N62645-16-R-0001_Amendment_01.docx

N62645-16-R-0001

Japan Medically Related Administrative and Programmatic Support Services Multiple Award Task Order Contract

AMENDMENT 0001

The purpose of this amendment is to answer questions included in Attachment 5 on FBO. Also, changes have been made throughout this document. The contractor is responsible for reading the amendment in its entirety. The closing date and time of the solicitation remain unchanged.

COMBINED SYNOPSIS SOLICITATION

This is a combined synopsis/solicitation for commercial items prepared in accordance with FAR 12.6, Streamlined Procedures for Evaluation and Solicitation of Commercial Items and FAR 16.504 Indefinite-Quantity Contracts, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. It is the contractor’s responsibility to be familiar with the applicable FAR and DFARS clauses and provisions. The FAR and DFARS clauses may be accessed in full text at http://farsite.hill.af.mil/

The NAICS code is 561320, with a business size standard of $27.5 million.

This Request for Proposal (RFP) is on behalf of the Naval Medical Logistics Command (NMLC). This requirement is for medically related administrative support services and medically related programmatic support services to support military beneficiaries at U.S. Naval Hospital Okinawa, Japan, U.S. Naval Hospital Yokosuka, Japan, and any associated branch health clinics.

The solicitation number is N62645-16-R-0001.

This solicitation will result in two or more firm fixed price, indefinite delivery/indefinite quantity (IDIQ) contracts with a five year ordering period from 01 September 2016 – 31 August 2021. This requirement will be fulfilled as a Small Business Administration (SBA) 8(a) competitive acquisition.

The scope of the requirement is listed in the Performance Work Statement.

The closing date of the solicitation can be found in ADDENDUM TO 52.212-1-- INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS.

UNIT

Months

Medically Related Administrative & Programmatic Support Services

FFP

Includes Medical Records Support, Patient Appointing Support, Clear and Legible Reporting Support, Medical Evaluation Board Support, General Medical Clerical Support, Medical Scribe Support, Medical Accounting Clerical Support, Credentialing Programmatic Support, and other Medically Related Administrative Support Services and Medically Related Programmatic Support Services contained in the PWS of the contract and task orders.

FOB: Destination

UNIT

Lot

Other Direct Costs

COST

Other Direct Costs to include reimbursement of travel/relocation expenses in accordance with the Special Contract Requirements section of the contract and Joint Travel Regulations (JTR).

Performance Work Statement Medically Related Administrative Support Services and Medically Related Programmatic Support Services

SECTION 1 – SCOPE

1.1. INTRODUCTION. The purpose of this contract is to provide U.S. Naval Hospital Okinawa, Japan, U.S. Naval Hospital Yokosuka, Japan, and any associated branch health clinics with medically related administrative support services and medically related programmatic support services to support military beneficiaries.

1.2. BACKGROUND. Medically related administrative support services and medically related programmatic support services are required to support the active duty, reservist, retiree, and dependent populations that receive clinical services at MTFs. Administrative support professionals are the first point of contact for patients seeking medical attention at Navy MTFs. As the care continuum continues to shift towards patient-centered care, the need for administrative support services has increased.

1.3. SCOPE. The contractor shall provide medically related administrative support and programmatic support services to support the overall mission of the MTF to provide high quality healthcare to military beneficiaries. It includes administrative and programmatic support efforts directly or indirectly related to the delivery of healthcare. This includes tasks that involve the direct interface with patients and tasks that involve exposure to Protected Health Information (PHI) by access to the medical records of patients. The required support shall be provided onsite at the MTF unless specified otherwise in the task order.

Contractor employees performing services under this order will be controlled, directed, and supervised at all times by management personnel of the contractor. Contractor management will ensure that employees properly comply with the performance work standards outlined in the statement of work. Contractor employees will perform their duties independent of, and without the supervision of, any Government official or other Defense Contractor. The tasks, duties, and responsibilities set forth in the task order may not be interpreted or implemented in any manner that results in any contractor employee creating or modifying Federal policy, obligating the appropriated funds of the United States Government, overseeing the work of Federal employees, providing direct personal services to any Federal employee, or otherwise violating the prohibitions set forth in Parts 7.5 and 37.1 of the Federal Acquisition Regulation (FAR). The Government will control access to the facility and will perform the inspection and acceptance of the completed work.

SECTION 2 - TASKS

2.1. GENERAL REQUIREMENTS THAT APPLY TO ALL CONTRACTOR PERSONNEL. Contractor employees shall perform a full range of tasks consistent with their profession, education, training, experience, and assigned responsibilities. General requirements that apply to all contractor employees are provided below.

2.1.1. The contractor shall follow the MTF Standard Operating Procedures (SOPs) to provide administrative support services to the MTF.

2.1.2. The contractor shall receive, greet, and direct patients, visitors, and hospital personnel and provide accurate responses in a friendly, courteous, and concerned manner.

2.1.3. The contractor shall fax, copy, scan, print, and type documents to complete daily tasks listed within this contract and the MTF SOPs.

2.1.4. The contractor shall utilize the Composite Healthcare System (CHCS), the Armed Forces Health Longitudinal Technology Applications (AHLTA), CarePoint Health Application System (CHAS), Ambulatory Data System, (ADS), Clinical Information System (CIS), Navy Medicine Secure Messaging (NMSM) web application, also known as RelayHealth, and various other databases in support of patient care and to satisfy administrative requirements.

2.1.5. Maintain a level of productivity comparable with that of other individuals performing similar services.

2.1.6. Complete orientation training required by the MTF for new personnel.

2.1.7. Complete all annual training required by the MTF. This includes annual information awareness training and HIPAA training.

2.2. TASKS FOR MEDICAL RECORDS SUPPORT

2.2.1. The contractor shall accurately record updates to medical records on a daily basis.

2.2.2. The contractor shall issue medical records to service members and dependents with approved authorizations for appointments.

2.2.3. The contractor shall locate/retrieve medical records and copy documents required by staff, patients, and for reports.

2.2.4. The contractor shall prepare, repair, and maintain medical records and documents for new and existing patients.

2.2.5. The contractor shall receive/retrieve medical records from staff /patients and file documents and return records in accordance with filing system.

2.2.6. The contractor shall fax and e-mail authorized medical records information requests on a daily basis for patients requiring continued care to outside providers, patients, Veteran Affairs, Legal, etc.

2.2.7. The contractor shall answer and direct questions to staff members about medical records from service members, retirees, and dependents.

2.2.8. The contractor shall report all medical records missing information to designated staff member and send to the physician for completion on a daily basis.

2.2.9. The contractor shall print out and maintain copies of the daily Ambulatory Data Information Sheets for reference until destroyed on a monthly basis.

2.2.10. The contractor shall ensure that all encounter sheets for all visits not coded are sent to the Coding Department for coding on a daily basis.

2.2.11. The contractor shall ensure the completed coding has all required documentation obtained from coders and the Ambulatory Data Module encounter sheets are attached on a daily basis.

2.3. TASKS FOR PATIENT APPOINTING SERVICES

2.3.1. The contractor shall provide appointing services that are prompt, delivered in a courteous manner and which are the most appropriate and acceptable to the patient. Appointments offered shall meet the guidelines for Defense Health Agency (DHA)/Department of Defense (DoD) access standards (http://www.tricare.mil/tma/tai/downloads/03-28-2008/OperationalDefinitionswithAccessStandard.pdf ). The volume of appointment transactions, to include telephone conversations (T-cons), will be provided in the task order.

2.3.2. The contractor shall follow MTF Appointment Criteria/SOPs and MHS Appointment Types and Access Criteria (see Enclosure 1) as detailed in the Appointment Standard Commander’s Guide To Access Success (http://www.tricare.mil/tma/tai/downloads/03-28-2008b/CDRGuideChangeJune4-2003.pdf ) or most recent version as required by 32 CFR 199.17 to schedule, cancel and/or reschedule appointments.

2.3.3. The contractor shall utilize CHCS, Managed Care Program (MCP) module to schedule, cancel and/or reschedule patient appointments for clinical services within the MTF.

2.3.4. The contractor shall receive questions and/or appointments by telephone call from patients or MTF staff members or by automated means (e.g. CHCS I or CHCS II Consult, or referral and authorizations transaction set) and shall resolve each call with minimal blockages and hold times.

2.3.5. The contractor shall utilize AHLTA to enter T-cons per month to communicate patient needs to the clinic. Each T-con takes approximately 3 minutes to complete.

2.3.6. The contractor shall verify patient information in CHCS and update contact information in the Defense Enrollment Eligibility Reporting System (DEERS) prior to scheduling an appointment.

2.3.7. The contractor shall enter TRICARE authorization information into CHCS each month at the MTF from the Managed Support Contractor.

2.3.8. The contactor shall utilize CHCS to identify in-house referrals each month, contact patients, and monitor in the Referral Tracking Database (RTB).

2.3.9. The contractor shall be responsible for reporting all appointment errors to the MTF Appointment Management Point of Contact.

2.3.9.1. Once validated, the error shall be documented on an Appointment Error Reporting Form and corrected immediately. Procedures for error reporting and a format in which to do so are provided in Enclosure 2.

2.4. TASKS FOR CLEAR AND LEGIBLE REPORTING (CLR) SUPPORT

Note: All specialty care and Right of First Refusal (ROFR) referrals/consults shall be managed per current DHA and MTF referral management policies and guidance. All specialty care referrals will be appointed to the MTF/Direct Care System within prescribed Access to Care (ATC) Standards or referred to the local network.

2.4.1. The contractor shall review all incoming CLRs for accuracy, completeness, and legibility and posting of consultation reports for patients referred both to and from civilian network providers.

2.4.2. Contact the civilian physician’s office, if an incoming report does not meet the CLR standards.

2.4.3. The contractor shall notify MTF providers when a CLR is posted and monitor timelines of incoming CLRs.

2.4.4. The contractor shall provide CLR receipts validation and shall cross-check referral authorizations against claims adjudicated.

2.4.5. The contractor shall properly document patient responses in CHCS, AHLTA, and the Referral Management System/Referral Management System Tracking Reports and Health Artifact and Image Management Solution (HAIMS). The contractor shall provide notification to the referring Provider of patient requests to cancel referrals.

2.4.6. The contractor shall contact civilian Provider offices to determine if patient was seen and if so, acquire referral results. The contractor shall properly close referrals in CHCS and the Referral Management System/Referral Management System Tracking Reports appropriately and shall forward an informational advisement of the referral status to the initiating MTF provider or PCM. If patient is not seen in a civilian office, the contractor shall contact the patient to assist the patient in completing their care. Contacts shall be documented per MTF instruction.

2.4.7. The contractor shall assist with the return of completed consult reports to civilian providers for patients seen within the MTF under ROFR. ROFRs shall be processed within the time limits outlined in the TRICARE Operations Manual, Chapter 8, Section 5 (http://manuals.tricare.osd.mil/DisplayManual.aspx?SeriesId=OPERATIONS).

2.5. TASKS FOR MEDICAL EVALUATION BOARD SUPPORT

2.5.1. The contractor shall provide a variety of clerical and patient contact services to the Medical Evaluation Board (MEB) staff, patients, and Physical Evaluation Board (PEB) Liaison Officer (PEBLO). Contractor support is required to assist the MEB Department at the MTF to achieve its Integrated Disability Evaluation System (IDES) goals and objectives. Contractor support contributes to timely processing of active and reserve component service member case records through IDES. Services also support members who are processing to the Temporary Disability Evaluation Board and the Permanent Disability Evaluation Board, as well as Limited Duty (LIMDU) boards.

2.5.2. The contractor shall assemble and maintain MEB case records following MTF guidelines for case record assemblage that are illustrated in SECNAVINST 1850.4E (http://www.public.navy.mil/asnmra/corb/PEB/Documents/References/SECNAV%20INST%201850_4e.pdf). Examples of MEB case record “maintenance” include correct chronological filing of test results and other reports and forms in case records for professional staff review and reference; printing and filing of required online health records from AHLTA. The contractor shall retrieve and return service member health records to the Medical Records section of the MTF, as needed to provide quality, timely patient care.

2.5.3. The contractor shall review case records for administrative accuracy and verify completion of administrative record requirements by the provider (e.g. signatures, date of service). The contractor shall send Government approved case records to the PEB.

2.5.4. The contractor shall route provider dictations and boards through hospital staff per MTF routing instructions. Associated services include coordination of administrative actions and edits among various internal MTF departments. This service is performed within administrative processing standards defined in SECNAVINST 5216.5D, DoN Correspondence Manual, March 2010 (http://doni.daps.dla.mil/SECNAV%20Manuals1/5216.5.pdf) .

2.5.5. The contractor shall provide printed and routine, non-technical information about medical boards and medical board processing to scheduled and walk in patients and others who inquire. The contractor shall respond to routine, non-technical requests for information. The contractor shall advise patients regarding policies related to hours of operation and services offered by the Department.

2.5.6. The contractor shall maintain orderly patient appointment schedules and assist patients by helping them make timely follow-up appointments, reminding them of scheduled appointments, and by notifying them of appointments. The contractor shall provide the patient with the appropriate paperwork for follow-up appointments and post-LIMDU officer counselings and suitability screenings.

2.5.7. The contractor shall use MTF computer systems to manage department activity, including data input and tracking in Medical Board Online Tracking System (MEDBOLTS), Temporary Limited Duty (TLD), CHCS, Veterans Tracking Application (VTA), AHLTA, Army Knowledge Online (AKO), Navy Knowledge Online (NKO), and other automated systems that may come on-line during the term of the contract. Accuracy of the data entry is paramount to the accuracy of the MTF's reports to higher authority and to internal process monitoring.

2.5.8. The contractor shall provide administrative services related to the processing of medical boards and efficient operation of the Department. Such activities include word processing, photocopying, facsimile transmissions, telephone management and communication with patients and providers, appointment scheduling for the Department, verification of patient’s identifying and demographic information, distribution of administrative materials, internal mail.

2.5.9. TASKS FOR PEBLO SUPPORT. The contractor shall perform the following tasks to accomplish the requirements of this contract to support members who are processing to the PEB.

2.5.9.1. The contractor is responsible for the effective application of policy/procedure and other related managerial tasks and provides information to various agencies on the status of all activities under his/her case workload (e.g. MEB/PEB processing, Line of Duty (LOD) management, and the tracking/medical statistical reporting, etc.).

2.5.9.2. The contractor shall coordinate evaluation appointments; assist in preparing appeals, rebuttals, and the assignment of a service member’s legal counsel as well as refer personnel to appropriate agencies to obtain counseling/guidance on benefits provided by the Department of Labor, Social Security Administration, Defense Financial and Accounting System, and the Department of Veterans Affairs.

2.5.9.3. The contractor shall use MTF computer systems to document progress, concerns, or other issues relevant to the member’s case, and shall enter all mandatory data in MEDBOLTs, VTA, Disability Evaluation System (DES) User-Interface, CHCS, AHLTA, AKO, NKO, and other automated systems that may come on-line during the term of the contract.

2.5.9.4. The contractor shall be responsible for obtaining, assembling, and forwarding all documents and records required by the PEB. In addition, the contractor shall be the focal point for accomplishing other actions essential for prompt, effective and adequate caseload processing. In discharging these tasks, the contractor is authorized and encouraged to communicate directly with the member’s command to obtain any required information or assistance. The contractor shall maintain communication with command representatives, medical providers, case managers, recovery care coordinators, service personnel department representatives, and administrative representatives to obtain required information or assistance.

2.5.9.5. The contractor shall counsel members whose cases are likely to be referred to the PEB. The Government will be responsible for identifying these counsel members. Examples of activities include assuring that the member has an opportunity to read the medical board report and narrative summary prior to the PEB referral, counseling members about signed statements to the PEB, and assisting the member to resolve questions concerning the content of the MEB or narrative summary. In cases where the member is mentally incompetent or where the attending physician has determined that the release of information to the member would be deleterious to the member’s well-being, counseling shall be provided to the next of kin on behalf of the member. A detailed account of other specific counseling tasks and related services are available in the Policy Guidance on Operating Procedures and Processes for the Disability Evaluation System (DES) Program at Navy Medical Treatment Facilities and Non-participating Medical Treatment Facilities at http://www.med.navy.mil/policy-guidance/Documents/NAVMED%20POLICY%2010-008.pdf and Directive-Type Memorandum (DTM) 11-015 – Integrated Disability Evaluation System (IDES) at http://www.woundedwarriorregiment.org/wwr/assets/File/PEBIDES/IDES_DTM-11-015.pdf .

2.5.9.6. The contractor shall counsel members about estimated severance pay, retirement pay, and computation methods, Permanent Disability Retirement List (PDRL) compensation and computation methods, disability severance compensation and computation, estimation of VA compensation and computation methods. A detailed account of specific counseling tasks is available in the Policy Guidance on Operating Procedures and Processes for the Disability Evaluation System (DES) Program at Navy Medical Treatment Facilities and Non-Participating Medical Treatment Facilities at http://www.med.navy.mil/policy-guidance/Documents/NAVMED%20POLICY%2010-008.pdf.

2.5.9.7. The contractor shall accurately monitor and track Bureau of Medicine and Surgery (BUMED) mandated metrics.

2.6. TASKS FOR GENERAL MEDICAL CLERICAL SUPPORT

2.6.1. The contractor shall provide administrative support services that are a mixture of the tasks included under Sections 2.2, 2.3, 2.4, and 2.5. This is for support that is not easily categorized into one of the listed support areas. The specific support required under the task order will include one or more of the tasks listed under Sections 2.2, 2.3, 2.4, and 2.5.

2.7. TASKS FOR ACCOUNTING CLERICAL SUPPORT

2.7.1. BILLING OF THIRD PARTY CLAIMS

2.7.1.1. The contractor shall utilize the claims program to create claims.

2.7.1.2. The contractor shall create claims by reviewing the encounters in the claims program to determine whether the encounter is billable which shall include evaluating the OHI and other information.

2.7.1.3. The contractor shall compare the OHI information in CHCS and other sources within the information in the claims program.

2.7.1.4. The contractor shall enter manual claims into the claims program for encounters that contain incorrect information in the existing file, or for billable encounters that do not appear in the claims program.

2.7.1.5. The contractor shall submit complete claims by electronic transmission or shall print and mail complete claims to the OHI company.

2.7.2. POSTING OF PAYMENTS AND DENIALS

2.7.2.1. The contractor shall post payments and denials into the claims program which may include researching the claims program to acquire the Control number for the claim.

2.7.2.2. The contractor shall balance the amounts of the checks deposited and reported to the Defense Finance and Accounting Service (DFAS) with the amounts posted into the claims program.

2.7.2.3. The contractor shall reconcile the Third Party Collection Program (TPCP) accounts with the deposit and reporting records.

2.7.2.4. The contractor shall prepare the Monthly Uniform Business Office (UBO) reports for entry into the appropriate website for submission to higher authority.

2.7.3. INSURANCE VERIFICATION

2.7.3.1. The contractor shall evaluate the Department of Defense (DD) 2569s form received from the clinics for completeness.

2.7.3.2. The contractor shall scan and copy the DD 2569s into the AHLTA Clinical Notes record for the patient.

2.7.3.3. The contractor shall contact the patient to complete or verify questionable information on the DD 2569.

2.7.3.4. The contractor shall contact the OHI company by phone, their website, or in writing to verify the OHI information contained on the DD 2569.

2.7.3.5. The contractor shall verify the OHI information entered or updated in the Patient Insurance Information (PII) module of CHCS.

2.7.4. MEDICAL SERVICE ACCOUNTS (MSA)

2.7.4.1. The contractor shall investigate the claims that print from CHCS to determine whether the claim is billable.

2.7.4.2. The contractor shall send the billable claims to the patients.

2.7.4.3. The contractor shall send follow-up letters from CHCS.

2.7.4.4. The contractor shall print reports for Interagency Billing (IAB) from CHCS and will verify the eligibility of patients, and complete a cover sheet and a Standard Form (SF) 1080.

2.8. TASKS FOR MEDICAL SCRIBE SUPPORT

2.8.1. The contractor shall accompany the physician during the patient encounter and transcribe the encounter in real-time as indicated by the provider to document the Electronic Medical Record (EMR). The contractor shall collect and transcribe a variety of clinical data from each patient into the EMR during the encounter. Clinical data includes, but may not be limited to, the patients’ interpretation of the present illness, interim history, documenting outside medical records, test results, medications, past medical/surgical history, allergies, family and social history.

2.8.2. The contractor shall modify the EMR draft as indicated by the physician at the end of the encounter to ensure accuracy of information before the provider validates the record.

2.8.3. The contractor shall identify and report critical errors (ex. inaccurate data entry, vital signs, medications, problem, etc.) immediately.

2.9. TASKS FOR OTHER MEDICAL PROGRAMMATIC SUPPORT

2.9.1. The contractor shall provide programmatic support services when the services are unique to a medical environment, such as but not limited to credentialing support and health promotions support. The specific support required will be specified in the task order.

2.9.2. CREDENTIALING PROGRAMMATIC SUPPORT SERVICES

2.9.2.1. The contractor shall assist in the review of credential files on a regular basis, which are presented for the granting of privileges.

2.9.2.2. The contractor shall assist with the processing, renewal, and maintenance of Credentials Records for staff, Temporary Assigned Duty (TAD), Annual Training (AT) reserves, Foreign National Labor Hires (FNLH), and volunteer providers.

2.9.2.3. The contractor shall maintain complete credential file information on the Computerized Credentials Quality Assurance System (CCQAS) of all licensed medical professionals associated with the command, in addition to the hard copy of the credentials file. The contractor shall use this information to accurately report demographic, statistical, educational, and professional information to various commands and higher authority.

SECTION 3 – HOURS OF OPERATION

3. 1. The contractor shall provide medically related administrative support services per Section 2 during the hours of operation identified in the task order.

3.2. The contractor shall implement the contractor-developed system for ensuring adequate staffing at all times. The contractor will support the MTF in placing the right number of people at the right time to ensure that the required support is provided.

3.3. All closings, delayed openings, and early closures for severe weather or other emergency shall be at the sole discretion of the Government. The contractor shall provide the required services unless the Contracting Officer’s Representative (COR) notifies the contractor that weather conditions or an emergency authorizes a closing, delayed opening, or early closure. The contractor will receive guidance from the COR of the MTF protocol that applies.

3.4. Furlough. Unless otherwise authorized by a defense appropriations bill, contractors shall not be reimbursed by the Government for services not rendered during Government furlough. In the event of a Government furlough, the Commanding Officer will determine which contract employees are considered critical and therefore must report to work. Contract employees deemed essential shall be compensated for services rendered during a furlough. All other contract employees shall be furloughed until the Government shutdown ends or they are notified by the Contracting Officer’s Representative that they have become essential employees.

SECTION 4 – DELIVERABLES

4.1. Quality Control Program (See Section 9)

4.2. Occupational Health Requirements (See Section 10.2.)

4.3. Other deliverables that are required will be identified in the task order.

4.4. Monthly Status Report. The contractor shall submit a monthly status report to the COR, no later than the 5th working day of the following month that includes information as follows for all task orders awarded to date:

4.4.1. Task order number, data of award, place of performance, total awarded dollar value, brief description of services provided, and progress and status including any issues impacting performance and resolution of issues previously reported. The total dollar value across all task orders shall be provided.

4.4.2. The proposed hours and amounts by labor classification, proposed travel expenses, and proposed other direct costs reflected in the final awarded price. This information shall be provided by individual task order, with totals across all task orders.

SECTION 5 - QUALITY ASSURANCE SURVEILLANCE PLAN (QASP) MATRIX

5.1. The following performance standards and acceptable quality levels apply to the task orders.

Level (AQL)

5.2. Other performance standards and acceptable quality levels that apply will be identified in the task order.

SECTION 6 - QUALIFICATIONS

6.1. GENERAL QUALIFICATIONS THAT APPLY TO ALL CONTRACTOR PERSONNEL

The contractor shall provide personnel having certain minimum levels of training and experience. This section is in no way intended to dictate a staffing plan to the contractor for the performance of the services delineated in this performance work statement. Additional and/or supplemental qualifications specific to a particular task order are contained in the applicable task order. The services require that contract employees possess the following minimum qualifications to meet contract requirements.

6.1.1. Be a U.S. Citizen per Enclosure 3, unless a citizenship waiver package has been successfully adjudicated by BUMED M4 (Installations & Logistics Directorate) in accordance with DOD and Navy policies.

6.1.2. Possess a High School Diploma or GED certificate.

6.1.3. Possess one year of experience providing medical administrative support services.

6.1.4. Possess experience using basic software applications, e.g. Microsoft Word and Excel.

6.2. QUALIFCATIONS THAT APPLY TO CLR SUPPORT ONLY

6.2.1. Possess one year experience interpreting coding records.

6.3. QUALIFICATIONS THAT APPLY TO ACCOUNTING CLERICAL SUPPORT ONLY

6.3.1. Possess one year of medical billing experience.

6.4. QUALIFICATIONS THAT APPLY TO MEDICAL SCRIBE SUPPORT ONLY

6.4.1. Possess one year of experience in a field requiring regular usage of medical terminology.

OR

6.4.2. Successful completion of a medical terminology course within the last six months.

6.5. LANGUAGE REQUIREMENTS

6.5.1. All contract employees shall be sufficiently competent in reading, writing, speaking, and understanding English to perform the work.

SECTION 7 - QUALIFICATIONS PACKAGE

7.1. Fifteen days prior to performing services, the contractor shall submit a qualifications package to the COR for each employee performing services under the task order. The qualifications package shall include documentation to demonstrate compliance with the qualifications in Section 6 and occupational health requirements in Section 10.1. Before contractor employees provide services, the COR will verify whether the contractor employees comply with the qualification requirements appropriate to their respective support category. The COR will inform the contractor whether qualification packages comply with Section 6 and occupational health requirements in Section 10.1., noting any discrepancies.

7.2. The contractor shall maintain a list of all individuals who provide services under the task order. The contractor shall provide a copy of the list to the COR within 14 days prior to performance of services under the task order and as required to maintain currency of the information.

7.3. The contractor shall inform the COR within 24 hours when it terminates a contract employee and/or removes the employee from the contract.

SECTION 8 - GOVERNMENT FURNISHED ITEMS. Only the property, materials, and services listed below, in the quantity needed, will be furnished by the Government. All other property, materials, and services required for the performance of this contract shall be furnished by the contractor.

8.1. The Government will provide, without cost, the facilities, materials, consumable supplies, equipment, and maintenance services required to perform the tasks outlined under this contract. Government-furnished property shall be used only in the performance of this contract. The Government will provide routine scheduled maintenance and repair of Government-provided equipment according to MTF Instructions. Upon the contractor’s request, through the COR, the Government will provide repairs of Government-provided equipment in accordance with MTF instructions.

8.2. The contractor shall requisition consumable supplies and equipment according to MTF procedures. The contractor is liable for loss of or damage to supplies and equipment if such loss or damage is due to negligence or willful misuse. The contractor shall ensure efficient and economical use of supplies.

8.3. At no time during the term of this contract shall the contractor remove Government-furnished supplies or equipment from the MTF facilities.

8.4. PUBLICATIONS AND FORMS.

8.4.1. The Government will furnish all forms and publications required for performance of the tasks included in the contract. The contractor is required to comply with various instructions, directives and regulations covering routine administrative, safety and security matters in the same manner as other members of the MTF staff. Such compliance does not constitute a material expense to the contract.

8.5. OCONUS SERVICES. Contract employee relocation expenses and other allowances associated with providing services in OCONUS MTFs are addressed in the Special Contract Requirements section of the contract.

SECTION 9 – QUALITY CONTROL

9.1. QUALITY OF SERVICE. This is a non-personal services contract that supports the MTF’s mission to oversee and coordinate the delivery of economical and effective medical, dental, and other health care services. The medically related administrative support services required by the contract support the provision of patient care in the MTF and ensure services are available to beneficiaries.

9.1.1. The contractor shall comply with applicable provisions of the law, rules, and regulations of all governmental authorities, including but not limited to, the regulations and standards of the MTF. The contractor shall adhere to and comply with all Department of Navy (DON), Bureau of Medicine and Surgery (BUMED), and MTF Instructions and notices which may be in effect during the term of the contract.

9.1.2. To achieve the MTF’s mission, the contractor shall establish, submit for Government approval, and implement a Quality Control (QC) Plan which is consistent with the MTF’s Quality Control Program. The contractor shall also actively participate in the established medical Quality Improvement (QI) Plan of the MTF. Current copies of this contract, the contractor’s QC Plan, and the MTF’s QI Plan shall be maintained on-site for ready reference by the contractor during the term of the contract. Contract employees shall read, be familiar with, and implement the contract, including the contractor’s technical proposal, QC Plan, medical QI Plan of the MTF, and any revisions.

9.1.3. After contract award, but not later than commencement of services, the contractor shall submit a QC Plan to the COR and the Contracting Officer for review. The contractor’s QC Plan shall be consistent with Joint Commission standards and the MTF Quality Control Program. The QC Plan shall, at a minimum, include (a) a plan for providing services by appropriately qualified personnel that includes a specific methodology for doing so; (b) a plan to ensure maintenance and enforcement of Standards of Conduct for contract employees as specified in Section 11.2; and (c) a plan for a patient relations program that is compliant with the MTF's patient relations protocols and which includes a notification process for all patient compliments and complaints.

9.1.4. Upon receipt of the contractor's QC Plan, the MTF will review and provide comments to the contractor. If the MTF finds deficiencies in any portion of the proposed QC Plan, the contractor shall have 5 working days to correct the deficiencies. The MTF COR will provide final approval of the QCP.

9.1.5. Sixty days prior to exercising any option year under this contract, the contractor shall submit to the COR an updated QC Plan that is consistent with updated Joint Commission standards and updated MTF Quality Control Program. The revised QC Plan shall be subject to the same review process as that required at the time of contract award.

9.2. INDEPENDENT CONTRACTOR

9.2.1. The services provided by the contractor are provided in the capacity of an independent contractor. The Government will evaluate the quality of services for purposes of contract inspection and acceptance. The contractor shall be solely responsible for any and all liability caused by the acts or omissions of its agents or employees. The contractor shall not in any manner represent or infer that it is an instrumentality or agent of the United States Government. The contractor shall recognize that the Commanding Officer of the MTF maintains administrative and operational responsibility for all activities within the Command and may take such actions as necessary to preserve and maintain the integrity of the Command, subject to the limitations prescribed by law and U.S. Navy Regulations.

9.3. MODIFICATIONS

9.3.1. The Contracting Officer will designate and authorize an individual to act as the COR under each task order. Any such representative appointed will be specifically designated by letter from the Contracting Officer. The COR exclusively represents the Contracting Officer in all technical phases of the work, but is not authorized to issue Change Orders, Supplemental Agreements, or direct any contract performance requiring contractual modification or adjustment. Changes in the scope of work can be made only by modification properly executed by the Contracting Officer. All observations made by persons other than the Contracting Officer or the COR are strictly advisory and shall not influence the contractor's operations except for administrative requirements and responsibilities specified herein.

SECTION 10 - START OF SERVICES

10.1. BACKGROUND INVESTIGATION

10.1.1. The Contractor shall report to the COR on the first day of contract performance. The COR will provide direction for a proper check-in and any additional documentation or instructions that may be necessary for contract performance. The Contractor Appointing Personnel shall return the completed check-in sheet to the COR within ten (10) business days.

10.1.2. Upon receipt of an adjudicated Federal background investigation or at a minimum advanced fingerprint results, the Command Trusted Agent will enter contract employee into the Contractor Verification System (CVS). The contractor employee is responsible for completing the CVS application for requesting issuance of a Common Access Card (CAC).

10.1.3. Fourteen (14) days prior to performance of services under this contract, the contractor’s Security Representative shall submit to the MTF Security Manager via the COR the necessary documents to obtain the appropriate Federal background investigation.

10.2. OCCUPATIONAL HEALTH REQUIREMENTS.

10.2.1. Within 60 days prior to performance of services by the contractor, the contractor shall obtain, at contractor expense, documentation of required immunizations and physical testing, and a statement from the contractor employee’s medical practitioner or a report of a physical examination. The physical examination and immunization documentation shall indicate that the contractor employee is free from mental or physical impairments that would restrict the contract employee from providing the services described herein. The requirements are provided on the HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM, the current version of which is available at: http://www.med.navy.mil/sites/nmlc/public_docs/Physical%20Exam%20and%20Immunization%20Form.pdf .

The Contractor shall always obtain the current version from the web page and shall have the form completed in its entirety in accordance with its instructions. The MTF will identify any contract employees who are not required to complete this documentation after contract award. Declinations shall only be permitted based on either the contract employee’s religious convictions or medical contraindications (as documented by a qualified health care provider). The Hepatitis B vaccine declination can be found on the World Wide Web at http://www.osha.gov/SLTC/etools/hospital/hazards/bbp/declination.html.

10.2.2. Except for those contract employees who decline Hepatitis B vaccine as given above, the Hepatitis B requirements given in HEALTH EXAMINATION AND IMMUNIZATION/SCREENING REQUIREMENT FORM provide that a contract employee must either show a positive titer or demonstrate persistent non-response to the vaccine. A contract employee may be approved for service at the DTF/MTF prior to achieving a Hepatitis B positive titer or demonstrating a persistent non-response according to the following provisions:

10.2.2.1. A contract employee must receive the first vaccination of his/her initial vaccination series prior to commencing service under the contract and must complete the series not later than 6 months after commencing service and, if a negative titer is obtained, must complete the second series within another 6 months; or

10.2.2.2. A contract employee who has completed his/her initial series and obtained a negative titer must commence his/her second vaccine series prior to commencing service and must complete the second series not later than 6 months after commencing service.

10.2.2.3. Contract employees approved according to the provisions above will be considered persistent non-responders until there is evidence to the contrary and will be counseled by a licensed practitioner regarding the implications of non-response.

10.2.2.4. If a contract employee fails to comply with the applicable schedule above, the Contractor shall replace the contract employee if so directed by the Contracting Officer.

10.2.3. The contract employee shall agree to undergo personal health examinations and such other medical and dental examinations at any time during the term of the contract, as the MTF Commanding Officer may deem necessary for preventative medicine, medical surveillance, or performance improvement. These examinations will not be provided by the Government unless the employee is an otherwise eligible beneficiary of the military health system. If the contractor chooses, these examinations may be provided by private physician or dentist, at no expense to the Government.

10.2.4. It is essential that contract employees be vaccinated annually against influenza according to BUMED and CDC guidelines aimed at reducing the impact of influenza disease in health care settings. The Government will provide the influenza vaccine free of charge as vaccine availability allows. If the employee chooses to be immunized by the Government, they shall sign a waiver in accordance with the MTF rules and regulations. Alternately, the contract employee may obtain the vaccine at another facility, with the contract employee bearing the total cost, and provide proof of vaccination to the Government. If a contract employee declines vaccination, a signed declination form shall be provided to the Government in accordance with CDC recommendations and BUMED policies.

10.2.5. Contract employees that do not show a positive varicella antibody titer after immunization and appear to have a “non-immune” status must report varicella exposure to the contractor. In accordance with the Centers for Disease Control Recommendations, such employees will be removed from service beginning on the tenth day following exposure and remain away from work for the maximum incubation period of (21 days). In this instance, personnel must be replaced during this period to ensure maintenance of contractually required services.

10.2.6. Prior to reporting for service at the MTF, each contract employee shall be screened at Contractor expense for risk of exposure to tuberculosis (TB) as part of the Health Examination and Immunization/Screening Requirement Form referenced in Section 10.2.1. If the contract employee is determined to have a low risk of exposure, no further screening or testing is required under this contract. The initial screening may be waived, at the discretion of the MTF, if the contractor provides evidence of a prior low risk assessment by a licensed physician. If the initial screening results in a determination that the contract employee has an increased risk of exposure to TB, the contractor is responsible for ensuring that the contract employee receives targeted screening and testing in accordance with CDC Guidelines for Health-Care Settings and submitting timely records of subsequent screening or testing to the COR.

10.2.7. BLOODBORNE PATHOGEN ORIENTATION PROGRAM. Contract employees shall participate in the Command’s Bloodborne Pathogen Orientation Program. The contract employee shall also participate in all required annual training and in periodic training for all procedures that have the potential for occupational exposure to bloodborne pathogens.

10.2.8. MANAGEMENT OF HIV POSITIVE CONTRACT EMPLOYEES. HIV positive contract employees will be managed in accordance with the current CDC guidelines and Section 503 of the Rehabilitation Act (29 U.S.C. 793) and its implementing regulations (41 CFR Part 60-741).

10.2.9. PREVENTION OF THE TRANSMISSION OF THE HIV VIRUS. Contract employees shall comply with the CDC’s “Universal Precautions” for the prevention of the transmission of the HIV virus.

10.2.10. MANAGING THE CLINICAL RISK IN THE WORK ENVIRONMENT. The work environment inherently involves risks typically associated with the performance of job duties. The contract employee may be exposed to contagious disease, infections and flying debris, requiring the wearing of personal protection equipment such as scrub attire, gloves, masks, and eye protection.

10.2.10.1. In the event of an exposure, the Contractor and the MTF will cooperate, in accordance with applicable MTF policy, regarding offering appropriate post-exposure testing to the affected contract employee and the MTF will use its best efforts to appropriately test the source patient and obtain the patient’s consent to disclose the test results to the contract employee and the Contractor. The Contractor will be responsible for providing appropriate follow-up medical care and counseling, if applicable, and record-keeping.

10.2.10.2. A contract employee with a bona fide medical emergency occurring while on duty, or with an on-the-job injury, will be provided stabilizing medical care according to the procedures of the MTF. The contractor shall reimburse the Government for all medical services provided unless the contract employee is otherwise entitled to Government medical services.

10.2.10.3. All accidents which may arise out of or in connection with the performance of services required herein, and which result in injury, death or property damage, shall be reported to the Safety Department and the COR immediately and to the MTF QI Department within 24 hours. Verbal reports shall be followed by written reports within 24 hours. Statements of witnesses shall be included. If any claim is made by a third party against the contractor on account of any accident which occurs in connection with the performance of this contract, the contractor shall promptly report the facts in writing to the Command Legal Advisor, the MTF QI Department, the Command Safety Department, and the COR.

10.3. ORIENTATION. Contract employees shall attend and complete Orientation within 30 days following the employee start date. Contract employees shall attend orientation sessions as follows:

10.3.1. Command Orientation is provided by the MTF consisting of annual training requirements for topics such as but not limited to fire, safety, infection control, family advocacy, Chemical, Biological, Radiological, Nuclear, and Explosive Events (CBRNE) Basic Awareness, and various Navy required on-line trainings. This training shall occur during normal working hours.

10.3.2. Contract employees shall attend Information Systems Orientation which includes CHCS and AHLTA, and other data systems. This training shall occur during normal working hours.

10.3.3. On a case-by-case basis, the Government may waive orientation sessions if the contract employee is currently or has previously worked at the MTF.

10.3.4. Contract employees shall complete all command required training, including but not limited to Diversity, HIPAA, Healthstream,…