75H70626Q00028 RFQ PKG 11.13.2025.pdf

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994) (Public Law 103-355). This announcement constitutes the only solicitation; quotes are being requested, and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) intends to award a Firm fixed Price, non-personal commercial medical service, purchase order; base year plus four (4) option years in response to Request for Quote (RFQ) 75H70626Q00028.

C. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2025-06 on October 1, 2025.

D. This RFQ is issued as 100% Indian Small Business Economic Enterprises (ISBEE) Set-Aside, and the associated NAICS Code is #621512 Diagnostic Imaging Centers, which has a small business size standard of $19 million in average annual receipts. Quoter is required to fill out the attached Indian Firm Representation Form.

E. The quoted unit pricing must be all inclusive. All-inclusive is defined to include travel, lodging, per diem, fringe benefits, federal, state and local taxes, plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

F. FAR 52.212-1 Instructions to Offerors-Commercial Products and Commercial Services (SEP 2023).

Quotes shall be submitted on company’s quote form. It shall include but not limited to the following information.

1. Solicitation number: 75H70626Q00028.

2. Closing Date: December 15, 2025 at 5:00 pm CST.

3. Name, address and telephone number of company and email address of contact person.

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents, if necessary.

5. Terms of any express warranty.

6. Price and any discount terms.

7. “Remit to” address, if different than mailing address.

8. Acknowledgment of Solicitation Amendments (if any issued)

9. Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information).

10. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offerors that fail to furnish required representations or information or reject the terms and conditions of the solicitation may be excluded from consideration.

The following forms must be filled out and completed.

1. SF 18 Request for Quote

2. Indian Firm Representation Form

The following form must be acknowledged and signed as it will be part of the award documents to the successful bidder.

3. Business Associate Agreement

G. FAR 52.212-2 Evaluation-Commercial Products and Commercial Services (NOV 2021) Basis of Award is Lowest Price Technically Acceptable (LPTA). The award selection will be conducted using LPTA procedures. To be eligible for award, a proposal must meet all technical requirements, conform to all required terms and conditions, and include all information required. All non-price evaluation factors must be rated as "ACCEPTABLE" in order to be eligible for award. An "UNACCEPTABLE" rating in any factor will result in the proposal being rated "UNACCEPTABLE". A proposal rating of "UNACCEPTABLE" makes a proposal ineligible for award. Since the LPTA methodology prohibits trade-offs, all evaluation factors are equally important. Proposals are evaluated for acceptability but are not ranked using the non-price factors.

A price evaluation will be performed for all offerors and proposals will be ranked from lowest to highest price based on the Total Proposed Price (TPP) provided by the offeror on the price schedule sheet. Next, an evaluation of each factor and, subsequently, the overall proposal will be performed beginning with the lowest priced proposal. Award will be made to the lowest evaluated priced proposal meeting the acceptability standards for the non-price factors. The Government intends to award a contract without conducting discussions; therefore, the initial proposal shall conform to the solicitation requirements and should contain the best offer from a technical and price perspective.

INTENT TO AWARD WITHOUT DISCUSSIONS: The Government intends to evaluate proposals and award a contract without discussions with Offerors. Therefore, the Offeror's initial proposal should contain the Offeror's best terms from a price and technical standpoint. The Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary. In the event discussions are held, a competitive range determination will be made. If the Contracting Officer determines that the number of proposals that would otherwise be in the competitive range exceeds the number at which an efficient competition can be conducted, the Contracting Officer may limit the number of proposals in the competitive range to the greatest number that will permit an efficient competition among the most highly rated proposals.

However, The Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary.

The LPTA evaluation process will be accomplished as follows - Technical Acceptability will be comprised of four (4) factors:

1. Solicitation Response: Meeting Contractor Qualifications and Contractor Requirements under the Statement of Work (SOW) which are consistent in the scope and complexity with Radiology Interpretation Services.

a. Solicitation Submittal Requirements: Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Governments SOW, will not be eligible for award. The offeror must submit an explanation that meets the requirements identified under Contractor Qualifications and Contractor Requirements.

b. Basis of Evaluation: This factor will be evaluated as “ACCEPTABLE” if explanation meets the requirements Contractor Qualifications and Contractor Requirements.

If explanation do not comply with Contractor Qualifications and Contractor Requirements, this factor will receive an “UNACCEPTABLE” rating.

2. Management: Meeting all other areas under the SOW which are consistent in the scope of complexity with Radiology Interpretation Services.

a. Solicitation Submittal Requirements: Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Governments SOW, will not be eligible for award. The offeror must submit an explanation that identifies the offeror’s management capabilities and responsibilities.

b. Basis of Evaluation: This factor will be evaluated as “ACCEPTABLE” if the explanation meets the requirement for management capabilities and responsibilities. If an explanation of one or more do not comply with the requirements, this factor will receive an “UNACCEPTABLE” rating.

3. Past Performance

a. Solicitation Submittal Requirements: The offeror’s performance on contracts completed during the past three (3) years and all contracts currently in progress for Radiology Interpretation Services provided to IHS locations.

b. Basis of Evaluation. Recency: For the purposes of this solicitation, a past performance record is recent if the CPAR final date of assessment listed in the “Period of Performance Being Assessed” block is within the 24-month period prec24-monthe proposal due date. Relevancy: For the purposes of this solicitation, a past performance record is relevant if the CPAR business sector is listed as “Services”. In order to receive an "acceptable" rating for this factor, an Offer's recent and relevant CPARs must NOT include one or more INTERIM and/or FINAL CPARs with a rating of "UNSATISFACTORY" in one or more categories OR one or more INTERIM and/or FINAL CPARs with a rating of "MARGINAL" in two or more categories. If an Offeror has one or more CPARs with a rating of "UNSATISFACTORY" in one or more categories OR one or more CPARs with a rating of "MARGINAL" in two or more categories, the Offeror's past performance will be evaluated as "UNACCEPTABLE". In the case of an Offeror without a record of recent and relevant past performance or for whom information on past performance is not available or so sparse that no meaningful past performance rating can be reasonably assigned, the Offeror may not be evaluated favorably or unfavorably on past performance. Therefore, the Offeror shall be determined to have unknown past performance. In the context of acceptability/unacceptability, “unknown” shall be considered “acceptable.” An “UNACCEPTABLE” rating for a single factor will result in the Offeror’s entire proposal being rated

“UNACCEPTABLE”.

4. Price

a. Solicitation Submittal Requirements: Completed Price Schedule Sheet

b. Basis of Evaluation: The Government will evaluate price based on the total proposed price calculated as the sum of bid item 0001 Base Year, item 0002 Option Year 1, item 0003 Option Year 2, item 0004 Option Year 3 and item 0005 Option Year 4 that includes Contract cost, Subcontractor cost, Overhead and Profit. Analysis will be conducted by one or more of the following techniques to ensure a fair and reasonable price: (i) Comparison of proposed prices received in response to the RFP. (ii) Comparison of proposed prices with the IGE. (iii) Comparison of proposed prices with available historical information.

Note: A price that is found to be either unreasonably high or unrealistically low in relation to the proposed work may be indicative of an inherent lack of understanding of the solicitation requirements and may result in the overall proposal being considered unacceptable.

H. FAR 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services (NOV 2023). Applied to this acquisition and it’s by reference.

I. Attached are the Federal Acquisition Regulations (FAR) & Health & Human Services Acquisition Regulation (HHSAR) provisions and clauses that are applicable.

J. SECURITY CLEARANCE

A security pre-clearance must be performed for any employees referred to IHS through this contract.

Fingerprints must be completed and adjudicated prior to services being performed under this contract.

No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems, each person must complete an FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System. Contractors shall allow five (5) business days for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty (30) business days for non-electronic processing of fingerprints using FBI Form http://exclusions.oig.hhs.gov/

FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov. As soon as practicable prior to the start of work, the performance of the work the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security pre-clearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

The Government will pay the cost to process the contractor's suitability clearances. However, multiple investigations for the same position may, at the Contracting Officers discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

Employees that DO NOT have access to LMS, contractors, volunteers, or IHS employees with IPAs or MOAs to tribal organizations please, click here IHS Sexual Abuse Prevention website. When the contractors have completed and passed the training, please have them send a copy of the last page of the training with Name, Date, and Time to their Supervisor, COR, and Kimmen LeBeau, e-mail: Kimmen.LeBeau@ihs.gov.

"Contract Personnel will arrive on a Business Day ONLY to complete all Orientation and Background procedures. The Clinical Director or Designee will ensure all Orientation and Background procedures have been completed and an email will be sent to the Contracting department to state as such. The Contract Personnel will NOT see patients until Background/Fingerprints have been cleared."

"The standards of medical practice and duties of the Contractor through its Contract Personnel shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of Contract Personnel and hospitals must be followed. Also, the standards and recommendations of Centers for Medicare and Medicaid Services (CMS) or the Accreditation organization must be adhered to. The Contract Personnel shall be required to http://exclusions.oig.hhs.gov/ mailto:Kimmen.LeBeau@ihs.gov participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care."

K. Offers will be accepted electronically, Submit via e-mail to the following:

Great Plains Area Indian Health Service Division of Acquisition Management Attn: William Kohl, Contract Specialist Email: William.Kohl@ihs.gov

Any questions, please submit by email to: William.Kohl@ihs.gov; before December 1, 2025, by 5:00pm CST. Contractors will need a Unique Entity ID (UEI) number, TIN number, and be registered with www.sam.gov.

L. Invoice Processing Platform (IPP)

The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system.

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests”.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register- however, we encourage you to make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at

(866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

ATTACHMENTS:

1. Notice to Quoters

2. SF18 Request for Quotes

3. Statement of Work

4. Provisions and Clauses

5. Indian Firm Representation Form

6. Business Associate Agreement

7. Wage Determination #2015-5373 mailto:William.Kohl@ihs.gov mailto:William.Kohl@ihs.gov http://www.sam.gov/ https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

75H70626Q00028

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

11/14/2025

1 5

INDIAN HEALTH SERVICE

Division of Acquisition Management 115 4th Ave SE Federal Building

Great Plains Area

Aberdeen SD 57401

Multiple

IHSFTTHOMPSON

1323 BIA Rt. 4 Box 200

FT THOMPSON SD 57339

FT THOMPSON

SD 57339

WILLIAM KOHL

12/15/2025 1700 CT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

NOTICE TO QUOTER

100% INDIAN SMALL BUSINESS ECONOMIC ENTERPRISE

(ISBEE) SET ASIDE

Firm fixed price, non-personal, commercial medical service purchase order for Radiology Interpretive Services for the Fort Thompson Health Care Center-Indian Health Service, Fort Thompson, South Dakota.

Contractor will be required to perform services according to the Statement of Work.

Base year plus four (4) option years.

Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 5

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626Q00028

The quoted unit price is an all-inclusive cost.

"All-inclusive" is defined to include travel, lodging, per diem, fringe benefits, Federal/State/Local taxes, plus any other cost pertinent to the performance of this contract.

The Government reserves the right to accept or reject services if the level of work is unsatisfactory.

Period of Performance: 12/29/2025 to 12/28/2030

1 BASE YEAR

X-RAY Interpretive Readings

3,600 EA

$______________________________ per reading

Total $____________________________________

Delivery: 12/28/2026

Period of Performance: 12/29/2025 to 12/28/2026

2 BASE YEAR

ULTRASOUND Interpretive Readings

360 EA

$______________________________ per reading

Total $____________________________________

Delivery: 12/28/2026

Period of Performance: 12/29/2025 to 12/28/2026

3 OPTION YEAR ONE (1)

X-RAY Interpretation Readings

3,600 EA

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2026

Delivery: 12/28/2027

Period of Performance: 12/29/2026 to 12/28/2027

4 OPTION YEAR ONE (1)

ULTRASOUND Interpretive Readings

360 EA

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

3 5

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626Q00028

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2026

Delivery: 12/28/2027

Period of Performance: 12/29/2026 to 12/28/2027

5 OPTION YEAR TWO (2)

X-RAY Interpretation Readings

3,600 EA

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2027

Delivery: 12/28/2028

Period of Performance: 12/29/2027 to 12/28/2028

6 OPTION YEAR TWO (2)

ULTRASOUND Interpretive Readings

360 EA

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2027

Delivery: 12/28/2028

Period of Performance: 12/29/2027 to 12/28/2028

7 OPTION YEAR THREE (3)

X-RAY Interpretation Readings

3,600 EA

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2028

Delivery: 12/28/2029

Period of Performance: 12/29/2028 to 12/28/2029

8 OPTION YEAR THREE (3)

ULTRASOUND Interpretive Readings

4 5

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626Q00028

360 EA

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2028

Delivery: 12/28/2029

Period of Performance: 12/29/2028 to 12/28/2029

9 OPTION YEAR FOUR (4)

X-RAY Interpretation Readings

3,600 EA

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2029

Delivery: 12/28/2030

Period of Performance: 12/28/2029 to 12/29/2030

10 OPTION YEAR FOUR (4)

ULTRASOUND Interpretive Readings

360 EA

$_____________________________ per reading

Total $___________________________________

(Option Line Item)

12/28/2029

Delivery: 12/28/2030

Period of Performance: 12/29/2029 to 12/30/2030

RFQ TOTAL $_________________________________

INVOICE PROCESSING PLATFORM (IPP)

The Indian Health Service (IHS) has implemented an electronic invoicing system in compliance with the Office of Management and Budget (OMB) M-15-19 memorandum Improving Government Efficiency and

Saving Taxpayer Dollars Through Electronic

Invoicing directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation

5 5

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626Q00028 will be required to utilize the Invoice

Processing Platform (IPP) in accordance with

HHSAR 352.232-71, Electronic Submission and

Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasury Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St.

Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register- however, we encourage you make sure your organization, and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or

IPPCustomerSupport@fiscal.treasury.gov.

Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

ATTACHMENTS:

1. Notice to Quoters

2. SF 18 Request for Quote (Required to be completed.)

3. Statement of Work

4. Provisions and Clauses

5. Indian Firm Representation Form (Required to be completed.)

6. Business Associate Agreement (Required to be acknowledged.)

7. Wage Determination for Buffalo County, SD.

Statement of Work: Radiology Interpretive Services Page 1 of 6

FORT THOMPSON HEALTHCARE CENTER

INDIAN HEALTH SERVICE

STATEMENT OF WORK

RADIOLOGY INTERPRETIVE SERVICES

BACKGROUND

The Indian Health Service (IHS) is an agency within the Department of Health & Human Services (DHHS) and is responsible for providing federal health services to American Indians and Alaska Natives. The IHS is the principle federal health care provider and health advocate for Indian people, and its goal is to raise their health status to the highest possible level. The IHS provides a comprehensive health service.

The Great Plains Area Office (GPAO) works in conjunction with 19 Indian Health Service Units and Tribal Managed Service Units to provide health care to approximately 130,000 Native American located in North Dakota, South Dakota, Nebraska, and Iowa. The Area Office's service units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics.

The Fort Thompson Healthcare Center (FTHC) falls under the GPAO. FTHC provides medical care for the Crow Creek Reservation. The reservation is located on the Missouri River 60 miles southeast of the state capital of Pierre, SD. The reservation, the Crow Creek Reservation is divided into 3 districts, which include Big Bend, Crow Creek, and Fort Thompson. FTHC is accredited by the Accreditation Association for Ambulatory Care, Inc. (AAAHC). Services provided at the FTHC consist of Behavioral Health, Dental, Laboratory, Nursing, Medical Imaging, Optometry, Pharmacy, Primary Care, and Public Health Nursing. Specialty clinics include Podiatry, OB/GYN, and Mammography.

OBJECTIVE

To provide diagnostic radiology interpretation services for standard x-ray and ultrasound imaging. The number of imaging studies varies but average 300 x-rays and 30 ultrasounds per month. The contract from this solicitation shall:

1. Be a fixed price, non-personal, commercial medical service Diagnostic Radiology/Medical Imaging contract.

2. Allow the Federal Government to evaluate the quality of professional and administrative services provided.

3. Require the Contractor to indemnify the Federal Government for any liability producing act or omission by the Contractor, its employees, and agents occurring during contract performance.

Statement of Work: Radiology Interpretive Services Page 2 of 6

PERIOD OF PERFORMANCE

Base year plus four (4) options years.

HOURS OF PERFORMANCE

Routine work shall be performed Monday through Friday, 8:00am – 5:00pm. All federal holidays will be observed.

GOVERNMENT FURNISHED PROPERTY, FACILITIES, AND SERVICES

The service unit will be responsible for performing standard radiologic and ultrasound exams and submitting any supporting documentation to the contractor.

The service unit will provide administrative and professional ancillary personnel deemed necessary to support the contractor.

STATEMENT OF WORK

The contractor shall:

• Adhere to the accepted standards, ethics, policies, and procedures adopted by the profession and the organization and regulated by law.

• Provide interpretation and final reports for all medical imaging studies sent to the Contractor.

• Have all equipment and/or systems necessary to perform the requirements of the contract.

• Provide a copy of the most recent health physicist’s survey report on any diagnostic reading workstations.

• By certified by the American College of Radiology (ARC). The interpreting physicians must have documentation showing that they meet minimum ARC and FDA qualifications. This would include initial, continuing experience, and continuing education.

• Provide telephone consultation to the FTHC providers on image interpretations which have unusual findings that may cause immediate health problems for the patient.

• Participate, when requested, in FTHC Quality Assurance and Peer Review activities.

• Be able to transcribe final reports and issue signed reports to the FTHC Radiology Department by electronic means.

• Be able to electronically transfer signed reports into the FTHC Electronic Health Records

• Provide copies of Peer Review, Medical Licensure, and approved privileges for all radiologists providing services under this contract.

Statement of Work: Radiology Interpretive Services Page 3 of 6

REPORTS

The Contractor will be required to provide transcription and electronic signatures for all radiology reports. An electronically signed report must be submitted to the Ft. Thompson Radiology Department within:

• Prior to 4:30pm Central Standard Time on the day of the study for all routine studies.

• Fifteen (15) minutes for STAT studies.

Interpretive electronic reports signed by reading radiologist will be available electronically for FTHC Radiology personnel and contractor will be responsible for electronically entering the signed report into the FTHC Electronic Health Record (EHR).

The Contractor is solely responsible for the completeness and accuracy of medical terminology spelling, grammar and punctuation. Corrections will be the responsibility of the Contractor without any additional charge to the IHS facility.

The Contractor shall immediately refer apparent discrepancies or inconsistencies to the appropriate physician for clarification and/or corrections, so reports are still transcribed within the required timeframe.

QUALITY ASSURANCE AND INVOICE PAYMENT

The Federal Government reserves the right to accept or reject services if the level of performance is unsatisfactory to the IHS. The Contractor will be paid when an invoice is submitted In IPP for the studies done.

In working with the Radiology Supervisor/QC Coordinator assuring work is satisfactory;

work will be thoroughly monitored and approved. After approval, invoices will be forwarded for payment. Along with this invoice, there shall be a record of total x-rays and ultrasounds signed by the office manager or designee.

No direct patient billing will be done by the Contractor. The Contractor will not do third party billing on its own for any interpretations done under this contract.

IMAGE STUDY DELIVERY

The studies will be electronically transmitted from the FTHC Smaart PACS via DICOM using an encrypted, secure method via a persistent LAN to LAN VPN connection.

Contractor will need to describe the security/encryption protocols used for retrieving transcribed reports.

To this end, the Contractor must sign a Data Exchange Agreement, or other Interconnection Security Agreement that the Indian Health Service provides to the Contractor in order to establish the VPN connection(s).

Statement of Work: Radiology Interpretive Services Page 4 of 6

CONTRACTOR QUALIFICATIONS

1. Contractor must be located within the United States.

2. Board certification from the American Board of Radiology has comparable qualifications, ACR and FDA.

3. Meet the criteria for medical staff membership including:

a. Current and unrestricted medical license from a stated, the District of Puerto Rico, or a temporary of the United States.

b. Diploma indication completion of an approved medical school program.

c. Completion of a medical residency-training program in Radiology.

d. If applicable, a copy of the Education Commission of Foreign Medical Graduate certificate (ECFMG).

e. Relevant experience and training in Radiology as evidenced by three (3) letters of reference from individuals who can attest to the radiologist’s judgement, competence, and character. One (1) letter must be from the Chief of Staff or Department Chairperson from a hospital where the applicant has provided radiology services.

f. Provide information on previously successful or currently pending challenges of licensures or registrations State, Districts, DEA, or the voluntary or involuntary termination of medical staff membership or voluntary or involuntary limitation reduction, or loss of clinical privileges at another hospital and current involvement with professional liability actions.

g. Evidence of medical liability/malpractice coverage.

All required certifications/licensures in this resultant contract must remain current during the life of the contract.

SPEICAL CONTRACT REQUIREMENTS

Contractors cannot serve as witnesses in any suit against the Federal Government. Many of the IHS patients receiving services may only speak a native language and/or reside on a Native American Reservation, therefore, the Contractor must demonstrate sensitivity to cross-cultural and language differences. The Privacy Act of 1974 mandates that the Contractor maintain complete confidentiality of all administrative, medical & personnel records and all other pertinent information that comes to his/her attention or knowledge.

The Privacy Act carries both civil and criminal penalties for unlawful disclosure of records.

Violation of such confidentiality shall be cause for adverse action. The IHS shall provide training on the Freedom of Information Act & Privacy Act. All lHS regulations and policies applicable to these Acts shall be enforced. Each radiologist that will be providing services under this contract must undergo a federal background investigation including an FBI fingerprint check. All Radiologists that will be providing services under this contract must be credentialed.

Statement of Work: Radiology Interpretive Services Page 5 of 6

CUSTOMER SERVICE

The Contractor shall identify a lead point-of-contact for questions and issues related to clinical service delivery. The Contractor shall also identify a customer service representative to assist IHS staff with billing and/or administrative questions during regular business hours from 8:00am-4:30 pm CST.

CONTRACTING OFFICER (CO) AUTHORITY

1.1 No person other than the CO has the authority to bind the Government with respect to this contract.

1.2 No action or omission of any government employee or representative other than the CO shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

1.3 In no event shall any of the following be effective or binding on the Government or imputed to the CO with respect to this contract:

1.3.1 An understanding or agreement between the Contractor and anyone other than the CO.

1.3.2 A purported modification or change order issued by anyone other than the

CO.

1.3.3 A promise by anyone other than the CO to provide additional funding or make payments; or

1.3.4 An order, direction, consent, or permission from anyone other than the CO to:

1.3.4.1 Incur costs in excess of a specified estimated cost, allotment of funds, or other ceiling; or

1.3.4.2 Expend hours in excess of a specified level of effort.

CONTRACTING OFFICER REPRESENTATIVE (COR)

The CO shall designate a COR in writing at the time of award. The COR shall be responsible for:

• Monitoring the Contractor’s technical progress.

• Interpreting the SOW.

• Technical evaluation as required.

• Technical inspections and acceptance required by this contract.

• Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.

Statement of Work: Radiology Interpretive Services Page 6 of 6

The COR for this contract is:

Mitchell Franklin, COR II

FTHC

1323 BIA Route 4 Fort Thompson, South Dakota 57339 605-245-1597 mitchell.franklin@ihs.gov mailto:mitchell.franklin@ihs.gov

Provisions and Clauses Fixed Price Commercial Services with Options

52.252-1 Solicitation Provisions Incorporated by Reference.

As prescribed in 52.107(a), insert the following provision:

SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): www.acquisition.gov/far

(End of provision)

FAR Citation Clause Title Clause Date 52.203-11 Certification and Disclosure Regarding the Influence Certain

Federal Transactions

SEP 2024

52.204-7 System for Award Management NOV 2024 52.204-16 Commercial and Government Entity Code Reporting AUG 2020 52.204-17 Ownership or Control of Offeror AUG 2020 52.204-20 Predecessor of Offeror AUG 2020 52.204-24 Representation Regarding Certain Telecommunications and Video

Surveillance Services or Equipment

NOV 2021

52.209-5 Certification Regarding Responsibility Matters AUG 2020 52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law

FEB 2016

52.212-1 Instructions to Offerors – Commercial Products and Commercial Services

SEP 2023

52.212-3 Offeror Representations and Certifications – Commercial Products and Services

OCT 2025

52.217-5 Evaluation of Options JUL 1990 52.219-1 Small Business Program Representations FEB 2024 52.225-25 Prohibition on Contracting with Entities Engaging in Certain

Activities or Transactions Relating to Iran – Representation and Certifications

JUN 2020

SOLICITATIONS IN FULL TEXT

FAR Citation Clause Title Clause Date 52.204-3 Taxpayer Identification OCT 1998 52.204-8 Annual Representations & Certifications OCT 2025 52.209-2 Prohibition on Contracting with Inverted Domestic Corporations-

Representation

NOV 2015

https://www.acquisition.gov/far/52.107#FAR_52_107 http://www.acquisition.gov/far

52.204-3 Taxpayer Identification.

As prescribed in 4.905 , insert the following provision:

TAXPAYER IDENTIFICATION (OCT 1998)

(a)Definitions.

Common parent, as used in this provision, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member.

Taxpayer Identification Number (TIN), as used in this provision, means the number required by the Internal Revenue Service (IRS) to be used by the offeror in reporting income tax and other returns. The TIN may be either a Social Security Number or an Employer Identification Number.

(b)All offerors must submit the information required in paragraphs (d) through (f) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C.6041, 6041 A, and 6050 M, and implementing regulations issued by the IRS. If the resulting contract is subject to the payment reporting requirements described in Federal Acquisition Regulation (FAR) 4.904, the failure or refusal by the offeror to furnish the information may result in a 31 percent reduction of payments otherwise due under the contract.

(c)The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror’s relationship with the Government ( 31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror’s TIN.

(d)Taxpayer Identification Number (TIN).

□ TIN: __________________.

□ TIN has been applied for.

□ TIN is not required because:

□ Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

□ Offeror is an agency or instrumentality of a foreign government;

□ Offeror is an agency or instrumentality of the Federal Government.

(e)Type of organization.

□ Sole proprietorship;

https://www.acquisition.gov/far/4.905#FAR_4_905 http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title31-section7701(c)&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title31-section3325&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section6041&num=0&edition=prelim https://www.acquisition.gov/far/4.904#FAR_4_904 http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title31-section7701(c)(3)&num=0&edition=prelim https://www.acquisition.gov/far/4.904#FAR_4_904

□ Partnership;

□ Corporate entity (not tax-exempt);

□ Corporate entity (tax-exempt);

□ Government entity (Federal, State, or local);

□ Foreign government;

□ International organization per 26 CFR 1.6049-4;

□ Other__________________.

(f)Common parent.

□ Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision.

□ Name and TIN of common parent:

□ Name__________________.

□ TIN__________________.

(End of provision)

52.204-8Annual Representations and Certifications.

As prescribed in 4.1202(a), insert the following provision:

ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2025)

(a)

(1)The North American Industry Classification System (NAICS) code for this acquisition is 621512.

(2)The small business size standard is $19.

(3)The small business size standard for a concern that submits an offer, other than on a construction or service acquisition, but proposes to furnish an end item that it did not itself manufacture, process, or produce is 500 employees, or 150 employees for information technology value-added resellers under NAICS code 541519 if the acquisition—

(i)Is set aside for small business and has a value above the simplified acquisition threshold;

https://www.acquisition.gov/far/4.1202#FAR_4_1202

(ii)Uses the HUBZone price evaluation preference regardless of dollar value, unless the offeror waives the price evaluation preference; or

(iii)Is an 8(a), HUBZone, service-disabled veteran-owned, economically disadvantaged women-owned, or women-owned small business set-aside or sole-source award regardless of dollar value.

(b)

(1)If the provision at 52.204-7, System for Award Management, is included in this solicitation, paragraph (d) of this provision applies.

(2)If the provision at 52.204-7, System for Award Management, is not included in this solicitation, and the Offeror has an active registration in the System for Award Management (SAM), the Offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The Offeror shall indicate which option applies by checking one of the following boxes:

(i)□ Paragraph (d) applies.

(ii)□ Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation.

(c)

(1)The following representations or certifications in SAM are applicable to this solicitation as indicated:

(i)52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless–

(A)The acquisition is to be made under the simplified acquisition procedures in part 13;

(B)The solicitation is a request for technical proposals under two-step sealed bidding procedures; or

(C)The solicitation is for utility services for which rates are set by law or regulation.

(ii)52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000.

(iii)52.203-18, Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements-Representation. This provision applies to all solicitations.

(iv)52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the provision at 52.204-7, System for Award Management.

https://www.acquisition.gov/far/52.204-7#FAR_52_204_7 https://www.acquisition.gov/far/52.204-7#FAR_52_204_7 https://www.acquisition.gov/far/52.203-2#FAR_52_203_2 https://www.acquisition.gov/far/part-13#FAR_Part_13 https://www.acquisition.gov/far/52.203-11#FAR_52_203_11 https://www.acquisition.gov/far/52.203-18#FAR_52_203_18 https://www.acquisition.gov/far/52.204-3#FAR_52_204_3 https://www.acquisition.gov/far/52.204-7#FAR_52_204_7

(v)52.204-5, Women-Owned Business (Other Than Small Business). This provision applies to solicitations that-

(A)Are not set aside for small business concerns;

(B)Exceed the simplified acquisition threshold; and

(C)Are for contracts that will be performed in the United States or its outlying areas.

(vi)52.204-26, Covered Telecommunications Equipment or Services-Representation. This provision applies to all solicitations.

(vii)52.209-2, Prohibition on Contracting with Inverted Domestic Corporations- Representation.

(viii)52.209-5, Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

(ix)52.209-11, Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law. This provision applies to all solicitations.

(x)52.214-14, Place of Performance-Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government.

(xi)52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government.

(xii)52.219-1, Small Business Program Representations (Basic, Alternates I, and II). This provision applies to solicitations when the contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii).

(A)The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard.

(B)The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard.

(C)The provision with its Alternate II applies to solicitations that will result in a multiple-award contract with more than one NAICS code assigned.

(xiii)52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii).

(xiv)52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity.

https://www.acquisition.gov/far/52.204-5#FAR_52_204_5 https://www.acquisition.gov/far/52.204-26#FAR_52_204_26 https://www.acquisition.gov/far/52.209-2#FAR_52_209_2 https://www.acquisition.gov/far/52.209-5#FAR_52_209_5 https://www.acquisition.gov/far/52.209-11#FAR_52_209_11 https://www.acquisition.gov/far/52.214-14#FAR_52_214_14 https://www.acquisition.gov/far/52.215-6#FAR_52_215_6 https://www.acquisition.gov/far/52.219-1#FAR_52_219_1 https://www.acquisition.gov/far/part-19#FAR_Part_19 https://www.acquisition.gov/far/19.000#FAR_19_000 https://www.acquisition.gov/far/52.219-2#FAR_52_219_2 https://www.acquisition.gov/far/part-19#FAR_Part_19 https://www.acquisition.gov/far/19.000#FAR_19_000 https://www.acquisition.gov/far/52.222-22#FAR_52_222_22 https://www.acquisition.gov/far/52.222-26#FAR_52_222_26

(xv)52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity.

(xvi)52.222-38, Compliance with Veterans’ Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial products or commercial services.

(xvii)52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of biobased products in USDA-designated product categories; or include the clause at 52.223-2, Reporting of Biobased Products Under Service and Construction Contracts.

(xviii)52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA–designated items.

(xix)52.223-22, Public Disclosure of Greenhouse Gas Emissions and Reduction Goals- Representation. This provision applies to solicitations that include the provision at 52.204-7.

(xx)52.225-2, Buy American Certificate. This provision applies to solicitations containing the clause at 52.225-1.

(xxi)52.225-4, Buy American-Free Trade Agreements-Israeli Trade Act Certificate. (Basic, Alternates II and III.) This provision applies to solicitations containing the clause at 52.225-3.

(A)If the acquisition value is less than $50,000, the basic provision applies.

(B)If the acquisition value is $50,000 or more but is less than…