Medical Statement.pdf
PDF 80 KB Posted
- Attached to
- EOS - Web-Based Training
- Solicitation number
- FA448426Q0030
About this file
This is a mandatory contractual statement for inclusion in all solicitations, awards, task orders, delivery orders, and calls with performance on Joint Base McDill-Tampa (JBMDL).
The statement establishes the medical care responsibilities and financial liability for contractor employees or agents who sustain injuries while on duty at JBMDL. The 87th Medical Treatment Facility (MTF) may provide urgent health care—defined as medical care necessary to save life or limb and prevent undue pain and suffering—to contractor personnel. However, all costs for such treatment are the responsibility of the contractor or the contractor's employee, not the 87th MTF, United States Air Force, or the federal government. Billing is processed based on services captured on Air Force FORM 552 (Pre-Hospital Evaluation Patient Care Report). If immediate payment is not possible, a statement of charges and letter of indebtedness will be issued to the contractor employee for collection. Contractor employees or agents must provide timely notice to their medical insurance companies and furnish those companies with adequate information and documentation to facilitate payment.
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Text version
The following statement will be placed in all solicitations/awards/TOs/DOs/calls with performance on JBMDL:
“The 87th Medical Treatment Facility (MTF) may provide urgent health care to any contractor employees or agents for injuries occurring while on duty. Urgent health care is defined as medical care authorized to the extent necessary to save life or limb and prevent undue pain and suffering. Contractor employees will be transferred to a civilian medical facility as soon as they are appropriately stabilized. The cost of such treatment will be paid for, in full, within a reasonable period of time (as determined with/by the Base Legal Office's assistance), by the contractor or the contractor's employee and will not be borne by the 87th MTF, the United States
Air Force or the government. Billing/accounts receivable is processed based on services provided, which is captured on an Air Force FORM 552 (Pre-Hospital Evaluation Patient Care
Report). If a contractor employee or agent cannot pay for the treatment at the time the bill is rendered, a statement of charges and a letter of indebtedness will be completed and billed to such contractor employee for medical services rendered. Contractor employee or agents shall ensure they provide timely notice to their medical insurance company and to the extent an insurance company is to make payment, provide the insurance company with adequate information and documentation necessary to make payment."
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