S02 - 36C26323Q0667 Marshalltown Solicitation.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. UEI: EFT:

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

36C26323Q0667 06-09-2023

Logan Crossley, Contract Specialist 651.293.3065 06-30-2023

7:00 AM CDT

36C263 Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

X

622110

$47.0 million

X

N/A

X

636A6

Marshalltown Community-based Outpatient Clinic (CBOC)

VA Central Iowa Healthcare System (VACIHCS) 3600 30th St Des Moines, IA 50310

36C263

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

316 Robert Street N. STE. 506 St. Paul MN 55101

Y

Department of Veterans Affairs Financial Services Center PO Box 149971

Austin TX 78714-9971

This is a solicitation for offsite General X-Ray Exam Services for the VA CBOC in Marshalltown, IA, a part of the VACIHCS.

Period of Performance: One Base Year (08-01-2023 to 07-31-2024) with four Option Years.

See Section B.2 for Schedule of Services.

See Section B.3 for Performance Work Statement.

See Section E.1 for Instructions to Offerors.

See CONTINUATION Page

X -ONE-

Raymond Holman Contracting Officer

36C26323D0111 8/1/2023

36C26323Q0667

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES

B.3 PERFORMANCE WORK STATEMENT (PWS)

B.4 RECORDS MANAGEMENT OBLIGATIONS

SECTION C - CONTRACT CLAUSES

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

COMMERCIAL SERVICES (DEC 2022)

C.2 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS (NOV

2021)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.8 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.9 VAAR 852.201-70 CONTRACTING OFFICER’S REPRESENTATIVE (DEC 2022)

C.10 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.11 VAAR 852.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY (FEB 2023)

C.12 VAAR 852.208-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-OWNED SMALL

BUSINESS EVALUATION FACTORS—ORDERS OR BPAs (JAN 2023)

C.13 VAAR 852.208-71 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-OWNED SMALL

BUSINESS EVALUATION FACTOR COMMITMENTS—ORDERS AND BPAs (JAN 2023) (DEVIATION) .. 37

C.14 VAAR 852.211-76 LIQUIDATED DAMAGES - REIMBURSEMENT FOR DATA BREACH COSTS

(FEB 2023)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

C.16 VAAR 852.237-70 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (OCT 2019)

C.17 VAAR 852.237-74 NON-DISCRIMINATION IN SERVICE DELIVERY (OCT 2019)

C.18 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.19 VAAR 852.239-74 SECURITY CONTROLS COMPLIANCE TESTING (FEB 2023)

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

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

EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAR 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

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

SERVICES (MAR 2023)

E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO

SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.3 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

E.4 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST (OCT 2020)

E.5 VAAR 852.273-70 LATE OFFERS (NOV 2021)

E.6 VAAR 852.273-73 EVALUATION - HEALTH-CARE RESOURCES (NOV 2021)

E.7 VAAR 852.273-74 AWARD WITHOUT EXCHANGES (NOV 2021)

E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (DEC 2022)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(continuation of Standard Form 1449 Block 20)

Under the authority of 38 USC 8153 and FAR Part 13, the Contractor agrees to provide healthcare resources in accordance with the terms and conditions stated herein, to furnish to and at the VA Central Iowa Health Care System the services and prices specified in Sections B.2, Schedule of Services, and B.3, Performance Work Statement.

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

a. CONTRACTOR:

b. GOVERNMENT: Department of Veterans Affairs Network 23 Contracting Office Logan Crossley Logan.Crossley@va.gov 651-293-3065 316 Robert Street N. STE. 506 St. Paul MN 55101

c. NOTE: Contractor and Government points of contact can be changed by written notification to the other party. Notification will be placed in the Contract file and will not require a modification to the Contract.

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the Contractor will be made in accordance with FAR 52.232-33, Payment by Electronic Funds Transfer – System for Award Management.

3. INVOICES: Invoices shall be submitted monthly in arrears (see Items 6.2 through 6.4 of Section B.3, Performance Work Statement).

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

5. TYPE OF CONTRACT: This is a solicitation for an indefinite-delivery/indefinite-quantity fixed-price contract IAW FAR Part 13.

6. 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 the facility, equipment, and radiologic technologist(s) services required to provide offsite general X-ray exams (technical component only) to eligible beneficiaries of the Department of Veterans Affairs, Marshalltown Community-Based Outpatient Clinic (CBOC), a part of the VA Central Iowa Health Care System (VACIHCS).

This is a CPT code-based contract. A listing of general X-ray exams required by this contract containing CPT Code, Description, and Estimated Quantity for each Base and Option Year is on the following page.

Should additional CPT codes be required, they may be added by mutual agreement of both parties through a modification to the contract.

Place of Performance: Services shall be provided at the Contractor’s facility which must be within ten (10) miles of the Marshalltown CBOC located at 101 Iowa Ave W, Marshalltown IA 50158.

Pricing Instructions:

The Offeror is instructed to provide proposed rates in Attachment 1, Pricing Schedule, by entering:

1. Percentage (using whole numbers, such as “98” or “102”) of current Medicare rates proposed as Base Year rates in the spreadsheet cell highlighted orange; and

2. Percent (using whole numbers, such as “0” or “2”) Option Year rates will increase from a previous year’s rates in the spreadsheet cell highlighted blue.

Current Medicare rates contained within Attachment 1: Proposed Rates were obtained from:

https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=0&HT=2&CT=2&H1=70130&H2=74019&C=59&M=4 and are included in the “CMS PFS 2023 Iowa” spreadsheet tab.

Minimum contract value: $1,000.00

Maximum contract value: 1.75 x total estimated cost of the successful proposal

Period of Performance: One Base Year with the possibility of up to four (4) Option Years exercised at the sole discretion of the Government.

BASE YEAR: 08/01/2023 to 07/31/2024

OPTION YEAR 1: 08/01/2024 to 07/31/2025

OPTION YEAR 2: 08/01/2025 to 07/31/2026

OPTION YEAR 3: 08/01/2026 to 07/31/2027

OPTION YEAR 4: 08/01/2027 to 07/31/2028 https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=0&HT=2&CT=2&H1=70130&H2=74019&C=59&M=4 https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=0&HT=2&CT=2&H1=70130&H2=74019&C=59&M=4

Base Year Option Year 1 Option Year 2 Option Year 3 Option Year 4

Est. # of

Procedures

Est. # of

Procedures

Est. # of

Procedures

Est. # of

Procedures

Est. # of

Procedures

74018 Abd 1 view 18 20 22 22 25

74019 Abdomen 2V 7 9 10 10 15

73610 Ankle 3 view 42 45 48 48 50

72050 Cervical 4 views 60 62 65 65 68

72052 Cervical 6 view 6 8 10 10 13

71045 Chest 1 view 1 2 3 3 5

71046 Chest 2 view 72 75 77 77 80

73000 Clavicle 2 view 1 2 5 5 5

73080 Elbow 3 view 1 3 5 5 7

73070 Elbow 2 view 12 14 18 18 20

70130 Facial Bones 5 view 1 1 1 1 1

73140 Finger(s) 3 4 5 5 7

73552 Femur 2 view 2 4 5 5 7

73620 Foot 2 views 12 13 15 15 18

73630 Foot 3 view 54 55 57 57 60

73090 Forearm 2 view 6 7 8 8 10

73130 Hand 3 view 6 8 10 10 12

73523 B/L Hips 5 views 1 2 3 3 4

73521 B/L Hips 2 views 1 2 3 3 4

73502 Hip 2 view 5 10 12 12 15

73060 Humerus 2 view 2 3 5 5 6

73560 Knee 2 view 18 20 20 20 25

73562 Knee 3 view Upright 18 21 25 25 27

73564 Knee Complete 6 10 12 12 15

73565 B/L Standing Knee 4 view 12 15 13 13 15

73590 Lower Leg 2 view 6 8 9 9 12

72100 Lumbar 3 view 5 8 10 10 12

72114 Lumbar 6 views 12 12 14 14 15

72110 Lumbar obliques 66 72 75 75 78

73650 Oscalcis 2 view 12 13 12 12 15

72170 Pelvis 1 view 6 8 10 10 15

71111 B/L Ribs w chest 6 6 7 7 8

73510 Uni Ribs 6 8 10 10 12

71101 Ribs w chest 6 8 10 10 15

73010 Scapula 1 3 4 4 5

73030 Shoulder 2 view 6 12 15 15 20

70250 Skull 2 view 1 1 1 1 1

70260 Skull 4 view 1 3 3 3 5

72070 Thoracic 2 view 6 7 8 8 10

72072 Thoracic 3 view 1 3 5 5 5

73660 Toe 3 view 3 5 5 5 7

73110 Wrist 3 view 6 12 12 12 15

72220 Sacrum/Coccyx 1 3 4 4 5

Total 518 607 671 671 769

DescriptionCPT Code

B.3 PERFORMANCE WORK STATEMENT (PWS)

1. GENERAL:

1.1. Services Provided: The Contractor shall provide the facility, equipment, and radiologic technologist(s) required for performing general X-ray exams (technical component only) on an as-needed basis for eligible Veterans as referred by the Marshalltown CBOC, a part of the VACIHCS based in Des Moines, IA. NOTE: Radiology images shall be captured by digital radiography, not on X-ray film.

1.2. Place of Performance: Contractor shall furnish services at the Contractor’s facility, which must be within ten (10) miles of the Marshalltown CBOC in order to allow Veterans to receive radiology services in a timely, safe, and efficient manner without compromising patient care.

The Marshalltown CBOC is located at 101 Iowa Ave W, Marshalltown, IA 50158.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority, and FAR Part 13.

1.4. Policy/Directives/Handbooks. The Contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications

1.4.1. VA Directive 1663: Health Care Resources (HCR) Contracting – Buying Title 38 U.S.C.

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy

1.4.3. VHA Directive 1088(1): Communicating Test Results to Providers and Patients

1.4.4. VHA Directive 1100.18: Reporting and Responding to State Licensing Boards

1.4.5. VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.6. VHA Directive 1100.21: Privileging

1.4.7. VHA Directive 1192.01: Seasonal Influenza Vaccination Program for VHA Health Care Personnel

1.4.8. VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures in Any Clinical Setting

1.4.9. VHA Directive 1605.01: Privacy and Release of Information

1.4.10. VHA Directive 1907.01: VHA Health Information Management and Health Records

1.4.11. 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 Acronyms/Definitions: 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. ARRT: American Registry of Radiologic Technologists

1.5.2. BLS: Basic Life Support

1.5.3. CME: Continuing Medical Education

1.5.4. CMS: Centers for Medicare and Medicaid Services

1.5.5. CO: Contracting Officer : 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.

1.5.6. COR: Contracting Officer’s Representative: 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.

https://www.va.gov/vapubs/ https://www.va.gov/vhapublications/index.cfm http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.5.7. COS: Chief of Staff

1.5.8. Covid-19: Coronavirus Disease 2019

1.5.9. CPARS: Contractor Performance Assessment Reporting System

1.5.10. Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience or other qualifications.

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

1.5.12. HIPAA: Health Insurance Portability and Accountability Act

1.5.13. ISO: Information Security Officer

1.5.14. Key Personnel: The individuals specified in this contract who are essential to work performance.

1.5.15. POP: Period of Performance

1.5.16. PWS: Performance Work Statement

1.5.17. 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.

1.5.18. QA/QI: Quality Assurance/Quality Improvement

1.5.19. QASP: Quality Assurance Surveillance Plan

1.5.20. QM/PI: Quality Management/Performance Improvement

1.5.21. VHA: Veterans’ Health Administration

1.5.22. VISN: Veterans Integrated Services Network

1.5.23. VISTA: Veterans Information Systems Technology Architecture

1.5.24. VAMC: Veterans Affairs Medical Center; unless otherwise identified, “VAMC” shall refer to the VACIHCS for purposes of this contract

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. Certification: Contractor’s radiologic technologist(s) designated to perform contract services shall be ARRT-certified. 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.

2.1.2. Technical Proficiency: Contractor’s radiologic technologist(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.

2.1.2.1. Such documents may include, but are not limited to:

2.1.2.1.1. credentials and qualifications; and

2.1.2.1.2. Contractor’s checklist assessing knowledge, skills, and abilities required to perform duties competently, including those necessary for providing care to appropriate patient populations.

2.1.2.2. Qualifications of Contractor’s radiologic technologist(s) shall also be subject to review by the VA Chief of Staff and approval by the VA Imaging Chief.

2.1.3. Training: Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the Contractor’s radiologic technologist(s) as required by the VA. Other training may become required.

VA will communicate any changes to the training requirement to the Contractor.

Training Frequency Annual Hours

VA Privacy and Information Security Awareness and Rules of Behavior Annually One

VHA Privacy and HIPAA Focused Training Annually One

2.1.4. Conflict of Interest: The Contractor is 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.

2.1.5. Citizenship-related Requirements:

2.1.5.1. 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.

2.1.5.2. 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.

2.1.5.3. 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.

2.1.5.4. 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.

2.1.5.5. 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.

2.1.6. 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.

2.1.6.1. 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 radiologic technologist(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.

2.1.6.2. 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 Facility COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Directive 1100.20 and VHA Directive 1100.21. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility 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 radiologic technologist(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 personnel are prohibited from referring VA patients to Contractor’s or their own practice(s).

2.6. Inherent Government Functions: Contractor and Contractor’s radiologic technologist(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.

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

2.7. No Employee status: The Contractor shall be responsible for protecting Contractor’s radiologic technologist(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 radiologic technologist(s). When a Contractor or Contractor’s radiologic technologist (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 radiologic technologist(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. 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 seven (7) 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 fourteen (14) calendar days prior to making any permanent substitutions.

2.9.1.1. 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 seven (7) 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.

2.9.1.2. 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 weeks will require the procedure as stated above.

2.9.1.3. 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 radiologic technologist(s), s/he may request, without cause, immediate replacement of said Contractor’s radiologic technologist(s). The CO and COR shall deal with issues raised concerning Contractor’s radiologic technologist(s) conduct. The final arbiter on questions of acceptability is the CO.

2.9.1.4. Contingency Plan: Because continuity of care is an essential part of the Facility’s medical services, the Contractor shall have a contingency plan in place to be utilized if the Contractor is unable to continue performance in accordance with the terms and conditions of the resulting contract due to facility, equipment, or personnel issues.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA CBOC Hours: 7:30 a.m. to 4:30 p.m, Monday through Friday.

3.1.1. The VA shall fax an order from a VA provider to the Contractor, and patients must be seen on a walk-in basis by Contractor’s radiologic technologist(s) at the Contractor’s facility in a timely manner (i.e., waiting fewer than 30 minutes after arrival) in accordance with VA Rules and Regulations on clinic wait times and consult/order completion.

Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.1.2. Contractor shall be available to perform general X-ray exam services during normal VA CBOC hours which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal VA CBOC hours are 7:30 a.m to 4:30 p.m., Monday through Friday.

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

• New Year’s Day

• President’s Day

• Martin Luther King’s Birthday

• Memorial Day

• Juneteenth

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any day specifically declared to be a national holiday

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor’s radiologic technologist(s) shall be competent, qualified per this performance work statement, and adequately trained to perform assigned duties.

4.2. Standards of Care: The Contractor’s care shall cover the range of general X-ray exam 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:

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

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

4.2.2. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contractor’s radiologic technologist(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment of VA patients. Based on this exception, a BAA is not required for this contract. Health records generated by this contract or provided to the Contractors by the VA are covered by the VA Privacy Act system of records entitled ‘Patient Medical Records-VA’ (24VA10A7). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed http://www.jointcommission.org/standards_information/hap_requirements.aspx except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in 4.3.5.

4.3.3. Security Accreditation Package: Certification and accreditation (C&A) requirements do not apply, and a Security Accreditation Package is not required.

4.3.4. Disclosure: Contractor’s radiologic technologist(s) may have access to patient medical records for the purpose of providing medical care and services to VA patients and performing services under the contract. VA authorizes the Contractor to discuss patient health information for coordination of care with community health care providers in compliance with VA regulations, HIPAA and VHA Directive 1605.01, Privacy and Release of Information. The VA will provide the Contractor with a copy of VHA Directive 1907.01, Health Information Management and Health Records, and VHA Directive 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.5. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Directive 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 and all guidelines provided by the facility.

4.3.6. Release of Information: The VA shall maintain control of releasing any copies of patient health information or health records and will follow policies and standards as defined, but not limited to Privacy Act requirements. Contractor will not release or disclose copies of records and will refer all such requests to the Release of Information Department at the VA facility were assigned.

4.3.7. Management for Medical Records: National Archives and Records Administration record disposition requirements are found in RCS 10-1 Chapter 6, 6000 series.

4.4. Direct Patient Care:

4.4.1. Scope of Care: Contractor shall provide the technical component of general radiology (X-ray) exams as ordered by a VA healthcare provider.

4.4.1.1. The Marshalltown CBOC will fax a VA provider-signed order containing the designated X-ray procedure, CPT code, and appropriate clinical history to the Contractor’s Radiology department.

4.4.1.2. The patient will arrive at the Contractor’s facility and be seen by Contractor’s radiologic technologist(s) within 30 minutes of check-in.

4.4.1.3. Contractor radiologic technologist(s) will perform ordered general X-ray exam (technical component only).

4.4.1.4. Upon completion of the X-ray examination, patient images will be stored on a CD in DICOM (.dcm) format and sent to the Marshalltown CBOC within one (1) hour for urgent requests, and within twenty-four (24) hours for routine requests.

4.4.1.4.1. Contractor will send CD to Marshalltown CBOC in accordance with Department of Veterans Affairs VA Directive 6609.

4.4.1.4.2. Alternatively, the Contractor can use the Medicom electronic image transfer format.

4.4.1.4.3. For urgent needs, the patient may hand-carry the CD back to the VA CBOC the same day.

4.4.1.5. If additional information is needed, the CBOC Coordinator may be contacted at 515- 249-0551.

4.4.2. Patient Safety Compliance and Reporting: Contractor shall follow all established patient safety and infection control standards of care, making every effort to prevent falls and patient injury caused by acts of commission or omission in the delivery of care. All https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=9235 events related to patient injury and other breeches of patient safety shall be reported to the COR as soon as practicable (but within 24 hours) for documentation in the medical record of those impacted, disclosure to the patient or surrogate, and VA Patient Safety Reporting System incident entry, following up with COR as required or requested.

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

4.5.1. Quality Management/Quality Assurance Surveillance: Contractor shall be subject to Quality Management measures 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 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.

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: Delivery of Images to Authorized Government System or Representative

4.5.4.1.1. Performance Requirement: All imaging studies must be delivered to the VA CBOC in a timely manner.

4.5.4.1.2. Standard: All (100%) imaging studies received within one hour (urgent) or 24 hours (routine) of exam

4.5.4.1.3. Acceptable Quality Level: 98%

4.5.4.1.4. Surveillance Method: Periodic inspection

4.5.4.2. Measure: Qualifications of Key Personnel

4.5.4.2.1. Performance Requirement: All Contractor’s radiologic technologists(s) shall be ARRT-certified.

4.5.4.2.2. Standard: All (100%) Contractor’s radiologic technologist(s) are ARRT-certified

4.5.4.2.3. Acceptable Quality Level: 100%

4.5.4.2.4. Surveillance Method: Verification of documents provided by Contractor

4.5.4.3. Measure: Patient Access

4.5.4.3.1. Performance Requirement: Patient wait time shall not exceed 30 minutes.

4.5.4.3.2. Standard: Contractor’s radiologic technologist(s) are available to begin all (100%) patient exams within 30 minutes of patient check-in.

4.5.4.3.3. Acceptable Quality Level: 98%

4.5.4.3.4. Surveillance Method: Validated patient complaints

4.5.4.4. Measure: Timeliness and Accuracy of Billing

4.5.4.4.1. Performance Requirement: Invoices to be received in a timely manner; no re-work needed.

4.5.4.4.2. Standard: All (100%) invoices to be received in Tungsten no later than 20 calendar days past the end of the month in which services performed

4.5.4.4.3. Acceptable Quality Level: 98%

4.5.4.4.4. Surveillance Method: Periodic Inspection

4.5.4.5. Measure: Privacy, Confidentiality and HIPAA

4.5.4.5.1. Performance Requirement: Contractor is aware of all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA and complies with all standards. Zero breaches of privacy or confidentiality

4.5.4.5.2. Standard: All (100%) Contractor radiologic technologist(s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and

HIPAA

4.5.4.5.3. Acceptable Quality Level: 100% compliance

4.5.4.5.4. Surveillance Method: Periodic Inspection; Contractor shall provide evidence of annual training required by the facility, reports violations per VA Handbook 6500.6.

4.5.5. Registration with Contractor Performance Assessment Reporting System

4.5.5.1. 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.

4.5.5.2. 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 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.

4.5.5.3. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one 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.

4.5.5.4. 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: If additional information is needed, the CBOC Coordinator may be contacted at 515-249-0551.

http://www.cpars.gov/

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:

5.2.1.1. The CO for this contract is: Ray Holman

Contracting Officer Raymond.Holman@va.gov 651-293-3013 Network 23 Contracting Office (NCO 23)

5.2.1.2. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall 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.

5.2.1.3. 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.

5.2.1.4. 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:

5.2.2.1. The COR for this contract is: Amy DoBraska

Supervisory Health System Specialist Imaging Service Amy.DoBraska@va.gov 515-699-5908 VA Central Iowa Health Care System

5.2.2.2. 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.

5.2.2.3. 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 Contractor-provided documents, validated patient complaints, and periodic inspection.

5.2.2.4. The COR will maintain a record-keeping system of services by Radiology orders from the VA electronic medical record. 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.

5.2.2.5. 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.

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

5.2.3. Changes to the CO and COR may be made with written notification to the Contractor.

A modification to the contract will not be required to make any such changes.

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 is required for all large businesses. Copy of Contractor Certification Statement if no-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

Certification that staff list has 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

Certificates of Completion for Cyber Security and Patient Privacy Training Courses

Before receiving an account on VA Network and annual training and new hires.

Contracting Officer

BLS Certification Upon award and every two years after award.

COR

Contingency plan for maintaining services as required under the terms of the contract

Upon proposal and as updated COR

6.2. Billing:

6.2.1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th calendar day 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. Veteran’s name

6.2.1.6. CPT performed

6.2.1.7. Total price

6.3. Vendor Electronic Invoice Submission Methods: Invoices will be electronically submitted to the Tungsten website at…