QASP_PRC Appeals.pdf

Quality Assurance Surveillance Plan (QASP) for

Medical Review of Purchased/Referred Care (PRC) Appeals

Base Year

(For base and option years except where indicated)

Purpose

The purpose of this quality assurance surveillance plan (QASP) is to provide a government‐developed and applied system to assure the use of quality assurance methods in the administration of the performance based acquisition standards included in the PRC appeals contract. The intent is to ensure that the Contractor performs services for the Division of Clinical and Community Services (DCCS) that are provided in accordance with performance requirements set forth in the contract documents, that the government receives the quality of services called for in the contract and that the government only pays for the acceptable level of services received.

This plan provides the basis for the Contracting Officer Representative (COR) to evaluate the quality of the contractor’s performance. The oversight provided for in the contract and in this plan will help ensure that service levels reach and maintain the required levels throughout the contract term. Further, this plan provides the COR with a proactive way to avoid unacceptable or deficient performance and provides verifiable input for the required annual past performance evaluations.

Authority

Authority to issue this QASP is provided under Section E – Inspection and Acceptance, which provide for inspection and acceptance of the articles, services, and documentation called for in task orders to be accomplished by the Contracting Officer or COR.

Scope

The Contractor is responsible for management and quality control actions necessary to meet the quality standards set forth by the contract. The Contractor develops and submits its quality control plan (QCP) for government approval in compliance with its contract deliverables. Once accepted, the Contractor then used the QCP to guide and rigorously document the implementation of the required management and quality control actions to achieve the specified results.

The QASP is put in place by the COR to provide government surveillance oversight of the Contractor’s quality control efforts to assure that they are timely, effective and delivering the results specified in the contract or task order. The QASP is not a part of the contract, nor is it intended to duplicate the

Contractor’s QCP.

Government Resources

Contracting Officer: TBD @ihs.gov

Contracting Officer Representative: TBD @ihs.gov

Technical Monitor: TBD @ihs.gov

Responsibilities

Contracting Officer: Manage overall contract to assure that the Contractor receives fair and equitable treatment under the contract, as well as, determine whether the Contractor’s performance is adequate.

Contracting Officer Representative: Provide technical administration of the project and assure government surveillance of the Contractor’s performance. Inform the Contracting

Officer and DCCS Director about Contractor performance and recommend payment of invoices. Participate in monthly meetings/conference calls with the Contractor. Purpose of communications is to review project progress, discuss issues or problems, and develop recommendations.

Technical Monitor: Provide technical oversight of the contract and report findings to the

Project Officer. Participate in monthly meetings/conference calls with the Contractor.

Purpose of communications is to review project progress, discuss issues or problems, and develop recommendations.

Methods of Surveillance

The below listed methods of surveillance shall be used in the administration of this QASP. In addition to specific instructions that may be mentioned, the appropriate and standardized form that is to be used for documentation for QA surveillance is the surveillance activity checklist.

Customer Feedback – 100% of customers annually

Review Reports – 100% monthly

Review Data Base Inventory and Distribution Report – 100% monthly

Identified QA Surveillance Tasks

The following PBSA items are identified within the contact performance work statement to be applicable on an agency‐wide basis and are to be monitored under this QASP

Updating Contracting Officer Representative and Technical Monitor on issues pertaining to warehoused inventory, management of inventory thresholds, and distribution of materials, and distribution costs. This will be accomplished during monthly meetings and written reports.

Progress report of tasks and recommendations provided to the DCCS Director via face‐to‐ face meetings, conference calls or by written reports monthly.

Data base inventory and distribution reports provided monthly.

Semi‐annual inspection of the warehouse facilities and inventory.

Summary report provided at the end of each year.

Documentation

The Contracting Officer Representative will, in addition to providing documentation to the Contracting

Officer, maintain a complete quality assurance file. The will contain copies of all reports, evaluations, recommendations, and any actions related to the government’s performance of the quality assurance function, including the originals of all surveillance activity checklist. All such records will be retained for the life of this contract. Subdivide documentation by base year and option year(s), if applicable. The

Project Officer shall forward these records to the Contracting Officer a termination or completion of the contract.