Teleradiology_PWS_FY14.docx

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Teleradiology Service Statement of Work

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STATEMENT OF WORK

For

AIR FORCE MEDICAL SERVICE

Teleradiology Service

NON-PERSONAL SERVICES

July 2014

TABLE OF CONTENTS

TITLE PAGE

1.0 DESCRIPTION OF SERVICES 3

2.0 SERVICES SUMMARY 4

3.0 GOVERNMENT FURNISHED PROPERTY AND SERVICES 5

4.0 GENERAL INFORMATION 5

5.0 APPENDICES 7

1.0. DESCRIPTION OF SERVICES: The contractor shall provide (NON-PERSONAL) professional diagnostic radiological interpretations and reports by a board certified radiologist for 96 MDG, Eglin Air Force Base, FL called for under this service contract. Services shall be performed at the contractor's facility.

1.1. SCOPE OF WORK: 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 Air Force radiologists. Examinations include basic film, ultrasound, and nuclear medicine, cross sectional imaging (Magnetic Resonance Imaging - MRI and Computerized Tomography – CT).

1.2. SPECIFIC TASKS FOR TELERADIOLOGY SERVICES:

1.2.1. The radiologist shall provide diagnostic interpretations and interpretations of radiological examinations performed by Government personnel and provide further diagnostic consultation that relates to diagnostic imaging, upon request, to the other members of the medical staff. “Examinations", as referred to herein consists of individual patient examinations, which may include preliminary and final interpretation of one or more images. Further diagnostic telephone consultation may be required upon request of the user. The services shall consist of, but are not limited to, those set forth below:

1.2.1.1. Diagnostic Plain Film

1.2.1.2. Ultrasound

1.2.1.3. Nuclear Medicine

1.2.1.4. Cross Sectional Imaging: Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT)

1.2.2. The contractor must provide preliminary diagnostic reporting within 1 hour of receipt of the transmitted images for all studies. Final interpretations must be provided within 24 hours of receipt of transmitted images.

1.2.3. The name of the interpreting radiologist shall be clearly noted on all interpretive reports.

1.2.4. In case of failed electronic communication, an interpretive report can be faxed to the user. Contractor shall be available telephonically until restoration of electronic communications.

1.2.5. The contractor must have and/or maintain all applicable information security clearances and authorizations required to establish connection and maintain connection to the Air Force network:

1.2.5.1. The contractor must demonstrate DoD Information Assurance Certification and Accreditation Process (DIACAP) certification/interim clearance for all electronic systems required to interface with the Air Force network. Contractor must submit evidence of DIACAP compliance at the time of submission of proposal and maintain such certification throughout the course of contract execution. The DIACAP process is described in Appendix D.

1.2.5.2. Prior to beginning to provide any services under this agreement, Contractor shall obtain all applicable government required authorizations to have a Virtual Private Network (VPN)/Business-to-Business connection (B2B) to the Air Force Computer Network System. This shall include an Authorization to Connect (ATC). The contractor shall provide a valid ATC within 3 days of contract award (if possessed) or submit a completed application for ATC and B2B within 14 calendar days after award of contract.

1.2.5.3. Contractor must employ electronic systems which have the ability to interface directly with the Department of Defense Composite Healthcare System (CHCS) by HL7 interface/BHIE adapter from their work site to directly transcribe interpretations into the patient record. The contractor must have computer hardware that is capable of receiving Digital Imaging and Communications in Medicine (DICOM) compliant images from the MOFMC.

1.2.6. Contractor shall provide personnel who qualify for all applicable security clearance requirements to maintain access to the Air Force network. Submission of required security clearance documents shall be performed within 7 days of contract award.

1.2.7. The contractor’s physicians shall provide written or telephonic advice and professional opinions upon request by the MOFMC. Although participation in MOFMC committees (Professional Staff Meeting, Executive Committee of the Medical Staff, Credentials Function, etc.) by contractor’s radiologists is not routinely required, the contractor agrees to make the credentialed radiologists available in support of the various boards and committees within the MOFMC if a particular event should require. Such a request will be provided through the contract administrator to the contractor at least 7 days in advance if a contractor’s radiologist participation is required.

1.2.9. CREDENTIAL REVIEW.

1.2.9.1. All physicians providing service under the provision of this contract shall have current ACR Board Certification.

1.2.9.2. The contractor shall submit all credentialing documentation to the Credential Office within 14 calendar days after award of contract for initial contractor personnel and 30 working days prior to performance of services by replacement contract personnel. Any incident that may impact the continued privileging of a physician shall be brought to the attention of the CO and 96MDG credentialing staff as soon as validated.

1.2.9.3. Credentialing and Privileging Process.

1.2.9.3.1. Physicians will not provide any patient care until credentialing process is complete.

1.2.9.3.2. Contractor shall complete a privilege application, as well as provide evidence of professional training and experience, board certification status, and current unrestricted Florida state licensure to the Credential Office for each physician who desires to work under this agreement. Documentation of currency in interpretation of modalities may also be requested.

1.2.9.3.3. Notify the 96MDG Credentialing Department of any changes to the Centralized Credentials Quality Assurance System (CCQAPS) data, to include addresses, or work unit.

1.2.9.3.4. Report any voluntary or involuntary relinquishment of licensure or registration to practice or voluntary relinquishment of privileges within 7 working days and explain reason by completing a form letter.

1.2.9.3.5. Complete a statement of health indicating any significant medical or mental condition, which has previously interfered, or may currently interfere with or limit ability to practice medical care.

1.2.9.3.6. All contract providers shall maintain malpractice insurance compliant with applicable state and federal licensing authority at the expense of the contractor/provider.

2.0. SERVICES SUMMARY

Performance Objective
PWS Ref
Performance Threshold
1. Preliminary interpretation response
1.2.2
98% returned within 1 hour of receipt of image
2. Final interpretation response
1.2.2
100% returned within 24 hours of receipt of image
3. Security of patient information
4.2.5
Zero unauthorized release of patient information
4. Consultant availability 24-7
4.2.7
100% availability of radiologist available for telephone consultation
5. Timely privileging submissions
1.2.9.
Zero late submission of credentialing applications.
6. Interpretation accuracy
4.15.2
Accuracy for preliminary interpretation shall be 98%, and 100% for final interpretations in evaluating for major discrepancies leading to changes in patient care

3.0. GOVERNMENT-FURNISHED PROPERTY AND SERVICES

3.1. The Government will perform and transmit all study images electronically to the contactor for diagnostic radiological interpretations along with any clinical information available to the radiologic technologist.

3.2. All digital images and accompanied data shall remain the property of, and subject to the exclusive control of the U.S. Government. All related reports, images, and documents prepared by the contractor for diagnostic imaging interpretation and support in fulfillment of this contract will become the property of the U.S. Government.

3.3. A fax number will be provided to the contractor within 3 calendar days after award.

3.4. The Government Hospital Info System (HIS) is using CHCS (Composite Health Care System) and AGFA PACS that has the ability to transmit DICOM images directly from the PACS system and the modalities.

3.5. The Government is currently using the HL-7 interface system which the contractor may utilize for directing final reports directly into the Hospital Information System at no cost to the Government.

3.6. The Government permits the contractor to place an approved DICOM send station behind the Government’s firewall in order to facilitate a central point of DICOM transfer once an ATC is issued.

4.0. GENERAL INFORMATION

4.1. CONTRACTOR FURNISHED PROPERTY: This is not intended to be a comprehensive list of all contractor furnished property, it covers the core components that are possibly involved in a complete personnel equipment, and service solution. The contractor is required to assess the full extent of support necessary to provide the required services, equipment, and/or personnel for this contract. Compliance with the elements of this section are only relevant to the extent it is applicable to this contract.

4.1.1. The contractor shall be required to obtain Virtual Private Network (VPN) access to connect to the Government Local Access Network (LAN) and must communicate with the network, DICOM, and HL7.

4.1.2. The contractor shall be responsible for network connectivity to access from their database location to the Government computer systems for the transference of interpretations.

4.1.3. The contractor shall ensure compliance with the electronic data security requirements as required under the Health Insurance Portability Act (HIPAA), see appendix B.

4.1.4. Computer hardware utilized for viewing images shall be capable of resolution display quality in accordance with the ACR–AAPM–SIIM Technical Standard For Electronic Practice of Medical Imaging, 20 September 2012 (or current edition). See http://www.acr.org/~/media/AF1480B0F95842E7B163F09F1CE00977.pdf The contractor will maintain all other applicable standards described in this document.

4.1.5. Maintenance of computer hardware to ensure capability and submission of those maintenance records if requested by the Government.

4.2. CONTRACTOR PERSONNEL. Radiologists assigned by the contractor to provide the official interpretation of images transmitted by teleradiology must maintain licensure appropriate necessary to deliver radiologic service. Physicians providing services under this contract must be privileged by the guidelines set by the Joint Commission (JC) and Air Force Instructions prior to execution of service and maintain their credentials while providing service. The contractor shall ensure professional liability coverage is in place in accordance with jurisdictional requirement of the state in which services are being performed.

4.2.1. The contractor shall ensure that all contractor personnel providing services under this contract are able to read, write and speak English fluently.

4.2.2. No work shall be performed outside of the United States.

4.2.3. After receipt of contract award, the contractor shall furnish a list of qualified radiologists, including name and telephone number, scheduled to perform services during the performance of this contract.

4.2.4. After receipt of contract award, the contractor shall provide the name and telephone number of an individual to act as his/her representative.

4.2.4.1. The designated representative shall be responsible for the administration and coordination of this contract with the Government Monday through Friday 7:30 a.m to 5:00 p.m, Central Time.

4.2.4.2. The contractor’s representative shall not be a radiologist providing the service under this contract. Duties shall include, but are not limited to:

4.2.4.2.1. Ensure interpretations and reporting are accomplished in a timely manner, see section 1.2.

4.2.4.2. Meet with Government personnel to discuss performance on a quarterly basis or as needed.

4.2.5. Contractor personnel shall not release medical information under any circumstance, but shall refer all requests for patient/hospital information to the 96MDG QAP.

4.2.6. The contractor shall communicate any problems encountered during the performance of the contract to the CO, who will seek a timely resolution of the problem.

4.2.7. Contractor shall be required to furnish interpretation and consultation services 24 hours a day 7 days per week including weekends and holidays. The contractor may faxed reports for stat and preliminary studies prior to the final report being entered into the HIS within the prescribe 24 hours. In addition, contractor shall be available for telephone consultation.

4.3. CONTINUITY OF SERVICES/REPLACEMENT STAFF. The contractor shall ensure sufficient staffing and resources to provide all required services and support throughout the term of the contract.

4.4. RELATIONSHIP OF THE PARTIES. This is a non-personal service contract. Contract personnel are not subject to the supervision and control of a Government officer or personnel [FAR 37.104(a)(1)(ii)]. Rather, contractor personnel perform their duties IAW specific tasks outlined in the PWS. Supervisory functions such as hiring, directing, counseling, and firing of contractor personnel are not performed by the Government. The contracted personnel who furnish services under this contract are subject to Government technical oversight of the services provided. The Government retains the right to reject services for contractual nonperformance.

4.5. FORMAL EDUCATION. Physicians providing services under this contract shall have completed residency at an institute recognized to provide such credentials in the United States.

4.6. LICENSURE/REGISTRATION. Contract personnel must maintain an active license or authorizing document from the state in which they are conducting the services under this contract.

4.7. CERTIFICATION. The provider shall have national approved and current board certification in the specialty area in which he/she provides clinical services.

4.8. EXPERIENCE. The radiologists shall have been continuously employed in the practice of diagnostic radiology or in training for 24 months within the last 36 months.

4.9. RECORDS. The contractor shall segregate the Government-owned data from other contractor-held data to include actual patient information. Upon completion of this contract, all contractor-held data (regardless of media) received, created, maintained or provided in the performance of the statement of work shall be turned over to the Government or signed document stating that files have been erased/destroyed and the means utilized to do so.

4.10. RELEASE OF MEDICAL INFORMATION. The Contractor shall release medical information obtained during the course of this contract to Military Treatment Facility (MTF) staff involved in the care and treatment of that individual patient only in accordance with Appendix B.

4.11. SECURITY. The Contractor is responsible for maintaining the security of patient information in accordance with HIPAA guidelines. Unauthorized access to Contractor controlled data will be reported to the CO and 96MDG QAP immediately. See Appendix B.

4.12. PROCEDURE GUIDANCE. Contractor shall perform procedures compatible with the medical facility's operating capacity and equipment. New medical procedures/services shall not be introduced without prior recommendation to, and approval of the Contracting Officer.

4.13. COMMUNICATION. Contractor personnel shall maintain open and professional communication with members of the MTF staff. Complaints validated by the Chief of Diagnostic Imaging Services shall be reported in writing to the QAP to the Contracting Officer and Contractor for action. Failure of the Contractor to correct validated complaints will be considered a failure to perform.

4.14. DOCUMENTATION. Contractor personnel shall prepare all documentation to meet or exceed established standards of the 96MDG, to include, but not limited to, timeliness, accuracy, content and signature.

4.15. QUALITY ASSURANCE/CONTROL

4.15.1. The Government shall monitor the contractor’s performance of this contract using quality assurance procedures established by the 96MDG and pursuant to the Inspection Services Clause. Additionally, the contractor’s performance is subject to scheduled and unscheduled review.

4.15.2. The contractor shall have an internal quality control procedure, which shall ensure the contractor’s performance/medical care evaluation will be at a level commensurate with standards of the medical profession and the American College of Radiology. Accuracy for preliminary interpretation shall be 98% and 100% for final interpretations in evaluating for major discrepancies that would result in a change to a patients care plan.

4.15.3. The 96MDG shall maintain a record-keeping system that monitors the contractor’s performance by exams interpreted for the purpose of payment verification.

4.15.4. Teleradiology Quality Control: a test image, such as the Society of Motion Picture and Television Engineers (SMPTE) test pattern shall be transmitted, archived, retrieved and displayed at least weekly, to test the overall operation of the system under conditions that simulate the normal operation of the system. The contractor shall maintain written documentation of the test performance and results. Failures of this QC test shall result in cessation of teleradiology services until technical problems have been successfully resolved.

5.0. APPENDICES Page

1. Acronyms & Abbreviations List1
1. HIPAA Business Associate Agreement2 – 5
1. Historical Data6
1. DIACAP Process7-8

APPENDIX A GENERAL DEFINITIONS

As used throughout this Performance Work Statement, the following terms shall have the meaning set forth below:

1.1. Composite Health Care System (CHCS) – DOD mandated Health Information System (HIS) that also serves as the Radiology Information System (RIS).

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

1.3. Healthcare Insurance Portability and Accountability Act (HIPAA) – Establishes national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addressed the security and privacy of health data.

1.4. Quality Assurance (QA) – Those actions taken by the Government to check services to determine if they meet the requirements of The Joint Commission (TJC), Department of Defense, individual Medical Treatment Facilities Quality Assurance and Risk Management Programs and ensure that the contractor personnel comply with the terms and conditions of the agreement.

1.5. Quality Assurance Personnel (QAP) – A Government personnel selected and designated in writing by the contracting officer to act as his/her designated representative in administering a contract.

1.6. Quality Control (QC) - Those actions taken by the contractor to control the production of goods and services so that they meet the requirements of the agreement. This includes those actions taken by the contractor to ensure quality patient care and clinical performance, resolving identified problems, and reporting information to the Contracting Officer.

APPENDIX B

HIPAA BUSINESS ASSOCIATE AGREEMENT

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) OF 1996

HIPAA is comprised of several different sections, each to be implemented by the Dept. of Health and Human Services. The medical facilities of the military services and the DOD health plans are specifically listed as covered by HIPAA. Currently, HIPAA Privacy and Security Rules, as set forth in the Code of Federal Regulations, are in effect for all MTFs. The specific implementation of HIPAA Privacy for DOD medical facilities is set forth in DOD 6025.18-R, and for HIPAA Security, the requirements for AF MTFs are contained in DOD 8580.02-R and AFI 41-217, which also contains additional Information Assurance requirements for all AF MTFs. DOD 6025.18-R, DOD 8580.02-R and AFI 41-217 are incorporated herein by reference. MTFs are responsible to insure overall compliance with HIPAA requirements, which includes incorporation of certain requirements in contracts entered or amended after the respective implementation dates.

IAW these regulations, the Contractor and its personnel meet the definition of Business Associates. Therefore, a Business Associate Agreement is required by law to comply with both the HIPAA Privacy and Security regulations. This clause serves as that agreement for each MTF, whereby the Contractor and its personnel agree to abide by all HIPAA Privacy and Security requirements regarding health information as defined in this clause, DoD 6025-18-R, DOD 8520.02-R and AFI 41-217. Additional HIPAA requirements will be addressed when implemented.

Introduction

(a) Definitions. As used in this clause generally refer to the Code of Federal Regulations (CFR) definition unless a more specific provision exists in DOD 6025.18-R, DOD 8520.02-R or AFI 41-217.

Individual has the same meaning as the term “individual” in 45 CFR 164.50 1 and 164.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR 164.502(g).

Privacy Rule means the Standards for Privacy of Individually Identifiable Health Information at 45 CFR part 160 and part 164, subparts A and E.

Protected Health Information has the same meaning as the term “protected health information” in 45 CFR 164.501, limited to the information created or received by The Contractor from or on behalf of the Government.

Electronic Protected Health Information has the same meaning as the term “electronic protected health information” in 45 CFR 160.103.

Required by Law has the same meaning as the term “required by law” in 45 CFR 164.501 and 164.103.

Secretary means the Secretary of the Department of Health and Human Services or his/her designee.

Security Rule means the Health Insurance Reform: Security Standards at 45 CFR part 160,162 and part 164, subpart C.

Terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in 45 CFR 160.103, 160.502, 164.103, 164.304 and 164.501.

(b) The Contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law.

c) The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Contract.

(d) The Contractor agrees to use administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic protected health information that it creates, receives, maintains, or transmits in the execution of this Contract.

(e) The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this Contract.

(f) The Contractor agrees to report to the Government any security incident involving protected health information of which it becomes aware.

(g) The Contractor agrees to report to the Government any use or disclosure of the Protected Health Information not provided for by this Contract of which the Contractor becomes aware of.

(h) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor on behalf of the Government agrees to the same restrictions and conditions that apply through this Contract to the Contractor with respect to such information.

(i) The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides electronic Protected Health Information, agrees to implement reasonable and appropriate safeguards to protect it.

(j) The Contractor agrees to provide access, at the request of the Government, and in the time and manner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524.

(k) The Contractor agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government.

(1) The Contractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of, the Government, available to the Government, or at the request of the Government to the Secretary, in a time and manner designated by the 'Government or the Secretary, for purposes of the Secretary determining the Government's compliance with the Privacy Rule.

(m) The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(n) The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

General Use and Disclosure Provisions

Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on behalf of, or to provide services to, the Government for treatment, payment, or healthcare operations purposes, in accordance with the specific use and disclosure provisions below, if such use or disclosure of Protected Health Information would not violate the HIPAA Privacy Rule, DOD 6025.18-R, the HIPAA Security Rule, or DOD 8580.02-R if done by the Government.

Specific Use and Disclosure Provisions

(a) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities of the Contractor.

(b) Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Contractor of any instances of which it is aware in which the confidentiality of the information has been breached.

(c) Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504(e)(2)(i)(B).

(d) Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502(j)(1).

Obligations of the Government

Provisions for the Government to Inform the Contractor of Privacy Practices and Restrictions

(a) Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice.

(b) The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclose Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures.

(c) The Government shall notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522.

Permissible Requests by the Government

The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the HIPAA Privacy Rule, DOD 6025.18R, the HIPAA Security Rule, or DOD 8580.02-R, if done by the Government, except for providing Data Aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause.

Termination

(a) Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract.

(b) Effect of Termination.

(1) If this contract has records management requirements, the records subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below.

(2) If this contract does not have records management requirements, except as provided in paragraph (3) of this section, upon termination of this Contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Government. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health Information.

(3) If this contract does not have records management provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the Government notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the Government and the Contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected Health Information.

Miscellaneous

(a) Regulatory References. A reference in this Clause to a section in DOD 6025.18-R, HIPAA Privacy Regulation or DOD 8580.02-R, HIPAA Security Regulation, or any CFR or AFI provision means the section as currently in effect or as amended, and for which compliance is required.

(b) Survival. The respective rights and obligations of Business Associate under the "Effect of Termination" provision of this Clause shall survive the termination of this Contract.

(c) Interpretation. Any ambiguity in this Clause shall be resolved in favor of a meaning that permits the Government to comply with DOD 6025.18-R, the CFR HIPAA Privacy Rule, DOD 8520.02-R, the CFR HIPAA Security Rule and AFI 41-217.

APPENDIX C

HISTORICAL DATA (Yearly Average)

1. Diagnostic Plain Film Studies: 1000

2. Ultrasound Studies: 1000

3. Nuclear Medicine Studies: 10

4. Cross Sectional Imaging Studies MRI: 10

5. Cross Sectional Imaging Studies CT: 2200

6. Flouroscopy Studies: 10

NDAA SECTION 8101

“The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the [NAMED COMPONENT] via a secure data collection site. The contractor is required to completely fill in all required data fields at http://www.ecmra.mil.

Reporting inputs will be for the labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October* of each calendar year. Contractors may direct questions to the CMRA help desk.”

*Reporting Period: Contractors are required to input data by 31 October of each year. However, due to the delayed implementation, input of FY12 data is required by 31 Mar 13.

Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the contractor name and contract number associated with the data.

User Manuals: Data for Air Force service requirements must be input at the Air Force CMRA link.

APPENDIX D

DIACAP PROCESS

What is DIACAP?

The DoD Information Assurance Certification and Accreditation Process (DIACAP) is a dynamic, information assurance (IA) certification and accreditation (C&A) process that supports the net-centric, Global Information Grid (GIG)-based environment by:

· Providing a standard C&A approach

· Establishing a Configuration Control and Management (CCM) process for managing and disseminating enterprise standards and guidelines

· Accommodating diverse Information Systems (ISs)

The DIACAP establishes a standard, enterprise process for:

· Identifying, implementing, and managing IA controls

· Authorizing the operation of DoD ISs

· Managing an IA posture across the DoD IS life cycle

· Ensuring enterprise visibility and synchronization of the DIACAP

The core activities of the DIACAP are consistent with DoDD 8500.01E, DoDI 8500.2, DoDI 8580.1, the acquisition life cycle requirements of DoDD 5000.1 and DoDI 5000.2, FISMA security requirements, Appendix III of OMB A-130, industry best practices, and lessons learned.

DoDI 8510.01 cancels the DoD Information Technology Security Certification and Accreditation Process (DITSCAP) (defined in DoDI 5200.40 and DoD 8510.1-M) and the DIACAP Interim Guidance.

DIACAP Activities

The DIACAP defines the following activities for the certification and accreditation of a specific DoD Information System. These activities may occur concurrently or sequentially, or at varied frequencies for different IA controls. The DIACAP parallels the system life cycle, and its activities should be initiated at inception. However, failure to initiate the DIACAP at system inception is not a justification for ignoring or non-complying with the DIACAP. Regardless of the system life cycle stage (e.g., acquisition, operation), unaccredited systems shall initiate the DIACAP immediately. The implementation of IA and services will be less expensive and problematic if the DIACAP is initiated early in the system life cycle.

The figure below illustrates the DIACAP core activities and underlying tasks.

Complete details on the DIACAP process are available at: https://diacap.iaportal.navy.mil/KS/Pages/default.aspx image1.png

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