of certifying civilian and military individuals who have applied for appointments to any of the five Service Academies, or applications to the Reserve Officers Training Corps (ROTC) Programs, or the Uniformed Services University of Health Sciences (USUHS) and other programs, as required. The information gained through this medical examination shall be utilized by DoDMERB, military and contracted services medical officials to determine applicants’ qualification status.

C.2 SCOPE

The objective of this contract is to provide a network of Medical Providers and Optometric Providers within the U.S. and U.S. territories to complete an IME and to complete or gather AMS. Medical evaluations are divided into IMEs and AMS. An IME consists of an optometric examination, hands-on medical examination, an audiometric screening, and potentially laboratory tests. A request for AMS represents information (consults and/or tests) that may be needed in addition to the information that was gathered during the IME. Not every IME will require AMS, as many applicants are healthy enough to receive a determination without AMS. AMS requirements will be determined by DoDMERB after review of the IME.

The IME is to be completed and electronically signed by a licensed independent practitioner (LIP) such as a Medical Doctor (MD), Doctor of Osteopathy (DO), Nurse Practitioner (NP), Physician Assistant (PA), Doctor of Optometry (OD) with an unrestricted license to practice in his/her state without supervision AND the IME element(s) completed fall within LIP’s accepted scope of practice for their state. If an IME is completed by a non-LIP, it will be countersigned by the supervising provider.

AMS shall be conducted by qualified and licensed MDs or DOs, Optometrists or potentially ancillary medical personal. For specialty consultations the physician will be Board Certified and actively practicing in their specialty or sub-specialty. Medical tests shall be performed by ancillary medical personnel certified/registered in their field. Eye examinations shall be conducted by Ophthalmologists or Optometrists unless specifically stated otherwise in the AMS requested by DoDMERB.

C.3 DEFINITIONS

AFROTC: Air Force Reserve Officer Training Corps

AGENCY: Refers to a specific US Service Academy, Reserve Officer Training Corps (ROTC) organization, and other programs as required (e.g., Army ROTC or Uniformed Services University of the Health Sciences {USUHS}).

AGENCY OFFICE: The Military Service office which processes all applications and nominations for appointment.

AMS: Additional Medical Services in the form of consults or tests, etc. A term used to describe a DoDMERB requirement - additional medical tests, information, evaluations, or consultations.

APPLICANT: An individual (military or civilian) who has applied for admission to one of the US Service Academies, ROTC Programs, USUHS and other programs as required.

CHASE: To contact applicant with respect to completing requirements.

COLLEGE SCHOLARSHIP PROGRAM: Individuals who are presently enrolled in a university and are applying for a 1, 2, or 3-year scholarship through AROTC, AFROTC, or NROTC.

COMPLETE INITIAL MEDICAL EXAMINATION (IME): A complete IME is made up of the medical, audiometric and optometric evaluations. All are completed by the Network Provider, quality controlled by the Contractor, forwarded to DoDMERB via electronic means, and acknowledged by DoDMERB as acceptable. an IME is considered a complete IME, when it is not rejected by DoDMERB for quality control issues (all boxes filled in, positive responses of the applicant were thoroughly addressed by the Network Provider, forms signed, etc.).

CONTRACTING OFFICER’S REPRESENTATIVE (COR): The Government's representative is responsible for quality assurance surveillance of contractor performance. The Contracting Officer (CO) will appoint this position.

CYCLE YEAR: (Same as selection cycle. The cycle year is a reflection of the academic (school) admission year of the Service Academies. It generally runs from 1 July of one year to 30 June the next year.

DOES NOT MEET MEDICAL STANDARDS (DNMMS): A certification which indicates an applicant has been found not to meet DoD medical standards. An applicant who DNMMS has an opportunity to receive a waiver from the military agency the applicant applied to.

DoDMERB: The Department of Defense Medical Examination Review Board.

DOWN DAY: A day that AF or DoDMERB leadership designates as a minimal manning day or liberal leave day.

EXAMINING FACILITY: The physical location where the IME or AMS is accomplished.

INITIAL MEDICAL EXAMINATION (IME): A group of completed forms (electronic) that reflects the findings of the examination. At a minimum, an IME includes DD Form 2808 (Report of Medical Examination) and DD Form 2807-2 (Report of Medical History), or current prescribed forms, appropriate questionnaires if applicable and possibly a separate optometric form created by the Contractor and approved by DoDMERB, prior to implementation.

LIAISON OFFICER: An individual in the civilian community who is a member of the Reserve Forces (i.e., Army, Navy, etc.) and is responsible for providing guidance to applicants.

MANAGEMENT RECORD: Those records, excluding IME or AMS records, used to perform and document the performance of this contract.

NETWORK PROVIDER: The physician, physician’s assistant, nurse practitioner, optometrist or specialist who accomplishes the IME or AMS.

PARTIAL IME: A Partial IME is when only one or two of the components of a Complete Initial Medical Examination are completed by the applicant - either the medical, audiometric or the optometric.

The completion of all three components of an IME is applicant driven. The partial IME is forwarded to the contractor (by the network provider) for quality control and is held in abeyance by the contractor (in accordance with the Performance Work Statement (PWS)). If the applicant does not complete the outstanding portion(s) of the examination within the required time period as stated in the PWS, the contractor then forwards the Partial IME to DoDMERB. The Contractor bills the examination as a “Partial IME” (either Partial Optometric IME or Partial Medical IME).

PERFORMANCE WORK STATEMENT (PWS): A statement of work for performance-based acquisitions that describes the required results in clear, specific, and objective terms with measurable outcomes.

QUALITY CONTROL (QC): The process by which the Contractor reviews the quality of all factors involved in the IME and AMS.

REVIEWER: A DoDMERB employee responsible for the evaluation and certification of an applicant examination.

SCHOLARSHIP RECIPIENT: An individual who has been offered a 1-, 2-, 3-, or 4-year ROTC scholarship by a ROTC Scholarship Program.

SELECTION CYCLE: 1 July through 30 June is generally the annual period in which applicants for appointments to the US Service Academies, ROTC Scholarships, and Uniformed Services University of the Health Sciences are considered for appointments.

SERVICES DELIVERY SUMMARY (SDS) or ACCEPTABLE QUALITY LEVELS (AQL): The minimum level of acceptable performance that the contractor must meet and still be considered a satisfactory performer.

TIMELY: means by the Government’s deadline or, if no formal deadline is set, within five (5) business days.

C.4 ACRONYMS

ACRONYM DEFINITIONS

ACO Administering Contracting Office AF Air Force AFROTC Air Force Reserve Officer Training Corp AFB Air Force Base AFJI Air Force Joint Instruction AFMS Air Force Medical Service AFMSA Air Force Medical Support Agency AFROTC Air Force Reserve Officer Training Corp AIS Automated Information Systems AO Action Officer AQL Acceptable Quality Levels

AROTC Army Reserve Officer Training Corps CAC Common Access Card CFR Code of Federal Regulations CO Contracting Officer CONUS Continental United States COR Contracting Officer’s Representative CPAR Contractor Performance Assessment Report CR Client Representative DoD Department of Defense DoDD Department of Defense Directive DoDI Department of Defense Instruction DoDMERB Department of Defense Medical Examination Review Board DOT Department of Transportation DFARS Defense Federal Acquisition Regulation Supplement FAR Federal Acquisition Regulation FOIA Freedom of Information Act FTE Full-Time Equivalent GFI Government Furnished Information GSA General Services Administration GSAM General Services Administration Acquisition Manual HAF Headquarters Air Force HIPAA Health Insurance Portability and Accountability Act of 1996 IT Information Technology MAJCOM Major Command MHS Military Health Systems MTF Military Treatment Facility NACI National Agency Check and Inquiries NATO North Atlantic Treaty Organization NDA Non-Disclosure Agreement NROTC Navy Reserve Officer Training Corps OCI Organizational Conflict of Interest OCONUS Outside Continental United States OSD Office of the Secretary of Defense OPM Office of Personnel and Management PA Privacy Act PII Personal Identifiable Information PM Program Manager POC Point of Contact PoP Period of Performance PWS Performance Work Statement

QA Quality Assurance QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Plan OPSEC Operational Security SDS Service Delivery Summary SI Sensitive Information USAF United States Air Force USAFA United States Air Force Academy USCGA United States Coast Guard Academy USMA United States Military Academy USMMA United States Merchant Marine Academy USNA United States Naval Academy USUHS Uniformed Services University of Health Services

C.5 SUMMARY OF REQUIREMENTS

5.1 Reserved

5.2 IME Providers. The Contractor shall develop and provide professional medical services including personnel, supervision, equipment, materials and other items necessary to accomplish IMEs (medical, audiometric, and optometric). Unless specifically identified herein these three (3) components shall be referred to as “IMEs”.

5.3 AMS Providers. The Contractor shall develop and provide professional medical services including personnel, supervision, equipment, materials and other items necessary to accomplish complete AMS (consultations and tests) in accordance with this contract, unless specifically identified herein these two components shall be referred to as “AMS”.

C.6 RESERVED

C.7 OPERATIONAL REQUIREMENTS

7.1 Training

7.1.1 Train Providers. The IME and the AMS consultations required under this contract are extensive and equivalent to the executive physical examination in the civilian community. The Contractor shall provide clinical, administrative processing and quality control training to their network providers. The number of personnel required to be trained at each Examining Facility shall be determined by the Contractor and shall be at the Contractor's expense.

7.1.2 Training Contractor Management Personnel. To ensure continuity between all stakeholders in performance/delivery of services, the Contractor shall provide and maintain a list of management personnel who are qualified to execute these services. The Contractor shall provide the list of management personnel to the CO and the Contracting Officer’s Representative (COR) in a timely manner when changes occur.

7.1.2.1 Ensure all management personnel receive a minimum of two (2) calendar-days training in the overall DoDMERB activities.

7.1.2.2 The training shall be coordinated with and conducted by the Chief of Operations, DoDMERB or Director of Administration, DoDMERB or a designated appointee; shall be conducted at DoDMERB located at the United States Air Force Academy (USAFA) Building 8034, 8034 Edgerton Drive, Colorado Springs, CO; and shall be conducted no less than thirty (30) calendar days of taking the management position assignment. Travel and accommodations for this training shall be at the Contractor’s expense.

7.2 Software Application Platform. The Contractor shall provide and maintain a secure website program that allows for:

7.2.1 ROTC Detachments to “add” applicants directly via the Contractor’s portal/website to a database.

Additionally, DoDMERB can electronically add applicants to the Contractor’s database.

7.2.1.1 Once added and electronically approved by DoDMERB, the applicants may then go into the Contractor’s database to begin their portion of the process.

7.2.2 All applicants to complete their medical forms on-line.

7.2.2.1 The required forms include the DD Form 2808, DD Form 2807-2, and associated questionnaires.

7.2.2.1.1 The applicants’ demographics must be electronically data filled onto the DD Form 2808.

7.2.2.1.2 The applicants’ demographics must be electronically data filled onto the DD Form 2807-2 and their medical history questions and responses must be data filled online.

7.2.2.1.2.1 The system must allow for up to sixty (60) additional questionnaires to be electronically completed, signed and dated based on positive responses to particular questions of the DD Form 2807-2 in the applicant portal. DoD forms and associated questionnaires are subject to change, addition or deletion. The Contractor should be capable of adding, removing, or editing electronic versions of the forms hosted in the portal within twenty-one (21) calendar days.

7.2.2.1.3 The DD Form 2807-2 must have the capability for the applicants to digitally sign and date the form.

7.2.2.2 The application must allow the applicant to data enter, securely save and print all required forms, as outlined in Appendix C and D.

7.2.2.3 These forms must be available prior to the applicants’ medical and optometric appointments.

7.2.3 Electronic transfer of the completed IMEs into the DoDMERB system.

7.2.4 Electronic transfer of the completed AMS into the DoDMERB system.

7.2.4.1 All AMS have individualized identifiable codes.

7.2.5 Electronically receive the authorization for IME and AMS from DoDMERB.

7.2.6 Online scheduling of both IME and AMS providing addresses and phone numbers to the applicants.

7.2.7 At a minimum, the Contractor shall be able to support flat file transfer of applicant demographic data and IME/AMS authorizations. To the extent the Contractor chooses to propose a more efficient means of data transfer, DoDMERB will consider alternatives provided DoDMERB incurs no additional cost, and it can internally support the alternative data transfer method or technology.

7.3 Procedural Variations. Any proposed procedural variations by the Contractor, after contract start date, shall be submitted in writing to the CO and the COR for review and consideration. The CO will return the proposed procedural variation to the Contractor with fifteen (15) days of receipt with a determination of the request.

7.4 Government Shutdown. In the event of a Government shutdown, the Contractor will continue performance unless a stop work order, or other direction, has been issued by the CO.

7.5 Provider Locations. IME centers shall be established by the Contractor in locations designated by the Government under Section F.6.1. AMS centers shall be established by the Contractor in locations designated by the Government under Section F.6.2.

7.5.1 Location Proximity. It is in the Government’s best interest for sites of the IMEs are as closely located as possible, when not co-located. Historically the co-location of the medical and audiometric portions of the IMEs have proven very beneficial to the applicant and the Government.

7.5.2 State, City and ZIP Codes

7.5.2.1 IME centers are identified by their ZIP code for the purposes of scheduling. Section F.6.1 specifies by ZIP code (first three digits) for the IME locations.

7.5.2.2 AMS centers are identified by state and city for the purposes of scheduling. Section F.6.2 specifies the state and city for AMS locations.

7.5.3 DoDMERB Amending IME and AMS Centers. Due to unforeseen events, situational dependent criteria such as base closures, downsizing Military Medical Treatment Facilities (MTFs), security issues, increased/decreased volume of applicants, and individual facility performance, the Government reserves the right to request additional IME and AMS centers be established or discontinued, as required. After notification by the CO, the Contractor shall have thirty (30) calendar days to provide evidence of compliance.

7.5.4 Contractor Amending IME and AMS Centers. The Contractor may terminate IME centers and AMS centers provided there is not an impact of service for that area/region as determined by DoDMERB and upon approval by the CO. The Contractor shall provide a written request to the CO of proposed deletions to the established centers and/or additions no later than ten (10) business days prior to execution. The Government reserves the right to disapprove the proposed request.

7.5.5 Site Inspections. The Government reserves the right to conduct on-site inspections of all IME and AMS centers. The purpose of such inspections will be to determine the suitability of the examining centers in terms of geographic location, accessibility to the main city thoroughfares, and safety concerns, and to ensure all privacy act, Federal, State and local (including HIPPA) laws, regulations and DOD policies are properly adhered to.

7.5.5.1 In the event the Government desires to accomplish an inspection, the Contractor shall be so advised five (5) calendar days in advance of the proposed inspection date and will be provided the name of the individual who will accomplish the inspection.

7.5.5.2 IME and AMS centers located in depressed or high crime rate areas are considered cause for termination of select sites. If an inspection (on-site or other) determines the IME and AMS centers as being unsuitable because of location, safety, staffing, or accessibility, the CO will notify the Contractor within fifteen (15) calendar days after the inspection. The Contractor shall have fifteen (15) calendar days to provide information satisfactory to DoDMERB that the location has adequate safeguards and/or cause for its continued usage.

7.5.5.3 DoDMERB maintains sole right of determination of suitability. If a facility is determined unsuitable per DoDMERB, the CO will provide a copy of the final determination report to the contractor within thirty (30) days of DoDMERB’s written notification.

7.5.5.4 In such case as a center is determined unsuitable by DoDMERB, the Contractor has thirty (30) calendar days to establish a new IME or AMS center for that ZIP code area.

7.6 Scheduling IMEs and AMS

7.6.1 Scheduling

7.6.1.1 IME. The scheduling system shall permit applicants to personally arrange for the IME appointment via the Contractor’s network providers. The Contractor shall make available an appointment (through the network providers) to the applicant within fifteen (15) calendar days of the applicant completing registration on the Contractor portal (unless the applicant is unable to conform to that period). If the applicant is unable to comply with any of those appointments and the Contractor has demonstrated compliance with the contract, the Contractor will not be penalized. The Contractor shall make available a matched facility within one (1) business day of data transmission receipt. No other method is authorized, unless unusual and unforeseen circumstances evolve. Data transfer format standards for IME shall be as determined by DoDMERB, and format can be changed, at no cost to the government, with a thirty (30) day written notice from DoDMERB.

7.6.1.2 AMS. The scheduling system shall permit applicants to personally arrange for the AMS (consult and/or test) appointment via the Contractor’s network providers. The Contractor shall make available an appropriate appointment (through the network providers) to the applicant within thirty (30) calendar days of the Contractor being contacted by the applicant (unless the applicant is unable to conform to that period). If the applicant is unable to comply with any of those appointments and the Contractor has demonstrated compliance with the solicitation, the Contractor will not be penalized. Data transfer format standards for AMS shall be as determined by DoDMERB, and format can be changed, at no cost to the government, with a thirty (30) day written notice from DoDMERB.

7.6.1.3 The Contractor shall maintain adequate staffing to support telephonic communications with the applicant pool to ensure timely response (24-hour call back at the latest) to applicant scheduling issues, complaints, issues with accessing the applicant portal, issues with authorizations (AMS providers) encountered by the applicants, etc.

7.6.2 Rescheduling. Applicants shall be permitted to reschedule any appointment one (1) time. Upon receiving a second rescheduling request for any one appointment from the applicant, the Contractor shall instruct the applicant to contact DoDMERB for additional rescheduling consideration/authorization.

7.6.3 Failures to Appear. Following an applicant’s failure to appear for any scheduled appointment, the applicant shall be permitted by the Contractor to reschedule a total of only one (1) IME appointment and only one (1) AMS appointment without DoDMERB authorization. Upon receiving a second failure to appear for any appointment (under any circumstances) and the applicant requests rescheduling, the Contractor shall instruct the applicant to contact DoDMERB for additional rescheduling consideration and authorization.

7.6.3.1 The Contractor shall report an applicant as a ‘Failure to Appear’ when an applicant fails to appear at a scheduled appointment without properly notifying the examination center on or prior to the previous business day.

7.6.3.2 An applicant shall be afforded one (1) “Failure to Appear” appointment that is reimbursable to the Contractor for an IME. An applicant shall be afforded one (1) “Failure to Appear” appointment that is reimbursable to the Contractor for AMS.

7.6.4 Partial IMEs. A Partial IME generally occurs when the applicant only completes one (1) element of the IME but fails to complete any remaining portions of the IME (e.g., applicant completes optometric portion of exam but chooses not to complete medical portion of exam). Payment for partial IMEs is acceptable. After thirty (30) days of any completed portion of the IME, the Contractor may submit its invoice for billing as a “Partial Examination”. The completed portion of the partial examination shall be submitted to DoDMERB prior to payment of the partial examination.

7.6.5 Reassignments. The Contractor shall allow for applicant reassignments between their initially scheduled centers to a subsequent center. This is usually a result of applicants leaving the scheduled area for a period of time, necessitating a reassignment to another center location (e.g., student departs campus and returns home for summer break). The Government will be responsible for a minimal administration and handling cost. An applicant is authorized a total of two (2) reassignments (IME and AMS combined) through the Contractor. Thereafter, the Contractor shall advise the applicant to contact DoDMERB for consideration/authorization.

7.7 Applicant Records and Personally Identifiable Information (PII)

7.7.1 Release of PII. The Contractor shall not release medical records/medical record information to any entity other than DoDMERB in accordance with the approved Privacy Impact Assessment (PIA).

Requests for medical records, or portions thereof, shall be forwarded to DoDMERB.

7.7.2 Safeguarding of Privacy Act (PA) Information. The Contractor shall establish standards designed to protect unauthorized or unintentional access, disclosure, modification, or destruction of patient information in accordance with the approved PIA and DoDI 8510.01.

7.7.3 Authorized Employees. The Contractor shall restrict access to personal information to authorized employees and authorized subcontractors only who have signed access authorization documents in accordance with DoDI 8510.01. The Contractor shall submit photocopy or digital signed copies of authorized employees and authorized subcontractors to the CO and/or COR when requested by DoDMERB or the CO.

7.7.4 Compliance documentation shall include a statement that authorized personnel are trained and will comply with the following: Safeguarding procedures; Health Insurance Portability and Accountability Act (HIPAA) rules, regulations, and requirements as set forth in the Code of Federal Regulations at 45 CFR Part 164 (Title 45 - Public Welfare, Subtitle A--Department of Health and Human Services, Part 164, Security and Privacy); and DoD Health Information Privacy Regulation 6025.18-R.

7.8 IME and AMS – General

7.8.1 General

7.8.1.1 Prior to submission to DoDMERB, the IMEs will be quality controlled by the Contractor for completeness and accuracy. For incomplete/inaccurate IMEs, the Contractor shall return documents to the Network Provider and document to DODMERB those IMEs were received, but incomplete, and returned to the Network Provider for correction/completion. IMEs will be submitted to DoDMERB within fifteen (15) calendar days of the date of the last examination (medical, audiometric or optometric). In the event an applicant does not complete all portions of the IME, the Contractor will process in accordance with the “Partial IME” section.

7.8.1.2 Prior to submission to DoDMERB, the AMS will be quality controlled by the Contractor for completeness and accuracy. For incomplete/inaccurate AMS, the Contractor shall return documents to the Network Provider and document to DODMERB that AMS were received, but incomplete, and returned to the Network Provider for correction/completion. AMS will be submitted to DoDMERB within fifteen (15) calendar days of the date of the examination. In the event an applicant does not complete all portions of the AMS, the Contractor will process in accordance with the “Partial AMS” section.

7.8.1.3 Special Cases. In the case of circumstances outside of the control of the Contractor (e.g., hurricanes, blizzards), DoDMERB shall be notified telephonically and/or through e-mail for resolution on a one-by-one basis.

7.8.1.4 Processing Standards Failures. Failure of the Contractor to maintain timeliness in execution of IMEs and AMIs submitted to DoDMERB shall be recorded in the Contractor Performance Assessment Record System (CPARS). The standard shall allow for no more than ten (10) rejections per calendar month for IMEs, and no more than ten (10) rejections per calendar month for AMIs.

7.8.1.5 Incomplete IMEs and AMS. If the Network Provider fails to complete an IME or AMS, the Contractor shall, within fifteen (15) calendar days, arrange for the completion of items omitted at no cost to the Government or applicants.

7.8.1.6 Rejected IMEs and AMIs. Results that are considered rejected shall, within fifteen (15) calendar days, be re-tested in a timely manner by the Contractor at no cost to the Government or applicant(s). The Government’s decision(s) related to the adequacy/inadequacy of technical data contained within an IME or AMS report/document shall be final.

7.8.1.7 Reprocessing Standards Failures. IMEs and AMS Examinations returned to the Contractor for reasons of incomplete/inadequate shall be completed or satisfied within fifteen (15) calendar days of delivery to the Contractor. The standard shall allow for no more than ten (10) rejections per calendar month. DoDMERB may allow exceptions to this timeline if the applicant is unable or unwilling to comply.

7.8.18 Inconsistency and Failures to Meet Standards. Failures and rejections may be reflected in CPARS at the Government’s discretion. Consistent with and subject to governing regulations of the FAR, the Government may terminate the contract at the convenience of Government.

7.8.2 IME

7.8.2.1 Scope of IME. The Contractor shall provide a complete and comprehensive examination to include a “hands-on” clinical examination, pure tone threshold audiometric tests, and a complete eye examination as described in Appendix E.

7.8.2.2 Medical Findings. The IME shall address and record findings related to all positive responses listed in the applicant’s medical history which the applicant shall fill out as DD Form 2807-2 (e.g., history of extremity injury, surgery, note the range of motion, strength, atrophy, any deformities, etc. of the affected area; if a history of rash/dermatitis, then note the presence or absence of findings) (Appendix D). Both positive and specific negative findings shall be commented on by the Network Provider.

7.8.2.3 One on One. The clinical or “hands-on” IME will be conducted on a one-on-one basis. Further, an appropriate gender chaperone will be present if applicant requested.

7.8.2.4 IME Reporting Method. Examinations shall be completed utilizing the DD Form 2808 and DD Form 2807-2 (Appendix C and Appendix D) and applicable questionnaires. The Contractor may create for DoDMERB consideration and approval, at no cost to the Government, a separate paper Optometric form or electronic Optometric Form for submission of optometric findings during the IME (Appendix E).

7.8.2.5 Provider Examination Instructions. The Contractor shall prepare a brochure for the examining centers that outlines the DoDMERB IME and requirements. This brochure shall specify the examination and administrative procedures the Contractor requires the Network Providers to follow. Through the CO, DoDMERB will approve the brochure prior to implementation. The Contractor shall issue the brochure to the IME Network Providers no less than five (5) calendar days after the contract start date or being assigned as a new Network Provider.

7.8.3 AMS (Consults and Tests)

7.8.3.1 AMS Volume. Historically, DoDMERB processes approximately 20-35K IMEs per year. Of these, approximately 35% required AMS, limited repeat physical examinations and/or specialty medical examinations in order for DoDMERB to finalize medical processing.

7.8.3.2 AMS - General (Consults and/or Tests). AMS could potentially encompass laboratory tests, radiographic procedures and procedures such as pulmonary function studies, echocardiograms and stress tests, functional orthopedic tests, or consultations, etc. AMS will never include any invasive studies or biopsy. Repeat physical examination of a limited nature and specialty examinations would be based on history or physical findings noted on the IME. AMS would be in the form of a specific consultation request, sometimes accompanied by supporting medical documents. AMS is for the sole purpose of providing additional information to DoDMERB and NOT intended to provide medical treatment or counseling to the examined applicant.

7.8.3.3 AMS Examinations will be determined by DoDMERB using the Current Procedural Terminology codes (CPT) listed in the current AMA Current Procedural Terminology book. Pricing for the CPT codes will be determined by the current CHAMPUS Maximum Allowable Cost (CMAC) for San Francisco, CA. Rates for the CPT codes can be found at the link below:

https://health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/CMAC- Rates

DODMERB permits the use of telehealth services under some circumstances for AMS as an efficient and potentially less costly means of accomplishing certain AMS, while possibly expediting access to the specialty provider for the applicant. Specific AMS, such as Psychiatric consultations, as well as Dermatology consultations are often well suited to telehealth encounters, though others can be considered as needed. The licensure and practice location requirements for the provider and the applicant must be consistent with the regulatory requirements of the state in which the applicant is physically located at the time of the AMS consultation. To the extent the state in which the applicant is physically located at the time of the AMS consultation allows cross-state reciprocity, DODMERB will accept such AMS telehealth consultations, provided specialty board certification requirements are otherwise met. IME will not be conducted via telehealth save for extraordinary circumstances with prior approval from DODMERB. Select AMS could be identified as ‘approved for telehealth’ unless stated otherwise by DODMERB. Whereas other AMS will be assumed in-person unless approved on a case-by-case basis by DODMERB. These will be negotiated and agreed to by the Contractor and

DODMERB.

7.8.3.4 AMS Examination Options of Applicant. The applicant will have two (2) other choices to complete the AMS other than using the Contractor for the services described herein. The applicant may utilize a Military Medical Treatment Facility, or the applicant may elect to pay for their own AMS with a provider of their choosing. The requirements listed in this contract refer to the applicants who choose the Contractor Services. For contractor business process consideration, the applicant’s demographics will be forwarded to the Contractor prior to the applicant’s decision as to where the applicant will complete the AMS, along with the requested AMS.

7.9 General Contractor Personnel Requirements. The Contractor shall provide personnel that meet the following standards:

7.9.1 Personnel Qualifications. The Contractor shall be responsible for employing technically qualified personnel to perform the work specified in this contract. The Contractor shall maintain the personnel, organization, and administrative control necessary to ensure that the work delivered meets contract specifications and requirements. Personnel assigned to, or utilized by, the Contractor in performance of work shall be fully capable of performing the contemplated functions in an efficient, reliable, and professional manner.

7.9.2 Specific Personnel Qualifications Requirements. Personnel required to perform the services set forth within this contract shall meet the minimum qualifications for the respective labor categories. Personnel assigned to or utilized by the Contractor in the performance of this contract shall, as a minimum, be a United States Citizen, meet the experience, educational, or other background requirements set forth in the contract and shall be fully capable of performing in an efficient, reliable, and professional manner. The following are the specific experiences required:

• The requirement for all providers is that they be licensed in the US and in good standing.

• They must be a Licensed Independent Practitioner to complete IME without countersignature by a supervising provider. Examples include:

• MD, DO, OD or

• NP, or PA if the provider is considered a LIP in their state of licensure/practice.

• NPs or PAs not considered LIPs in their state of licensure/practice shall have their exams counter-signed by a MD or DO.

• Optometrists or Ophthalmologists must be currently licensed and in good standing.

• Specialists must be currently Board Certified in good standing in their specialty.

• Doctors of Psychology (PSYDs) are acceptable for the conduct of behavioral/mental health AMS.

• Chiropractic physicians, and/or any other Chiropractic variant are NOT acceptable for any aspect of this contract.

• Credentialing is NOT a requirement for this contract, just verification and validation of licensing, Board Certifications when applicable, and good standing.

7.9.3 English Language Requirement. On-site contract personnel shall fluently read, understand, speak and write English.

7.9.4 Employees. The Contractor shall not employ persons for work on this contract if such employee is identified to the Contractor as a potential threat to the health, safety, security, general well-being or operational mission of the installation and its population.

7.9.5 Work performed under the contract is unclassified, however the technical and medical privacy data used within the scope of this contract requires adherence to security/privacy requirements imposed by the Government, DoD, DHA and other applicable information security requirements as applicable to this contract. The Contractor shall handle and protect all data as directed and implemented by DoDMERB and its implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Appendix A).

7.9.6 During the course of this contract, contractor personnel shall not release any personal or medical/patient information to include patient content with personal health information. Information shall be treated FOR OFFICIAL USE ONLY in accordance with the following:

7.9.6.1 The Privacy Act of 1974 (5 U.S.C. § 552a), which includes Public Law 100-503, Department of Defense Directive (DoDD) 5400.11, and DoD 5400.11-R must be treated as FOR

OFFICIAL USE ONLY.

7.9.6.2 The Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), which includes DoD 6025.18-R and is FOR OFFICIAL USE ONLY (Appendix A).

7.9.7 The Contractor shall provide to the COR within ten (10) business days after contract award signed Non-Disclosure Agreements for each contract employee (Appendix B).

7.9.8 The Contractor shall provide patient information only to Government employees and employees of Government contractor and subcontractor employees having a need-to-know. Only information required for the performance of duties for this contract shall be provided.

7.9.9 No foreign national employees shall be utilized within the scope of this contract without prior approval of the Government.

7.9.10 The Contractor shall provide a point of contact (POC) for tasking, who shall be responsible for the performance of the work. The POC shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual, in writing, to the CO and the COR immediately after contract start date. An alternate may be designated, but the Contractor shall identify those times when the alternate shall be the primary POC.

7.10 Conduct of Contractor Personnel

7.10.1 No information will be provided by the Contractor or Network Provider regarding qualification determinations of the applicant. Under no circumstances will the Network Provider make references to the applicant’s “qualification” status for military service.

7.10.2 No independent medical or optometric relationships will be formed by the Network Provider, as a result of this contract. Soliciting additional business is strictly prohibited. Applicants are free to pursue services under their own volition.

7.10.3 When medical conditions are discovered by examination, such that reporting to authorities or recommending the applicant seek emergent or urgent care for a medical malady is required, state laws and standard of care will apply. The Contractor will immediately notify DoDMERB of such cases.

7.10.4 Contractor personnel are required to observe all base and facility parking, safety and traffic regulations that apply to all facility employees. Alcoholic beverages on the job will not be tolerated.

7.10.5 There shall be no loud, profane or abusive language used on the job.

7.11 Notification of Discontinuance of Current Contract Support Personnel. The Contractor shall provide the Government a two-week notice prior to loss of current contractor employee or Network Provider (if time allows for the two-week notice). The Contractor shall assist the Government in a smooth transition of services when a change of personnel is necessary, whether due to contractor personnel’s notice of discontinuance of service or by Government termination of the contract. The transition service entails providing familiarization, on-the-job training and appropriate documentation required by replacement personnel. This transition service will be provided to the replacement personnel.

C.8 RESERVED

C.9 GREEN/SUSTAINABLE PROCUREMENT PRACTICES/REQUIREMENTS

In accordance with FAR 23.103, “Sustainable Acquisitions,” Federal agencies shall advance sustainable acquisition by ensuring that 95 percent of new contract actions for the supply of products and for the acquisition of services (including construction) require that the products are— (1) Energy-efficient (ENERGY STAR® or Federal Energy Management Program (FEMP)-designated);(2) Water-efficient;

(3) Biobased; (4) Environmentally preferable (e.g., EPEAT-registered, or non-toxic or less toxic alternatives); (5) Non-ozone depleting; or (6) Made with recovered materials. And, that the required products in the contract actions for services include products that are— (1) Delivered to the Government during performance; (2) Acquired by the contractor for use in performing services at a Federally-controlled facility; or (3) Furnished by the contractor for use by the Government.

The purpose of the statutes and executive orders is to create, demonstrate the viability of, and sustain markets for green products and services. Green purchasing requirements apply to direct purchase of products by the Government, products supplied or used in the performance of a Government contract, micro-purchases, simplified acquisitions, and the purchases of commercial items. Below is a chart representing the elements of FAR Part 23 that apply to the requirements defined in this PWS. If for any reason the Government has failed to identify an applicable requirement in the chart below, the Contractor shall notify the Government immediately and a modification to the PWS clauses and the chart below shall be completed. The contractor shall comply with the Executive Orders, and applicable Laws/official “Acts” and Government timelines that are enacted/in place at the time of contract award, without exception.

Designated Sustainable Procurement Categories Reference Materials

Applicable/Not Applicable to PWS Requirements

Environmental Protection Agency (EPA) designated recycled content products (Eight EPA categories are: vehicles, construction, transportation, parks and recreation, non-paper office products, paper and miscellaneous products (e.g., awards, bike racks, industrial drums, signage, sorbents, plaques, etc.)

FAR 11.002(d), Resource Conservation and Recovery Act section 6002, Executive Order (E.O.) 13423 and 13514;

FAR 52.223-17

www.epa.gov/cpg

Not applicable

Information technology related Energy Star® energy products (e.g., fluorescent lamps, exit signs, transformers, etc.)

FAR 11.002(d), FAR 23.204, FAR 52.223-15, Energy Independence and Security Act of 2007 http://www.energystar.gov

Not applicable

Federal Energy Management Program (FEMP) designated energy efficient low standby power products

FAR 11.002(d), E.O.s 13423, 13514, and 13221, http://www.energystar.gov

Not applicable

Department of Agriculture designated biobased/bio-preferred products (examples of USDA designations: Mobile equipment hydraulic fluids, Urethane roof coatings, Water tank coatings, Diesel fuel additives, Penetrating lubricants, Bedding, bed linens, towels, sorbents, hand cleaners and sanitizers, FAR 11.002(d), FAR 52.223-1 (P), FAR 52.223-2, Farm Security and Rural Investment Act of 2002 section 9002, E.O. 13423; http://www.usda.gov/biopreferred http://www.epa.gov/cpg http://www.energystar.gov/ http://www.energystar.gov/ http://www.usda.gov/biopreferred adhesives/mastic removers, composite panels, etc.)

Environmentally preferable products (e.g., green cleaning products, cafeteria ware (biobased disposable plates, forks, etc., furniture, electronic office equipment, green meetings and conference services, etc.)

FAR 11.002(d), E.O.s 13423 and 13514 www.epa.gov/epp

Electronic Product Environmental Assessment Tool (EPEAT) registered products

FAR 11.002(d), E.O. 13423 and 13514, FAR 52.223-16 (for EPEAT bronze registered products or higher) or Alt I for purchasing EPEAT silver rated products or higher; For more information about the standards:

http://www.epeat.net

Not applicable

Water-efficient products FAR 11.002(d); E.O. 13514 Section 2 Not applicable

Non-ozone-depleting substances (e.g., refrigeration, foam blowing agents, sterilants, aerosols, adhesives, etc.)

FAR 11.002(d); E.O. 13514 www.epa.gov/ozone/snap/lists/index.html

Not applicable

Non or low toxic or hazardous constituents FAR 11.002(d), FAR 52.223-17 Not applicable

Printed or Copied Double Sided on Recycled Paper (All deliverables shall be submitted electronically to the Government, no paper copies necessary)

FAR 4.303, FAR 11.303, FAR 52.204-4 Applicable

Pollution Prevention FAR 23.1005, FAR 52.223-5 (Alt I or Alt II as applicable).

Applicable if work is being performed on a Government facility.

C.10 GOVERNMENT FURNISHED SUPPORT/INFORMATION

10.1 The Government will provide the Contractor all required information to perform their tasks and duties. The Government will provide existing information regarding the current organization structure, mission, goal, objectives, as well as other information requested by the Contractor and deemed appropriate by DoDMERB.

10.2 Manuals, texts, briefs and other materials associated with the execution of contract requirements shall be provided, and all provided documentation shall remain the sole property of the Government and shall be returned to the Government upon completion of this contract. The Contractor shall not disseminate information provided by the Government or developed by the Contractor during the execution of this contract without written approval by the COR.

10.3 The Contractor shall comply with local, DHA and DoD policies concerning information Technology (IT) applications and connecting to authorized military systems.

10.4 Contractor furnished items and services. Except for those items or services specifically stated as Government Furnished Support/Information, the Contractor shall furnish everything required to perform this contract.

C.11 SECURITY REQUIREMENTS

11.1 The Contractor is responsible for licensure and board certification background checks of all Network Providers.

http://www.epa.gov/epp http://www.epeat.net/ http://www.epa.gov/ozone/snap/lists/index.html

11.2 For the purposes of exchanging properly encrypted emails with DoDMERB staff when applicant PII/PHI is involved, the Contractor should consistently maintain adequate staff members that have obtained External Certificate Authority (ECA). This is a GSA/DoD approved Certificate (similar to CAC) commercially available. The process for obtaining ECA can be found at https://public.cyber.mil/eca/obtain-an-eca-certificate/.

11.3 Information System Safeguards.

11.3.1 All non-DoD information systems that…