Atch 5. Medical Statement.docx
DOCX document 25 KB Posted
- Attached to
- Handheld Explosive Trace Detectors
- Solicitation number
- FA448426Q0045
About this file
This is a medical statement attachment for solicitations and task orders with performance at Joint Base McGuire-Dix-Lakehurst (JBMDL). The statement establishes the terms under which the 87th Medical Treatment Facility (MTF) will provide urgent health care to contractor employees or agents who sustain injuries while on duty at the base. Urgent health care is defined as medical care authorized to the extent necessary to save life or limb and prevent undue pain and suffering. The contractor is responsible for all costs associated with such treatment, which will be billed based on services documented in Air Force Form 552 (Pre-Hospital Evaluation Patient Care Report). If a contractor employee cannot pay the bill when rendered, the contractor will receive a statement of charges and letter of indebtedness and will be billed directly for medical services provided. Contractor employees are required to provide timely notice to their medical insurance companies and furnish adequate information and documentation to facilitate insurance payment.
This statement applies to the current RFQ solicitation FA448426Q0045 for Handheld Explosive Trace Detectors being issued by the 87th Contracting Squadron at JBMDL for the 87th Security Forces Squadron. Contractors responding to this and any other solicitations with performance requirements at JBMDL must acknowledge and accept these medical liability terms as a condition of the contract.
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Text version
The following statement will be placed in all solicitations/awards/TOs/DOs/calls with performance on JBMDL:
“The 87th Medical Treatment Facility (MTF) may provide urgent health care to any contractor employees or agents for injuries occurring while on duty. Urgent health care is defined as medical care authorized to the extent necessary to save life or limb and prevent undue pain and suffering. Contractor employees will be transferred to a civilian medical facility as soon as they are appropriately stabilized. The cost of such treatment will be paid for, in full, within a reasonable period of time (as determined with/by the Base Legal Office's assistance), by the contractor or the contractor's employee and will not be borne by the 87th MTF, the United States Air Force or the government. Billing/accounts receivable is processed based on services provided, which is captured on an Air Force FORM 552 (Pre-Hospital Evaluation Patient Care Report). If a contractor employee or agent cannot pay for the treatment at the time the bill is rendered, a statement of charges and a letter of indebtedness will be completed and billed to such contractor employee for medical services rendered. Contractor employee or agents shall ensure they provide timely notice to their medical insurance company and to the extent an insurance company is to make payment, provide the insurance company with adequate information and documentation necessary to make payment."
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