SOW_-_RADIOLOGY.doc

STATEMENT OF WORK

FOR RADIOLOGY INTERPRETATION AND ONSITE SERVICES

A.

PURPOSE OF CONTRACT:

Contract provisions as shown below:

1. The Government will evaluate the quality of professional and administrative services provided through a Technical Evaluation process.

2. The Contractor shall indemnify the Government for any liability resulting from errors or acts of omission by the Contractor, its employees and agents occurring during contract performance.

3. The Contractor shall maintain liability insurance similar to Industry Standard for Radiology services performed in the private sector.

4. The Contractor shall ensure its subcontracts, for provisions of health care services, contain the requirements of the clause at FAR 52.237-7, including the maintenance of medical liability insurance.

5. The performance that will include a base year plus four (4) option years.

6. For bidding purposes, a “study” shall include the receipt of the film, reading, interpretation, notification of findings, and transcription of the findings. All aspects will be included in the price for each “study” as listed in the bid schedule.

B.

SPECIFICATIONS OF SERVICES:

The contractor will assure availability of professional Radiologic services to manage the following estimated procedures:

1. 35-55 x-ray films daily

2. 4-5 Multi-film studies daily (Intravenous pyelogram, venogram, acute abdomen, I Series, etc.)

3. 20-50 mammography screening exams/month

4. 15 diagnostic mammography exams/month

5. 80-100 ultrasound exams/month

6. 200-300 CT Scan exams/month

7. 4 fluoroscopy studies/month

The workload shall be managed in the following manner:

1. On-site services will be a minimum of (2) two days per month and a maximum of (4) four days per month (exact days to be determined by mutual agreement between Radiology Manager and Contractor), between the hours of 0900 and 1700 to provide diagnostic Interventional procedures and associated interpretations. These procedures will include, but are not limited to biopsies, needle localizations, aspirations, fluoroscopic procedures such as UGI, Small Bowel, Barium Enema, Myleograms, Arthrograms, thorocentasis, etc. The Contractor will interpret all diagnostic procedures performed on-site and will assure that final interpretations results are accessible from the IHS radiology package within 48-72 hours. To facilitate this requirement, the contractor and his/her transcription are required to have approved access to the Indian Health Service Record Patient Management System (RPMS) and a approved Virtual Private Network (VPN) connection with IHS; prior to the award of the contract. Upon completion of IHS Information Technology Security requirements the contractor shall be provided access to the IHS radiology package, which will permit transcription of radiologist reports directly into the package, as well as providing a rapid method of interpretation review, and signature by the radiologist. All interpretations shall be entered into the IHS Radiology package. The contractor shall assume the responsibility and expense of any and all transcription services required to fulfill this contract.

2. Off-site services will be required 0800-1700 Monday through Friday to provide interpretations and reports on films sent by RSU courier or via teleradiology to the Contractor for this purpose. The Contractor will interpret and assure that final interpretation results are accessible from the IHS radiology package within 24-48 hours.

3. After hour services will be considered anytime outside of Monday through Friday 0800-1700 and holidays. The contractor is required to provide 24 hours, 7 days per week interpretations and verbal reports (within 30 minutes of receipt) on emergency diagnostic studies sent by RSU via teleradiology to the Contractor for this purpose. It will be incumbent upon RSU to clearly identify such films so as to avoid confusion about which films are emergent and which are routine. It is estimated that the after-hours requirements may constitute in excess of 50% of the workload.

C.

GOVERNMENT FURNISHED EQUIPMENT, FACILITIES AND PROPERTY:

The Government shall provide the Contractor with the following:

The Rosebud Service Unit shall provide films sent by RSU either in hard-copy form or via teleradiology (IMPAX) to the Contractor.

The Rosebud Service Unit shall provide all equipment required for the on-site radiology procedures described in this document.

The Rosebud Service Unit shall provide office space including an ergonomic desk and chair for reviewing and interpreting patient images on the Agfa PACs system. Reports will be dictated and transcribed into RPMS by the Radiologist(s).

In the provision of medical services, the Contract Radiologist will be authorized to use all areas of the medical treatment facility available to civil service and commissioned personnel in similar positions. The same restrictions apply to the contract Radiologist as any other Indian Health Service personnel to use these areas for official business activities only.

The Contract Radiologist will be authorized to use all administrative and ancillary support available to Indian Health Service personnel. This will include but not be limited to copy machines, fax machines, medical library, Internet, and telephone service. The same restrictions to use these items for official Indian Health Service business apply.

The Service Unit shall provide all required blank Government forms applicable for documentation in the Indian Health Service patient record system. Applicable forms shall include Patient Care Component (PCC) forms and Service Unit charge tickets. An appropriate orientation to the necessity of such forms and access to the Electronic Health Record (EHR) will be provided by Service Unit personnel.

The Rosebud Service Unit shall assume the responsibility of patient care coordination.

The Rosebud Service Unit shall provide a multidisciplinary approach in order for patients to receive the best care possible. Making all the necessary appointments for patients, encouraging them to keep their appointments, and following up and implementing recommendations are all necessary parts of the care coordination activity.

D.

CONTRACTOR FURNISHED EQUIPMENT, FACILITIES, AND PROPERTY:

Contractor will provide his/her own equipment to perform duties such as office equipment, glasses, etc.

E.

WORK SCHEDULE/PAYMENT SCHEDULE:

Monday through Friday 0800-1700 the contractor will provide interpretations and reports on films sent by Rosebud Service Unit and assure that a final interpretation is accessible by IHS radiology package within 72 hours. For emergency diagnostic studies the contractor will provide interpretations and verbal reports within 30 minutes of receipt. Contractor availability will be required 24 hours, 7 days per week. One day per month, the contractor will provide on-site diagnostic procedures and associated interpretations. Contractors will provide one quarterly on-site, in-service for the purpose of teaching the staff on subjects of interest and importance regarding techniques, appropriateness of services, continuing education, and patient welfare. Service will be within the state practice guidelines and privileges granted by the service unit medical staff. Adheres to work duties and schedule for shifts in accordance with SOW with no more than one (1) unplanned absence per quarter.

Invoice Submission:

The contractor shall submit an original and two (2) copies of its invoice through the Indian Health Service Contracting Officer Representative (COR):

Craig Lafferty, COR

Rosebud Indian Health Service Hospital PO Box 400

Rosebud, South Dakota 57570

The IHS COR will review the invoice and forward the original and two copies to Great Plains Area for payment:

Great Plains Area Indian Health Service

Division of Finance 115 4th Ave. SE, Room 309, Federal Building

Aberdeen, South Dakota 57401

The Contractor agrees to include the following information on each invoice:

1. Contractor’s name and invoice dates

2. Contract number, or other authorization for delivery of property and/or services, Method of Payment:

Payments under this contract will be made either by check or by wire transfer through the Treasury Financial Communication System at the option of the Government.

The Contractor shall forward the following information in writing to the DAGM-Contracting Office, Great Plains Area Indian Health Service, Room 309, Federal Building, Aberdeen, South Dakota 57401, not later than seven (7) days after receipt of notice of award:

1.

Full name(where applicable), title phone number, and complete mailing address of responsible official(s) (i) to whom check payments are to be sent, and (ii) who may be contacted concerning the bank account information requested below.

2.

The following bank account information required to accomplish wire transfers:

a. Full Name, address, and telegraphic abbreviation of the receiving financial institution.

b. Receiving financial institution’s 9-digit American Bankers Association (ABA) identifying number for routine transfer of funds. (Provide this number only if the receiving financial institution has access to the Federal Reserve Communications System.)

c. Recipient’s name and account number at the receiving financial institution to be credited with the funds.

If the receiving financial Institution does not have access to the Federal Reserve Communications System, Provide the name of the correspondent financial institution through which the receiving financial institution receives electronic funds transfer messages.

F.

QUALITY ASSURANCE:

Participate in: 1. All Radiology PI Monitors and/or Peer Reviews. 2. Corrective Actions, if needed.

Quality Assurance and Control – The contractor is required to provide, implement and monitor a full QA/QC program to the Rosebud Radiology Departments in a manner which will satisfy requirements and expectations as outlined by the Centers for Medicare and Medicaid Services (CMS). The Program will consist of reporting the utilization of Radiology Services (Computed Tomography, Sonography, Mammography, Fluoroscopic and Diagnostic) by the Ordering Physicians provided by Rosebud Service Unit.

· Monitoring Appropriateness and Technical Aspects of Exams

· Quality of History

· Appropriateness of Exam

· Patient Positioning

· Other Technical Aspects

· Random sampling by day with 5 days/quarter, all exams each day, all technologists involved.

· Week 1- Monday, Week 3- Tuesday, Week 5-Wednesday, Week 7- Thursday, Week 9- Friday.

· Each exam to be evaluated by the Quality Improvement Evaluation Form.

· Rosebud I.H.S. Personnel to place form on each case when submitted for reading.

· At end of sampling, results of submitted forms to be tabulated and all significant comments submitted back to supervising radiologist for preparation of Quarterly report.

· Quarterly report will include average rating in each category and a summary of problem areas and recommendation for improvement goals.

The Contractor will also be required to provide a quarterly, on-site, in-service to the Medical and Radiology staff at the RSU for the purpose of teaching the staff on subjects of interest and importance regarding techniques, appropriateness of services, continuing education, and patient welfare. The Contractor also be available during these in-services to consult with attending physicians about the studies ordered and read for their patients, and to provide professional and technical advice to the RSU providers for improvements in the Radiologic services offered by RSU.

Contractor or Vendor must reside within a 200 mile radius of the Rosebud Service Unit for the availability of On Site Interventional Services.

Clinical notes made by the RSU primary provider will accompany each diagnostic procedure request to aid the Contractor in planning and diagnosis.

The Contractor will assist RSU in every way possible to achieve and maintain a high level of patient services with efficiency and economy consistent with the highest standards of quality patient care.

The Contractor will assist the RSU in attaining and maintaining CMS/FDA/ACR standards by:

a.) Evaluating and providing advice regarding the Quality Assurance studies done regularly by the RSU radiology department.

b.) Provide direct input to the Medical Staff to enhance the Radiology services at RSU.

Additional duties will include:

a.) notifying the Radiology Manager and the Clinical Director of significant technical or administrative problems interfering with or threatening patient care in any way;

b.) Monitoring the technical aspects of every radiograph sent to the Contractor for read and reporting monthly on the overall state of the films form a technical standpoint;

c.) Contractor will create and implement a Peer Review/Cross Review Program that assures quality imaging interpretation and verifies competency of every Radiologists.

· This Peer Review/Cross Review program will be specific to the RSU.

· The Review process will separate the review data specifically related to the hospital and submit a quarterly report that shows breakout of individual Radiologist reads.

· The report will reflect a random sample of Plain films, Mammograms, Computed Tomography (CT’s) and Ultrasounds.

d.) Documenting any recommendations made to enhance radiology services at RSU.

The contractor shall present one educational In-Service subject to the Medical and Radiology staff each quarter between the hours of 9 am and noon. The contractor may select the topic of the presentation and obtain concurrence from the Clinical Director.

The Contractor will utilize government furnished equipment and will not be required to establish or maintain hardware at the RSU designed to scan and transmit films.

The Government employs a Department Head for the Radiology Department at RSU who manages the staff, supplies, equipment, and ordering. The RSU does not employ a Radiologist or other individual who is qualified to provide Clinical oversight of the Radiology program at RSU. As a result, the contractor will ensure that the program operates in a manner consistent with CMS expectations and may be asked for technical advice and assistance as RSU deems necessary.

G.

REPORTING REQUIREMENTS:

Contractor shall provide quarterly reports regarding quality control aspects of the Radiology department. These are due by the 15th day of April, July, October and January for the preceding quarter.

Contractor shall provide an invoice that delineates the number and type of procedures and number of emergent procedures; monthly on-site procedures; and quarterly on-site in-service.

H.

PROFESSIONAL QUALIFICATIONS CRITERIA:

The Contractor will apply for medical staff appointment and privileges to the Medical Staff of the RSU. The Service Unit will evaluate and if applicable will credential the successful contractor to practice at RSU. Using Forms 855 and 855R, the contractor will have a UPIN through RSU, thus permitting RSU to bill any third parties for reads done by the Contract.

This position is subject to P.L. 101-630, The Indian Child Protection and Family Violence Prevention Act, as determined by the Service Unit Director. The Office of Personnel Management will conduct the criminal background investigation on the awardee following award of the service contract. The character investigation may be waived if, in the judgement of the Contracting Officer, in consultation with the Personnel Officer, an investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified of the results, the contractor must not have unsupervised contact with Indian Children.

I.

CHARACTER INVESTIGATION FOR CONTRACTORS WHO WILL HAVE CONTACT WITH INDIAN CHILDREN:

Indian Health Service contractors whose duties and responsibilities involve regular contact or control over Indian children are subject to a character investigation as required by P.L. 101-630, The Indian Child Protection and Family Violence Prevention Act. The IHS personnel offices will conduct these investigations following award of this contract. The character investigation may be waived if, in the judgment of the Contracting Officer, in consultation with the Personnel Officer, an investigation has already been conducted and is on file. Until the character investigation has been completed and the Contracting Officer notified of the results, the contractor must not have unsupervised contact with Indian children in the government operated facility. The contractor physicians performing services in accordance with this contract will have regular contact with Indian Children and will be subjected to compliance with P.L. 101-630.

The Contracting Officer has the authority to temporarily waive the character investigation of a contractor. The Agreement to a Temporary Waiver of Character Investigation and Addendum to declaration for Federal Employment- Indian Health Service-Child Care Worker Positions authorizes an agency to hire a contractor prior to the completion of a background check provided that at all times that contractor is within the sight and is being monitored by a government employee who has successfully completed the National Agency Check with written Inquiries (NACI).

J.

REQUIRED MALPRACTICE INSURANCE:

Contractor will provide and maintain their own Malpractice Insurance for the term of the contract.

K.

COMPLIANCE WITH IHS RULES AND REGULATIONS:

Medical Practices must be within the standards of their established credentialed specialty and maintains continuing medical education, licensing, registration and certifications 100% of the time.

Documents medical screenings and examinations 100% of the time (Emergency Room Only).

Complies with all policies, By-laws, Safety, Infection Control, and rules and regulations of HHS/IHS/Rosebud Hospital with zero (0) violations.

Consults with other specialty practitioners when applicable 100% of the time.

Maintains patient privacy/confidentiality/HIPAA with zero (0) breaches of privacy.

Timely documentation that is completed 100% of the time which is to be completed PRIOR to the end of the daily shift and PRIOR to signing an invoice for payment.

Complaints on quality of care and/or conduct should be minimal and no more than three (3) per quarter (all issues will be addressed in writing to the contractor so that action can be taken).

The standards of medical practice and duties of the Contractor through its Physician(s) shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of physicians and hospitals must be followed. Also the standards and recommendations of Centers for Medicare and Medicaid Services (CMS) or the Accreditation Organization must be adhered to. The Contract Physician(s) shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care.

L.

ANY SPECIAL REQUIREMENTS:

Utilizes EHR and RPMS computer system.

FAR 52-237-7 - IDENTIFICATION AND MEDICAL LIABILITY INSURANCE:

A. It is expressly agreed and understood that this is a Non-Personal Service Contract, as defined in Federal Acquisition Regulations (FAR) 37.101, under which the professional services rendered by the Contractor are rendered in its capacity as an independent contractor.

The Government may evaluate the quality of professional and administrative services provided, but retain no control over professional medical judgment diagnoses, or specific medical treatments.

The Contractor shall be solely liable for and expressly agrees to indemnify the government with respect to any liability producing acts or omissions by it or by its employees or agents.

The Contractor shall maintain liability insurance issued by a responsible insurance carrier in the amount of not less than the minimum requirements established by the state in which the contract is performed during the term of the contract.

B. An apparently successful offer, upon request by the Contracting Officer shall furnish, prior to the contract award, evidence if its insurability concerning the medical liability insurance required by paragraph (1.) of this clause.

C. Liability insurance may be either on occurrence basis or a claims-made basis. If the policy is on claims-made basis, an extended reporting endorsement (tail) for a period of not less than 3 years after the end of the contract term must also be provided.

D. A Certificate of Insurance evidencing the required coverage shall be provided to the Contracting Officer prior to the commencement of services under this contract. If the insurance is on claims-made basis, evidence of an extended reporting endorsement shall be provided to the Contracting Officer prior to the expiration of this contract. Final payment under this contract shall be withheld until evidence of the extended endorsement is provided to the Contracting Officer.

E. The policies evidencing required insurance shall also contain an endorsement to the effect that any cancellation or material change adversely affecting the government’s interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer. If during the performance period of the contract, the Contractor changes insurance providers, the Contractor must provide evidence that the Government will be indemnified to the limits specified in paragraph (a) of this clause for the entire period of the contract, either under the new policy or a combination of old and new policies.

F. The Contractor shall insert the substance of this clause, including this paragraph in all subcontracts under this contract or health care services and shall require such subcontractors to provide evidence of and maintain insurance in accordance with paragraph (a) of this clause. At least 5 days before the commencement of work by any subcontractor, the Contractor shall furnish to the Contracting Officer, evidence of such insurance.

G. The contract terminates when the performance period expires or the Hospital (i.e. lack of funding, workload, etc.) no longer requires services.

M.

CONTRACTING OFFICER REPRESENTATIVE (COR): (NAME, TITLE, PHONE NUMBER) (ATTACH CERTIFICATE):

Craig Lafferty, Radiology Manager – 605-747-3336

Rosebud Comprehensive Healthcare Facility – Radiology WCL – 5-8-2016