J2 -QASP CMC Contract RFP.docx

QASP Solicitation Number: 1605C3-22-R-00001 Office of Workers’ Compensation Programs (OWCP), Division of Energy Employees’ Occupational Illness Compensation (DEEOIC), Energy Employees Occupational Illness Compensation Program (EEOICP) DOL/ CMC 2022 Contract Medical Consultant Services

Quality Assurance Surveillance Plan (QASP)

NOTES ON USING THIS TEMPLATE:

This template has been developed to assist DOL requiring activities with creating a Quality Assurance Surveillance Plan (QASP). The purpose of the QASP is to provide the Government and contractor with evaluation criteria that determines whether or not the performance standards for a specific contract have been met.

TO FINALIZE THIS DOCUMENT:

Complete as much development of the QASP as possible before contract award. Since the winning offeror; their key staff; and final performance standards are not known until after award, the QASP will remain in draft form until the contract is awarded. Upon contract award, you should complete this QASP and perform the following steps.

This template should be TAILORED to meet your specific requirements. Before proceeding, please select a unique file name and save the file on your computer. The following guidelines are provided for using this template:

Instructions, explanations, and comments are embedded throughout this template in two forms:

AND

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All instruction boxes and user input guidance must be removed before finalizing this document. To remove instruction boxes, click on the border of the box and press the ‘Delete’ key on your keyboard. Where user input guidance offers a choice or presents optional language, delete only those options that do not apply and remove the ‘< >’ markers and highlighting from the applicable choices.

For: Contract Medical Consultants Contract Number: TBD Contract Description: The Energy Employees Occupational Illness Compensation Program (EEOICP) provides worker’s compensation benefits authorized by the Energy Employees Occupational Illness Compensation Program Act (EEOICPA or the Act). Part B of the program went into effect on July 31, 2001 and Part E of the program went into effect on October 28, 2004. The Department of Labor’s Office of Workers’ Compensation Programs (OWCP) is responsible for adjudicating and administering claims filed by employees, former employees or certain qualified survivors under the Act.

Contractor’s name: TBD Purpose This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

· What will be monitored?

· How monitoring will take place?

· Who will conduct the monitoring?

· How monitoring efforts and results will be documented?

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance. In addition, the QASP should recognize that unforeseen and uncontrollable situations may occur.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Updates shall ensure that the QASP remains a valid, useful, and enforceable document. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

The following FAR clauses may apply depending on contract type:

52.246-4 Inspection of Services – Fixed-Price, Government Roles and Responsibilities The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: Elvis Colbert Organization or Agency: U.S. Department of Labor (DOL), Office of the Assistant Secretary for Administration and Management (OASAM, Office of the Senior Procurement Executive (OSPE) Telephone: (202) 693-4588 Email: Colbert.Elvis.R@dol.gov

b. Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. At the conclusion of the contract or when requested by the CO, the COR shall provide documentation to the CO. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf. The contractor shall refer any changes they deem may affect contract price, terms, or conditions to the CO for action.

Assigned COR: TBD Telephone: TBD Email: TBD

c. Other Key Government Personnel - Title: Alternate Contracting Office Representative (ACOR) Telephone: TBD Email: TBD Contractor Representatives The following employees of the contractor serve as the contractor’s Contract Manager and Task Manager for this contract.

a. Contract Manager - TBD Telephone: TBD Email: TBD

b. Task Manager -TBD Telephone: TBD Email: TBD

c. Other Contractor Personnel - TBD Title: TBD Telephone: TBD Email: TBD Methods of QA Surveillance Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

Regardless of the surveillance method, the COR shall always contact the contractor's task manager or on-site representative when a defect is identified and inform the manager of the specifics of the problem. The COR, with assistance from the CO, shall be responsible for monitoring the contractor’s performance in meeting a specific performance standard/AQL.

PRS # 1

The contractor shall ensure sufficient and adequate numbers of “required specialties” physicians and medical specialists are active, current, and available that meet the criteria set forth in PWS in order to provide necessary medical examinations.

100% inspection

PRS # 2

The contractor shall meet all scheduling requirements in accordance with PWS once a referral is received

PRS # 3

Assure timely delivery to examining physicians of all pertinent documents supplied by DEEOIC including SOAFs, examiners’ questions to physicians, medical records, etc. The Contractor shall ensure that any electronic transmissions to physicians or medical specialists conform to the government’s secure website requirements

PRS #4

The contractor shall ensure all reports noted in PWS are comprehensive, unequivocal, unbiased, well-reasoned, consistent with the physical findings, responsive to all questions posed by the requestor , and presented in a form and format specified by OWCP.

* Only complaints validated by the National Office will be considered in determining performance

PRS #5

The contractor shall ensure all invoices/bills are submitted in accordance with OWCP Medical Bill Processing System Procedures in order to ensure the timely processing of all invoices/bills in accordance with the Prompt Payment Act.

Bills/Invoice validation process.

Documenting Performance Documentation must be accurate and thorough. Completeness, currency, and accuracy support both satisfactory and unsatisfactory performance.

Deliverable

Frequency Number of Copies

Medium/Format

Submit To

Status Reports

Weekly

One (1) Microsoft Office Product Excel

COR

Status Reports

Monthly

One (1) Microsoft Office Product Excel

Detailed Management Reports

Quarterly

One (1)

Microsoft Office Product Excel

Management Reports Summary

One (1) Narrative Summary and Microsoft Office Product Excel

Management Reports CMC

One (1) Microsoft Office Product Excel

COR

Management Reports, SECOP, Referee Diagnostic Testing, Expedite/ Terminal, Impairment, Supplemental and Pharmacy Utilization

Quarterly

One (1) Microsoft Office Product Excel

a. ACCEPTABLE PERFORMANCE The Government shall document positive performance. A report template is attached. Any report may become a part of the supporting documentation for fixed fee payments, award fee payments, or other actions.

b. UNACCEPTABLE PERFORMANCE.

When unacceptable performance occurs, the COR shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in the COR file.

When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the contractor's task manager or on-site representative. A CDR template is attached to this QASP.

The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the COR. The Government shall review the contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for contract payment deductions, fixed fee deductions, award fee nonpayment, or other actions deemed necessary by the CO.

a. FREQUENCY OF PERFORMANCE ASSESSMENT MEETINGS.

The COR shall meet with the contractor at least quarterly to assess performance and shall provide a written assessment.

Prepared by: TBD Signature – Contracting Officer’s Representative

Performance Report

1. CONTRACT NUMBER: TBD

2. Prepared by: (Name of COR) TBD

3. Date and time of observation:

4. Observation:

11.3.1 WEEKLY STATUS REPORTS TO THE COR

On a weekly basis, the Contractor shall provide to the COR or designee by secure internet e-mail a report of all referrals, including those not yet assigned that exceed the time frame of two (2) days from initial receipt to assignment and five (5) days for SECOP and Referee exams.

1. The report shall be sorted by the referring District Office and contain the following data:

a. case number

b. claimant name (last, first)

c. medical specialty requested

d. age of referral (days since initial receipt)

e. type of report.

11.3.2 MONTHLY STATUS REPORTS TO THE COR

On the first business day of each month, the Contractor shall provide to the COR or designee by secure internet e-mail a report detailing the status of all cases, including any that are outstanding an exceed the standard completion of twenty-one (21) days for CMCs.

1. The report shall be sorted by referring District Office and contain the following data:

a. case number

b. claimant name (last, first)

c. medical specialty requested

d. age of the referral (days since initial receipt)

e. explanation for non-completion within two (2) days for causation and impairment evaluation, and five (5) days for SECOP and Referee exams

f. expected date of delivery.

11.3.3 QUARTERLY MANAGEMENT REPORTS

For each calendar quarter, the Contractor shall provide to the COR or designee, quarterly management reports in four parts – DETAIL, SUMMARY, CONTRACT MEDICAL CONSULTANTS, IMPAIRMENT EVALUATIONS, EXPEDITE/TERMINAL REFERRALS, CAUSATION REFERRALS, DIAGNOSIS CLARIFICATION, PHARMACY UTILIZATION, DIAGNOSTIC TESTING, SECOND MEDICAL OPINIONS and REFEREE MEDICAL OPINION. All reports shall include both electronic (Microsoft EXCEL) and hard copy versions.

1. DETAIL REPORTS shall include listing of all causation opinions, impairment evaluations , wage loss evaluations, SECOP, Referee evaluations and expedite reports requested during the quarter, sorted by date delivered to DEEOIC and showing for each:

a. claimant’s name (first and last)

b. case number (last 4 digits)

c. medical specialty referred to

d. type of referral (e.g., for medical opinion service or impairment evaluation)

e. date referral was received by the Contractor

f. date the case was assigned to a CMC or SECOP physician

g. whether CMC postponed or declined the case

h. date the CMC report was delivered to DEEOIC

i. current status of report if not yet delivered to DEEOIC

j. indicate if report was returned for deficiencies or clarification, and if so, the total days required from initial referral to submission of acceptable report

2. SUMMARY REPORTS shall include the following:

a) the number of referrals pending completion at the beginning of the quarter, the number of referrals received during the quarter, and the number of CMC referrals still pending completion on the 21st day after the end of the quarter;

b) the mean, minimum, and maximum completion times for CMC and SECOPs, i.e., elapsed times from first receipt of a request for medical opinion until receipt of the acceptable report by DEEOIC;

c) the number of CMC reports, and percent of total completed, for which completion times exceeded twenty-one (21) days, and the case numbers associated with those reports;

d) the number of times each CMC declined a medical opinion or impairment evaluation and the associated case numbers;

e) the number of medical opinion reports, impairment evaluations, SECOP and Referee Medical Opinions, and percent of total completed, which had to be returned for deficiencies or clarification, and the case numbers associated with those reports;

f) the number of medical opinion reports, and percent of total completed, which required follow-up reports due to receipt of additional information and the case numbers associated with those reports;

g) the total number of reports and the case numbers associated with those reports;

h) percentage of referrals that were for CMC medical opinions, impairment evaluation SECOP, referee medical opinions or expedite referrals;

i) total number of reports assessing an individual’s ability to work during a given time period, as it relates to the covered condition;

j) total number of reports providing an explanation of treatment modalities, the interpretation of clinical test results, assistance with establishing or confirming a diagnosis and the clarification of other physician’s reports.

3. CONTRACTOR REPORTS CONCERNING CONTRACT MEDICAL CONSULTANTS shall include the following:

a. number of CMCs used to deliver medical opinion services during the quarter;

b. number of reports delivered by each;

c. number of causation reports delivered by each;

d. number of impairment evaluation reports delivered by each;

e. number of cases declined by each;

f. number of reports returned for deficiencies or clarification by each;

g. number of reports that exceeded the due date by each.

4. CONTACTOR REPORTS CONCERNING SECOND MEDICAL OPINIONS and REFEREE MEDICAL OPINONS shall include the following:

a. total number completed;

b. number completed by each physician;

c. the number of times each physician declined a SECOP or Referee Medical Opinion, and the associated case numbers;

d. percent of total completed, which had to be returned for deficiencies or clarification, and the case numbers associated with those reports;

e. number of cases with assigned SECOP or Referee Medical Opinion pending examination;

f. number of cases with assigned SECOP or Referee Medical Opinion with scheduled examination (i.e., date of appointment);

g. number of cases with assigned SECOP or Referee Medical Opinion with completed examination, but no report

h. number of claimants travelling more than 200 miles from claimant’s residence for SECOP or Referee Medical Opinion.

i. number of cases that have not been assigned SECOP or Referee Medical Opinion within 14 days of the referral request.

j. number of cases that have not been assigned due to the Contractor being unable to provide a qualified physician within fourteen (14) days of the receipt of the referral.

k. number of cases that have not been assigned within 5 days of the referral request.

l. number of cases that require diagnostic testing and the total amount of the diagnostic testing per case.

m. number of claimants travelling less than 200 miles from claimant’s residence for SECOP or Referee Medical Opinion.

Quarterly Management Reports will be due no later than twenty-eight (28) calendar days from the end of the previous quarter. If the 28th day falls on a Saturday, Sunday, or Federal Holiday, the report shall be due the next business day.

CONTRACT MEETINGS

Contract meetings shall occur monthly (or as needed) with the COR and/or COR designee to report on the program’s progress and Contractor responsiveness. In addition, contract administration reviews shall occur on the deliverables outlined in Section 11.

based

OTHER MEETINGS

The DEEOIC may require the Contractor’s participation and presentation in other meetings as required. The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The COR and other Government personnel, as appropriate, may meet periodically with the Contractor to review the Contractor’s performance. At these meetings, the COR will apprise the Contractor of how the Government views the Contractor’s performance and the Contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. In addition, the Contractor shall make available quarterly conference calls between DEEOIC and the Contractor physicians to address questions or discuss ongoing issues. These meeting shall be at no additional cost to the Government.

Prepared by: TBD

QUALITY ASSURANCE SURVEILLANCE PLAN

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