Directed Medical Services -PWS.docx

C - Description/Specifications

PART 1 – GENERAL INFORMATION

1.1 Description of Services/Introduction:

The Contractor shall provide all personnel, equipment, tools, materials, supervision, facilities, other items, and non-personal services necessary to manage and provide Directed Medical Services for the purpose of establishing one or more of the following: work-related medical diagnoses, disability, and degree of permanent impairment as defined in this Performance Work Statement, except as Specified in -Part 3 “Government Furnished Property and Services”. The Contractor shall perform to the standards in this contract action.

1.2 Background:

The Division of Federal Employees’ Compensation (DFEC) program is responsible for the administration of the Federal Employees’ Compensation Act (FECA), its amendments, and additional statutes that extend coverage to other injured workers. The Act provides for medical benefits, wage-loss replacement, survivors' annuities, and other benefits to employees of the United States or their survivors when the employee is injured or dies in the course of employment.

DFEC processes claims for FECA claimants located within the United States, its Possessions, Territories and Trust Territories. DFEC functional operations include adjudicating incoming claims to determine eligibility for compensation payments; managing claims in which eligibility has been established; determining wage-loss compensation payments for covered disability or death; and processing payments for allowed medical services incurred in the treatment of injured workers covered under the Act.

Under the FECA, medical care and compensation for wage loss and for permanent physical impairment are provided to Federal employees who are injured in the performance of duty. The medical evaluation of workers who submit compensation claims is part of the adjudication and case management process. In certain instances, the OWCP must refer a claimant to a specialist in an appropriate field for a Second Opinion Examination (SECOP) or an Independent Medical Examination (IME, aka Impartial Medical Examination, aka Referee Examination). A medical evaluation may be necessary to determine: (1) the causal relationship between work factors and the disease or injury; (2) the extent and duration of the physical impairment or disability; (3) the appropriateness of therapy, including some surgical procedures; (4) when recovery has occurred and a return to work is feasible; (5) resolve a conflict in the medical evidence; or (6) to obtain the physician/specialist’s written, unbiased, viable medical diagnosis and report based on medical evidence and that answers questions posed by OWCP and the Statement of Accepted Facts (SOAF). Case file records may be referred to appropriate specialists for reviewing impairment ratings and assessing other workers’ compensation issues. Impairment ratings are conducted using the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment. DFEC currently uses the 6th edition (issued March 15, 2009) but may adopt succeeding editions and updates.

Directed Medical Services require full file reviews and delivery of a timely viable narrative medical report utilizing the SOAF as a framework and responding to SOAF each specific question posed by OWCP. SECOPs and IMEs also require physical or psychiatric examination of the claimant and performance of any clinical or laboratory tests deemed necessary in the diagnostic work-up. The SOAF contains information concerning events, working conditions and employment data that is accepted as factual by the OWCP responsible claims examiner (RCE). Both the questions and the SOAF are critical elements and serve as a mandatory framework for physicians in developing viable diagnoses and medical reports.

In cases where work capacity is being evaluated, the physician/specialist shall complete the appropriate OWCP-5 Work Capacity evaluation form as a complement to the narrative medical report.

1.3 Objectives:

The Government’s objective is to solicit and award a single contract to a vendor capable of managing and providing a nationwide consortium of various medical specialists dedicated to facilitating the timely adjudication of workers’ compensation claims via the timely scheduling of appointments and case file reviews and delivery of viable medical reports.

As outlined in the following Performance Work Statement (PWS), the basic service objectives are: (1) to determine the causal relationship between work factors and the disease or injury; (2) to assess the extent and duration of the physical impairment or disability; (3) to determine the appropriateness of therapy, including some surgical procedures; (4) to determine when recovery has occurred and a return to work is feasible; (5) to resolve a conflict in medical evidence; and (6) to obtain the physician/specialists written unbiased, viable medical diagnosis and report based on medical evidence and that answers questions posed by OWCP and the SOAF. In some cases, OWCP will request a file review only, including IME File reviews, but the objectives will remain the same.

1.4 Scope:

The Contractor shall provide sufficient resources to manage and provide Directed Medical Services as outlined below and in Section 5:

1) Second Opinion Examination (SECOP): Examine covered workers, review the covered worker’s medical file, and provide a written medical opinion and diagnosis (based on a SOAF provided by OWCP, and a review of the case file) in response to questions posed by the RCE, for the purposes of assessing work-related causality, disability, impairment, diagnosis, pharmacy utilization, and other medical-related issues.

2) Independent Medical Examination (IME, aka Impartial Medical Examination, aka Referee Examination): Examine covered workers, review the covered worker’s medical file, and provide a written medical opinion (based on a SOAF provided by OWCP, and a review of the case file) to questions posed to resolve a conflict in medical opinion, for the purposes of assessing work-related causality, disability, impairment, diagnosis, pharmacy utilization, and other medical-related issues. In some instances, an IME File Review without examination is required, when the examination is either not necessary or not possible.

3) Case File Review (aka Chart Review): Review the medical file without physical examination and provide a written medical opinion (based on a SOAF provided by OWCP) and to questions posed by the RCE, for the purposes of addressing causality, disability, impairment, diagnosis, pharmacy utilization, and other medical-related issues.

Upon contract award, the successful Contractor shall have the ability to:

1) Manage and provide a robust network of contracted, qualified, and appropriate medical specialists nationwide within the US, its Possessions, Territories and Trust Territories and within a reasonable commuting distance of each claimant’s residence.

2) Arrange timely scheduling of appointments for examinations and notify claimants, their appointed representatives, and their employers of the claimants' responsibilities to appear and cooperate with scheduled medical exams.

3) Arrange for electronic receipt of referrals and associated documents via OWCP-designated Secure File Transfer Protocol (SFTP) locations.

4) Provide a secure website (password protected [https protocol/SSL]) that is operational and available for the initiation of referrals and uploading of all pertinent imaged documents if OWCP has determined that electronic submission via SFTP is not available.

5) Perform timely pick-up and delivery of all pertinent documents to and from the Government, Contractor, and sub-Contractor (when applicable).

6) Assure all medical providers agree to provide a witness and medical chaperone, in accordance with OWCP policies, during examinations involving sensitive portions of a physical examination or at the patient’s request.

7) Assure all medical providers allow the patient’s attending physician or accessibility assistant to attend examinations, if approved by the RCE.

8) Assure all medical facilities are safe.

9) Perform timely delivery of all medical reports in accordance with Section 5.4 of this PWS.

10) Ensure that each medical report is comprehensive, unequivocal, unbiased, well-reasoned, consistent with the physical findings, responsive to all questions posed by the claims examiner and presented in a form and format specified by the OWCP.

11) Electronically transmit all medical reports and related documents (including appointment letters, notifications and other appointment related communication) to an OWCP designated SFTP location, with an accompanying XML data file that provides indexing attributes for each document.

12) Ensure that all documentation containing Personally Identifiable Information (PII) in possession of the Contractor, its employees, and its Subcontractors is returned to the Government or destroyed upon completion of individual service, in conformance with section 5.3.1.1. Comply with applicable provisions of the Privacy Act of 1974 and the security and confidentiality of claimant medical records (and related materials) entrusted to the custody of the contractor or examining physician.

1.5 Period of Performance:

The period of performance is one (1) 12-month base period and four (4) 12-month option periods The period of performance reads as follows:

Base Period: March 28, 2026 – March 27, 2027 Option Period 1: March 28, 2027 – March 27, 2028 Option Period 2: March 28, 2028 – March 27, 2029 Option Period-3: March 28, 2029 – March 27, 2030 Option Period 4: March 28, 2030 – March 27, 2031

The Government reserves the right to extend the term of the contract up to 6-months at the prices set forth in Section B (Option Period 4) and in accordance with FAR clause 52.217-8 “Option to Extend Services”.

1.6 General Information

1.6.1 Quality Control:

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 non-recurrence of defective services. The contractor’s quality control program is the means by which he assures himself that his work complies with the requirement of the contract. As a minimum, the contractor shall develop quality control procedures that address the areas identified in Technical Exhibit 1, “Performance Requirements Summary”.

The contractor shall submit the Quality Control Plan to the COR within 10 calendar days of award. The Quality Control Plan is subject to COR/Contracting Officer’s approval and will be incorporated into the award via modification. After acceptance of the quality control plan, the contractor shall receive the Contracting Officer’s acceptance in writing of any proposed change to his QC system. The Quality Control Plan is to be delivered with the Contractor’s proposal.

1.6.2 Quality Assurance:

The government shall evaluate the Contractor’s performance under this contract action in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the government must do 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 rates Reference Quality Assurance Plan and surveillance methodology as described in Technical Exhibit 1 “Performance Requirements Summary – Performance Threshold and Method of Surveillance”

1.6.3 Government Remedies:

The Contractor understands and agrees that timely and satisfactory performance of the services required under this Contract is essential to the health and welfare of OWCP claimants and to their ability to return to work, as well as to the effectiveness and efficiency of the Government agencies that employ them, and to the financial and operational integrity of OWCP programs.

In accordance with the inspection and acceptance provisions of FAR 52.212-4, Contract Terms and Conditions—Commercial Products and Commercial Services (Nov. 2023), except as otherwise directed by the Contracting Officer, the Contractor is required to reproduce/correct work products it delivers which do not conform to the requirements of the Contract, at no increase in Contract price. For any such nonconforming work products, whether identified by the Government or discovered by the Contractor, except as otherwise directed by the Contracting Officer, the Contractor shall immediately undertake corrective work and must complete any required reperformance, and resubmit the deliverable, within seven (7) calendar days of the rejection/request. In cases where the Contractor fails to correct the deficiencies within this timeframe, or where the Contracting Officer rejects the nonconforming deliverable having determined that repair or reperformance is not possible, the Government will incur damages in the form of additional costs, for which the Government may seek price reductions or other adequate consideration and remedies, including assessment of Liquidated Damages as provided below, claims for breach of contract damages, less than satisfactory ratings in the Contractor Performance Assessment Reporting System (CPARS), and other Government remedies.

1.6.3.1 Liquidated Damages

The following liquidated damages are provided for this contract. See FAR Subpart 11.5.

The Contractor is required to deliver services under this Contract, as demonstrated by submitting the associated Billable Work Products, no later than the Due Dates set out throughout the PWS and Technical Exhibits which are referenced in the table below. If the Contractor fails to submit the Billable Work Products by the Due Date, the Contractor shall, in place of actual damages, pay to the Government liquidated damages, calculated as set out below. The Government presents to the Contractor, and the Contractor understands, that the liquidated damage amounts below reflect the Government’s reasonable conservative estimates, at the time of award, of the probable costs to the Government for delayed performance.

If the Government terminates this Contract in whole or in part for cause, the Contractor is liable for liquidated damages accruing until the Government reasonably obtains delivery or performance of similar supplies or services. These liquidated damages are in addition to excess costs of repurchase under the termination provision of this Contract.

The Contractor will not be charged with liquidated damages when the delay in delivery or performance is beyond the control and without the fault or negligence of the Contractor as defined in the termination for cause provisions of this Contract.

Billable Work Products (Deliverables)

Supplemental Report Section 5.4.1.3.2 No more than 21 calendar days from the date of the request for the supplemental report.

A conforming report submitted after 21 calendar days, or after 35 calendar days when diagnostic testing or consultations are necessary, is considered late and subject to liquidated damages.

$50.70 per every 10-calendar day period after the report is due, charged only at the end of the 10-day period, until a conforming report is submitted.

MAX: $152.10 after 30 calendar days.

SECOP Medical Report Section 5.4.2.2 No more than 7 calendar days from the date of examination, or no more than 14 additional calendar days (21 total) when diagnostic testing or consultations are necessary.

A conforming report submitted after 7 calendar days, or after 21 calendar days when diagnostic testing or consultations are necessary, is considered late and subject to liquidated damages.

$50.70 per every 10-calendar day period after the report is due, charged only at the end of the 10-day period, until a conforming report is submitted.

IME Medical Report Section 5.4.3.2 No more than 14 calendar days from the date of examination, or no more than 14 additional calendar days (28 total) when diagnostic testing or consultations are necessary.

A conforming report submitted after 14 calendar days, or after 28 calendar days when diagnostic testing or consultations are necessary, is considered late and subject to liquidated damages.

$50.70 per every 10-calendar day period after the report is due, charged only at the end of the 10-day period, until a conforming report is submitted.

Case File Review - Surgical Review Report Section 5.4.4.2(1)

No more than 7 calendar days from the date of referral.

A conforming report submitted after 7 calendar days is considered late and subject to liquidated damages.

$50.70 per every 10-calendar day period after the report is due, charged only at the end of the 10-day period, until a conforming report is submitted.

Case File Review - Impairment Rating Report or IME File Review Section 5.4.4.2(2)

No more than 30 calendar days from the date of referral.

A conforming report submitted after 30 calendar days is considered late and subject to liquidated damages

$50.70 per every 10-calendar day period after the report is due, charged only at the end of the 10-day period, until a conforming report is submitted.

Case File Review – Other Report Section 5.4.4.2(3)

No more than 21 calendar days from the date of referral.

A conforming report submitted after 21 calendar days is considered late and subject to liquidated damages

$50.70 per every 10-calendar day period after the report is due, charged only at the end of the 10-day period, until a conforming report is submitted.

The Liquidated Damages listed above are determined based on Government Staff Costs, those costs include only the effort of DOL personnel which will be needed to monitor, identify, address, and correct the Contractor’s delays in performance. Additional costs beyond these are possible but have not been included in the calculation. There may be instances of delays where the Government may need to spend extraordinary efforts to correct the Contractor delays (incurring costs not reflected in the liquidated damages amounts below) in which case the Government may pursue actual damages in lieu of or in addition to liquidated damages.

· Liquidated Damages Calculation: ([X# of calendar days after due date a conforming billable work product is submitted] / 10 calendar days, rounded down to a whole number), multiplied by $50.70 Assessed Liquidated Damages

· Below are some examples for calculating the Liquidated Damages for delayed billable work products:

Billable Work Product is delivered 9 calendar days after due date (16 calendar days after the examination) 9 calendar days / 10 calendar days = 0.9 = 0 after rounding down * $50.70 = $0.00 in assessed damages.

Billable Work Product is delivered 11 calendar days after the due date (or 18 calendar days after examination). 11 calendar days / 10 calendar days = 1.1 = 1 after rounding down * $50.70 = $50.70 in assessed damages Billable Work Product is delivered 21 calendar days after due date (28 calendar days after the examination) 21 calendar days / 10 calendar days = 2.1 = 2 after rounding down * $50.70 = $101.40 in assessed damages The due date does not shift if the first/last day is on a holiday, weekend. Further, DOL may seek actual damages from the contractor for its failure to perform the billable work product (including the impacts to the Government from the delay in return to work by the OWCP claimant).

Reference Technical Exhibit 2 “Deliverables Schedule” for a list of billable work products, service periods and due dates.

1.6.4 Recognized Holidays:

The Contractor is not required to perform services on the following holidays:

1.6.5 Hours of Operation:

The contractor is responsible for conducting performance between the hours of 8:00 am to 5:00 pm, Monday thru Friday, except Federal holidays or when the government facility is closed due to local or national emergencies, administrative closings, or similar government directed facility closings. The contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this statement of work when the government facility is not closed for the above reasons. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential.

1.6.6 Place of Performance:

The work to be performed under this contract action will be performed nationwide within the United States, and also within U.S. Territories, Possessions and Trust Territories. Covered workers may reside within any metropolitan statistical area (MSA) as defined by the Office of Management and Budget (OMB) U.S. Census Data Tool at https://data.census.gov/all?q=msa. Covered workers may also reside outside of MSAs, such as in rural areas. The Contractor must have the ability to provide medical services and schedule medical examinations within each MSA’s urban and non-urban areas, as well as outside of MSAs.

1.6.7 Type of Contract:

The government anticipates award of a Fixed Unit Rate type contract for the services identified in the “Schedule of Services/Supplies”.

1.6.8 Ownership

All products, information and deliverables generated under this contract are and will remain the property of the U.S. Government and DOL. The Contractor may not change, modify, or use any materials outside the scope of this contract without the Government’s approval. Release of reports to claimants or third parties is prohibited.

1.6.9 Security:

The Contractor shall comply with the Federal information security standards, DOL Computer Security guidelines and DOL Manual Series (DLMS). The Federal information security guidelines include, but are not limited to, the following:

1) Privacy Act of 1974 (5 U.S.C. § 552a)

2) Federal Information Security Modernization Act of 2014 (FISMA), 44 USC § 3551 et seq.

3) OMB Circular No. A-130, Managing Information as a Strategic Resource, July 28, 2016

4) OMB Memorandum M-17-12, Preparing for and Responding to a Breach of Personally Identifiable Information, January 3, 2017

5) OMB Memorandum M-16-24, Role and Designation of Senior Agency Officials for Privacy, September 15, 2016

6) OMB Memorandum M-03-22, Guidance for Implementing the Privacy Provisions of the E-Government Act of 2002, September 30, 2003

7) OMB Memorandum M-01-05, Guidance on Inter-Agency Sharing of Personal Data - Protecting Personal Privacy, December 20, 2000

8) OMB Memorandum M-00-13, Privacy Policies and Data Collection on Federal Web Sites, June 22, 2000

9) OMB Memorandum M-99-05, Instructions on Complying with President's Memorandum of May 14, 1998, "Privacy and Personal Information in Federal Records,” January 7, 1999

10) DLMS 7 – Chapter 400 – Information Technology Security. To be provided as after award.

11) DLMS 7 – Chapter 1100 - Safeguarding Sensitive Data Including Personally Identifiable Information. To be provided as after award.

12) Department of Labor Cyber Security Policy Portfolio (CPP). To be provided as after award.

1.6.9.1 Employee Security and Background Investigations

The Contractor shall conduct background investigations on all personnel assigned to this contract. The background investigations shall comply with applicable agency personal identity verification procedures, Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

After award, OWCP will provide the Contractor with a copy of the presentation covering new user computer security training and a copy of the DOL IT Rules of Behavior (ROB). Each contractor providing services under this contract shall sign an acknowledgement that they have received and reviewed the training and the ROB prior to the employee performing any work under the contract.

The Contractor shall ensure that an electronic copy of this acknowledgement is maintained on file in the event it is requested by the COR (and/or the Office of Inspector General (OIG) for use in audits. This signed acknowledgement shall be maintained until the new contract employee has separated from the contract.

The signed certification document and OWCP Contractor Non-Disclosure Agreement (NDA) must be maintained by the contractor’s federal supervisor until the new contractor has left the organization. Both documents must be made available upon request of COR of the OIG for audit purposes. A link to the DOL ROB and the NDA will be provided after award.

1.6.9.2 User Accounts for Government IT Systems

The Contractor shall ensure that the proper user account request forms are completed and submitted to the FECA program for all contract users needing access to the DOL systems prior to the employee performing any work under the contract. Such paperwork is needed for access to the Government’s current and future IT systems including, but not limited to, OWCP’s WCMBP portal. The specific forms will be provided to the Contractor after award.

The Contractor shall maintain user account request forms and security documentation review documents. Upon seven (7) calendar days of contract personnel resignation, dismissal or reassignment, the Contract Manager shall notify the COR/FECA Federal Program Managers. On the day of employment termination all necessary account deletion forms must be filled out and made available to OWCP (within 24 hours). When applicable, the Contractor must also take direct steps to disallow a transferred or terminated user’s access to DOL systems immediately. The Contractor shall review information system accounts every six (6) months to also include the matching of user accounts with relevant user records (including, but not limited to, personnel files) to ensure that terminated or transferred individuals do not retain system access. The annual recertification of accounts must be a full review of all user accounts.

1.6.9.3 Removing Employees for Misconduct and Security Reasons The Government reserves the right to request the Contractor remove contractor employees from any work within the scope of this contract for gross misconduct or security reasons (i.e., conflict of interest, etc.). The Contracting Officer will notify the Contractor of all violations, and the Contractor will be responsible for removing from case work and replacing those persons immediately, but no later than five (5) calendar days upon notification. Removal of a Contractor employee from work within the scope of this contract does not relieve the Contractor of the responsibility to continue to provide all services required under the awarded contract. The COR in coordination with the Federal Program Manager (reference Section 1.6.12) will provide the Contracting Officer with a written explanation to support any request to remove and/or replace an employee or Subcontractor prior to submission to the Contractor.

The Contractor shall be responsible for safeguarding all Government property provided for contractor use. At the close of each work period, Government facilities, equipment, and materials shall be secured.

1.6.9.4 Commitment to Protect Sensitive Information

Information relating to individual claims of Federal employees for benefits under the Federal Employees' Compensation Act (FECA) is maintained in the Privacy Act System of Records entitled DOL/GOVT-1. Information from the DOL/GOVT-1 system of records is protected by the provisions of the Privacy Act of 1974; therefore, all personnel assigned to this contract shall take proper precautions to protect the information from disclosure. All personnel assigned to this contract are responsible for protecting this Privacy Act information in the same way, and to the same extent, as Federal employees (including criminal penalties for improper disclosure).

Additionally, Contractor shall ensure that all personnel assigned to this contract must take an online training course on DOL Cybersecurity and Privacy Awareness Training prior to the employee performing any work under the contract. Training presentation will be provided after award. This training course is required before system access is granted and then must be completed annually by all employees (including Contractor employees) with access to DOL systems.

The Contractor shall not release, publish, or disclose sensitive information to unauthorized personnel, and shall protect such information in accordance with provisions of the following laws and any other pertinent laws and regulations governing the confidentiality of sensitive information: 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records).

The Contractor agrees that only persons authorized by the Government shall access and/or utilize the Government’s current and future IT systems, including but not limited to the WCMBP portal.

During the performance of this contract the Contractor will come into contact with proprietary Government information (i.e., Financial/accounting records) or sensitive information. With respect to any such information obtained in the course of the performance of this contract where such effort may reasonably lead to an employee having access to this information, and when specified in a delivery order, the Contractor agrees as follows:

1) Not to use such information for any purpose other than in the performance of the contract.

2) To limit access to such Government information to those in Contractor’s employment who are actually performing work on the task and need to know in order to perform the services under this contract

1.6.9.5 Disposition of Sensitive Documentation

The individual physicians must not retain case-specific personal information or documents pertaining to a FECA case after closure of the case. Physicians are required to document the disposition of all OWCP case file information, materials, medical records, and/or emails that may exist in any form (hard copy and/or electronic). This includes documenting how this action was performed, e.g., permanently deleting, shredding, or burning. Upon termination of employment, in addition to above, within 10 calendar days, the physician must provide a signed letter to the Contractor verifying the disposition of all OWCP case file information, materials, medical records, and/or emails that may exist in any form (hard copy and/or electronic) in their possession. This includes documenting how this action was performed, e.g., permanently deleting, shredding, or burning. The contractor is required to maintain a copy of letter(s) on all outgoing employees and provide copies upon the Government’s request. If the Contractor’s physician fails to produce final letter verifying disposition of case file materials; the Contractor will notify the COR. The Contractor will assist in any follow up actions as needed to ensure security and final disposition of case file materials.

1.6.9.6 PII Breach

In accordance with this PWS and with the applicable Personally Identifiable Information (PII) contract clause (Privacy Breach Notification Requirements), the Contractor shall be responsible for reporting any breach or suspected breach of PII data within one (1) hour of becoming aware of the incident. PII is defined as any and all documents or electronic records containing information of a personal nature, which can be searched or retrieved, by name, social security number or other personal identifying designation.

Any failure to provide data protection and/or timely notification of a breach may result in action by the Government. The Contractor shall notify the designated points of contact immediately via whatever means (e.g., phone call, email, etc.) which satisfactorily accomplishes this requirement.

Thereafter, the Contractor shall confirm the breach and gather all necessary facts to complete the Government-provided Incident Report form to notify the Government of all details of the security incident involving PII. Incident Report form will be provided after award.

In the event of a suspected, potential or PII breach, the Contractor shall notify within one (1) hour of the breach: zzOWCPSECURITY@dol.gov.

If E-mail is not possible then please notify: (To be provided after contract award) As additional information becomes known, the Contractor shall update the Incident Report form and resend to the e-mail group above. Once the DOL receives the Incident Report, someone within the OWCP will review the report to determine if there was a breach. In the event of a breach, the Contractor is not to notify the injured workers and/or their authorized representatives. The Government will perform that notification.

1.6.9.7 Memorandum of Understanding (MOU)

The contractor must work with the DOL to draft an MOU and an accompanying ISA, using DOL furnished templates, which cover the security and privacy-related expectations surrounding data exchange and the connection mechanism. The DOL and the contractor must not transmit sensitive data, including PII and protected health information (PHI) in the absence of a fully executed MOU and ISA. The MOU and ISA may be digitally signed by the signature authorities.

1.6.10 Special Qualifications:

1.6.10.1 Physician Qualifications:

The Contractor shall ensure that each participating physician meets the following criteria and/or professional qualifications at the time the appointment is scheduled.

1) All physicians shall possess an M.D. degree, D.O. degree, DPM degree, or Psy. D. Degree, as applicable.

2) All physicians shall hold an active, unrestricted license to practice medicine in the state in which they perform examination(s) or otherwise practice under this contract and have medical liability insurance.

3) All physicians shall be Board-certified in their respective specialties by one of the medical specialty Boards such as the American Board of Medical Specialties, the American Osteopathic Association or the American Board of Foot and Ankle Surgery (ABFAS) (formerly known as the American Board of Podiatric Surgery (ABPS)).

4) A clinical psychologist may serve as a physician only within the scope of his or her licensure under state law. A clinical psychologist may not be selected for conditions that include a physical component.

5) For the purposes of this contract, all physicians shall be engaged in an active medical practice with no less than a minimum of 120 hours of direct patient care over the previous twelve (12) months. The use of retired physicians is strictly prohibited under this contract. Under no circumstances shall the Contractor schedule a medical examination service with a physician who is not engaged in active medical practice or does not have a medical facility where examinations can be performed. The Contractor is expected to obtain attestations that contain the details of such practice and/or CME. The use of physicians that only provide disability type examinations is strictly prohibited under this contract nor can disability evaluations count as direct patient care. While attestation of professional hours of practice will be accepted, OWCP reserves the right to review such attestations and to request supporting documentation.

6) The physician may not have restrictions on his or her licensure/practice or be suspended or debarred from providing such services. The Contractor shall not use a physician that is on any of the following excluded provider lists: HHS-OIG excluded providers (https://exclusions.oig.hhs.gov/); National Provider Data Bank; state exclusion lists; and the System for Award Management (SAM) list. Additionally, OWCP will provide a list of entities to which payments shall not be made. The Contractor shall ensure that medical services are not scheduled, nor bills submitted with any such entity.

7) The Contractor shall maintain a copy of each physician’s signed subcontract or agreement to confirm the physician is legally obligated to perform work on behalf of the Contractor for the Government. The contractor shall also maintain documentation that substantiates the physician meets criteria in Section 5.2 of this PWS and provide such documentation to OWCP for approval before commencing the required referral service.

1.6.10.2 Additional Qualifications for Physicians Performing Examinations or Evaluations for Impairment Ratings:

FECA Impairment Ratings: Physicians who perform examinations and provide reports for disability ratings for the determination of impairment ratings for FECA shall also have familiarity with and experience in the use and application of the American Medical Association (AMA) Guides that is designated by the OWCP. The Contractor shall verify the physician’s experience specifically with the required edition(s) prior to the scheduled examination or case file review. For the Base year, FECA requires use of the second printing of the 6th Edition of the AMA guides (2009), as indicated during individual referrals, but may require use of newer or different editions during the life of this contract during Option Periods 1, 2, 3, and 4. All proposed pricing shall consider the use of subsequent updates to the AMA Guidelines and editions without the need for further negotiations, amendments or modifications to the price schedule and contract.

1.6.11 Post Award Conference/Periodic Progress Meetings:

The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The Contracting Officer, COR, and other government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor's performance. At these meetings, the Contracting Officer will apprise the Contractor of how the government views the Contractor's performance and the Contractor will apprise the government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.6.12 Contracting Officer’s Representative (COR):

The COR will be designated in writing by the DOL and a copy of the letter of designation will be forwarded to the contractor. The COR monitors the technical aspects of the contract and assists in contract administration, but the COR is not authorized to make changes to the terms and conditions of the contract. Changes to the terms and conditions of the contract must be made by the CO. The COR oversees contract performance, assures that the contractor adheres to the technical requirements of the contract, communicates with the contractor concerning the technical aspects of the contract, issues written interpretations of the technical requirements, and notifies the CO and the contractor of any deficiencies in the contractor’s performance. All contract-related communication from the contractor must be forwarded to the COR.

1.6.13 Key Personnel:

The following personnel are considered required key personnel by the Government: Contract Manger/Alternate Contract Manager. The Contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the Contractor when the manager is absent shall be designated in writing to the Contracting Officer. The contract manager or alternate shall have full authority to act for the Contractor on all contract matters relating to daily operation of this contract action. The contract manager or alternate shall be available between 8:00 a.m. to 5:00 p.m. Monday through Friday, except Federal holidays or when the government facility is closed for administrative reasons.

1.6.14 Identification of Contractor Employees:

All contract personnel attending meetings, answering calls on behalf of the Government, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are government officials. They must also ensure that all documents or reports produced by Contractors are suitably marked as Contractor products or that Contractor participation is appropriately disclosed.

1.6.15 Organizational Conflict of Interest:

Contractor and sub-Contractor personnel performing work under this contract action may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI), as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may affect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

1.6.16 Transition In/Transition Out Period

To minimize any decreases in productivity and to prevent possible negative impacts on additional services, the Contractor shall have personnel on board during the ninety (90) day transition in/transition out periods. During the transition in period, the Contractor shall become familiar with performance requirements in order to commence full performance of services on the contract action start date, to include any testing necessary for the successful implementation of the SFTP connection and other communication vehicles.

1.6.16.1 Case Transfers and Loans

Cases pending at the end of contract performance may only be transferred from the existing contract to a new vendor if approved by the COR. The incumbent must request written approval from the COR or other designated OWCP official and ensure reporting requirements, billing and invoicing DO NOT DUPLICATE.

1.6.17 Pricing and Payment for Services Pricing for the required services is fixed unit rate based on the specified work products detailed in the Billable Work Products table in this section. All costs for contract management services, contractor personnel training, outreach, oversight, task and performance reports, and additional support services must be incorporated into the fixed pricing for the listed billable work products. This includes any and all labor, direct and indirect costs, general and administrative costs, materials, pick-up and delivery, ancillary costs, applicable fees and profit associated with providing the required services. The only items other than billable work products which may be billed, with prior authorization, are direct expenses for the following, for which the government set NTE limits in attachment J.1 Pricing Sheet:

1) Interpreter services, diagnostic testing, and other unforeseen necessities in rendering a complete medical report

2) Transportation for arranged transport and travel.

These direct expenses must be submitted using the approved OWCP direct expense invoice template via the WCMBP portal for approval and payment.

Once the contract is awarded, all terms and conditions of the initial contract shall remain unchanged, except whereas expressly and formally modified by both parties, when applicable. The price is inclusive of any/all labor, indirect costs, materials, pick-up and delivery, ancillary costs and applicable fees. Notwithstanding the above, Service Contract Labor Standard price adjustments may modify contract prices as permitted by FAR 52.222-43 to comply with prevailing Wage Determination.

Payment for services under this contract is made through the FECA fund, as outlined in Section 5.5.5, based on the approval of billable work products accompanied by associated billing/invoice. The billable work products and associated invoices must be accurate, complete, timely and fully address all questions posed by the Federal claims examiner. The Contractor must note and apply the applicable Tier Pricing and any applicable liquidated damages for each billing/invoice submitted. The billing/invoice and associated work product are both considered late if not submitted in appropriate format together within required timeframes through approved mechanism(s) of transmission. The Contractor shall correct any deficiencies/issues identified by the Government and resubmit within seven (7) calendar days of notice from the Government.

Pricing for this contract is based on the delivery date for conforming billable work products. The Government will apply tier pricing to the billable work products listed in the table below, based on the submission date. The tier pricing unit rates for the respective billable work products will be approved at contract award. Tier 1 represents the base billable price applicable for a respective work product and the highest billable price for resubmitted work products. Tier 2 represents the incentive pricing (10% increase of the Tier 1 price) and highest billable price for initial (i.e. not resubmitted) work products. Tier 2 pricing does not apply to resubmissions.

The rest of the billable work products where tier pricing does not apply will have fixed price per unit also determined at contract award.

Price)

Supplemental Report Section 5.4.1.3.2

No more than 21 calendar days from the date of supplemental request.

A report submitted after 21 calendar days, or after 35 calendar days when diagnostic testing or consultations are necessary, is considered late and subject to liquidated damages.

Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 11-21calendar days from receiving the supplemental request Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within ten (10) calendar days after receiving the supplemental request.

SECOP Medical Report Section 5.4.2.2

No more than 7 calendar days from the date of examination, or no more than 14 additional calendar days (21 total) when diagnostic testing or consultations are necessary.

A report submitted after 7 calendar days, or after 21 calendar days when diagnostic testing or consultations are necessary, is considered late and subject to liquidated damages.

testing.

IME Medical Report Section 5.4.3.2

No more than 14 calendar days from the date of examination, or no more than 14 additional calendar days (28 total) when diagnostic testing or consultations are necessary.

A report submitted after 14 calendar days, or after 28 calendar days when diagnostic testing or consultations are necessary, is considered late and subject to liquidated damages.

Base billable price if the required report is approved by the FECA program and the conforming report is submitted within 9-14 calendar days after examination, or within 17-28 calendar days after diagnostic testing.

Highest billable price (10% increase of Tier 1 price) if the required report is approved by the FECA program and the conforming report is submitted within eight (8) calendar days after examination, or within sixteen (16) days after diagnostic testing.

Case File Review - Surgical Review Report Section 5.4.4.2(1)

No more than 7 calendar days from the date of referral.

A report submitted after 7 calendar days is considered late and subject to liquidated damages.

examination.

Case File Review - Impairment Rating Report or IME File Review Section 5.4.4.2(2)

No more than 30 calendar days from the date of referral.

A report submitted after 30 calendar days is considered late and subject to liquidated damages

receiving the referral

Case File Review – Other Report Section 5.4.4.2(3)

No more than 21 calendar days from the date of referral.

A report submitted after 21 calendar days is considered late and subject to liquidated damages

receiving the referral

Tier 1 (Base Price) always applies in any situation where Tier 2 does not apply.