RFP-36C26322R0033.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. DUNS: DUNS+4:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C26322R0033 02-28-2022

Anna Leitzke, Contract Specialist 651-293-3022 03-31-2022

15:00 CDT

36C263 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

Erica Morris, Contracting Officer 316 Robert Street N. STE. 506 St. Paul MN 55101

X 100

X

621111

$12 Million

N/A

N/A

X

Department of Veterans Affairs Minneapolis VA Health Care System One Veterans Drive

Minneapolis MN 55417

NETWORK 23 CONTRACTING OFFICE

Anna Leitzke, Contract Specialist 316 Robert Street N. STE. 506 St. Paul MN 55101

Y

Financial Services Center PO Box 149971

Austin TX 78714-9971

Off-Site/On-Call Gynecology Phone Consultation Services for the Minneapolis VA Health Care System.

See the Schedule of Services in Section B.2.

See the Performance Work Statement in Section B.3.

X one

Erica Morris Contracting Officer

36C26322R0033

Table of Contents

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2021)

C.2 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (JAN 2011)

C.3 PROHIBITION ON CONTRACTING FOR CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

C.4 52.216-18 ORDERING (AUG 2020)

C.5 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.6 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.7 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.8 52.219-14 LIMITATIONS ON SUBCONTRACTING (SEP 2021)

C.9 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.10 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.11 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.12 VAAR 852.204-70 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR

PERSONNEL (MAY 2020)

C.13 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA

ACQUISITION OF COMMERCIAL ITEMS (APR 2020)

C.14 852.219-10DEV VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS SET-ASIDE (JUL 2019) (NOV 2020) (DEVIATION)

C.15 VAAR 852.219-77 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (SEP 2021)

(DEVIATION)

C.16 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.17 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(OCT 2019)

C.18 VAAR 852.237-72 CRIME CONTROL ACT—REPORTING OF CHILD ABUSE

(OCT 2019)

C.19 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.20 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) ..41

C.21 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (JAN 2022)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

D.2 IMMIGRATION AND NATIONALITY ACT

D.3 ORGANIZATIONAL CONFLICT OF INTEREST

D.4 VA RULES OF BEHAVIOR

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.3. COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES-

REPRESENTATION (OCT 2020)

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.8 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (NOV 2021)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (FEB 2021) (JUL 2020) (DEVIATION)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C263

NETWORK 23 CONTRACTING OFFICE

Erica Morris, Contracting Officer 316 Robert Street N. STE. 506 St. Paul MN 55101

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly, in arrears

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs

Financial Services Center PO Box 149971 Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 SCHEDULE OF SERVICES

The contractor shall furnish all personnel to provide services necessary to perform On-Call Gynecology Phone Consultation Services (off-site) to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Minneapolis VA Health Care System (MVAHCS) (hereinafter referred to as VAMC). The contractor’s provider(s)’ care shall cover the range of Gynecology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by the American College of Obstetricians and Gynecologists https://www.acog.org.

Place of Performance: Contractor shall furnish telephone consultation services from the contractor’s place of business to the Minneapolis VA Health Care System

(MVAHCS).

Pricing Instructions:

The offeror is instructed to edit the number of Sub-Line Item Numbers (SLIN) to correspond with the number of key personnel submitted for the Line Item Number (LIN). Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SLINs if adding or removing Key Personnel.

The Contractor shall propose a minimum of two (2) board certified/board eligible Gynecologist to provide the required services and be available for scheduling to meet the requirements of the contract. The contractor shall be required to provide as a minimum, enough appropriately qualified board certified/board eligible Gynecologist that meet or exceed twice the number of FTE required to fulfill this contract’s obligations.

The five year ordering period is effective from May 1, 2022, through April 30, 2027.

Year One of the Ordering Period: May 1, 2022, through April 30, 2023

LIN SLIN Description Estimated Quantity Unit Unit Cost

Estimated Annual

Cost

1001 None Emergency Department Physician Services 365 Day

Key Personnel

None 1001a Name:

Title:

None 1001b

Estimated Total Price for Year One of the Ordering Period https://www.acog.org/

Year Two of the Ordering Period: May 1, 2023, through April 30, 2024

LIN SLIN Description Estimated Quantity Unit Unit Cost

Estimated Annual

Cost

1001 None Emergency Department Physician Services 365 Day

Key Personnel

None 1001a

Estimated Total Price for Year Two of the Ordering Period

Year Three of the Ordering Period: May 1, 2024, through April 30, 2025

LIN SLIN Description Estimated Quantity Unit Unit Cost

Estimated Annual

Cost

1001 None Emergency Department Physician Services 365 Day

Key Personnel

None 1001a

Estimated Total Price for Year Three of the Ordering Period

Year Four of the Ordering Period: May 1, 2025, through April 30, 2026

Quantity Unit Unit Cost

Estimated Annual

Cost

1001 None Emergency Department Physician Services 365 Day

Key Personnel

None 1001a

Estimated Total Price for Year Four of the Ordering Period

Year Five of the Ordering Period: May 1, 2026, through April 30, 2027

Quantity Unit Unit Cost

Estimated Annual

Cost

1001 None Emergency Department Physician Services 365 Day

Key Personnel

None 1001a

Estimated Total Price for Year Five of the Ordering Period

Estimated Total for Five-Year Ordering Period: __________________________

In accordance with FAR 16.504(a)(1), the guaranteed minimum and maximum dollar amounts are listed in the table below. These amounts cover the entire ordering period of the contract.

The maximum dollar amount listed shall not be exceeded.

Minimum $ 34,000.00 Maximum $ 530,000.00

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The contractor shall provide off-site Gynecology Phone Consultation Services in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Minneapolis VA Health Care System.

The contractor will be required to provide the services of board certified/board eligible Gynecologists. The Gynecologists provided must be practicing Gynecologists experienced in surgical management of the entire scope of clinical pathology involving female pelvic floor and reproductive organs.

1.1.1. Scope of Services: The scope of services required for this contract is call coverage for the MVAHCS Gynecology. On-call coverage is defined as carrying a pager off-site 24/7 x 365 days a year.

1.2. Place of Performance: Contractor shall furnish telephone consultation services from the contractor’s place of business (carrying a pager off-site) to the Minneapolis VA Health Care System.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority and FAR 12 and VAAR 873.

1.4. Policy/Handbooks: The contractor shall be subject to the following policies, including any subsequent updates during the period of performance.

1.4.1. VHA Handbook 1100.17: National Practitioner Data Bank Reports:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.4.2. VHA Handbook 1100.18: Reporting and Responding to State Licensing Boards:

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.4.3. VA Directive 1663: Health Care Resources Contracting – Buying:

https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.4.4. Privacy Act of 1974 (5 U.S.C. 552a) as amended:

http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1.5. Definitions/Acronyms: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.5.1. ABMS: American Board of Medical Specialties

1.5.2. ABOG: American Board of Obstetrics & Gynecology

1.5.3. ACGME: Accreditation Council for Graduate Medical Education

1.5.4. ACOG: American College of Obstetricians and Gynecologists

1.5.5. AOD: Admitting Officer of the Day

1.5.6. BLS: Basic Life Support

1.5.7. CCNE: Commission on Collegiate Nursing Education:

www.aacn.nche.edu/accreditation

1.5.8. CDC: Centers for Disease Control and Prevention

1.5.9. CDR: Contract Discrepancy Report

1.5.10. CEU: Certified Education Unit

https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135 https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2 http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm http://www.aacn.nche.edu/accreditation

1.5.11. CME: Continuing Medical Education

1.5.12. CMS: Centers for Medicare and Medicaid Services

1.5.13. Contracting Officer (CO): The person executing this contract on behalf of the

Government with the authority to enter into and administer contracts and make related determinations and findings.

1.5.14. Contracting Officer’s Representative (COR): A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.15. COS: Chief of Staff

1.5.16. CPARS: Contractor Performance Assessment Reporting System

1.5.17. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.5.18. DEA: Drug Enforcement Agency

1.5.19. ED: Emergency Department

1.5.20. EHR: Electronic Health Record - electronic health record system used by the VA

1.5.21. FSMB: Federation of State Medical Boards

1.5.22. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of

80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.5.23. HHS: Department of Health and Human Services

1.5.24. HIPAA: Health Insurance Portability and Accountability Act

1.5.25. HR: Human Resources

1.5.26. ISO: Information Security Officer

1.5.27. Medical Emergency: A sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.5.28. MOD: Medical Officer of the Day

1.5.29. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.5.30. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.5.31. Non-Contractor’s provider(s): Any person, organization, agency, or entity that is not directly or indirectly employed by the contractor or any of its subcontractors

1.5.32. NP: Nurse Practitioner

1.5.33. NPPES: National Plan and Provider Enumeration System

http://www.nlnac.org/

1.5.34. PA: Provider Assistant

1.5.35. POP: Period of Performance

1.5.36. PWS: Performance Work Statement

1.5.37. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.5.38. QA/QI: Quality Assurance/Quality Improvement

1.5.39. QM/PI: Quality Management/Performance Improvement

1.5.40. QASP: Quality Assurance Surveillance Plan

1.5.41. Veterans Health Administration (VHA): The central office for administration of the

VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.5.42. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

1.5.43. VetPro: A federal web-based credentialing program for healthcare providers.

1.5.44. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the Minneapolis VA Health Care System./

2. QUALIFICATIONS:

2.1. Staff/Facility:

2.1.1. License: Contractor’s provider(s) assigned by the contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property. All licenses held by the personnel working on this contract shall be full and unrestricted licenses.

Contractor’s provider(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification: All contractor’s provider(s) must be Board Certified or Board Eligible by the American Board of Obstetrics and Gynecology (ABOG); American Board of Medical Specialties (ABMS); or the American Osteopathic Board of Obstetrics and Gynecology.

2.1.2.1. All continuing education courses required for maintaining certification must be kept up to date at all times. Documentation verifying current certification shall be provided by the contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Technical Proficiency: Contractor’s provider(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all Contractor’s provider(s) and contractor’s provider(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.4. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor’s provider(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential’s office for tracking. These documents are required for both privileging and re-privileging.

Failure to provide shall result in loss of privileges for contractor’s provider(s).

2.1.5. Conflict of Interest: The contractor and all contractor’s provider(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.6. Citizenship related Requirements:

2.1.6.1. The contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the contractor while providing services to Department of Veterans Affairs patient referrals.

2.1.6.2. While performing services for the Department of Veterans Affairs, the contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.6.3. If the contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.6.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.6.5. The contractor agrees to obtain a similar certification from its subcontractors.

The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.7. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs.

Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.7.1. Therefore, contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contractor’s provider(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.7.2. By submitting their proposal, the contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Performance: The qualifications of contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19 and VHA Directive 2012-030. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-Personal Healthcare Services: The parties agree that the contractor and all contractor’s provider(s) shall not be considered VA employees for any purpose.

2.4. Indemnification: The contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the contractor, its agents, or employees.

2.5. Prohibition Against Self-Referral: Contractor’s provider(s) are prohibited from referring VA patients to contractor’s or their own practice(s).

http://oig.hhs.gov/exclusions/index.asp

2.6. Inherent Government Functions: Contractor and contractor’s provider(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The contractor shall be responsible for protecting contractor’s provider(s) furnishing services. To carry out this responsibility, the contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.7.1. Workers’ compensation

2.7.2. Professional liability insurance

2.7.3. Health examinations

2.7.4. Income tax withholding, and

2.7.5. Social security payments.

2.8. Tort Liability: The Federal Tort Claims Act does not cover contractor or contractor’s provider(s). When a contractor or contractor’s provider(s) has been identified as a provider in a tort claim, the contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a contractor’s (or contractor’s provider(s)) action or non-action shall be the responsibility of the contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The contractor will be responsible to ensure that the contractor’s personnel providing work on this contract are fully trained and fully competent to perform the required services for the duration of the contract period. Contractor’s personnel provided under this contract must meet the qualifications as stated in Section 2 – Qualifications.

2.9.1.1. This contract is a call coverage contract with no on-site contract requirements required FTE hours.

2.9.2. The contractor shall be responsible for providing coverage to the VA during periods of vacancies of the contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required.

2.9.3. Personnel Substitutions: During the first ninety (90) calendar days of performance, the contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The contractor shall notify the CO, in writing, within fifteen (15) calendar day(s) after the occurrence of any of these events and provide the information required below. After ninety (90) days, the contractor shall submit the information required below to the CO at least fifteen (15) calendar days prior to making any permanent substitutions.

2.9.3.1. The contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the contractor within fifteen (15) calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.9.3.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays or more, the contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two (2) weeks will require the procedure as stated above.

2.9.3.3. The Government reserves the right to refuse acceptance of any contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives.

Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contractor’s provider(s), s/he may request, without cause, immediate replacement of said contractor’s provider(s).The CO and COR shall deal with issues raised concerning contractor’s provider(s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.3.4. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, the contractor shall have a contingency plan in place to be utilized if the contractor’s provider(s) leaves contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: The Minneapolis VA Health Care System is open 24 hours per day, 7 days a week, 365 days per year. Administrative offices, clinics and the OR general hours of operation are Monday through Friday 7:00AM – 5:00PM. The services covered by this contract shall be furnished by the contractor as defined in the work schedule below.

Contractor will provide more than two (2) Gynecologist to provide the required services. Gynecologists will be provided for off-site telephone consultations for VA staff back-up and emergency services.

GYN Consultation Services:

• Contract Gynecologists shall provide off-site telephone consultation services to the Minneapolis VA Health Care System, 24 hours per day, 7 days a week, 365 days per year including weekends and holidays.

• Consultant will respond to the VA call within 30 minutes.

• Contractor will be paid a daily rate for providing consultation services.

• There are no on-site requirements for this contract. On-call contract physicians must be available at all times for phone consultations with VA residents and physicians.

3.2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

• New Year’s Day

• Martin Luther King’s Birthday

• President’s Day

• Memorial Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Juneteenth

• Any day specifically declared to be a national holiday.

4. CONTRACTOR RESPONSIBILITIES:

4.1. Clinical Personnel Required: The contractor shall provide contractor’s provider(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.2. Responsibilities of the GYN Consultant:

4.2.1. Gynecologists shall be qualified to provide consultations for the care of female patients with common gynecological problems as well as complex gynecological conditions including but not limited to: benign pelvic conditions, gynecologic oncology, lower urinary tract disorders, pelvic floor dysfunction, and the therapeutic and surgical procedures necessary for the treatment of patients with these conditions and the complications resulting from them.

4.2.2. GYN consultants will make appropriate referrals for patient care. If the consultation results in determining that there is a medical necessity requiring further treatment or services that are not provided by the MVAHCS, the MVAHCS would authorize the Contractor to provide services for patient off site at Contractor’s designated facility.

4.2.3. Gynecological services/procedures performed off-site require a VA non-care consult. Consults for direct patient care at contractor’s designated facility must be approved by the Surgery/Specialty Care Director or their designee. All facility fees must be submitted on a HCFA claim form to MVAHCS Fee Basis Unit. Payment for facility fee is based on the VA fee basis schedule.

4.2.4. Contractor will provide consultative services, and evaluation for treatment in an organized and properly directed manner, consistent with the community standard of care for related gynecological treatment and surgical procedures of vary complexity as required to maximize effective patient care for female veterans with the same range of services as would be provided in a civilian medical treatment facility.

4.2.5. Contractor consultant will respond to the VA call within 30 minutes.

4.2.6. Contractor shall coordinate, provide professional guidance, and ensure that the appropriate, most effective delivery of care and treatment methodology is set forth for patients seen in the MVAHCS Women’s Health Service for clinical care or other advanced gynecologic surgical procedures, including pre-procedure evaluations and post-procedure outcomes.

4.2.7. Contractor will possess collaborative skills sufficient to work effectively with physicians from referral specialties and to cultivate effective collaborative relationships between the MVAHCS Women’s Health Service and referring physicians /departments. Complies with all appropriate and applicable policies, procedures and regulations of the VHA and MVAHCS to ensure compliance with Joint Commission guidelines.

4.2.8. Physicians must maintain professional conduct and the highest standard of integrity during interactions with patients, patients’ families, nurses, physicians and other health care professionals. Contractor will consistently communicate and treat others in a courteous, tactful and respectful manner.

4.2.9. Approximate amount of time spent on the following activities:

- Clinical: 100% consultative

4.3. Standards of Care: The contractor’s physician(s)’ care shall cover the range of Gynecology consultative services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:

4.3.1. The professional standards of the Joint Commission (TJC):

http://www.jointcommission.org/standards_information/standards.aspx

4.3.2. The standards of the American Hospital Association (AHA):

http://www.hpoe.org/resources?show=100&type=8 and;

4.3.3. The requirements contained in this PWS.

4.4. Patient Care: 100% of the time involved in consultative care.

4.4.1. Per the qualification section of this PWS, the Contractor shall provide the following staff:

4.4.1.1. Board Certified /Board Eligible Gynecologist

4.4.2. Scope of Care: Contractor’s physician(s) hall be responsible for providing gynecology care, including, but not limited to:

4.4.2.1. Clinic and Surgical Care: Contractor’s Gynecologists provided must be practicing Gynecologists experienced in surgical management of the entire scope of clinical pathology involving female pelvic floor and reproductive organs.

4.5. Performance Standards, Quality Assurance (QA) And Quality Improvement(QI):

4.5.1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures. Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.5.2. Patient Complaints: The CO will resolve complaints concerning contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that the contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

http://www.jointcommission.org/standards_information/standards.aspx http://www.hpoe.org/resources?show=100&type=8

4.5.3. The Government reserves the right to refuse acceptance of any contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives.

Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.5.4. Performance Standards:

4.5.4.1. Measure: Qualifications of Key Personnel

Performance Requirement: All contractor’s physician(s) shall be board certified/board eligible in accordance with American Board of Obstetrics & Gynecology (ABOG) Standards.

Standard: All (100%) contract provider(s) are board certified/board eligible.

Acceptable Quality Level: 100%; no deviations accepted.

Surveillance Method: Periodic Inspection Frequency: At least quarterly

4.5.4.2. Measure: Access

Performance Requirement: The contractor shall provide contractor’s provider(s) in accordance with hours outlined in this PWS.

Standard: All (100%) contractor’s provider(s) are available to perform services.

Acceptable Quality Level: Contractor’s provider(s) available to perform services 100% of the time.

Surveillance Method: Random Sampling Frequency: Monthly

4.5.4.3. Measure: HHS OIG List of Excluded Individuals

Performance Requirement: All contractor’s provider(s) shall not be listed Standard: All (100%) contractor provider(s) are not listed Acceptable Quality Level: 100% compliance Surveillance Method: Periodic Inspection Frequency: Upon submission of new key personnel

4.5.4.4. Registration with Contractor Performance Assessment Reporting System:

4.5.4.5. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the

Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed the Simplified Acquisition Threshold and shares those evaluations with other Federal Government Contract Specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Sea Logistics Center in Portsmouth, New Hampshire. CPARS has connectivity with the Past Performance Information

Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS).

FAPIIS is a web-enabled application accessed via CPARS for contractor responsibility determination information.

4.5.4.6. Each contractor whose contract award is estimated to exceed the Simplified Acquisition Threshold requires a CPARS evaluation. A government Focal Point will register your contract within thirty (30) days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207- 438-1690.

4.5.4.7. For contracts with a period of one (1) year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one (1) year, the Contracting Officer will evaluate the contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the contractor’s designated representative for comment. The contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.

4.5.4.8. Failure for the contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the contractor failed to respond;

the contractor’s representative will be “locked out” of the evaluation and may no longer send comments.

5. GOVERNMENT RESPONSIBILITIES:

5.1. VA Support Personnel, Services or Equipment: The Minneapolis VAHCS will provide support personnel necessary for the operation of the services contracted for, at the Minneapolis VAHCS. The support personnel will be provided by the medical center at levels mutually agreed upon which are compatible with the safety of patients and the personnel required for the provision of quality medical care programming.

5.2. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to:

5.2.1. CO RESPONSIBILITIES:

CO – Erica Morris Erica.Morris1@va.gov 651-293-3053 Veterans’ Health Administration Burger Federal Building & U.S. Courthouse 316 Robert St N, Suite 506 St Paul, MN 55101

5.2.1.1. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The contractor shall http://www.cpars.gov/ mailto:Erica.Morris1@va.gov communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.

5.2.1.2. The Contracting Officer shall resolve complaints concerning contractor relations with the Government employees or patients. The Contracting Officer is final authority on validating complaints. In the event the contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.

5.2.1.3. In the event that contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.

5.2.2. COR Responsibilities:

The CORs for this contract are:

Minneapolis VA Health Care System One Veterans Drive Minneapolis, MN 55417

5.2.2.1. The COR shall be the VA official responsible for verifying contract compliance.

After contract award, any incidents of contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.2.2.2. The COR will be responsible for monitoring the contractor’s performance to ensure all specifications and requirements are fulfilled. Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to the QASP.

5.2.2.3. The COR will maintain a record-keeping system of services through telephone consult logs, minutes of meetings, or other appropriate records that services called for in the contract have been received. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices. Any evidence of the contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.

5.2.2.4. The COR will review and certify monthly invoices for payment. If in the event the contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.

5.2.2.5. All contract administration functions will be retained by the VA.

6. SPECIAL CONTRACT REQUIREMENTS:

6.1. Reports/Deliverables: The contractor shall be responsible for complying with all reporting requirements established by the contract. Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each. Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.

6.1.1. The following are brief descriptions of required documents that must be submitted by contractor: upon award; weekly; monthly; quarterly’; annually, etc. identified throughout the PWS and is provided here as a guide for contractor convenience. If an item is within the PWS and not listed here, the contractor remains responsible for the delivery of the item.

What Submit as noted Submit To Quality Control Plan: Description and reporting reflecting the contractor’s plan for meeting of contract requirements and performance standards

Upon proposal and as frequently as indicated in the performance standards.

Contracting Officer

Copy of Subcontracting Plan (as required) Copy of Contractor Certification Statement if non-subcontracting possibilities exist.

Upon proposal and as updated

Contracting Officer

Copies of any and all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff

Upon proposal and upon renewal of licenses and upon renewal of option periods or change of key personnel.

Contracting Officer with proposal;

renewal submitted to

VETPRO

system.

Certification that staff have been compared to OIG list

Upon proposal and upon new hires.

Contracting Officer

Proof of Indemnification and Medical Liability Insurance

Upon proposal and upon renewals.

Contracting Officer

Contingency plan for replacing key personnel to maintain services as required under the terms of the contract

Upon proposal and as updated

Contracting Officer

6.2. Billing:

6.2.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the following month in which services were rendered. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:

6.2.1.1. Name and Address of Contractor

6.2.1.2. Invoice Date and Invoice Number

6.2.1.3. Contract Number and Purchase/Task Order Number

6.2.1.4. Date of Service

6.2.1.5. Contractor’s provider(s)

6.2.1.6. Hourly Rate

6.2.1.7. Quantity of hours worked

6.2.1.8. Total price

6.2.2. Vendor Electronic Invoice Submission Methods:

Invoices…