IME RFR~1.pdf

COMMONWEALTH OF MASSACHUSETTS

Executive Office of Energy & Environmental Affairs

Request for Response (RFR)

Independent Medical Examination (IME), Fitness-for- Duty, and Medical Cost Containment Services for

Massachusetts Environmental Police Officers

COMMBUYS BID #

BD-27-1042-ENV-ENV01-133439

Date Issued: 9/15/2026

1 RFR INTRODUCTION AND GENERAL DESCRIPTION

1.1 PROCUREMENT SCOPE AND DESCRIPTION

1.2 BACKGROUND INFORMATION

1.3 APPLICABLE PROCUREMENT LAW

1.4 NUMBER OF AWARDS

1.5 ADDING CONTRACTORS AFTER INITIAL CONTRACT AWARD

1.6 ELIGIBLE ENTITIES

1.7 ACQUISITION METHODS

1.8 PERFORMANCE AND PAYMENT TIMEFRAMES WHICH CONTINUE BEYOND DURATION OF THE

CONTRACT

1.9 CONTRACT DURATION

1.10 ESTIMATED VALUE OF THE CONTRACT

2 ESTIMATED PROCUREMENT CALENDAR

2.1 WRITTEN QUESTIONS VIA THE BID Q&A ON COMMBUYS

2.2 LOCATING BID Q&A

2.3 AMENDMENT DEADLINE

2.4 ORAL PRESENTATIONS/PRODUCT DEMONSTRATIONS

3 SPECIFICATIONS

3.1 BIDDER QUALIFICATIONS

3.1.1 COMPANY EXPERIENCE

3.1.2 REFERENCES AND REFERENCE INFORMATION AND/OR REQUIREMENTS

3.3 SERVICE SPECIFICATIONS

3.3.2 GEOGRAPHIC SERVICE AND DELIVERY AREAS

3.3.3 STATEMENT OF WORK (SOW) REQUIREMENTS

3.4 SMALL BUSINESS PURCHASING PROGRAM

3.4.1 PROGRAM BACKGROUND

3.4.2 SBPP AWARD PREFERENCE

3.4.3 SBPP PARTICIPATION ELIGIBILITY

3.4.4 SBPP COMPLIANCE REQUIREMENTS

3.4.5 PROGRAM RESOURCES AND ASSISTANCE

Table of Contents Page ii

3.5 SUPPLIER DIVERSITY PROGRAM

3.5.1 PROGRAM BACKGROUND

3.5.2 FINANCIAL COMMITMENT REQUIREMENTS

3.5.3 ELIGIBLE SDP PARTNER CERTIFICATION CATEGORIES

3.5.4 ELIGIBLE TYPES OF BUSINESS-TO-BUSINESS RELATIONSHIPS

3.5.5 PROGRAM FLEXIBILITY

3.5.6 SDP PLAN FORM REQUIREMENTS

3.5.7 EVALUATION OF SDP FORMS

3.5.8 SDP SPENDING REPORTS AND COMPLIANCE

3.5.9 SDP SPENDING VERIFICATION

3.5.10 PROGRAM RESOURCES AND ASSISTANCE

3.5.11 EXECUTIVE ORDER 515, ESTABLISHING AN ENVIRONMENTAL PURCHASING POLICY

3.5.12 ENVIRONMENTAL PLAN

3.6 COMPENSATION STRUCTURE/PRICING

4 OTHER TERMS

4.1 REPORTING

4.2 SECURITY AND CONFIDENTIALITY

4.3 FAILURE TO PERFORM CONTRACTUAL OBLIGATIONS

5 AUDIT

6 EVALUATION CRITERIA

6.1 MANDATORY REQUIREMENTS

6.2 DESIRABLE SPECIFICATIONS

6.3 ALTERNATIVES

6.4 EVALUATION COMPONENTS

6.4.1 PRICE

6.4.2 SUPPLIER DIVERSITY PLAN

6.4.3 COMPANY CERTIFICATIONS AND AFFILIATIONS

6.4.4 COMPANY EXPERIENCE

6.4.5 REFERENCES AND REFERENCE INFORMATION AND/OR REQUIREMENT

6.4.6 EMPLOYEE REQUIREMENTS

6.4.7 TECHNICAL AND LEGAL COMPLIANCE

6.4.8 SAMPLES FOR EVALUATION

6.4.9 OTHER DESIRABLE OR OPTIONAL SPECIFICATIONS

7 HOW TO SUBMIT A QUOTE

7.1 QUOTE SUBMISSION METHOD

7.2 COMMBUYS QUOTE SUBMISSION TRAINING AND INSTRUCTIONS

7.3 COMMBUYS SUPPORT

Table of Contents Page iii

7.4 BID OPENING DATE/TIME

7.5 QUOTE CONTENTS

7.5.1 RFR SUBMISSION CHECKLIST

7.5.2 ELECTRONIC SIGNATURES

7.5.3 ACCEPTABLE FORMS OF SIGNATURE

7.6 LIMITS AND RESTRICTIONS

7.6.1 FILE NAMING CONVENTIONS

7.6.2 FILE SIZE LIMITS

7.6.3 FILE FORMAT RESTRICTIONS

7.6.4 DOCUMENTS AND ITEMS THAT CANNOT BE SUBMITTED ELECTRONICALLY

7.7 WITHDRAWING A QUOTE

7.7.1 PRIOR TO BID OPENING DATE/TIME

7.7.2 AFTER BID OPENING DATE/TIME

7.8 ADDITIONAL QUOTE TERMS

7.8.1 PROHIBITION REGARDING CONTRACT TERMS

7.8.2 BIDDER RESPONSE FORM

8 APPENDIX 1 – REQUIRED TERMS FOR ALL RFRS

8.1 GENERAL PROCUREMENT INFORMATION

8.1.1 ACCESS TO SECURITY-SENSITIVE INFORMATION

8.1.2 ALTERATIONS

8.1.3 OWNERSHIP OF SUBMITTED QUOTES

8.1.4 PROHIBITIONS

8.2 TERMS AND REQUIREMENTS PERTAINING TO AWARDED CONTRACTS

8.2.1 COMMONWEALTH TAX EXEMPTION

8.2.2 CONTRACTOR’S CONTACT INFORMATION

8.2.3 CONTRACTUAL STATUS OF ORDERS AND SERVICE CONTRACTS

8.2.4 PUBLICITY

9 APPENDIX 2 – RFR – REQUIRED SPECIFICATIONS

10 APPENDIX 3 - OTHER SPECIFICATIONS

11 APPENDIX 4 INSTRUCTIONS FOR EXECUTION AND SUBMISSION OF

COMMONWEALTH STANDARD FORMS

11.1 COMMONWEALTH STANDARD CONTRACT FORM

11.2 COMMONWEALTH TERMS AND CONDITIONS/COMMONWEALTH IT TERMS AND CONDITIONS

11.3 REQUEST FOR TAXPAYER IDENTIFICATION NUMBER AND CERTIFICATION (MASS. SUBSTITUTE

W9 FORM)

11.4 CONTRACTOR AUTHORIZED SIGNATORY LISTING

11.5 SUPPLIER DIVERSITY PROGRAM PLAN FORM

11.6 CURRENT ENVIRONMENTALLY PREFERABLE PRODUCTS / PRACTICES FORM

Table of Contents Page iv

11.7 PROMPT PAYMENT DISCOUNT FORM

11.8 BUSINESS REFERENCE FORM

12 APPENDIX 5 INSTRUCTIONS FOR VENDORS RESPONDING TO BIDS

ELECTRONICALLY THROUGH COMMBUYS

1 RFR INTRODUCTION AND GENERAL DESCRIPTION

1.1 Procurement Scope and Description

The Commonwealth of Massachusetts, Executive Office of Energy and Environmental Affairs (EOEEA), is seeking qualified bidders to provide Independent Medical Examination (IME) and Medical Cost Containment Services (Managed Care Services for Injured Workers).

These services will primarily support Massachusetts Environmental Police Officers who sustain work-related injuries and are eligible for Injury on Duty (IOD) benefits pursuant to M.G.L. c. 21A, §10J. Services may also include medical evaluations for employees who are not work-injured, including fitness-for-duty examinations and other employment-related medical assessments, as requested by EOEEA.

EOEEA administers Injury on Duty (IOD) benefits under M.G.L. c. 21A, §10J through its Human Resources Department, including both wage replacement and medical benefits. The selected Contractor will provide medical management services that support EOEEA's administration of these benefits by facilitating timely, objective, and high-quality medical evaluations and related managed care services.

The Contractor shall provide comprehensive IME and medical cost containment services designed to ensure broad, timely, and equitable access to qualified medical professionals throughout the Commonwealth. Services shall include, but are not limited to:

• Coordinating and scheduling Independent Medical Examinations (IMEs) in a timely manner, including accommodations for urgent requests and examinations at multiple geographic locations.

• Maintaining a statewide network of board-certified and appropriately credentialed physicians representing a broad range of medical specialties, including, but not limited to, orthopedic surgery, neurology, psychiatry, occupational medicine, and other specialties as required.

• Providing access to both in-person and, where clinically appropriate, telehealth-based examinations.

• Matching each referral with a physician possessing the appropriate specialty expertise based on the medical and occupational issues presented.

• Maintaining sufficient provider network capacity to minimize scheduling delays and ensure equitable access for employees throughout the Commonwealth.

• Providing medical cost containment and managed care services that support the effective administration of work-related injury claims, including utilization review, medical bill review, case management, peer review, and other related services, as requested by

EOEEA.

The Contractor shall ensure that all services are delivered in accordance with applicable federal and Massachusetts laws, regulations, professional standards, and confidentiality requirements while maintaining impartiality, clinical objectivity, and timely communication with EOEEA.

1.2 Background information

The Executive Office of Energy and Environmental Affairs (EOEEA) currently contracts with vendors to provide Independent Medical Examination (IME) services and related managed care services in support of its Injury on Duty (IOD) program for Massachusetts Environmental Police Officers. The current contracts are scheduled to expire on June 30, 2027.

This Request for Responses (RFR) is being issued to establish new contract(s) to ensure the continued provision of timely, objective, and high-quality IME, fitness-for-duty, and medical cost containment services in support of EOEEA's administration of Injury on Duty benefits under M.G.L.

c. 21A, §10J.

1.3 Applicable Procurement Law

This Bid is issued under the following law(s):

• MGL c. 7, § 22; c. 30, § 51, § 52; and 801 CMR 21.00 (Goods and Services)

1.4 Number of awards

The target maximum number of Contractors is 1. This is a target number; the Strategic Sourcing Services Team (SSST) may award more or fewer Contracts if it is in the best interests of the Commonwealth to do so.

1.5 Adding Contractors after initial Contract award

If, over the life of the Contract, the SSST determines that additional Contractors should be added, these may first be drawn from qualified companies that responded to this Bid but were not awarded contracts. If necessary to meet the requirements of the Commonwealth, the Bid may be reopened to obtain additional Quotes.

1.6 Eligible Entities

Limited User Contract – Restricted to Use by Defined Entities Only. Any contract resulting from this Bid will be open for use by the Issuing Entity as well as the following other entities: The Executive Office of Energy and Environmental Affairs and all agencies and offices within the EOEEA Secretariat..

1.7 Acquisition Methods

The acquisition method(s) to acquire goods and/or services from this Bid is Fee for Service.

1.8 Performance and Payment Timeframes Which Continue Beyond Duration of the Contract.

All term leases, rentals, maintenance, or other agreements for services entered into during the duration of this contract and whose performance and payment timeframes extend beyond the duration of this contract shall remain in effect for performance and payment purposes no longer than 3 months after final contract end date. No new leases, rentals, maintenance, or other agreements for services may be executed after the contract has expired. Any contract termination or suspension pursuant to this section shall not automatically terminate any leases, rentals, maintenance, or other agreements for services already in place unless the department also terminates said leases, rentals, maintenance, or other agreements for service, which were executed pursuant to the main contract.

1.9 Contract Duration

The expected duration of this contract is as follows:

Contract Duration Number of Options

Number of Years/Months Instructions

Initial Duration 1 year 12 months

Renewal Options 2 years Two (2) renewal options up to one (1) year each

Total Maximum Contract Duration

3 years 36 months

No goods may be ordered and no new leases, rentals, maintenance, or other agreements for services may be executed after the Contract has expired.

1.10 Estimated Value of the Contract

Contracts will not have a maximum obligation amount. This is fee for service contract and rates will be negotiated prior to contract execution and based on scope of services outlined in this RFR.

Compensation will be based on use of contractor services. The Commonwealth makes no guarantee that any commodities or services will be purchased from any Contract resulting from this Bid. Any estimates or past procurement volumes referenced in this Bid are included only for the convenience of Bidders and are not to be relied upon as any indication of future purchase levels.

2 ESTIMATED PROCUREMENT CALENDAR

EVENT DATE

Bid Release Date 9/15/2026

Deadline for Submission of Questions through COMMBUYS “Bid Q&A”

9/23/2026 at 5:00 pm

Official Answers for Bid Q&A published (Estimated)

9/30/2026

Deadline for Quotes/Bid Responses (“Bid Opening Date/Time” in COMMBUYS)

10/06/2026 12:00 PM EST

Notification of Apparent Successful Bidder(s) (Estimated)

10/09/2026

Estimated Contract Start Date 10/16/2026

Times are Eastern Standard/Daylight Savings (US), as displayed on the COMMBUYS system clock displayed to Bidders after logging in. If there is a conflict between the dates in this Procurement Calendar and dates in the Bid’s Header, the dates in the Bid’s Header on COMMBUYS shall prevail. Bidders are responsible for checking the Bid record, including Bid Q&A, on COMMBUYS for Procurement Calendar updates.

2.1 Written questions via the Bid Q&A on COMMBUYS

The “Bid Q&A” provides the opportunity for Bidders to ask written questions and receive written answers from the SSST regarding this Bid. Bidders’ questions must be submitted through the Bid Q&A found on COMMBUYS (see below for instructions) and prior to the Deadline for Submission of Questions stated in the Estimated Procurement Calendar. The issuing department reserves the right not to respond to questions submitted after this date. It is the Bidder’s responsibility to verify receipt of questions.

Please note that questions submitted to the SSST using any other medium (including those that are sent by mail, fax, email, or voicemail, etc.) will not be answered. To reduce the number of redundant or duplicate questions, Bidders are asked to review all questions previously submitted to determine whether the Bidder’s question has already been posted.

Bidders are responsible for entering content suitable for public viewing since all questions are accessible to the public. Bidders must not include information that could be considered personal, security sensitive, inflammatory, incorrect, collusory, or otherwise objectionable, including information about the Bidder’s company or other companies. The SSST reserves the right to edit or delete submitted questions that raise any of these issues or that are not in the best interest of the Commonwealth or this Bid.

All answers are final when posted. Any subsequent revisions to previously provided answers will be dated.

It is the responsibility of the prospective Bidder and awarded Contractor to maintain an active registration in COMMBUYS and to keep current the email address of the Bidder’s contact person and prospective contract manager, if awarded a contract, and to monitor that email inbox for communications from the Purchasing Department, including requests for clarification. The Purchasing Department and the Commonwealth assume no responsibility if a prospective Bidder’s/awarded Contractor’s designated email address is not current, or if technical problems, including those with the prospective Bidder’s/awarded Contractor’s computer, network, or internet service provider (ISP), cause email communications sent to/from the prospective Bidder/Awarded contractor and the Purchasing Department to be lost or rejected by any means, including email or spam filtering.

2.2 Locating Bid Q&A

Log into COMMBUYS, locate the Bid, acknowledge receipt of the Bid, and scroll down to the bottom of the Bid Header page. The “Bid Q&A” button allows Bidders access to the Bid Q&A page.

2.3 Amendment Deadline

The SSST reserves the right to make amendments to the Bid after initial publication. It is each Bidder’s responsibility to check COMMBUYS for amendments, addenda, or modifications to this Bid, and any Bid Q&A records related to this Bid. The SSST and the Commonwealth accept no responsibility and will provide no accommodation to Bidders who submit a Quote based on an out-of-date Bid or on information received from a source other than COMMBUYS.

2.4 Oral Presentations/Product Demonstrations

Selected Bidders who are asked to participate in Oral Presentations / Product Demonstrations will be expected to prioritize this in their schedules. The SSST will make every effort to find a mutually convenient time for the Bidder and the SSST. However, failure to appear at the scheduled time of the presentation/demonstration may result in disqualification, reduction of points, or other action that the SSST deems appropriate.

3 SPECIFICATIONS

3.1 Bidder Qualifications

3.1.1 Company experience

Bidder should have at least 5 years’ experience in the business of providing and delivering IME services.

3.1.2 References and reference information and/or requirements Bidder must provide names and contact information for 3 customers, preferably performing and delivering services in MA Bidder shall provide names and details of state government customers if applicable

3.1.3 Employee requirements

Bidder must ensure all employees engaged in the coordination of IME services are sufficiently trained in quality analysis and review (including grammatical editing), to ensure a thorough, high quality IME report, typically without need for addendums or revisions.

• QA staff must ensure all questions posed by EOEEA and their legal counsel are addressed and answered within the report before it is signed by IME physician and submitted to EOEEA.

• QA staff must ensure that medical records submitted in advance of the IME are commented upon and summarized within the report.

3.2 Commodity specifications

3.2.1 Sample products for evaluation

Bidder must submit at least 2 sample IME reports with bid, which reflect the standard and typical IME report which would be submitted to EOEEA as their final work product

3.3 Scope of Service

The Contractor shall provide comprehensive Independent Medical Examination (IME), Fitness-for-Duty, and other employment-related medical evaluation services, as well as managed care and medical cost containment services, for the Executive Office of Energy and Environmental Affairs (EOEEA) and its agencies, including the Massachusetts Environmental Police.

Independent Medical Examinations (IMEs), Fitness-for-Duty Examinations, and Employment-Related Medical Evaluations The Contractor shall provide objective, timely, and independent medical evaluations for EOEEA employees and employees of agencies within the EOEEA Secretariat, including Massachusetts Environmental Police Officers. Services shall include, but are not limited to:

• Independent Medical Examinations (IMEs) for employees with work-related injuries, including those receiving Injury on Duty (IOD) benefits under M.G.L. c. 21A, §10J.

• Fitness-for-duty examinations to determine an employee's ability to safely perform the essential functions of their position.

• Other employment-related medical evaluations requested by EOEEA, including return-to-work evaluations, medical clearance examinations, and other assessments necessary to support employment decisions.

• Coordination and scheduling of examinations with qualified physicians possessing the appropriate specialty expertise.

• Preparation of timely, comprehensive, and objective medical reports that address the specific referral questions provided by EOEEA.

3.4 Medical Cost Containment and Managed Care Services

The Contractor shall provide comprehensive medical cost containment and managed care services to support EOEEA's administration of Injury on Duty (IOD) benefits and other employment-related medical services. At a minimum, the Contractor shall provide the following services.

3.4.1 Medical Bill Review and PPO Repricing

The Contractor shall provide medical bill review and PPO repricing services, including:

• Medical bill review and processing.

• Issuance of Explanation of Review (EOR).

• Application of the Massachusetts Workers' Compensation Medical Fee Schedule or Usual, Customary, and Reasonable (UCR) reimbursement methodology, as applicable.

• Clinical code review and medical necessity review.

• Identification and prevention of duplicate billing.

• Processing provider reconsideration requests and appeals.

• Distribution of EORs.

• Payment disbursement and controlled banking services.

3.4.2 Technology and Electronic Data Exchange

The Contractor shall provide:

• Secure web portal access for authorized EOEEA staff.

• User training and technical support.

• System implementation and configuration.

• Electronic Data Interchange (EDI) capabilities for claims, payment, and EOR files.

• Secure File Transfer Protocol (SFTP) services for secure exchange of electronic records.

3.4.3 Nurse Case Management and Vocational Rehabilitation

The Contractor shall provide:

• Early intervention and injury triage.

• Telephonic nurse case management for initial 30 days, with renewal period subject to claim adjuster approval.

• Continued case management upon EOEEA approval.

• Vocational rehabilitation consultation when medically appropriate.

• Secure online case management access for authorized EOEEA personnel.

3.4.4 Utilization Review

The Contractor shall provide prospective, concurrent, and retrospective utilization review services, including:

• First-level review by qualified utilization review nurses.

• Second-level physician review.

• Retrospective medical record reviews.

• Written determinations with supporting clinical rationale.

• Compliance with all applicable Massachusetts utilization review regulations.

3.4.5 Drug Utilization Review

The Contractor shall provide Drug Utilization Review (DUR) services to:

• Evaluate medication appropriateness.

• Identify therapeutic duplication and drug interactions.

• Review long-term pain management and high-risk medications.

• Provide written clinical recommendations.

3.4.6 Independent Medical Examination (IME) Scheduling

The Contractor shall coordinate Independent Medical Examinations for Injury on Duty cases, fitness-for-duty examinations, and other employment-related medical evaluations. Responsibilities shall include:

• Scheduling examinations.

• Identifying qualified specialists.

• Coordinating appointment logistics.

• Ensuring examiner independence.

• Delivering completed IME reports.

• Coordinating report addenda when requested.

3.4.7 Diagnostic Testing Coordination

When requested, the Contractor shall coordinate diagnostic testing, including but not limited to:

• MRI

• CT Scan

• X-ray

• Ultrasound

• EMG

• Nerve Conduction Studies (NCS)

3.4.8 Data Security and Confidentiality

The Contractor shall comply with all applicable Commonwealth information security requirements and state and federal laws governing Protected Health Information (PHI) and Personally Identifiable Information (PII).

3.4.9 Reporting Requirements

The Contractor shall provide, at a minimum:

• Monthly cost savings reports.

• Medical bill review reports.

• Utilization review activity reports.

• Nurse case management reports.

• IME scheduling performance reports.

• Annual program analytics and performance summaries.

3.4.10 Performance Standards

The Contractor shall maintain performance standards that include timely service delivery, accurate application of medical fee schedules, regulatory compliance, responsive customer service, and timely reporting.

3.4.11 Implementation and Training

The Contractor shall provide implementation services, systems integration assistance, user training, and ongoing technical support at no additional cost to EOEEA.

3.4.12 Pricing Schedule

The Bidder shall submit an itemized pricing schedule for each required service, including medical bill review, PPO repricing, nurse case management, utilization review, drug utilization review, IME scheduling, diagnostic testing coordination, vocational rehabilitation consultation, and any optional value-added services.

3.5 Service Level Agreements (SLAs)

The Contractor shall meet the service levels established by EOEEA throughout the term of the Contract. At a minimum, the Contractor shall:

• Provide qualified staff during normal Commonwealth business hours (Monday through Friday, excluding Commonwealth holidays), with procedures in place to respond to urgent or time-sensitive requests.

• Meet mutually agreed-upon response and turnaround times for all required services, including IME scheduling, medical bill review, utilization review, nurse case management, and report delivery.

• Maintain sufficient staffing and operational capacity to ensure continuity of services and minimize delays.

• Comply with all contract performance standards, billing requirements, reporting obligations, and quality assurance measures established by EOEEA.

• Cooperate with EOEEA in monitoring performance and promptly implement corrective action plans if service levels are not achieved.

• Participate in periodic performance review meetings, upon request, to evaluate service delivery, discuss operational issues, and identify opportunities for continuous improvement.

3.5.1 Performance Standards

The Contractor shall maintain the highest standards of professional, ethical, and clinical performance throughout the term of the Contract. Failure to comply with these requirements may result in corrective action, suspension of referrals, or termination of the Contract.

Provider Qualifications The Contractor shall:

• Ensure all physicians performing Independent Medical Examinations (IMEs) are actively engaged in private clinical practice and possess appropriate expertise in the medical specialty for which they are performing evaluations.

• Ensure each physician holds a current, unrestricted professional license in the jurisdiction where the examination is performed and remains in good standing throughout the Contract term.

• Maintain a network of qualified physicians located both within and, when necessary, outside the Commonwealth of Massachusetts to ensure timely access to specialty evaluations.

• Maintain an accurate and current provider directory by promptly adding newly contracted physicians and removing providers who are no longer available or eligible to perform IMEs.

• Ensure physicians remain available to respond to requests for report revisions, clarifications, or addenda as required by EOEEA.

3.5.1.1 Service Requirements

The Contractor shall provide comprehensive Independent Medical Examination (IME), fitness-for-duty, and other employment-related medical evaluation services in accordance with the requirements of this RFQ. At a minimum, the Contractor shall comply with the following service requirements:

A. Referral Management and Scheduling

The Contractor shall:

• Accept and acknowledge receipt of IME referrals electronically and transmit all completed IME reports electronically to the EOEEA IME Coordinator.

• Schedule examinations promptly upon receipt of a referral and notify EOEEA immediately of any scheduling issues or anticipated delays.

• Provide written confirmation of each scheduled examination to the employee, the employee's legal representative (if applicable), and EOEEA, including the examination date, time, location, and any preparation instructions.

• Confirm scheduled appointments with the employee and/or the employee's legal representative by telephone no less than twenty-four (24) to forty-eight (48) hours prior to the appointment.

• Refer all requests to cancel or reschedule an examination to EOEEA for approval. The Contractor shall not independently reschedule or cancel appointments without prior authorization from EOEEA.

B. Missed Appointments and Delays

The Contractor shall:

• Notify EOEEA on the same business day, or no later than the next business day, if an employee fails to appear for a scheduled examination.

• Promptly notify the EOEEA Claims Adjuster and IME Coordinator of any circumstances that may delay the examination or completion of the report.

C. Examination Requirements

The Contractor shall ensure that:

• All examinations are conducted in facilities that comply with the Americans with Disabilities Act (ADA).

• The examining physician establishes and documents the identity of the employee prior to the examination using a valid government-issued or employer-issued photo identification. A copy of the identification shall accompany the examination report and invoice, when permitted by applicable law and EOEEA requirements.

• Examining physicians perform any required medical record reviews and address all referral questions and supporting documentation provided by EOEEA.

• Physicians obtain any additional medical records or diagnostic information necessary to complete the evaluation by coordinating with EOEEA before issuing a final report.

D. Physician Independence and Professional Conduct

The Contractor shall ensure that examining physicians:

• Are independent and impartial and have not previously treated the employee for the medical condition under review or have any conflict of interest that could impair their objectivity.

• Do not discuss examination findings, opinions, or treatment recommendations with the employee during the examination.

• Do not communicate directly with the employee's treating healthcare providers unless specifically authorized by EOEEA.

E. Surveillance and Investigative Materials

When EOEEA provides investigative or surveillance video for review, the Contractor shall ensure that the examining physician:

• Reviews all materials provided by EOEEA before completing the examination report.

• Addresses whether the surveillance is consistent with the employee's presentation during the examination and whether it changes any medical opinions or conclusions.

• Does not disclose or discuss the existence of surveillance materials with the employee during the examination.

If a physician declines to review surveillance materials, the Contractor shall notify EOEEA before the examination is scheduled.

F. Reports and Deliverables The Contractor shall:

• Submit a comprehensive IME report electronically within ten (10) business days following the examination, or by any earlier deadline established by EOEEA.

• Ensure that all reports fully address the referral questions and comply with the report requirements set forth in this RFQ.

• Review all reports for completeness, accuracy, grammar, spelling, and punctuation before submission.

• Submit requested report revisions, clarifications, or addenda at no additional cost within five (5) to seven (7) business days of EOEEA's request.

G. Court Testimony Upon request by EOEEA, the Office of the Attorney General, or authorized legal counsel representing the Commonwealth, the Contractor shall ensure that the examining physician is available to provide deposition testimony, court testimony, or other legal proceedings related to the examination and resulting medical opinions.

3.5.1.2 Billing Requirements

• M.G.L. c. 29, s 29A, provides that in no event shall a vendor be paid for services rendered prior to the date of service. Vendors must submit an invoice for each IME and may not batch bill.

• Rates must be consistent with the rates for IMEs set out in the fee schedule agreed to by EOEEA and the vendor. In cases of individual consideration, a rate may be negotiated. All rates must be negotiated prior to the IME. Rates in excess of the agreed upon rates in the contract, or not pre-negotiated, will not be negotiated after the IME has been completed.

• The IME rate is an all-inclusive rate.

• One copy of the IME invoice must be attached to the report that is sent to EOEEA. Each invoice should contain the injured worker’s name, file number, name of employing agency, date of exam, IME fee and the vendor’s federal tax identification number.

• An IME that is not returned within the 10 business day timeline may be subject to a 20% reduction to the fee

• The issues noted in the Mandatory IME Reporting Requirements in this RFR or the EOEEA IME cover letter must be addressed in the IME report. Failure to comply with any service directives could result in non-payment of services.

• Reports that are re-written due to quality issues will be completed at no additional cost.

3.5.2 Geographic service and delivery areas

Vendor must offer, and have available, a reasonable number of IME physicians of various medical specialties, located throughout the Commonwealth of MA and surrounding states.

3.5.3 Statement of Work (SOW) requirements

Through the Statement of Work, vendor responsibilities during the ordering, conducting and reporting back on IMEs to EOEEA will be developed.

3.5.4 Requirements at Contract or engagement termination

Upon expiration of contract, all outstanding IME reports will be submitted to EOEEA in a timely manner as required under the vendor contract. Any addendums or additions to IME reports will continue to be handled as outlined in the vendor contract until the IME is considered completed by EOEEA.

3.6 Small Business Purchasing Program

3.6.1 Program Background

The Massachusetts Small Business Purchasing Program (SBPP) was established pursuant to Executive Order 523 to increase state contracting opportunities with small businesses having their principal place of business within the Commonwealth of Massachusetts. Pursuant to the SBPP, it is the intention of the issuing department to award this Small Procurement to one or more SBPP participating business(es) as described below.

3.6.2 SBPP Award Preference

While all businesses, no matter the size or principal place of business, may submit responses to this solicitation, should an SBPP participant respond and meet the best value criteria as described in this solicitation, the SBPP participant shall be awarded the contract. The Strategic Sourcing Services Team (SSST) will not evaluate submissions from non-SBPP participants unless no SBPP Bidder meets the SSST’s best value evaluation criteria.

3.6.3 SBPP Participation Eligibility

To be eligible to participate in this procurement as an SBPP participant, an entity must meet the following criteria, and be marked as an SBPP registered business in COMMBUYS:

1. Have its principal place of business in the Commonwealth of Massachusetts;

2. Been in business for at least one year;

3. Employ a combined total of 50 or fewer full-time equivalent employees in all locations, or employees work less than a combined total of 26,000 hours per quarter; and

4. Have gross revenues, as reported on appropriate tax forms, of $15 million or less, based on a three-year average.

Non-profit firms also must be registered as a non-profit or charitable organization with the MA Attorney General’s Office and be up to date with all filings required by that office and be tax exempt under Section 501(c) of the Internal Revenue Code.

3.6.4 SBPP Compliance Requirements

It is the responsibility of the Bidder to ensure that their SBPP status is current at the time of submitting a response and throughout the life of any resulting contract. Misrepresentation of SBPP status will result in disqualification from consideration, and may result in debarment, contract termination, and other actions. To learn more about the SBPP, including how to apply, visit the SBPP webpage, http://www.mass.gov/sbpp.

https://www.mass.gov/executive-orders/no-523-establishing-the-massachusetts-small-business-purchasing-program https://www.commbuys.com/bso/ http://www.mass.gov/sbpp

3.6.5 Program Resources and Assistance

Bidders and Contractors seeking assistance regarding SBPP may visit the SBPP webpage or contact the SBPP Help Desk at sbpp@mass.gov.

3.6.6 Executive Order 515, Establishing an Environmental Purchasing Policy

Products and services purchased by state agencies must comply with Executive Order 515, issued October 27, 2009. Under this Executive Order, Executive Departments are required to reduce their impact on the environment and enhance public health by procuring environmentally preferable products and services (EPPs) whenever such products and services perform to satisfactory standards and represent best value, consistent with 801 CMR 21.00. In line with this directive, all contracts, whether departmental or statewide, must comply with the specifications and guidelines established by OSD and the EPP Program. EPPs are products and services that help to conserve natural resources, reduce waste, protect public health and the environment, and promote the use of clean technologies, recycled materials, and less toxic products. Questions concerning the EO or the appropriate specifications may be directed to OSD’s EPP Procurement Program, www.mass.gov/epp. The Order may be seen at https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy.

3.6.7 Environmental plan

Beginning the first year of the Contract and throughout the life of the Contract, awarded Bidders must agree to work with the SSST to examine the feasibility of implementing an environmental plan. The objective of this requirement is to actively encourage suppliers to incorporate sustainable practices throughout their business operations and further market such practices to Contract users. Such a plan may include, but not be limited to, the following:

• Implementing energy efficiency initiatives at the corporate level in line with Executive Order 484, such as lighting retrofits, purchase of energy from renewable sources, use of bio-heat fuel, and other energy reduction technologies.

• Encouraging environmental initiatives at the corporate and/or manufacturing level for the purpose of reducing the impact of manufacturing on the environment; such as clearly identifying recycled content of packaging on the packaging, providing product life cycle assessments, working toward the elimination of ozone-depleting chemical usage in the manufacturing or refining process (where applicable), and conducting internal environmental auditing related to pollution control.

• Adopting standards and/or obtain certifications, where applicable, for product development and manufacturing processes such as, but not limited to. LEED, ISO 14001, Cradle to Cradle (C2C) Protocol, Green Seal, Environmental Choice, and others.

• Using alternative fuel vehicles for delivery or transportation purposes and/or vehicles equipped with diesel emission control devices and operating such vehicles with guidance on anti-idling initiatives.

• Working with the SSST to develop and distribute information and/or materials to Commonwealth customers about the Awarded Bidder’s/Contractor’s environmental practices and initiatives throughout the term of the Contract.

• Developing a plan to implement the recycling of materials used or produced in normal business operations.

• The SSST may award points to Bidders who provide evidence that measures and initiatives such as these are in place within their operations, and/or for written proposals submitted with their Quote detailing a commitment to action contingent upon receipt of a Contract award. (See the Additional Environmentally Preferable Products / Practices form on COMMBUYS).

3.7 Compensation Structure/Pricing

Vendors must submit their best possible pricing for IME services. EOEEA recognizes that IMEs will differ according to medical specialty, level of complexity, number of medical records and other http://www.mass.gov/sbpp mailto:sbpp@mass.gov https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy?_ga=2.237660352.1741219494.1633353146-758386467.1632336759 http://www.mass.gov/epp https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy https://www.mass.gov/executive-orders/no-484-leading-by-example-clean-energy-and-efficient-buildings?_ga=2.100925761.1741219494.1633353146-758386467.1632336759 https://www.mass.gov/executive-orders/no-484-leading-by-example-clean-energy-and-efficient-buildings?_ga=2.100925761.1741219494.1633353146-758386467.1632336759 information to review, and availability of physicians; however, recognizing most IMEs are routine, straight forward and should be priced as such.

Vendors shall complete the following price grid for each specialty, taking into account the appropriate tier level of physicians and the number of medical records to be reviewed. Contracts shall take into account the following services:

• Standard IME

• Complex IMEs

• No Show fees

• Late cancellation fees

• Interpreter services

• Medical record review

• Addendums with new information or medical reports provided after original IME

• Transportation services

• Physician deposition and attendance at DIA proceedings

Fees for complex IMEs, including out of state exams, will be pre-negotiated on a case-by-case basis.

No negotiations will be done following the IME. There will be no payment for an addendum or request for clarification if the request was presented at the time of scheduling the IME.

All bidders must provide the following proposed rates by specialty.

Orthopedic Surgeon Type Tiers

1 2 3 Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE Interpreter Services hourly rate Physician Hearing Testimony or Deposition hourly rate

Orthopedic Hand Surgeon Type Tiers

1 2 3 Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE

Neurologist Type Tiers

1 2 3 Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker

Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE

Neurosurgeon Type Tiers

Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE

Psychiatrist Type Tiers

Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE

Psychologist Type Tiers

Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE

Ophthalmology Type Tiers

Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE

Pain Management Type Tiers

1 2 3 Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE

Occupational Medicine Type Tiers

1 2 3 Less Than 250 Pages 251-500 Pages

500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE Interpreter Services hourly rate $125 $125 $125

Physical Medicine Type Tiers

1 2 3 Less Than 250 Pages 251-500 Pages 500+ Pages Addendums No Shows by the injured worker Cancellation by EOEEA within 48 hours NO FEE NO FEE NO FEE Interpreter Services hourly rate $125 $125 $125

Any other specialties will be subject to individual consideration between vendor and EOEEA. Vendors are welcome to submit alternative pricing structures for review and consideration as part of this bid;

however, vendors are required to submit the aforementioned pricing grid that is included in this RFR.

4 OTHER TERMS

4.1 Reporting

Contractors are responsible for compliance with all contract reporting requirements including, but not limited to, Supplier Diversity Program (SDP) and other contract reports, as required by this contract.

4.2 Security and confidentiality

The Contractor shall comply fully with all security procedures of the Commonwealth and Commonwealth Agencies in performance of the Contract. The Contractor shall not divulge to third parties confidential information obtained by the Contractor or its agents, distributors, resellers, subcontractors, officers, or employees in the course of performing Contract work, including, but not limited to, security procedures, business operations information, personally identifiable information, or commercial proprietary information in the possession of the Commonwealth Agency.

4.3 Failure to perform contractual obligations

As outlined in the Standard Contract Form, Terms and Conditions, and RFR may result in the following:

• Removal from approved list of IME vendors

5 Audit

During the term of this Agreement and for a period of six years thereafter EOEEA , its auditors, the Operational Services Division, the Office of the Inspector General, or other authorized representatives shall be afforded access at reasonable times to Contractor’s accounting records, including sales information on any system, reports or files, to audit all records relating to goods sold or services performed pursuant to this Agreement. If such an audit indicates that the Contractor has materially overcharged EOEEA, then the Contractor shall remit the overcharged amount and be responsible for payment of any costs associated with the audit.

6 Evaluation Criteria

The Evaluation Committee will evaluate each Quote based on the criteria identified in this RFR. The evaluation will consider the Vendor's demonstrated ability to provide high-quality Independent Medical Examination (IME), fitness-for-duty, employment-related medical evaluation, and medical cost containment services in accordance with the requirements of this RFR.

Evaluation Criteria Weight Technical Approach and Understanding of the Scope of Services 40% Qualifications, Experience, and Network Capacity of the Firm and Proposed Physicians, including years of experience providing services to the Commonwealth of Massachusetts or other state agencies

30%

Cost Proposal 20% Past Performance and References 10%

In evaluating Quotes, the Evaluation Committee will consider, among other factors:

• The Vendor's understanding of EOEEA's requirements and the quality of the proposed approach to delivering IME, fitness-for-duty, and medical cost containment services.

• The qualifications, experience, and geographic availability of the Vendor's physician network and clinical staff.

• The Vendor's years of experience providing IME, managed care, medical bill review, utilization review, and related services to the Commonwealth of Massachusetts and/or other state or public-sector entities.

• The Vendor's demonstrated ability to meet the required performance standards, turnaround times, reporting requirements, and data security requirements.

• The quality of the Vendor's past performance, including references from comparable governmental or public-sector clients.

• The reasonableness, completeness, and competitiveness of the proposed pricing.

• The Evaluation Committee reserves the right to request clarifications, conduct interviews or demonstrations, and verify any information provided in a Vendor's Quote as part of the evaluation process.

6.1 Mandatory requirements

Mandatory Specifications must be met for a Bid to be evaluated and may be used to disqualify Bidders. In addition, certain mandatory specifications have desirable components that may be evaluated by the SSST. The SSST reserves the right, in its discretion, to determine if non-compliance with a Mandatory Specification is insignificant or may be easily corrected.

Bid sections that include terms such as: “must,” “shall,” “will,” and “required” are mandatory.

Failure to meet the requirements of a mandatory specification without providing an alternate that is acceptable to the evaluators may result in the disqualification of a Bidder's proposal.

6.2 Desirable specifications

Desirable specifications may be scored according to the Evaluation Criteria.

RFR specifications prefaced with language such as: “desirable,” “could,” ”may,” ”should,” “preferably,” “prefers,” “suggested,” and ”requested” identify a desirable or discretionary item or factor that is considered by the Purchaser to be “desirable.” The Purchaser has listed all desirable specifications which will receive points in the evaluation criteria.

6.3 Alternatives

A Quote that fails to meet any material term or condition of the Bid, including the submission of required attachments, may lose points or be deemed unresponsive and disqualified. Unless otherwise specified, Bidders may submit Quotes proposing alternatives that provide equivalent, better, or more cost-effective performance than achievable under the stated Bid specifications.

These alternatives may include related commodities or services that may be available to enhance performance during the period of the Contract. The Quote should describe how the alternative achieves substantially equivalent or better performance than those described in the Bid specifications.

The SSST will determine if a proposed alternative method of performance achieves substantially equivalent or better performance. The goal of this Bid is to provide the best value of commodities and/or services to achieve the goals of the procurement.

6.4 Evaluation Components

The following components will be some of the criteria considered by the SSST when evaluating each Quote.

6.4.1 Price

Please note that price will carry a significant weight in the evaluation process. The following price components will be evaluated:

The overall rate structure as outlined in the IME pricing grid see Compensation Structure/Pricing).

This includes standard IME fees, higher tiered IMEs, IME addendums, IME no show fees, physician hourly fees for live testimony or deposition, optional IME services Vendor shall complete the enclosed breakdown of all IME fees as outlined in this RFR.

6.4.2 Company certifications and affiliations

The number and variety of affiliated physician specialties will be considered in the bid evaluation process. Physician lists submitted by bidder should include all IME physicians available to provide IME services. Physicians must be licensed in their state of practice. IME physicians should have sufficient knowledge and training in the conducting and writing of IME reports.

6.4.3 Company experience

Must have at least 5 years in the business of scheduling IMEs for insurers and employers.

Additional years of service may receive additional points. Bidders must have experience with providing services to at least 3 different insurers/self-insurers. Bidders must demonstrate the ability to work with EOEEA to design and streamline an efficient workflow.

6.4.4 References and reference information and/or requirement Bidders must provide references from 3 customers for whom you currently provide IME services.

6.4.5 Employee requirements

Quality analysis (QA) of reports is a priority of EOEEA. The bidder must outline their plan to ensure proper QA is done on all IMEs from request for service through to submission of IME report. Important components include:

• A summary of medical records, job descriptions and other documents submitted by EOEEA are included in the submission package to the physician, along with EOEEA’s specific questions. Vendor must contact EOEEA should specific medical reports be missing that EOEEA has referenced in the referral. All medical records and referrals must be submitted to the IME physician with sufficient time for the physician to review in advance of the IME, to ensure records are considered and incorporated into the IME report.

• It is the responsibility of the bidder to ensure all questions posed by EOEEA to the IME physician are answered. In the event the IME physician has not answered any questions asked at the time of requesting the IME, the vendor must go back to the physician for the answer(s) to unanswered question(s).

• Bidder will not submit IME report and bill to EOEEA unless all questions have been addressed/answered within said report.