Performance Work Statement.pdf

PERFORMANCE WORK STATEMENT

Laboratory and Radiology Services for Occupational Health Clinic

1. BACKGROUND.

1.1. Reynolds Army Health Clinic, Fort Sill, Oklahoma requires the non-personal services of laboratory and Radiology services in support of the Occupational Health Clinic, McAlester Army Clinic USAOHC, MCAAP, Bldg. 5, 1 C-Tree Road, McAlester, OK 74501. McAlester Army Clinic supports a small population of military personnel, their families, veterans, and beneficiaries. Located 150 miles from Dallas, Texas, 150 miles from Oklahoma City, Oklahoma, and more than 90 miles from Tulsa, Oklahoma, timely laboratory, and radiology services are needed to support the population.

1.2. The Occupational Health Clinic requires laboratory and radiology services for the testing of CXR, CBC, Urinalysis; Liver Profile; LDH: GGT; Lipid Panel; TSH; Chem 8 Panel; G6PD;

Free T4; Free T3; Free Testosterone, Total; FSH; LH; PRL; SHGB; CMP; TG Antibody; TPO Antibody; Estradiol Levels; HIV Screen; Uric Acid; Cholesterol Total; Lead, Blood; Zinc Protoporphyrin; Magnesium; Cadmium; PSA; ABO Type; RH type; Fluoride; Peripheral Smear Referral; Chem 20; RBC cholinesterase; varicella/rubella/rubeola titers, methemoglobin, HBsAb, occasional special labs to include urine heavy metals, Sars-COV-2 PCR Test, and reading of chest x-rays.

1.3. Abbreviation appendix: CXR=chest x-ray, CBC=complete blood count, LDH=lactate Dehydogenase, LFT=liver function test, UA=urinalysis, F1=fluoride, HIC=human immunodeficiency virus, GHCG=beta- human chorionic gonadotropin, PCR=polymerase chain reaction, PSA=prostate specific antigen, Pb=lead, ZPP=zine protoporphyrin, RBC=reb blood cell, CA=calcium, HBsAb=hepatitis B surface antibody, GGT= Gama-glutamyl transerase, TSH= thyroid-stimulating hormone, G6PD= Glucose-6-Phosphate Dehydrogenase, ABO=Type-blood type, RH Type- RHtype, CAP=college of American Pathologists.

2. Scope of Work:

2.1. The contractor shall provide laboratory and radiology services including, but not limited to, the following:

CXR, CBC, Urinalysis; Liver Profile; LDH: GGT; Lipid Panel; TSH; Chem 8 Panel; G6PD;

Free T4; Free T3; Free Testosterone, Total; FSH; LH; PRL; SHGB; CMP; TG Antibody; TPO Antibody; Estradiol Levels; HIV Screen; Uric Acid; Cholesterol Total; Lead, Blood; Zinc Protoporphyrin; Magnesium; Cadmium; PSA; ABO Type; RH type; Fluoride; Peripheral Smear Referral; Chem 20; RBC cholinesterase; varicella/rubella/rubeola titers, methemoglobin, HBsAb, occasional special labs to include urine heavy metals, Sars-COV-2 PCR Test, and reading of chest x-rays.

2.2. All bills shall be itemized to show the procedures done along with the corresponding CPT codes.

2.3. Laboratory shall be CAP accredited (or any other nationally recognized accrediting body for laboratories), and Radiology dept accredited by a recognized radiological accrediting body. Must provide Proof of Certifications.

2.4. The following labs shall have a turnaround time of no greater than 48 hrs if required: CBC, LDH, LFT, UA, HIC, urine, bHCG, chem 8, PSA, and lipid profile.

2.5. All phlebotomy supplies shall be provided by contractor (needed, tubes, vacutainer interface, Styrofoam boxes, cold packing's etc.)

2.6. Contractor shall provide phlebotomy services if service cannot be performed on site at MCAAP Occupational Health Clinic.

2.7. Lab results must be faxed to MCAAP Occupational Health Clinic.

2.8. The reading of x-rays will be sent by mail and will be read at Reynolds Army Health Clinic.

2.9. LAB TESTS

ALP (Alkaline Phosphatase) AMH (3 days) (Antimullerian Hormone) B12 Bilirubin Direct Blood Type, ABO Blood Type, Rh BMP (Basic Metabolic Panel) Cadmium CBC with Differential Cholesterol, total Chromium, serum CMP (Comprehensive Metabolic Panel) Estradiol Fe (Iron) Flouride Urine Folate

FSH

G6PD

GGT (GGPT)

Haptoglobin HBsAb HBsAG HCG Qualitative Heavy Metals Hepatitis ABC Acute Panel HGBAlC HIV Ab Screen

LDH

Lead, Blood

LH

Lipid Profile Liver Profile Magnesium Met/HGB Prolactin

PSA

Pseudocholinesterase Reticulocyte Count Rubella Rubeola Sars-COV-2 PCR

SHBG

Sperm Analysis T3, Free T3 Total T4, Free T4, Total (Thyroxine) Testosterone, Total Testosterone, Free TG (Thyroglobulin) Antibody TPO (Thyroperoxidase)Antibody

TSH

UA with microscopic Uric Acid Heavy Metals Zinc Protoporphrin Varicilla

2.10. X-RAY

Chest X-ray

3. Contractor Manpower Reporting "ACCOUNTING FOR CONTRACT SERVICES-The Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure Army data collection site where the contractor will report ALL contractor manpower (including subcontractor manpower) required for performance of this contract.

4. Exclusion from Participation in Federal Health Care Programs (October 2015)

4.1. The Contractor shall not employ or contract with any individual or entity (hereinafter collectively referred to as “person”) to provide items or services that will be included in invoices submitted to the Government under this contract if such person is listed on the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) List of Excluded Individuals and Entities (LEIE) or the TRICARE Sanctioned Provider List. The Government is legally prohibited from paying for provision of items or services by such persons. The prohibition extends to services beyond direct patient care, such as services of persons in executive or leadership roles and administrative and management services, whether or not such services are billed separately. The LEIE may be found at http://oig.hhs.gov/fraud/exclusions.asp, and the TRICARE Sanctioned Provider list at http://www.health.mil/Military-Health-Topics/Access-Cost-Quality-and-Safety/Quality-And- Safety-of-Healthcare/Program-Integrity/Sanctioned-Providers. The LEIE and TRICARE Sanctioned Provider List are hereinafter collectively referred to as “the Lists.”

4.2. Prior to start of contract performance, the Contractor shall (a) query the Lists to determine whether the name of any person the Contractor employs or contracts with to provide services or items for which payment may be made under this contract appears on the Lists, and (b) certify to the Contracting Officer that the Contractor has queried the Lists and no such names appear on either of the Lists.

4.3. During performance of the contract, and prior to persons other than those whose names were queried in accordance with paragraph 2, above, (hereinafter “new persons”) providing services or items under the contract, the Contractor shall (a) query the Lists as in paragraph 4.2., and (b) certify to the Contracting Officer that the names of such new persons do not appear on either of the Lists.

4.4. Should any person providing items or services under the contract appear on either of the Lists at any time during contract performance, the Contractor shall (a) in cases where the Contractor identified the person, notify the Contracting Officer, and (b) promptly remove that person from the contract.

4.5. Violation of any aspect of the above paragraphs shall be considered a material breach of the contract and may result in termination of the contract.

4.6. The Contractor is further advised that, in accordance with Civil Monetary Penalties Law [CMP] (codified at 42 USC § 1320a-7a):

a. There are steep civil monetary penalties associated with billing the Government for providing items or services by a person on either of the Lists, and with failing to return to the Government any overpayments received for provision of such items or services.

b. Billing under the contract for provision of items or services by a person on either List may also result in exclusion of the person that employs or contracts with such person.

8. HHS OIG has issued a Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs with additional information on the CMP. The Special Advisory Bulletin may be found at http://oig.hhs.gov/exclusions/files/sab-05092013.pdf.

APPENDIX A

PERFORMANCE REQUIREMENTS SUMMARY (PRS)

The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Performance Requirement

Performance Standard

Acceptable Quality Level

(AQL)

Surveillance Method

Invoices submitted with correct CPT codes.

IAW PWS Para 2.2. 100% compliance 100% Inspection

Accreditation current for both radiology and laboratory departments.

IAW PWS Para 2.3. 100% compliance Periodic Inspection

Turnaround time for specified labs meets requirements.

IAW PWS Para 2.4. 100% compliance 100% Inspection

Results appropriately communicated.

IAW PWS Para 2.7. 100% compliance 100% Inspection