DHA_PWS_Teleradiology.pdf

DHA PWS Teleradiology Recompete

Department of Defense Defense Health Agency

Performance Work Statement

DEFENSE HEALTH AGENCY ENTERPRISE (OFF-SITE) TELERADIOLOGY

SERVICES

Solicitation Number: TBD Version: DRAFT 0.1 Date: 7 JULY 2026

PART 1

1.0 GENERAL INFORMATION

1.1 Background: The Defense Health Agency (DHA) is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force and ready medical force to Combatant Commands in both peacetime and wartime.

The DHA uses the principles of Ready Reliable Care to advance high reliability practices across the Military Health System by improving our system operations, driving innovative solutions, and cultivating a culture of safety.

1.2 Objective: Provide a standardized enterprise teleradiology services contract for DHA MTFs to employ to optimize radiology capabilities, especially for on-call support and overflow work.

1.3 Scope:

1.4.1. This is a non-personal services contract for credentialed and privileged professional diagnostic radiology services. Services shall be performed at Contractor facilities by board certified radiologists in support of basic assistance with case volume and on-call scenarios throughout the Military Health System (MHS). The supported DHA MTFs include medical centers, hospitals, clinics, and similar facilities located worldwide, both within the continental United States (CONUS), outside the continental United States (OCONUS), and in U.S.

Territories. All patient age groups are covered.

1.4.2. Services shall be performed using Department of War (DoW) approved secure broadband connections as indicated herein to transmit radiology images and data between the requiring DHA MTFs and the Contractor’s facilities.

1.5 Description of services: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform professional diagnostic radiological services as defined in this Performance Work Statement (PWS) except for those items specified as government furnished property and services.

1.5.1 Teleradiology services shall include professional preliminary and final interpretation, as well as specific consultation as needed. The services provided in this contract will be utilized to supplement DHA MTF radiologists, including any terms and conditions defined in Task Orders (TOs) issued under this contract. Examinations include Radiography, Ultrasound, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), nuclear medicine, bone densitometry, dental cone beam CT, and PET/CT.

1.5.2 The Contractor shall provide complete and accurate diagnostic interpretations of radiology examinations performed by Government personnel and provide further professional consultation that relates to diagnostic imaging, upon request, to members of the medical staff.

1.5.2.1.“Examinations" as referred to herein consists of individual patient diagnostic imaging examinations.

1.5.2.2. “Interpretations” may include preliminary and final interpretation of one or more images from examinations. Further professional telephone consultation may be required upon request of the user.

1.5.3. The Contractor must be authorized to connect to and transmit data between the Army, Navy, Air Force, and DHA Medical Community of Interest (MEDCOI) Information Networks and have computer hardware that is capable of receiving Digital Imaging and Communications in Medicine (DICOM) compliant diagnostic imaging studies from the requiring MTF and to return a final interpretation report that will automatically upload into the patient’s Electronic Health Record (EHR).

1.6 Period of Performance (PoP): The PoP shall be specified in the base enterprise teleradiology contract. Each task order PoP shall be coterminous with the base PoP.

1.6.1 Transition Period: A 180-calendar-day base contract transition period will commence prior to commencement of the ordering period,. Task orders will provide at least 30 calendar days between task order award and start of performance, but task order transition periods will not be invoiceable.

1.6.1.2. Requirements During Transition Periods

1.6.1.2.1. The Contractor shall have a project manager available during all transition periods to complete requirements listed in part 4 of this PWS.

1.6.1.2.2. The transition-out period occurs 60 calendar days prior to the end of the final period of performance of this contract and will include turnover/closeout/purge of any residual Government data and general cooperation with the successor Contractor. If the Contracting Officer (KO) requires additional transition efforts by the incumbent in transitioning a successor Contractor, FAR Clause 52.237-3 Continuity of Service may be invoked and associated costs will be negotiated in accordance with the terms of this clause at that time.

1.7. Place of performance: The work shall be performed at Contractor facilities inside the United States.

1.8 Standards: Contractor shall comply with all applicable federal, state, and local laws, DoW, DHA, agency-specific, installation, and MTF policies, procedures, and instructions.

1.9 Recognized Federal holidays: services may be required on federally recognized holidays as outlined in the TO. Recognized federal holiday:

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Juneteenth Day Christmas Day Independence Day

1.10. Hours of operation: The Contractor shall provide services seven days per week, twenty-four (24) hours per day, and on federal holidays.

1.13 Conduct: Contractor personnel shall adhere to standards of conduct as established by the policy letters of the DHA Director, and other applicable Department of War policies.

1.14 Post Award Conference The Contractor shall attend a virtual post-award conference.

1.15 Quality

1.10.1 Quality Control (QC): The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure nonrecurrence of defective services. The contractor’s quality control program is the means by which the work complies with stated requirements. The QCP is to be delivered within 10 days after date of award. A comprehensive written QCP shall be submitted to the KO and COR within 5 working days when changes are made thereafter. After acceptance of the Quality Control Plan Quality Control Plan (QCP) the contractor shall receive the KO’s acceptance in writing of any proposed change to his QC system.

1.10.2 Quality assurance (QA): The government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan provides a systematic method for the Government to evaluate performance and to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.16 Contractor personnel

1.11.1 CAC requirements: All contract radiologists must have an EDIPI as required by MHS GENESIS for studies to be accepted. A CAC is not required.

1.11.2 Contractor onboarding and training. The contractor shall complete all requirements, training, and forms per the following DHA instructions:

1.11.2.1 The DHA’s Onboarding Checklist for Contractor Employees is located at the DHA Onboarding and Offboarding Portal at https://info.health.mil/cos/admin/hr/IO/SitePages/Home.aspx. This document will be provided to the Contractor as required.

1.11.2.2 The DHA’s Contractor training instructions embedded at Part 7 Section 7.6.

1.11.3. Contractor Radiologists: Radiologists assigned by the Contractor to provide the official interpretation of images transmitted by teleradiology must maintain licensure appropriate and necessary to deliver services. Physicians providing services under this contract must be privileged by the guidelines set by accrediting organization and IAW DHA guidelines prior to execution of service. Credentials and privileges must be current/maintained while providing service. The first time the Contractor provides services to each MTF during TO execution under this contract, the Contractor will provide that MTF credentials office a list of all radiologists (Provider Listing), by name and NPI that the Contractor intends to utilize for services. That MTF will inform the Contractor when radiologists are authorized to provide services after a verification process. The Contractor will notify each MTF receiving services when radiologists already providing services or planned to provide services to that MTF change within 24 hours of the change. The Contractor will submit a semi-annual Provider Activity Report (every 6 months) of practice activity to the Privileging Authority MTF that includes number and type of examinations reported under this contract with reporting radiologist name and NPI grouped by Originating Site MTF. The Contractor shall ensure professional liability coverage is always maintained in accordance with jurisdictional requirement of each state in which services are being performed. Proof of coverage shall be provided to the enterprise level COR.

1.11.3.1 Qualifications and Requirements: Contract radiologists performing services under this PWS shall possess the skills, knowledge and abilities to perform such services. The Contractor shall meet the following requirements for education and training, certification, experience, licensure, credentialing/privileging, and continuing medical education.

1.11.3.2 Education and Training: The Contract radiologists shall hold the degree of either a Doctor of Medicine (MD), Doctor of Osteopathy/Osteopathic Medicine (DO), or have completed the Educational Commission for Foreign Medical Graduates certification process, be eligible for medical licensure in the United States, and shall have successfully completed an approved residency program in diagnostic radiology.

1.11.3.3 Board Certification(s): Each contract radiologist shall hold and maintain a current certification from the American Board of Radiology or the American Osteopathic Board of Radiology in diagnostic radiology and shall otherwise comply with all applicable Joint Commission and American Hospital Association standards. The National Institute for Occupational Safety and Health (NIOSH) shall certify each contractor performing B-Reads. The NIOSH certification demonstrates proficiency in classifying radiographs of pneumoconiosis according to the International Labour Office (ILO) standardized classification system.

1.11.3.4 The Contractor shall provide radiologists capable of interpreting studies on patients of all ages.

1.11.3.5 A Contractor performing teleradiology services shall understand the basic technology of image acquisition, transmission, manipulation, processing, archiving, retrieval, and display, including the strengths, weaknesses, and limitations of different methods. They shall be knowledgeable in how to optimally utilize the image viewing equipment. The Contractor https://info.health.mil/cos/admin/hr/IO/SitePages/Home.aspx performing the official interpretation shall be responsible for the quality of the images being reviewed and understand the elements of Quality Control (QC) of digital image management systems. The Contractor shall demonstrate qualifications in accordance with the appropriate ACR Practice Guideline or Technical Standard for the particular diagnostic modality being interpreted.

1.11.3.6 Experience: The contract radiologists shall have been continuously employed in the practice of diagnostic radiology or in clinical radiology training for 24 months within the last 36 months. Time spent in an administrative capacity as a claims reviewer, medical school instructor, medical director, etc. does not qualify as practicing time.

1.11.3.7 Licensure: The Contractor shall have and maintain a current, active, valid, and unrestricted license to practice medicine in the State (to include D.C. or US Territory, where the images originate as well as the State or US Territory where interpreted). If images originate outside the US or US Territories, only a current, active, valid, and unrestricted State license in the State in which the images are interpreted is required. In the event a radiologist changes his/her interpretation location, that radiologist shall not interpret examinations until a license is obtained from the new location and the license is presented to the credentialing office of the MTF affected (this applies if the radiologist is not already in possession of that location’s license). The Contractor shall not use any radiologists licensed only by a foreign country or are physically located in a foreign country.

1.11.3.8 Credentialing/Privileging: The Contractor shall ensure each radiologist obtains clinical privileges from the MTF Privileging Authority prior to beginning work. The Contractor shall follow the clinical privileging processes and requirements outlined in the PWS and each TO (if applicable). Contractor shall plan for up to 60 calendar days for Government review and approval with granting of privileges. The clinical privileges granted by the MTF will be sufficient to allow for performance of all specific tasks identified in this contract. If a radiologist is not privileged to perform all the specific tasks in this contract, the radiologist will not be allowed to provide services under this contract, and the Contractor shall provide another radiologist. The Contractor shall ensure that each radiologist remains privileged.

1.11.3.8.1 The Contractor shall ensure successful completion of the credentialing and privileging process by the Privileging Authority MTF for all contract radiologists and that each Originating Site MTF acknowledges all contract radiologists designated by the Contractor to provide services for that MTF are authorized prior to providing services.

1.11.3.8.2 The Contractor shall, on a continuing basis, verify all information submitted to the MTF for the purpose of credentialing/privileging. During the term of the contract, the Contractor shall notify the privileging authority MTF and any affected Originating Site MTFs upon becoming aware of any information that may compromise the radiologist’s privileges at the MTF within 24 hours. This includes, but is not limited to, information linking the radiologist with chemical dependency, a requirement or change in licensure status, a felony or malpractice. The information will be reviewed and may result in rescinding privileges.

1.11.3.8.3. Once privileges are granted, subsequent actions taken concerning the privileges of radiologists, including any limitation on privileges, will be governed by the procedures described in DHA PM 6025.13, this PWS, and each TO (if applicable). Action that suspends, revokes, or otherwise restricts the privileges of a radiologist results in that radiologist not being authorized to perform under the contract. Such action does not excuse the Contractor from providing performance. Any lapse in coverage may be considered as cause for grounds for termination of the contract, at the discretion of the KO. Requirements for privileging or for licensing verification are the same for replacement radiologists.

1.11.3.8.4 The MTF Privileging Authority is the sole authority who can revoke or otherwise restrict the privileges of any radiologist who he/she determines is not qualified to perform the contract services. Adverse actions on radiologist privileges, once the Commander/Director takes action, may be appealed in accordance with DHA PM 6025.13, Vol 3, but may not be appealed by the Contractor. All documents generated through professional review activities are protected as Medical Quality Assurance Program (MQAP) documents, in accordance with Section 1102 of USC Title 10.

1.11.4 Radiologists who have previously undergone MTF adverse action processes resulting in an adverse action outcome (e.g., privilege revocation or restriction) or have otherwise been determined by the Government to be ineligible to perform contracted services are excluded from providing services under this contract. The current CQM process/reviews for non-personal services contractors' process is in DHA-PM 6025.13:

1.11.5 Continuing Health Education (CHE)/ Certified Education Units (CEU) Requirements:

Contractor personnel registered or certified by national/medical associations shall continue to meet the minimum standards for CHE to remain current as prescribed by the State licensure and maintenance of board certification requirements. The Government will not reimburse for these costs.

1.17 U.S. Citizenship

Radiologists performing under this contract must be U.S. citizens. The Government shall not be held liable for not allowing performance under this contract by a contractor employee who fails to comply with, or to maintain, the citizenship or legal alien status requirements stated herein.

1.18 English language requirement: The Contractor shall ensure that all Contractor personnel providing services under this contract are able to read, write, and speak English fluently.

1.19. Continuity of services: The Contractor shall ensure sufficient staffing and resources to provide all required services and support throughout the term of the contract.

1.19.1. The Contractor shall provide a point of contact that is available via telephone 7 days a week, 24-hours per day, Monday through Sunday, including Federal Holidays.

1.19.2. The Contractor shall notify the KO and no later than five calendar days prior to change of any management personnel or other personnel that represent the contract to the government. The notification shall be submitted in writing,

1.20. Conflict of interest: The Contractor shall not employ any person who is an employee of the United States Government if the employment of that person would create a conflict of interest.

The Contractor shall not employ any person who is an employee of the Department of Defense, either military or civilian, unless such person seeks and receives approval IAW DoD Directive (DoDD) 5500.7, Standards of Conduct, 29 Nov 07, and Service policies, and the contracting officer provides prior contract approval.

1.21. Invoicing and billing: The Government will only pay for services ordered. If the Contractor submits invoices for services that were not ordered by the government, it may constitute fraud or a false claim and may result in administrative or criminal action or both.

1.21.1 Billing of beneficiaries. The Contractor shall not bill the patient for services rendered under this contract. The Contractor shall not accept compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this contract, at the rate specified in the bid schedule.

1.18.2. Some exams consist of images that could be considered as more than one study.

However, these examinations shall only be billed as one study when there exists a single Current Procedural Terminology (CPT) code that describes the examination. Examples of such examinations include CT Abdomen/Pelvis, CT or MRI with and without contrast of same body region, bilateral hip x-ray and bilateral rib x-ray. See Appendix B, paragraph 1: “Requirements for counting of examinations for CLIN charges described by modality” for additional description of these requirements.

1.22 Non personal services: This is a non-personal services agreement. Contractor personnel are subject to neither the supervision nor control of a government officer or employee. The Contractor personnel shall perform their duties IAW specific tasks outlined in this PWS/resultant contract and TOs (if applicable). Supervisory functions and managing Contractor employees, such as hiring, directing, counseling, and firing of Contractor personnel are the responsibility of the Contractor and performed by the Contractor, not the Government.

1.20 Communication: The Contractor shall ensure contract providers maintain open and professional communication with providers in the MTF. The Contractor shall abide by federal and local MTF regulations and requirements concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act (HIPAA) of 1996. All medical records and reports will remain the property of the Government.

1.21 PII/PHI, and federal information requirements: See Appendix F of this PWS.

1.22 Privacy act program: The Contractor shall create, maintain, and destroy Privacy Act data IAW 38, USC 5701, and 38 USC 7332; and Privacy Act systems of records notice(s) (http://dpcld.defense.gov/Privacy /SORNs.aspx). If the Contractor receives a Privacy Act request, the Contractor shall be responsible for searching for the records and providing those records to a Government official who, as the authorized official, will make the decision on releasing the Government records.

1.23 HIPAA and Privacy Act Training: Contractor personnel requiring network access to the hosted applications shall successfully complete the MHS Privacy Act and Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security training prior to access to the hosted applications and then annually thereafter. The Contractor shall submit a copy of the Privacy Act and HIPAA course certificate along with the completed System Authorization Access Request (SAAR) and DoD IA Awareness training certificate to the TO level COR for each affected Contractor personnel. The Contractor is responsible for maintaining an active database of Contractor employee HIPAA and Privacy Act training status and providing initial and annual training certificates to the TO COR, as requested. The course is accessible via Joint Knowledge Online (JKO). Please refer to the Joint Knowledge Online (JKO) Instructions on accessing JKO.

http://dpcld.defense.gov/Privacy

1.28. Functional requests: A functional request is a written request for DOD records received from any person (including a member of the public), or a business that does not cite either the FOIA or Privacy Act. The Contractor shall direct requests to the COR and KO.

1.29. Release of Medical Information: The provider shall only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient. All patient information will comply with HIPAA standards included in Appendix F of this PWS.

1.30. Indemnification and Medical Liability Insurance: The Contractor shall provide and maintain adequate liability coverage for their employees, consistent with the risks associated with the performance of all services required by this PWS/contract. Refer to Federal Acquisition Regulation (FAR) clause 52.237-7, "Indemnification and Medical Liability Insurance." If the Contractor uses subcontractors in the performance of this contract, the Contractor is required to ensure that its subcontracts for provisions of healthcare services contain the requirements of FAR clause 52.237-7, including the maintenance of medical liability insurance.

1.31. The Contractor shall be responsible for any liability producing acts or omissions arising from its radiologists’ performance. The Contractor shall indemnify the Government against all claims by third parties for death or bodily injury (including sickness or disease) to the extent that such a claim arises in any way from Contractor performance under this contract. In the event of litigation/investigation of a claim or malpractice, the Contractor shall ensure its radiologists’ full cooperation with Government authorities and designated officials in investigation of claim and/or preparation of litigation.

1.32. If any suit or action is filed or any claim is made against a contract radiologist resulting from work performed by the contract radiologist under this contract, the contract radiologist shall immediately notify the privileging authorities and the Contractor, who in turn shall notify the COR and KO. The Contractor shall promptly furnish copies of all pertinent papers received.

1.33. Inquiries, Comments, or Complaints. All inquiries from the media, third parties, private or public agencies shall be relayed within 24 hours to the COR and TOKO or KO, as applicable.

The Contractor shall not respond directly to these or any inquiries. All inquiries, comments or complaints arising from any matter observed, experienced, or learned of as a result of or in connection with the performance of this contract, the resolution of which may require the dissemination of official information, shall be directed to the Contracting Officer Representative (COR) and TOKO or KO, as applicable.

1.34. Patient lists. All patient lists, no matter how developed, shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way to any unauthorized person or for any use outside the MTF without prior written permission by the MTF Commander/Director, in accordance with federal law, to include the Privacy Act, the Health Insurance Portability and Accountability Act (HIPAA) (see Appendix F) and DHA and Service specific requirements denoted in each contract and TO.

1.35 Physical security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use.

1.38 Contractor Program manager: The Contractor shall provide skilled, experienced professional and/or technical personnel essential for successful Contractor accomplishment of the work to be performed, otherwise defined as “program manager”. The Contractor shall designate and electronically submit to the KO, program manager contact information, to include phone and email, at least five business days prior to contract performance start date.

1.38.1 Qualifications for the program manager a: The Program Manager shall possess 5 years’ experience. 1.38.2 Program Manager The designated program manager shall communicate with the contract COR(s), via phone or email, at a minimum, monthly and when requested by the COR to discuss any problems the Contractor may be experiencing during the performance of this contract. Program manager shall be available via phone and email in the event of emergencies to include weekdays, weekends, and holidays. The program manager or alternate shall be available between 9:00 a.m. to 5:30p.m. ET, Monday through Friday except Federal holidays or when the government facility is closed for administrative reasons. If program manager is unavailable for work under this contract for a continuous period exceeding thirty (30) business days, the Contractor shall immediately notify the KO in writing and promptly replace such program manager with personnel of at least substantially equal ability and qualifications.

1.38.2 Designated program manager shall be available to discuss all aspects of performance during the life of the contract and have the authority to resolve issues and problems as they arise.

The designated program manager shall have full authority to act on behalf of the Contractor on all contractual matters relating to contract.

1.39 Data rights: The Government will maintain data rights to all documents/material produced under this contract. All documents and materials produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/ copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the Contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.40 Reporting

1.40.1 Reserved.

1.40.3 Government’s COR: The Government will identify a COR for the contract and for each TO. The COR monitors all technical aspects of the contract and assists in contract administration. The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract; perform inspections necessary in connection with contract performance; maintain written and oral communications with the Contractor concerning technical aspects of the contract; issue written interpretations of technical requirements,; monitor Contractor's performance and notifies both the KO and Contractor of any deficiencies; coordinate availability of government furnished property; and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting contract.

1.40.4 Periodic Performance meetings: The Contractor Program Manager is required to attend contract level and task order performance meetings when requested by the Government.

Required attendance is virtual. . The time and location will be identified upon the issuance of the award. All key Contractor and Government representatives shall attend either in person or virtually. . These meetings shall be at no additional cost to the government. Task orders may include additional requirements for these meetings.

1.41 Contractor Identification

1.41.1 Contractor personnel performing services in a contractor capacity in a government facility are required to possess and wear an identification badge that displays his or her name and the name of their company. All contractor personnel shall identify themselves as contractor support personnel in all forms of communication with all entities with whom DHA/Deputy Assistant Director for Acquisition (DAD-A)/Head of the Contracting Activity (HCA) has business dealings. The contractor shall: Answer all telephone calls and have a personalized voice message with an introductory statement that includes the fact that the person is contractor support personnel. Ensure all those with whom the person interacts in any face-to-face dealings while supporting the DAD-A understand that the person is contractor support personnel. Include a title block in all emails that states the fact that the person is contractor support personnel. Ensure all those with whom the person interacts in any face-to-face dealings while supporting DHA/DAD- A/HCA understand that the person is contractor support personnel.

1.41.2 Contractor personnel will be required to attend meetings or otherwise communicate with Government and/or other contract representatives to meet the requirements of this contract and associated TOs. Contractor personnel shall make their contractor status known during introductions.

1.41.3 Contractor personnel, while performing in a contractor capacity, are prohibited from using their retired or reserve component military rank or title in any written or verbal communications associated with the contracts in which they provide services.

1.42 Contractor Access to Health Affairs (HA)/DHA Network(s)

1.42.1 FSO/Company's Security POC shall notify the DHA Personnel Security Office after being awarded a contract that requires access to a DoD system. Contractor personnel requiring access to the HA/DHA networks for performance of their tasks require a background investigation and the security awareness training. The Contractor shall be prepared for this process as it could take two (2) or more weeks. The Facilities Security Officer/Security POC shall submit a Standard Form (SF) 85/86 to DHA's Personnel Security Office for a background investigation.

1.42.2 Company's FSO/Security POC must notify the Personnel Security Office when the contractor has submitted the SF-85/86. The FSO/Security POC, or the COR must notify the DHA Personnel Security Office in writing of a contractor's termination from the contract, including the termination date.

1.43. Personnel Security

1.43.1 The contractor shall comply with DoD 8570.01-M, “Information Assurance Workforce Improvement Program,” December 19, 2005 as amended; DoDI 8500.01, “Cybersecurity”, dated March 14, 2014; DoD Manual (DoDM) 6025.18, “Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule Compliance in DoD Health Care Programs”, DoDI 6025.18 “HIPAA Privacy Rule Compliance in DoD Health Care Programs”, dated March 13, 2019; and DoDM 5200.02 “Procedures for the DoD Personnel Security Program (PSP),” dated April 3, 2017 as amended. Contractor responsibilities for ensuring personnel security include, but are not limited to, meeting the following requirements:

1.43.1.1 Follow the DHA Personnel Security Office guidelines for submittal of security clearances. Contact the DHA Personnel Security Office for guidance on the appropriate background investigation required for personnel on the contract. The DHA Personnel Security Office can be reached at (703) 681-6777.

1.43.1.2 Initiate, maintain, and document personnel security investigations appropriate to the individual’s responsibilities and required access to Controlled Unclassified Information (CUI).

1.43.1.3 DHA Personnel Security Office will deny any access to any automated information system (AIS), network, or CUI if a contractor receives an unfavorable adjudication, or if information that would result in an unfavorable adjudication becomes available.

1.44. ACCESS AND GENERAL PROTECTION SECURITY POLICY AND PROCEDURES.

If required to enter a Government facility, the Contractor, to include associated subcontractor employees, shall comply with applicable installation, facility, and area commander installation/facility access and local security policies and procedures (provided by Government representative). The Contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshall Office, Director of Emergency Services or Security Office. The Contractor shall comply with all personal identity verification requirements as direct by DoD, Services, and or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in Contractor security matters or processes.

1.441. Contractor shall complete required security background checks and obtain the minimum required clearance prior to starting work.

1.44.2. It is the Contractor’s responsibility to ensure its employees undergo proper criminal history background checks by providing the Government support, cooperation and active assistance throughout the process.

1.44.3. All Contractors requiring access to their systems for administrative/maintenance support of systems/applications on the DoD network will meet DoD requirements for a privileged-level account before being granted a network account. Position of Trust is the minimum eligibility for Information Assurance Technical level II (IAT-II) which is required for B2B Gateway/DoD network access. Contractors designated as filling IAT II positions shall be responsible for obtaining and maintaining a Tier 3 (T3) investigation. It is the Contractor’s responsibility to ensure security background investigations are completed prior to starting performance on the contract. This includes following the DoD Access Process attached in Section 7.1, and Attachment D of this PWS, submitting all required paperwork, and submitting fingerprints to the appropriate DHA security office. A favorable Tier 3 (T3) investigation is required to perform IAT-II duties.

1.44.4. The preferred method for the submission of fingerprints is via digital fingerprint machine through the Defense Manpower Data Center (DMDC) Secure Web Fingerprint Transaction (SWFT +) System. Digital fingerprints may be submitted at designated Government facilities, using the SOI and SON obtained by the DHA security office. If digital fingerprints are not possible, a candidate must submit ink prints on the Standard Form 87 Fingerprint Card. The use of hard copy fingerprint cards will delay the security review. The preparation and submission of the Tier 3 shall be at the expense of the Contractor, upon commencement of services. The

Contractor shall advise their employees that a Government approved background check is needed as a condition of employment under this contract.

PART 2

2.0 DEFINITIONS, ACRONYMS, AND APPLICABLE PUBLICATIONS/INSTRUCTIONS

2.1 Definitions.

American College of Radiology (ACR). The principal nonprofit, professional organization of radiologists, radiation oncologists, and clinical medical physicists in the United States

B-Read. A more sophisticated interpretation of the chest x-ray that may identify exposure and illness caused by substances such as silica and asbestos.

Beneficiary. An individual eligible and entitled to military healthcare system (MHS) benefits under provisions of Title 10 U.S.C. Chapter 55, which generally include Active Duty, Service members, retirees, certain reserve and national guard members, and eligible dependents and survivors.

Business-to-Business (B2B) Gateway. B2B gateways enable information exchange from one business partner to another. B2B gateways provide e-commerce platforms via a centralized point for transformation of multiple data sources using established interoperability standards.

Category D: Information Technology (IT) and Telecommunications Services (called D- Services)

Category R: Support (Professional/Administrative/Management) Services (called R-Services)

Certification. An official recognition by a national agency or association that the individual worker has successfully completed an approved education program or evaluation process. This includes formal processes designed to assess the knowledge, experience, skills and abilities required to provide quality services.

Clinical Privileges. The permission to provide medical and other patient care services in the granting organization, within well-defined limits, based on the individual’s education, professional license, training, experience, current competence, judgment and health.

Clinical Privileging. The granting of permission and responsibility of a healthcare provider to independently provide specified or delineated healthcare within the scope of his or her license, certification, or registration. Clinical privileges define the scope and limits of practice for individual providers and are based on capability of the healthcare facility, licensure, relevant training and experience, current competence, health status, judgment, and peer and department head recommendations.

Clinical Quality Management. A collection of programs that emphasize leadership, commitment to quality performance, regardless of the practice site, a supportive organizational culture, and evaluation of the effectiveness of clinical performance improvement activities.

Commander/Commanding Officer. The individual (military officer) responsible for the operations of the MTF for which the contract services are provided.

Competence. The state of having adequate ability and up-to-date knowledge to perform the duties, functions, and requirements of a particular discipline, job or duty position in accordance with credentialing requirements.

Contracting Officer (KO): A person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

Contracting Officer’s Representative (COR): An individual, including a contracting officer’s technical representative (COTR), designated and authorized in writing by the KO to perform specific technical or administrative functions. This individual does NOT have authority to change the terms and conditions of the contract.

Contract Service Provider. For the purpose of this contract, “contract service provider” means an individual employed by the prime or subcontractor. Also see “Health Care Provider.”

Contractor. The entity or its representative responsible for the delivery of the services or materials specified in the contract, as designated by contract award.

Credentialing. The process of obtaining, verifying, and assessing the qualifications of both privileged and non-privileged providers to provide safe patient care services. This assessment serves as the basis for decisions regarding delineation of clinical privileges, as well as appointments and reappointments to the medical staff. The required information should include qualification data such as relevant education, training, and experience; current licensure; and specialty certification (if applicable) as well as performance data, such as current competency, and the ability to perform the selected privileges. This data is collected, verified, and assessed initially and on an ongoing basis.

Cyber Incident. Actions taken through the use of computer networks that result in a compromise or an actual or potentially adverse effect on an information system and/or the information residing therein. (DoDI 8582.01, December 2019)

Defense Health Agency (DHA). Defense Health Agency (DHA) is a combat support agency that provides a host of shared health services across the MHS, from operating the TRICARE health benefit to providing pharmacy and medical logistics, performing medical research and development and operating health information technology systems, with a goal of providing integrated and efficient service to the joint force.

Digital Imaging and Communications in Medicine (DICOM). A standard for interconnection of medical digital imaging devices, developed, and sponsored by the American College of Radiology and the National Electrical Manufacturers Association, consisting of a standard image format and a standard communications protocol.

Digital Imaging Network Picture Archiving and Communications Systems (DINPACS or PACS). A medical imaging system used for storing, retrieving, presenting and sharing images produced by various medical hardware modalities, such as X-ray, CT scan, MRI and ultrasound machines.

Digital Radiography. A digital radiography detector (active) used to describe a flat-panel digital x-ray system that reads the transmitted x-ray signal immediately after exposure with the detector in place.

Distant Site (or receiving site). The location of the Contractor providing teleradiology services.

See also “originating site” below.

Healthcare Information and the Management Systems Society (HIMSS). A professional non-profit healthcare organization dedicated to improving health care in quality, safety, cost-effectiveness, and access through the best use of informational technology and management systems.

Health Layer Seven (HL7). A set of international, standardized protocols and clinical messaging formats designed to facilitate the transfer, integration, sharing, and retrieval of electronic health information across diverse healthcare systems. DHA utilizes Corepoint Rhapsody to proctor HL7 information between MHS GENESIS and any system requiring HL7.

License. A grant of permission by an official agency of a State, the District of Columbia, or a Commonwealth, territory, or possession of the United States to provide healthcare within the scope of practice of a specified discipline. Licenses must be:

• Current: Active, not revoked, suspended, or lapsed in registration.

• Active: Characterized by present activity, participation, practice, or use.

• Valid: The issuing authority accepts, investigates, and acts upon quality assurance information, such as practitioner professional performance, conduct, and ethics of practice, regardless of the practitioner's military status or residency.

• Unrestricted: Not subject to limitations on the scope of practice ordinarily granted all other applicants for similar specialty in the granting jurisdiction.

• Providers in the MHS may not have one active license and another currently suspended or probationary license. For example, if a provider is licensed in both Texas and Tennessee, and the provider’s Texas license is active, but the provider’s Tennessee license is on probation, restricted, or is temporarily suspended, the provider would not meet requirements for clinical practice in the MHS.

Military Health System (MHS). Enterprise within the United States Department of Defense that provides health care to active duty and retired U.S. Military personnel and their dependents.

MHS GENESIS. MHS GENESIS, the new electronic health record for the Military Health System, provides enhanced, secure technology to manage health information. This system is based on Cerner millennium, and its RadNet module is the new new MHS Radiology

Information System, which generates radiology order messages and receives radiology report messages.

Military Treatment Facility (MTF). A medical center, military hospital or clinic to include dental and veterinary clinics. The MTF includes all activities providing outpatient and/or inpatient health care services for eligible beneficiaries. Originating site (or transmitting site). The location of the MTF where the patient obtained the radiological images. See also “distant site” above.

Non-DoD Information System. Any information system that is not owned, controlled, or operated by the DoD and that is not used or operated by a contractor or other non-DoD entity exclusively on behalf of the DoD. Includes information systems owned and operated by other departments and agencies of the U.S. Government; State and local government; allies, coalition members, host nations and other nations; multinational organizations; non-government organizations; and the private sector. (Reference: DoDI 8582.01, December 9, 2019)

Non-Personal Services Contract. A contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

Non-Routine Communication. Reference ACR Practice Parameter for Communication of Diagnostic Imaging Findings Revised 2014 (Resolution 11)

Originating Site. The site where the patient is physically located and medical imaging is acquired.

Picture Archiving and Communication System (PACS). See DINPACS.

2.1.5 Nonpersonal services contract: a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

Privileging Process. The process established by the MTF for granting clinical privileges to Radiologists.

Protocol. Applies to information technology; a set of guidelines by which two different computer devices communicate with each other.

Radiography. A digital radiography detector (passive) system that uses a storage phosphor plate contained in a cassette instead of a film-screen cassette. A laser beam scans the exposed plate to produce the digital data that is then converted into an image.

Quality Assurance. Actions taken by the Government to assess services to determine if performance meets the requirements of the contract.

Quality Assurance Surveillance Plan (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance. The Government may either prepare the quality assurance surveillance plan or require the offerors to submit a proposed quality assurance surveillance plan for the Government’s consideration in development of the Government’s plan.

Quality Control. Actions taken by a Contractor to control the performance of services to ensure performance meets the requirements of the contract.

Radiologist. (Or, collectively, “Radiologists”) shall mean individual physicians employed by the Contractor to perform duties pursuant to this contract who shall possess the qualifications specified herein. (Alternative phrasing: “Health Care Provider.”)

Society for Imaging Informatics in Medicine (SIIM). A healthcare professional organization representing the interests and goals of those who work with and are affected by the rapidly changing world of imaging technologies and information management.

Special Finding. Any abnormal, life threatening, or significant findings.

STAT. At once/immediately, as commonly used in medical terminology for the Latin “statim.”

Check Section 5 for ensuring ordering Contractor provides phone number.

Technical Standard. For the purpose of a technical standard, the images referred to are those that Contractor’s diagnostic radiologists would normally interpret, including transmission projection and cross-sectional X-ray images, ionizing radiation emission images, and images from ultrasound and magnetic resonance modalities. Research, non-human and visible light images (such as dermatologic, histopathologic, or endoscopic images) are out of scope and not applicable to this effort.

The Joint Commission (TJC). A national organization dedicated to improving the care, safety, and treatment of patients in healthcare facilities; publishers of the Joint Commission Accreditation Manual for Hospitals and the Ambulatory Healthcare Standards Manual.

Teleradiology. The transmission of radiological patient images, such as radiographs, Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), from one location to another for the purposes of remote study interpretation.

2.2 Acronyms and Abbreviations

ACO Administrative Contracting Officer ACR American College of Radiology ADP/IT Automated Data Processing/Information Technology AHLTA Armed…