ESBD_534300_1783009060716_Exhibit_G_Scope Of Work (SOW).pdf
PDF 198 KB Posted
- Attached to
- HHSC Facilities seek Radiology and EKG reads
- Solicitation number
- HHS0017505
- Issued by
- Texas
About this file
This is a Statement of Work (SOW) for the Health and Specialty Care System (HSCS), a division of the Texas Health and Human Services Commission (HHSC), soliciting radiology and cardiology read and over-read services for X-rays and electrocardiograms (EKGs). The performing agency must provide radiological and cardiological interpretation services submitted by 11 state hospitals and 13 State Supported Living Centers (SSLCs) located across Texas, including facilities in Abilene, Austin, Big Spring, Brenham, Corpus Christi, Denton, El Paso, Kerrville, Lubbock, Lufkin, Mexia, Richmond, Rio Grande, Rusk, San Angelo, San Antonio, Terrell, Vernon, Waco, and Wichita Falls. Services include reading X-rays and EKGs accompanied by appropriate clinical history and preliminary physician reports, with facilities having the discretion to submit materials physically or electronically. The vendor must maintain The Joint Commission accreditation, Medicare certification, and all required federal, state, and local licenses, and must provide quarterly updates of all licensed Texas providers to HHSC.
The vendor shall invoice HHSC monthly for services rendered at the rates submitted in response to the solicitation, with invoices submitted to the central facility contracts mailbox and containing specific required information including vendor name, address, telephone number, contract number, service delivery dates, facility location, service descriptions, rates, quantities, and total amounts. All providers must be credentialed and privileged according to the vendor's processes while satisfying Medicare Conditions of Participation requirements, maintain valid Texas state licenses, and work within their scope of medical practicing privileges. HHSC retains the authority to exclude any provider from performing services and to evaluate provider performance and compliance with contract terms, with any provider failing to maintain employment or privileging at the vendor automatically losing privileges at all HHSC facilities.
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STATEMENT OF WORK
I. DEFINITIONS
As used in this Contract, unless the context clearly indicates otherwise, the following terms and conditions in this Statement of Work have the meaning assigned below:
The Health and Specialty Care System, a division of HHSC, operates 11 state hospitals and 13 State Supported Living Centers (“SSLCs”) across the state. A State Supported Living Center, or a State Hospital, may be referred to in this SOW as a “Facility.”
Vendor is the Performing Agency selected in response to solicitation.
Provider is the physician(s) performing serviced to HHSC on behalf of the Vendor
II. PERFORMING AGENCY RESPONSIBILITIES
Performing Agency shall:
A. Provide radiology and cardiology reads and over-read services for X-rays and electrocardiograms (EKGs) submitted or transmitted by any Facility to the Vendor accompanied by an appropriate clinical history, reason for examination (doctor’s orders or R/O pathology are not adequate), and a preliminary physician report indicating recognition of any abnormality and appropriate corresponding treatment. Facility may, at its discretion, choose to physically submit or electronically transmit the radiology films or EKGs. The submitting Facility physician’s name and contact information shall be clearly indicated with the submission.
B. Provide a list of all Providers, licensed by the State of Texas (with correct contact phone numbers) quarterly to HHSC at the following address hscsfacilitycontracts@hhs.texas.gov.
C. Maintain the following certification, registrations, licenses, and permits: The Joint
Commission (“TJC”) accreditation; Medicare certification; and all required federal, state, and local governmental licenses and/or permits. The Vendor shall immediately notify HHSC’s Contract Representative if any accreditation, certification, license, or permit is terminated or cancelled.
D. Ensure that all Work provided by the Vendor’s Provider is within the scope of their medical practicing privileges.
E. Acceptance of Medicaid/Medicare rates preferred.
F. Invoice HHSC for all Vendor’s Work consistent with the rate schedule submitted in response to posting.
mailto:hscsfacilitycontracts@hhs.texas.gov
a. Vendor shall submit invoice(s) to the respective Facility Contracts central mailbox for all Work performed on a monthly basis to the at the following address hscsfacilitycontracts@hhs.texas.gov .
b. Each invoice shall contain the following information:
1. Name, address, and telephone number of Vendor
2. HHSC Contract Number;
3. Date(s) on which Contract services were delivered;
4. Name and location of Facility for which services were provided;
5. Description of services provided;
6. Rate and quantity of invoiced services; and
7. Total invoice amount.
c. Submitted invoices shall be legible, complete, and correct. Illegible, incomplete, or incorrect invoices shall be denied payment.
III. SERVICE AREAS
• The 13 SSLC’s are located in Abilene, Austin Brenham, Corpus Christi, Denton, El Paso, Lubbock, Lufkin, Mexia, Richmond, Rio Grande, San Angelo and San Antonio.
• The 11 State Hospitals are located in Austin, Big Spring, El Paso, Kerrville, Vernon, Wichita Falls, Rio Grande, Rusk, San Antonio, Terrell, and Waco.
Facility & Address Facility & Address Abilene State Supported Living Center 2501 Maple St.
Abilene, TX 79602
Austin State Supported Living Center 2203 W. 35th St.
Austin, TX 78703
Austin State Hospital 4110 Guadalupe St.
Austin, TX 78751
Big Spring State Hospital 1901 N. Hwy 87 Big Spring, TX 79720
Brenham State Supported Living Center 4001 Hwy 36 South Brenham, TX 77833
Corpus Christi State Supported Living Center and Corpus Christi Bond Homes 902 Airport Rd.
Corpus Christi, TX 78405
Dallas State Hospital 4855 Harry Hines Blvd.
Dallas, TX 75235
Denton State Supported Living Center 3980 State School Rd.
Denton, TX 76210
El Paso Psychiatric Center 4615 Alameda Ave.
El Paso, TX 79905
El Paso State Supported Living Center 6700 Delta Dr.
El Paso, TX 79905 mailto:hscsfacilitycontracts@hhs.texas.gov
Kerrville State Hospital 721 Thompson Dr.
Kerrville, TX 78028
Lubbock State Supported Living Center 3401 N. University Ave.
Lubbock, TX 79415
Lufkin State Supported Living Center 6844 Hwy 69 North Pollok, TX 75969
Mexia State Supported Living Center 540 Chapel Dr.
Mexia, TX 76667
Richmond State Supported Living Center 2100 Preston St.
Richmond, TX 77469
Rio Grande State Center 1407 S. Rangerville Rd.
Harlingen, TX 78550
Rio Grande State Supported Living Center 1401 S. Rangerville Rd.
Harlingen, TX 78552
Rusk State Hospital 805 N. Dickinson Dr.
Rusk, TX 75785
San Angelo State Supported Living Center 11640 N US Hwy 87 Carlsbad, TX 76934
San Antonio State Hospital 6711 S. New Braunfels San Antonio, TX 78223
San Antonio State Supported Living Center 6711 S. New Braunfels Ave.
San Antonio, TX 78223
San Antonio State Hospital / Casa Amistad Unit 1500 Pappas St.
Laredo, TX 78041
Terrell State Hospital 1200 E. Brin St.
Terrell, TX 75160
Vernon State Hospital 4730 College Dr.
Vernon, TX 76385
Waco Center for Youth 3501 N. 19th St.
Waco, TX 76708
Wichita Falls State Hospital 6515 Kemp Blvd.
Wichita Falls, TX 76308
IV. CREDENTIALING AND PRIVILEGING
A. Performing Agency warrants the following:
a. Each provider performing work under this contract shall be credentialed, privileged, and reappointed, as necessary, according to Vendor’s credentialing and privileging processes and standards; and
b. Each provider performing work under this contract shall render contract services withing the scope of the provider’s respective medical practicing privileges.
B. All provider credentialling and privileging processes shall satisfy, at minimum, the
Medicare Conditions of Participation at 42 CFR § 482.12(a)(1-9) and 42 CFR § 482.22(a)(1-4).
C. Vendor shall furnish services that, in accordance with 42 CFR § 482.12(e), permit HHSC to comply with all applicable conditions of participation for the Contracted services.
D. State or Territorial Licensure. At all times while providing Contract services to a Facility, each Provider shall hold a valid and unrestricted license issued or recognized by the state of Texas and the municipality or territory in which that Facility is located and where the Provider resides.
E. Decision of Governing Body. In addition HHSC relying upon its own credentialing and privileging criteria and requirements, the HHSC governing body and its medical staff may also rely on Vendor’s credentialing and privileging decisions for the purpose of determining whether to recommend HHSC medical practicing privileges for a practitioner at a Facility. HHSC is responsible for determining whether reliance on the Vendor’s credentialing and privileging decisions is warranted and for conducting its own internal processes in a manner that complies with Medicare Conditions of Participation and the requirements of the Facility's accrediting body. HHSC’s medical staff are not obligated to issue medical practicing privileges to those practitioners that the Vendor submits to HHSC.
Successful privilege is based on information reviewed, including data collected, as part of on-going profession practice evaluations.
F. The Vendor will supply HHSC with a list of Physicians to identify each Provider and the scope of medical practicing privileges granted to the Provider by the Vendor. The Vendor shall notify HHSC in the event of any change in the information previously furnished in accordance with the following within five (5) calendar days of revising the Provider’s privilege.
G. Action by HHSC to Initiate Removal of Vendor’s Provider. HHSC may, in its sole discretion, exclude any of the Vendor's Provider from performing under the contract and in compliance with the terms and conditions of the contract.
H. The Vendor’s Provider’s failure to maintain the Vendor's employment or privileging shall automatically result in termination of that provider’s privileges at all HHSC Facilities from providing services under the contract.
V. PERFORMANCE MEASURES
A. Receiving agency Shall monitor the Provider’s performance and compliance with the contract’s terms and conditions. The Vendors signature authority shall be advised of all adverse events and complaint that result from any provider’s provision of Contract services.
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