7_Section_G_5-19-15.doc

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TRICARE Quality Monitoring Contract (TQMC)
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HT9402-15-R-0005
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Section G

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SECTION G, CONTRACT ADMINISTRATION DATA

1.0 CONTRACT CLAUSES:

FAR 52.232-33, PAYMENT BY ELECTRONIC FUNDS TRANSFER--SYSTEM FOR AWARD MANAGEMENT

DFARS 252.204-7006 BILLING INSTRUCTIONS (OCT 2005)

When submitting a request for payment, the Contractor shall—

(a) Identify each contract line item number (CLIN) on the payment request that reasonably reflects contract work performance; and

(b) Separately identify a payment amount for each contract line item included in the payment request.

(End of clause) DFARS 252.232-7003 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS AND RECEIVING REPORTS (JUN 2012)

(a) Definitions. As used in this clause—

(1) “Contract financing payment” and “invoice payment” have the meanings given in section 32.001 of the Federal Acquisition Regulation.

(2) “Electronic form” means any automated system that transmits information electronically from the initiating system to all affected systems. Facsimile, e-mail, and scanned documents are not acceptable electronic forms for submission of payment requests. However, scanned documents are acceptable when they are part of a submission of a payment request made using Wide Area WorkFlow (WAWF) or another electronic form authorized by the Contracting Officer.

(3) “Payment request” means any request for contract financing payment or invoice payment submitted by the Contractor under this contract.

(4) “Receiving report” means the data required by the clause at 252.246-7000, Material Inspection and Receiving Report.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests and receiving reports using WAWF, in one of the following electronic formats that WAWF accepts: Electronic Data Interchange, Secure File Transfer Protocol, or World Wide Web input. Information regarding WAWF is available on the Internet at https://wawf.eb.mil/.

(c) The Contractor may submit a payment request and receiving report using other than WAWF only when—

(1) The Contracting Officer administering the contract for payment has determined, in writing, that electronic submission would be unduly burdensome to the Contractor. In such cases, the Contractor shall include a copy of the Contracting Officer’s determination with each request for payment;

(2) DoD makes payment for commercial transportation services provided under a Government rate tender or a contract for transportation services using a DoD-approved electronic third party payment system or other exempted vendor payment/invoicing system (e.g., PowerTrack, Transportation Financial Management System, and Cargo and Billing System);

(3) DoD makes payment for rendered health care services using the TRICARE Encounter Data System (TEDS) as the electronic format; or

(4) When the Government wide commercial purchase card is used as the method of payment, only submission of the receiving report in electronic form is required.

(d) The contractor shall submit any non-electronic payment requests using the method or methods specified in Section G of the contract.

(e) In addition to the requirements of this clause, the contractor shall meet the requirements of the appropriate payment clauses in this contract when submitting payment requests.

(End of clause)

2.0 CONTRACT ADMINISTRATION:

2.1 The Procuring Contracting Officer (PCO) is responsible for the administration of this contract and is solely authorized to take action on behalf of the Government. Unless specified otherwise within this contract, the PCO is referred to as the Contracting Officer (CO).

2.2 Contracting Officer’s Representative (COR): The CO will designate a COR in writing and provide a copy of the designation letter to the contractor. The designation letter will delineate the scope of authority of the COR to act on behalf of the CO. The COR has no authority to make any commitments or changes that affect any term or condition of the contract.

2.3 Contractor Points of Contact Personnel: The names and addresses of the contractor’s primary and alternate point of contact (POC) for contract implementation and compliance are stated below. The contractor shall submit any changes to the POC to the CO in writing.

Primary:

Company Name:

Address:

Telephone:

Email:

Alternate:

Company Name:

Address:

Telephone:

Email:

3.0 ORDERING: The contracting officer shall authorize all performance by issuing task orders in accordance with the ordering terms of the contract. The CO will order the majority of the contact requirements on a single task order.

3.1 Quality Improvement Studies: (Section C, paragraph 6.6). The COR will notify the contractor of the approved study topics and the applicable CLIN (X017, X018 or X019, and X008 if applicable) for the study. Prior to starting the study, the contractor shall provide an estimate of the number of hours required or charts it anticipates it will review to complete the study.

3.2 Medical Reviews: (Section C, paragraph 6.5). As DHA requires reviews under Section B CLINs X009, X010, X011, X012, X014, X015, and X016, DHA will notify and provide the charts requiring medical review pursuant to the referenced paragraph to the contractor. The charts may be provided by the COR, Office of General Counsel (OGC), the Military Service, or other means by US Mail or other service, or the contractor may also be directed to access the charts electronically via a secure website such as the Army Knowledge Online (AKO) Website.

3.3 The CO will issue separate task orders for the following CLINs:

3.3.1 Office of General Counsel (OGC) Appeals Hearings and Claims Collection Division (OGC-AC) Hearing Support: (Section C, paragraph 6.5.3, Section B CLIN X013 and Attachment J-6). Upon receiving an OGC-AC request, the CO will issue a task order in accordance with Section C, para 6.5.3 and Section J, Attachment J-6, Internal and External Reviews and Appeals & Hearing Support, paragraph 7. Witness Hearing–Pre-Hearing Preparations, Hearing Attendance, Post Hearing--Transcription, and CDRL R070, Internal Reviews.

3.3.2 CLINs X021, X022, Assessment of Evolving Practices, Devices, Medicines, Treatments, and Procedures: (Section C paragraph 6.7). Upon receiving the description of the assessment to be performed, the CO shall issue a task order for the specific assessment type (CLINs X021 or X022) with the questions to be addressed in the assessment and the due date in accordance with Section C, paragraph 6.7.

4.0 PAYMENTS: Payments shall be in accordance with FAR Clauses 52.232-1, Payments; 52.232-8, Discounts for Prompt Payment; 52.232-18, Availability of Funds; 52.232-19, Availability of Funds for the Next Fiscal Year; and 52.232-25, Prompt Payment as listed in Section I.

5.0 SUBMISSION OF INVOICE:

5.1 The contractor is responsible for submitting invoices and initiating receiving reports electronically through Wide Area Work Flow – Receipt and Acceptance (WAWF) for services rendered under this contract. For fixed price contracts, the WAWF 2 IN 1 format (for services), is the preferred method of processing electronic invoices and receiving reports within DHA. Back up documentation (such as timesheets) can be included and attached to WAWF documents as requested by the responsible COR. Attachments created in any Microsoft Office product are attachable to the invoice in WAWF.

5.2 Contractor personnel (WAWF Vendor role) shall self-register at the website https://wawf.eb.mil/, and be activated by the contractor’s designated Electronic Business POC. WAWF training is available on the internet at http://wawftraining.com.

5.3 The contractor shall submit invoices for payment and initiate receiving reports every month or as specified by task order. The Government shall also process invoices for payment and associated receiving reports every month or by task order.

5.4 Prior to submitting the first WAWF-RA electronic form for a given task order, contractors should first coordinate with the TQMC COR.

5.5 When initiating documents within WAWF, contractors must use the appropriate two-part DHA location code to include Government Acceptor DoDAAC/Extension (Ext) fields and the Local Processing Office (LPO) DoDAAC/Extension fields as displayed within the WAWF application and illustrated below:

Service Acceptor / Ext.

LPO DoDAAC / Ext.

HT0003 / FTPFAO

HT0003 / FTPFAO

Paying Office:

DFAS IN VP DAI TMA (Code HQ0649)

Attn: DAI/TMA

8899 East 56th St.

Indianapolis, IN 46249-1500

5.6 Travel and Meeting Attendance: (Section C paragraphs 6.1.13, 6.5.3 and Attachment J-6). This contract includes activity that may require contractor travel to destinations outside of the United States. The contractor shall ensure that assigned participants obtain valid passports and immunizations to support project activities.

5.6.1 The CO shall pre-approve any contractor travel and meeting attendance required to support the TQMC requirement. If the contractor fails to obtain CO approval for travels or meeting attendance, the contractor shall not invoice for the costs incurred.

5.6.2 After the contractor completes approved travel or meeting attendance, the contractor shall submit its incurred allowable costs to the COR who will verify the costs are allowable.

5.6.3 Once the COR approves the costs, then the contractor may submit an invoice for approved costs using CLIN X024 or X025. Travel shall be reimbursed in accordance with FAR 31.205-46.

6.6 CLIN Invoicing Instructions:

6.6.1 Unless specified differently below, the contractor shall invoice as follows

a. CLINs with Unit of Issue “Lot” (LO): The contractor shall submit one invoice after completion of the task and COR’s acceptance of any applicable CDRL(s).

b. CLINs with Unit of Issue “Month” (MO): The contractor shall submit its invoice each month after the end of the month and COR’s acceptance of any applicable CDRL(s).

6.6.2 National Hospital Quality Measures (NHQM) and Joint Commission ORYX® Hospital Quality Measures: (Section C paragraphs 6.3.2, 6.3.3). For CLINs X003, X004, the contractor may invoice quarterly after the tasks are completed, all data are submitted and reported, and the COR accepts any applicable CDRL(s).

6.6.3 Institute for Healthcare Improvement (IHI) Global Trigger Tool (GTT): (Section C, paragraph 6.3.4). For CLIN X004, the contractor may invoice for chart reviews completed each month after the COR accepts any applicable CDRL(s).

6.6.4 Behavioral Health Facility Application Reviews and Onsite Certification Reviews: (Section C paragraph 6.4). For CLINs X006 and X007, the contractor may invoice for reviews completed each month after the COR accepts any applicable CDRL(s).

6.6.5 Medical Reviews: (Section C, paragraph 6.5). For CLINS X008, X009, X010, X011, X012, X014, X015, X016, the contractor may invoice for reviews completed each month after the COR accepts any applicable CDRL(s).

6.6.6 OGC Appeals & Hearing Support: (Section C, paragraph 6.5.3 and Section J, Attachment J-6, Internal and External Reviews and Appeals & Hearing Support). When invoicing for OGC Appeals and Hearing Witness Appearance pursuant to CLIN X013, the contractor shall invoice SLINs X013AA, AB, AC, and AD after completion of the services and the COR’s acceptance of any applicable CDRL(s).

6.6.7 Quality Improvement and Autism Care Demonstration Studies: (Section C paragraphs 6.6.1 and 6.6.2). For CLINs 2017, 2018, 2019, 2020, the contractor shall invoice after completion of the study and the COR’s acceptance of any applicable CDRL(s).

6.6.8 Assessment of Evolving Practices, Devices, Medicines, Treatments, and Procedures: (Section C paragraph 6.7). For CLIN X021 or X022, the contractor shall invoice after completion of the assessment and the COR’s acceptance of any applicable CDRL(s).

6.6.9 Untimely Performance:

6.6.9.1 Joint Commission ORYX® Hospital Quality Measures: If untimely performance occurs on CLINs X004, SLINs X004AB, the contractor shall separately itemize the price chargeable for the number of days for which performance was untimely, the deduction rate for untimely performance, the dollar amount deducted for untimely performance, the net chargeable amount after the deduction by the CLIN.

6.6.9.2 Medical Reviews: (Section C paragraph 6.5, Section B CLINs X009, X010, X011, X012, X014, X015, X016). If the contractor fails to deliver a review required under Section C, paragraph 6.5 (CDRLs R010, R020, R070 and R090) by the date specified, the contractor shall reduce its invoice price for each late medical review by 10% per day for each business day the review is late. The contractor shall separately itemize the price chargeable for the number of days for which performance was untimely, the deduction rate for untimely performance, the dollar amount deducted for untimely performance, the net chargeable amount after the deduction by the CLIN.

TQMC HT9402-15-R-0005, Section G

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