Imaging Interpretation SOW 2025.pdf

Statement of Work: Diagnostic Medical Imaging Interpretation Services

WOODROW WILSON KEEBLE MEMORIAL HEALTH CARE CENTER

INDIAN HEALTH SERVICE

STATEMENT OF WORK

DIAGNOSTIC IMAGING INTERPRETATION SERVICES

GENERAL

This work statement describes the requirements for a non-personal service contract to provide diagnostic imaging interpretation services to support the mission of the Sisseton Indian Health Service

(IHS)/Woodrow Wilson Keeble Memorial Health Care Center (WWKMHCC).

BACKGROUND

The IHS is an agency within the Department of Health & Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The Indian Health Service provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 567 federally recognized tribes, in 35 states. The Indian Health Service

Headquarters is located in Rockville, MD and then divided into (12) physical areas: Alaska, Albuquerque, Bemidji, Billings, California, Great Plains, Nashville, Navajo, Oklahoma, Phoenix, Portland, and Tucson.

The Great Plans Area Office (GPAO) works in conjunction with 19 Indian Health Service Units and

Tribal Managed Service Units to provide health care to approximately 130,000 Native Americans located in North Dakota, South Dakota, Nebraska, and Iowa. The Area Office’s service units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics.

Our facility, the WWKMHCC, falls under the GPAO. WWKMHCC provides medical care for approximately 7,000 tribal members living on the Lake Traverse Reservation. Serving a rural area, many of our patients travel 100 miles round trip to receive care. The WWKMHCC was built in 2007 to provide an expanded level of outpatient health care services specifically designed to meet the needs of the

WWKMHCC population. Services include: Behavioral Health, Community Health, Dental, Laboratory, Nutrition Services, Optometry, Pharmacy, Physical Therapy, Public Health Nursing, Purchased &

Referred Care Services, and Radiology Services.

OBJECTIVE

To provide interpretation of diagnostic imaging for WWKMHCC. The WWKMHCC requires contractor support from board certified radiologists for these services.

PERIOD OF PERFORMANCE

Date of award for one year of service, plus four (4) option years.

AVAILABILITY

WORK SCHEDULE: Teleradiology services will be required 0800-1700 Monday through Friday to provide interpretations and reports on images sent via teleradiology to the Contractor for this purpose.

The Contractor will interpret and assure that final interpretation results are accessible from the IHS radiology package within 24-48 hours.

After hour services will be considered anytime outside of Monday through Friday 0800-1700 and holidays. The Contractor is required to provide 24 hours, 7 days a week interpretations and verbal reports sixty (60) minutes or less for preliminary ultrasounds and thirty (30) minutes or less on preliminary x-rays sent by WWKMHCC via teleradiology to the Contractor for this purpose. It will be incumbent upon

WWKMHCC to identify which images as to avoid confusion about which films are emergent and which are routine.

PLACE OF PERFORMANCE

Woodrow Wilson Keeble Memorial Health Care Center

Indian Health Service

100 Lake Traverse Drive

Sisseton, SD 57262

DESCRIPTION OF SERVICES

The mission of WWKMHCC is to provide the best possible healthcare services to the patients on the

Lake Traverse Reservation in South Dakota. To meet this mission, the WWKMHCC is requesting a Non-

Personal Service Contract for diagnostic imaging interpretation services from board certified radiologists.

This contract resulting from this solicitation shall:

1. Allow the Government to evaluate the quality of professional services provided through a

Technical Evaluation Process.

2. Require the Contractor to indemnify the Government for any liability producing an omission by the Contractor, its employees and agents, occurring during contract performance.

3. Maintain liability insurance similar to Industry Standard for Radiology Services performed in the private sector.

4. Shall ensure its subcontracts, for provision of health care services, contain the requirements of the clause at FAR 52.237-7, including the maintenance of medical liability insurance.

5. For bidding purposes, a “study” shall include the receipt of the images, reading, interpretation, notification of findings, and transcription of the findings. All aspects will be included in the price for each “study” as listed in the bid schedule.

6. The standards of medical practice and duties of the Contractor through its physician’s shall be determined pursuant to the bylaws of the WWKMHCC, the regulations of the facility, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of Physicians and outpatient facilities, and accrediting standards. All

Contract Radiologists shall be required to participate in a quality improvement program which is consistent with current accreditation standards and Medicaid Services (CMS) Conditions of

Participation (CoP) requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

SPECIFICATIONS OF SERVICES:

The contractor will assure availability of professional Radiologic services to manage the following estimated procedures:

Direct Labor by Category Estimated Quantity per month

Read of Plain Films 150-200

Read of Ultrasound Exams 42-50

Read of Mammogram Exams 25-40

Peer Review 4

Import Radiology reports into RPMS 300

CONTRACTOR RESPONSIBILITY

The Contract Radiologist shall:

1. Provide interpretations of all standard radiologic examinations performed at WWKMHCC by qualified technologists. The Contractor shall assume professional responsibility for assisting the

Radiology Department at WWKMHCC in meeting and maintaining American Registry of

Radiologic Technologists (ARRT, and Accreditation Association for Ambulatory Health Care

(AAAHC) accreditation standards.

2. Provide interpretation of ultrasound studies performed by Registered Diagnostic Medical

Sonographer (RDMS) accredited technologists or equivalent.

3. Provide interpretation of mammography exams. This will include CAD and tomography mammography exams. The Contract Radiologist must be certified by the American College of

Radiology Mammography Accreditation Program.

4. Provide a Lead Interpreting Physician to review and approve mammography images and who will be responsible for ensuring that all MQSA-required activities are carried out.

5. Provide setup, technical support, and quality control for equipment associated with teleradiology provided by the contractor.

6. Transcribe reports directly into the Indian Health Service’s Resource and Patient Management

System (RPMS)/Electronic Health Record (EHR) computer system. The contractor will need to complete all the appropriate documentation (with the assistance of appropriate IHS staff) and fulfill training requirements to be complaint such as: annual Information System Security

Awareness (ISSA) training, HIPAA training, and Privacy Act Training. In the event that

RPMS/EHR computer system is inaccessible to the contractor, the method of transmission to submit reports will be via fax transmission to the WWKMHCC radiology department who in turn, will enter the information into the RPMS/EHR computer system.

7. Provide consultation to the WWKMHCC radiology technologists concerning quality of x-ray studies submitted for interpretation. If necessary, the contractor shall assist the technologists in developing and improving quality standards, and monitor repeat rates as required by accreditation standards for diagnostic radiology services.

8. During normal working hours, the contract radiologist shall serve as the consultant for the radiology services provided at the WWKMHCC and participate in a peer review process.

9. Ensure AAAHC accreditation standards are in use during the life of this contract:

a) Diagnostic radiology department meeting and maintaining current accreditation standards. The contractor shall assume professional responsibility for assisting the WWKMHCC and all individuals who provide diagnostic radiology services to have delineated clinical privileges

b) Diagnostic radiology department is directed and staffed to provide quality radiologic services:

i. Clinical Director is MD/DO.

ii. At least one (1) technologist is available during normal business hours.

iii. Outside services available for the services the department cannot provide (CT scans, MRI scans)

c) Diagnostic radiology department conducts an ongoing process improvement program, which includes mechanisms to monitor:

i. Performance evaluations and calibration of equipment annually.

ii. Reject rate and monthly analysis.

iii. Participation in the biomedical equipment management program.

iv. Radiation doses emitted for fixed units and each procedure.

d) Diagnostic radiology consultants, interpretations, and reports are included in the medical record:

i. All procedure requests are ordered by a physician or provider with specific privileges.

ii. Requests include information necessary to ensure appropriate exam(s).

iii. Interpretations only made by staff with specific privileges.

iv. Only authenticated reports are entered in the medical record.

10. Shall review and revise, if necessary, the written process improvement plan relating to radiology services. The process improvement plan is designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, pursue opportunities to improve patient care and resolve problems. The contractor shall be responsible for the implementation of this plan.

CREDENTIALING: The Contractor shall investigate, verify, maintain, and submit the documents required for credentialing in accordance with the Indian Health Circular, No. 95-01, for all radiologists providing services under this contract. Each radiologist must be credentialed and granted clinical privileges by the WWKMHCC prior to providing services, and must obtain appropriate appointment forms from the Clinical Director at WWKMHCC.

The Contract Radiologist shall meet the same privileging requirements as permanent IHS physician providers before being allowed to provide medical services in an IHS facility. Medical services shall not be performed by a Contract Radiologist until professional staff membership and clinical privileges have been granted in writing by the Governing Body of the WWKMHCC and the GPA. As a prerequisite to performance under the resultant contract, the Contract Radiologist performing the services must be privileged in accordance with IHS policy. Therefore, compliance with the IHS privileging requirements is essential in the performance of this contract. Any failure to comply with IHS privileging requirements shall be considered to be nonperformance of this contract.

The Contractor is responsible for ensuring that proposed providers possess the requisite credentials to enable granting of privileges by the Sisseton Medical Staff sufficient to allow for performance of all tasks identified. Medical Services cannot be performed by a Contract Radiologist until the GPA IHS and the

WWKMHCC Governing Body has granted clinical privileges in writing.

In accordance with the Indian Health Service credentialing policy, a primary source verification shall be completed for all Contract Radiologist performing services under this contract. The WWKMHCC will provide the credentialing packet and all associated documents to the Contractor and the Contractor shall complete and return all documents within five (5) business days. Re-appointment shall occur no less than every two years, in accordance with WWKMHCC Medical Bylaws.

Contents of the credentialing packet include:

1. Medical Staff Application (provide explanations to any “yes” questions on liability, final judgments, settlements, or claims from the application); Must have evidence of good standing at all facilities where the Contract Physician Provider practices; Must not have been subject to involuntary limitation, reduction, denial or loss of clinical privileges, and have no current federal sanctions and provide a history of previous or pending malpractice lawsuits

2. Copies of pre-professional and professional school diplomas showing proof of graduation from an accredited school of their profession; must be in good standing with National Practitioner’s Data

Bank and the Health Integrity Protection Data Bank

3. Copies of certificates of completion of post-graduate training (residency)

4. Copy of Board Certification certificate or letter

5. Copies of all current licenses (active and inactive); Must maintain a current active and unrestricted license in at least one of the 50 United States or US territories

6. Copy of current DEA certificate if applicable

7. Copy of current liability insurance

8. Completed and signed clinical privileges request form (must be specific to the facility assigned and specific to the applicant’s abilities/competencies)

9. Signed Medicare Agreement form

10. Signed Health Status Statement, including provider signature

11. Copy of immunization record (PPD within past year with x-ray if positive)

12. Signed Medical Staff Bylaws Attestation Statement

13. Three (3) letters of reference within the past year (one reference must be from the same discipline peer and one reference must be from the current or most recent medical supervisor)

14. Copy of a government issued photo identification card (Driver’s license or passport)

15. Copy of Social Security card

16. Signed Confidentiality Statement

17. Signed Child Care and Indian Child Care Worker Positions Agreement

18. Current Continuing Medical Education (CME) for the past two (2) years

19. Copies of Basic Life Support (BLS)/Acute Cardiac Life Support (ACLS) certification

20. Copy of National Provider Identification (NPI) notification letter

21. Signed Provider Signature Card

22. A current copy of the proposed contract provider’s professional curriculum vitae (submitted with initial candidate presentation)

Exceptions to the Indian Health Service credentialing review and clinical privileges process will not be considered. The Contractor's failure to submit successful applicants shall not excuse nonperformance of contract requirements. Any Contract Radiologist who fails to maintain medical staff appointment and clinical privileges will not be permitted to perform services under the contract and shall be promptly replaced by the Contractor.

PHYSICIAN QUALIFICATIONS: Each Contract Radiologist must meet the following licensure, certification, educational, and experience requirements:

1. Board certification from the American Board of Radiology or has comparable qualifications.

2. Meet the criteria for medical staff membership including:

a) Current and unrestricted medical license from any of the 50 United States, the

District of Columbia, Puerto Rico, or a territory of the United States.

b) Diploma indicating completion of an approved medical school program.

c) Completion of an approved medical residency training program in Radiology. If applicable, a copy of the Educational Commission of Foreign Medical Graduate

Certificate (ECFMG) or Fifth Pathway Certificate.

d) Verification from the Contractor that the health status of the Radiologist is sufficient for the performance of radiology services under the contract. Evidence of a recent physical examination shall be acceptable.

3. Provide information on previously successful or currently pending challenges to any licensure or registration (state or district, DEA) or the voluntary relinquishment of such licensure or registration; voluntary or involuntary termination of medical staff membership, or voluntary or involuntary limitation, reduction, or loss of clinical privileges at another hospital; and current involvement with professional liability actions.

4. Evidence of medical liability coverage.

5. The contractor and any subcontractors must be physically practicing medicine in the United

States. The Contractor shall furnish proof of a minimum of 4 peer review (over-reads) annually.

QUALITY ASSURANCE

Participate in:

1. All Radiology PI Monitors and/or Peer Reviews

2. Corrective Actions, if needed

Additional duties will include:

1. Notifying the Radiology Supervisor and Clinical Director of significant technical or administrative problems interfering with or threatening patient care in any way;

2. Monitoring the technical aspects of every radiograph sent to the Contractor for read and reporting monthly on the overall state of the films from a technical standpoint;

3. Contractor will create and implement a Peer Review/Cross Review Program that assures quality imaging interpretation and verifies competency of every Radiologist.

a) This Peer Review/Cross Review program will be specific to WWKMHCC.

b) The Review process will separate the review data specifically related to the hospital and submit a quarterly report that shows breakout of individual

Radiologist reads.

c) The report will reflect a random sample of plain films, mammograms, and ultrasounds.

4. Documenting any recommendations made to enhance radiology services at WWKMHCC.

The Government employs a Department Head for the Radiology Department at WWKMHCC who manages staff, supplies, equipment, and ordering. The WWKMHCC does not employ a Radiologist or other individual who is qualified to provide Clinical oversight of the Radiology program at WWKMHCC.

As a result, the contractor will ensure that the program operates in a manner consistent with the CMS expectations and may be asked for technical advice and assistance as WWKMHCC deems necessary.

PROFESSIONAL QUALIFICATIONS CRITERIA

The Contractor will apply for medical staff appointment and privileges to the Medical Staff of the

WWKMHCC. The Service Unit will evaluate and if applicable will credential the successful contractor to practice at WWKMHCC. Using Forms 855 and 855R, the contractor will have a UPIN through

WWKMHCC, thus permitting WWKMHCC to bill any third parties for reads done by the Contract.

This position is subject to P.L. 101-630, The Indian Child Protection and Family Violence Prevention

Act, as determined by the Service Unit Director. The Office of Personnel Management will conduct the criminal background investigation on the awardee following award of the service contract. The character investigation may be waived if, in the judgement of the Contracting Officer, in consultation with the

Personnel Officer, an investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified of the results, the contractor must not have unsupervised conduct with Indian Children.

REQUIRED MALPRACTICE INSURANCE

Contractor will provide and maintain their own Malpractice Insurance for the term of the contract.

COMPLIANCE WITH IHS RULES AND REGULATIONS

Medical Practices must be within the standards of their established credentialed specialty and maintains continuing medical education, licensing, registration, and certifications 100% of the time.

Complies with all policies, By-laws, Safety, Infection Control, and rules and regulations of WWKMHCC with zero (0) violations.

Consults with other specialty practitioners when applicable 100% of the time.

Maintains patient privacy/confidentiality/HIPAA with zero (0) breaches of privacy.

Timely documentation that is completed 100% of the time which is to be completed PRIOR to the end of the daily shift and PRIOR to signing an invoice for payment.

Complaints on quality of care and/or conduct should be minimal and no more than three (3) per quarter

(all issues will be addressed in writing to the contractor so that action can be taken).

The standards of medical practice and duties of the Contractor through its Physician(s) shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals must be followed. Also the standards and recommendations of

Centers for Medicare and Medicaid Services (CMS) or the Accreditation Organization must be adhered

to. The Contract Physician(s) shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

ANY SPECIAL REQUIREMENTS

Utilizes EHR and RPMS computer system.

The Contractors viewing equipment shall interfaced with the service units’ teleradiology platform. The

Contractor’s computer system must be compatible with the service units PACS software. The Contractor must be able to provide compression software to ensure timely transmission times of images.

All interpretations shall be performed on diagnostic, medical-grade, high resolution monitors. All monitors shall be calibrated at least semi-annually, or consistent with proper quality control procedures at the interpretation site.

FAR 52-237-7 IDENTIFICATION AND MEDICAL LIABILITY INSURANCE

1. It is expressly agreed and understood that this is a Non-Personal Service Contract, as defined in the Federal Acquisition Regulations (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor.

The Government may evaluate the quality of professional and administrative services provided, but retain no control over professional medical judgement diagnoses, or specific medical treatments.

The Contractor shall be solely liable for and expressly agrees to indemnify the government with respect to any liability producing acts or omissions by it or by its employees or agents.

The Contractor shall maintain liability insurance issued by a responsible insurance carrier in the amount of not less than the minimum requirements established by the state in which the contract is performed during the term of the contract.

2. An apparently successful offer, upon request by the Contracting Officer shall furnish, prior to the contract award, evidence if its insurability concerning the medical liability insurance required by paragraph (1.) of the clause.

3. Liability insurance may be either on occurrence basis or a claims-made basis. If the policy is on claims-made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided.

4. A Certificate of Insurance evidencing the required coverage shall be provided to the Contracting

Officer prior to the commencement of services under this contract. If the insurance is on the claims-made basis, evidence of an extended reporting endorsement shall be provided to the

Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended endorsement is provided to the Contracting Officer.

5. The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the government’s interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting

Officer. If during the performance period of the contract, the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause for the entire period of the contract, either under the new policy or a combination of old and new policies.

6. The Contractor shall insert the substance of this clause, including this paragraph in all subcontractors under this contract or health care services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer, evidence of such insurance.

7. The contract terminates when the performance period expires or the clinic (i.e. lack of funding, workload, etc.) no longer requires services.

COMMUNICATION BETWEEN ALL PARTIES

POINT OF CONTACT. The Contractor shall provide a point of contact who shall be responsible for the performance of the work. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual, in writing, to the Contracting Officer before the contract start date. An alternate may be designated, but the

Contract shall identify those times when the alternate shall be the primary point of contact.

The contractor representative shall be available during normal duty hours within 30 minutes to meet with the government personnel designated by the Contracting Officer to discuss and resolve performance issues.

After normal duty hours, the representative shall be available within 1 hour.

The contractor representative must be able to read, write, speak, and understand English.

QUALITY ASSURANCE

The Contracting Officer’s Representative responsible for monitoring the Contractor’s technical progress, interpreting the statement of work, technical evaluation as required, technical inspections and acceptance required by this contract, and assisting in the resolution of technical problems encountered during performance of this contract.

GOVERNMENT MONITORING. Government will monitor the contractor’s performance under this contract using the method(s) of surveillance specified in the SOW. All monitoring observation will be recorded by the government. When an observation indicates defective performance, this COR will request the contractor’s representative to confirm defective work and perform corrective action.

GOVERNMENT FURNISHED PROPERTY, FACILITIES, AND SERVICES

The WWKMHCC shall provide:

1. Images sent by WWKMHCC via teleradiology to the Contractor.

2. All required blank Government forms applicable to the WWKMHCC’s radiology services program. Radiology department personnel will provide appropriate orientation to the necessity of such forms.

3. Administrative and professional ancillary personnel deemed necessary to support the Contractor.

These services shall be available during normal business hours.

4. All necessary radiology equipment for the Contractor to conduct his/her duties.

5. The WWKMHCC shall assume the responsibility of patient care coordination.

6. The WWKMHCC shall provide a multidisciplinary approach in order for patients to receive the best care possible. Making all the necessary appointments for patients, encouraging them to keep their appointments, and following up and implementing recommendations are all necessary parts of the care coordination activity.

CONTRACTOR FURNISHED EQUIPMENT, FACILITIES, AND PROPERTY

The Contractor will provide his/her own equipment to perform duties such as office equipment, glasses, etc.

The Contractor shall provide a complete written report for each medical imaging study. The Contractor shall have the completed report electronically dictated and signed, via the Contractors voice recognition software, delivered directly into the Service Units Radiology Information System (RIS)/Hospital

Information System (HIS).

IMAGE STUDY AND DELIVERY. The studies will be electronically transmitted from the Service Units

PACS system via DICOM using an encrypted, secure method via a persistent LAN to LAN VPN connection. Contractor will need to describe the security/encryption protocols used for retrieving transcribed reports. To this end, the Contractor must sign a Data Exchange Agreement, or other

Interconnection Security Agreement that the Indian Health Service provides to the Contractor in order to establish the VPN connection.

SPECIFIC REQUIREMENTS. The Contractor will have a system that is compatible with the IHS computer system. This is conditional upon the existence of interfaces between the Contractors software and the Service Unit RIS/HIS. This scope of work is not intended to limit the application of technology that improves efficiency in the process. The expense of developing any Contractor dictation software interface with the Service Unit RIS/HIS shall be the responsibility of the Contractor.

All radiology reads will be imported and verified into RPMS. A 24-hour window from the time report is read to verification is a requirement Monday-Sunday. Appropriate personnel will have access to

Contracting reporting system for readings 24/7. In the event a report needs an amendment, the reading

Radiologist will notify each Service Unit ordering provider/Radiology Department.

The Contractor will provide WWKMHCC protocols for general x-ray, ultrasound, and mammography.

The average turnaround time for preliminary interpretations shall be sixty (60) minutes or less for ultrasound exams and thirty (30) minutes or less for regular preliminary x-ray exams.

Contractor will provide 24/7 technical IT support for any issues that may arise after regular business hours.

AUTHORITY

1.1. No person other than the Contracting Officer has authority to bind the Government with respect to this contract.

1.2. No action or omission of any government employee or representative other than the Contracting

Officer shall increase or decrease the scope of this contract or shall otherwise modify the terms and conditions of this contract.

1.3. In no event shall any of the following be effective or binding on the Government or imputed to the Contracting Officer with respect to this contract:

1.3.1. An understanding or agreement between the Contractor and anyone other than the

Contracting Officer;

1.3.2. A purported modification or change order issued by anyone other than the Contracting

Officer;

1.3.3. A promise by anyone other than the Contracting Officer to provide additional funding or make payments; or

1.3.4. An order, direction, consent, or permission from anyone other than the Contracting Officer to:

1.3.4.1. Incur costs in excess of a specified estimated cost, allotment of funds, or other ceiling; or

1.3.4.2. Expend hours in excess of a specified level of effort.

PRIVACY/CLAUSES

FAR 52.225-1 PRIVACY ACT NOTIFICATION (APR 1984)

The Contractor will be required to design, develop, or operate a system of records on individuals, to accomplish an agency function subject to the Privacy Act of 1974, Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable agency regulations. Violation of the Act may involve the imposition of criminal penalties.

FAR 52-224-2 PRIVACY ACT (APR 1984)

(a) The Contractor agrees to—

(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and regulations issued under the Act in the design, development, or operation of any system of records on individuals to accomplish an agency function when the contract specifically identifies—

(i) The systems of records; and

(ii) The design, development, or operation work that the contractor is to perform;

(2) Include the Privacy Act notification contained in this contract in every solicitation and resulting subcontract and in every subcontract awarded without a solicitation, when the work statement in the http://uscode.house.gov/uscode-cgi/fastweb.exe?getdoc+uscview+t05t08+2+3++%285%29%20%20AND proposed subcontract requires the redesign, development, or operation of a system of records on individuals that is subject to the Act; and

(3) Include this clause, including this paragraph (3), in all subcontracts awarded under this contract which requires the design, development, or operation of such a system of records.

(b) In the event of violations of the Act, a civil action may be brought against the agency involved when the violation concerns the design, development, or operation of a system of records on individuals to accomplish an agency function, and criminal penalties may be imposed upon the officers or employees of the agency when the violation concerns the operation of a system of records on individuals to accomplish an agency function. For purposes of the Act, when the contract is for the operation of a system of records on individuals to accomplish an agency function, the Contractor is considered to be an employee of the agency.

(c)(1) “Operation of a system of records,” as used in this clause, means performance of any of the activities associated with maintaining the system of records, including the collection, use, and dissemination of records.

(2) “Record,” as used in this clause, means any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and that contains the person’s name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a fingerprint or voiceprint or a photograph.

(3) “System of records on individuals,” as used in this clause, means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual.

FAR 52.239-1 Privacy or Security Safeguards (Aug 1996)

(a) The Contractor shall not publish or disclose in any manner, without the Contracting Officer’s written consent, the details of any safeguards either designed or developed by the Contractor under this contract or otherwise provided by the Government.

(b) To the extent required to carry out a program of inspection to safeguard against threats and hazards to the security, integrity, and confidentiality of Government data, the Contractor shall afford the

Government access to the Contractor’s facilities, installations, technical capabilities, operations, documentation, records, and databases.

(c) If new or unanticipated threats or hazards are discovered by either the Government or the

Contractor, or if existing safeguards have ceased to function, the discoverer shall immediately bring the situation to the attention of the other party.

HHSAR 352-224-70 Privacy Act (December 18, 2015)

This contract requires the Contractor to perform one or more of the following: (a) design; (b) develop; or

(c) operate a federal agency system of records to accomplish an agency function in accordance with the

Privacy Act of 1974 (Act) (5 U.S.C. 552a(m)(1)) and applicable agency regulations.

The term system of records means a group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual. Violations of the Act by the Contractor and/or its employees may result in the imposition of criminal penalties (5 U.S.C. 552a(i)).

The Contractor shall ensure that each of its employees knows the prescribed rules of conduct in 45 CFR part 5b and that each employee is aware that he/she is subject to criminal penalties for violation of the Act to the same extent as Department of Health and Human Services employees. These provisions also apply to all subcontracts the Contractor awards under this contract which require the design, development or operation of the designated system(s) of records (5 U.S.C. 552a(m)(1)). The contract work statement:

(a) Identifies the system(s) of records and the design, development, or operation work the Contractor is to perform; and

(b) Specifies the disposition to be made of such records upon completion of contract performance.

Indemnification, Liability, Statute of Limitations: Any provisions in the TOS related to indemnification and filing deadlines are hereby waived, and shall not apply except to the extent expressly authorized by law. Liability for any breach of the TOS as modified by this Amendment, or any claim arising from the

TOS as modified by this Amendment, shall be determined under the Federal Tort Claims Act, or other governing federal authority. Federal Statute of Limitations provisions shall apply to any breach or claim.

Governing law: Any arbitration, mediation or similar dispute resolution provision in the TOS is hereby deleted. The TOS and this Amendment shall be governed by and interpreted and enforced in accordance with the laws of the United States of America without reference to conflict of laws. To the extent permitted by federal law, the laws of the State of [Company to insert name of state if one is mentioned in its TOS] (excluding [Company's state] choice of law rules) will apply in the absence of applicable federal law.

CONTRACTING OFFICERS REPRESENTATIVE

The designated COR for this contract is:

Megan Grassel

Radiology Supervisor

Woodrow Wilson Keeble Memorial Health Care Center

100 Lake Traverse Drive

Sisseton, SD 57262

Phone: (605) 742-3824

Megan.Grassel@ihs.gov

PAYMENT PROCESS

The contractor shall submit a bi-weekly invoice of services rendered, that is mutually agreed upon by the

Contractor and the COR or his/her designated representative, using the Department of Treasury Invoice

Processing Platform (IPP). Information regarding IPP, including IPP Customer Support is available at www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-

3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasure.gov.

http://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasure.gov

The following information must be included on the invoice to process payment:

1. Contractor Name

2. Mailing Address

3. Telephone Number

4. Tax ID Number

5. Purchase Order Number (in Block #3 of the OF-347 form)

6. Invoice Number and Date

7. Description of Services Provided, Quantity, Unit of Issue, and Total Amount Due

8. DUNS Number (Data Universal Number)

Please send copy of the invoice to:

Woodrow Wilson Keeble Memorial Health Care Center

ATTN: Property and Supply

100 Lake Traverse Drive

Sisseton, SD 57262

PERFORMANCE SURVEILLANCE PLAN

Required Service

Performance

Indicators

Acceptable

Quality Level

(AQL)

Method of

Surveillance

Payment % for

NOT Meeting

AQL

Interpretation services for

Radiology

Certified to interpret

Diagnostic X-ray, Mammogram, Ultrasound, Provide coverage for radiographic interpretation services during clinic hours of operation.

Radiographic interpretation services during clinic hours of operation.

100%

Daily workload logs checked for completed reports.

Negative contract evaluation for each documented instance when a

“routine” exam report is submitted after 72 hours.

Positive contract evaluations