S02 - Request for Proposals 36C24826R0072.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

36C24826R0072 05-18-2026

Jayne Messer 239-373-9064 06-10-2026 4:30pm EDT

36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8)

8875 Hidden River Pkwy Suite 525 Tampa FL 33637

X

621111

$16 Million

N/A

Department of Veterans Affairs San Juan VA Medical Center (SJVAMC) VA Caribbean Healthcare System (VACHS) 10 Casia Street San Juan PR 00921

36C248

Department of Veterans Affairs Network Contracting Office 8 (NCO 8)

8875 Hidden River Pkwy Suite 525 Tampa FL 33637

Department of Veterans Affairs Financial Services Center Website: https://www.fsc.va.gov/einvoice

1-877-353-9791

See CONTINUATION Page

The contractor shall provide On-site and On-call Board Certified/Board Eligible Cardiothoracic Physician Services to eligible beneficiaries of the Department of Veterans Affairs (VA), San Juan VA Medical Center (VAMC), VA Caribbean Healthcare System (VACHS), Puerto Rico. Services shall be provided in accordance with (IAW) the Performance Work Statement (PWS) and the terms and conditions listed herein.

The Period of Performance is for one (1) base year plus (+) four (4) - one (1) year option periods.

Reference pages six (6) through eleven (11) for the Schedule of Services and pages 12 through 50 for the Performance Work Statement (PWS).

All questions concerning the Request for Proposal (RFP) and related documents shall be submitted via email to the Contracting Officer at jayne.messer@va.gov no later than 12:00pm EST on Wednesday, May 27, 2026.

See CONTINUATION Page

X One (1)

Jayne Messer

VA-VHA-RPOE-2023-0120

36C24826R0072

Table of Contents

SECTION A

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 (PWS)

SECTION C - CONTRACT CLAUSES

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

AND COMMERCIAL SERVICES (OCT 2025) (DEVIATION)

C.2 52.216-18 ORDERING (AUG 2020)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.4 52.216-22 INDEFINITE QUANTITY (NOV 2025) (DEVIATION)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ... 58

C.7 52.222-90 ADDRESSING DEI DISCRIMINATION BY FEDERAL CONTRACTORS

(APR 2026)

C.8 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS (NOV 2025)

(DEVIATION)

C.9 52.240-93 BASIC SAFEGUARDING OF COVERED CONTRACTOR

INFORMATION SYSTEMS (NOV 2025) (DEVIATION)

C.10 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.11 52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (NOV 2020)

C.12 852.204-72 PERSONNEL VETTING AND CREDENTIALING (MAR 2026)

C.13 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.14 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—CERTIFICATE OF

COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023) (DEVIATION)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)……………………………79

D.2 ORGANIZATIONAL CONFLICT OF INTEREST……………………………………….79

D.3 CONTRACTOR CERTIFICATION IMMIGRATION AND NATIONALITY ACT OF

1952……………………………………………………………………………………………...79

D.4 CONTRACTOR RULES OF BEHAVIOR……………………………………………….79

D.5 PAST PERFORMANCE QUESTIONNAIRE……………………………………………79

SECTION E - SOLICITATION PROVISIONS

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

COMMERCIAL SERVICES (OCT 2025) (DEVIATION)

E.2 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (OCT 2025) (DEVIATION)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (NOV 2025)

(DEVIATION)

E.4 52.216-1 TYPE OF CONTRACT (NOV 2025) (DEVIATION)

E.5 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (NOV 2025)

(DEVIATION)

E.6 52.233-2 SERVICE OF PROTEST (NOV 2025) (DEVIATION)

E.7 52.240-90 SECURITY PROHIBITIONS AND EXCLUSIONS REPRESENTATIONS

AND CERTIFICATIONS (NOV 2025) (DEVIATION)

E.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.9 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (NOV 2020)

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: _____________________________

Title:

Address:

Telephone:

Facsimile:

Email:

Federal Taxpayer Identification Number:

SAM Unique Entity Identifier (UEI)

b. GOVERNMENT: Contracting Officer 36C248

Jayne Messer Department of Veterans Affairs Network Contracting Office 8 (NCO 8) Email: Jayne.messer@va.gov Phone: (239) 373-9064

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

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.

5. ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

mailto:Jayne.messer@va.gov

6. SECURE FAX DOCUMENTS: All fax cover sheets shall include the following statement: "This fax is intended only for the use of the person or office to which it is addressed and may contain information that is privileged, confidential, or protected by law. All others are hereby notified that the receipt of this fax does not waive any applicable privilege or exemption for disclosure and that any dissemination, distribution, or copying of this communication is prohibited. If you have received this fax in error, please notify this office immediately at the telephone number listed above."

7. CAUTION: Late submission, modification, and withdrawals: See Provision 52.212-1.

Proposals are subject to all terms and conditions of this solicitation.

8. POST AWARD ORIENTATION: The Contracting Officer will schedule a post award orientation for contract orientation purposes as required by Federal Acquisition Regulation (FAR) Overhaul 42.302, FAR Companion (FC) 42.3, and any local policy established by the Head of Contracting Activity (HCA).

9. MANDATORY DISCLOSURES: Mandatory written disclosures required by FAR clause 52.203-13 to the Department of Veterans Affairs, Office of Inspector General (OIG) must be made electronically through the VA OIG Hotline at https://www.vaoig.gov/hotline/online-forms and clicking on "FAR clause 52.203-13 Reporting." If you experience difficulty accessing the website, call the Hotline at 1-800-488-8244 for further instructions.

B.2 SCHEDULE OF SEVICES

The Contractor shall furnish all key personnel to provide services necessary to perform onsite and on-call Cardiothoracic Surgery Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, 672, VA Caribbean Healthcare System (hereinafter referred to as VACHS). The Contractor’s physician(s) care shall cover the range of Cardiothoracic Surgery 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 American Associate for Thoracic Surgery (AATS): https://www.aats.org/.

Contract Type: Indefinite Delivery Indefinite Quantity (IDIQ).

Place of Performance: Services shall be provided on site, 672-VA Caribbean Healthcare System, 10 Casia St, San Juan PR 00921.

Period of Performance: The anticipated contract period of performance is one (1) base year and four (4), one (1) year option periods to be exercised at the sole discretion of the Government based on the continual need for services.

Minimum and Maximum Quantity: This requirement includes a guaranteed minimum of $2,500.00 of services for the base and any exercised options. The maximum amount to be ordered for this contract for the base, and all option periods, if exercised by the Government, is $12,000,000.00. If the maximum aggregate amount of $12,000,000.00 is reached prior to the end date of the final period of performance, no further task orders will be issued against the contract.

Task Order Procedures: Task orders will be issued by NCO 8 Contracting Officers. The Task Order will contain date of order, order number, line-item number, description, quantity, unit price, performance schedule, accounting and appropriation data and method of payment.

Estimated Quantities: The quantities or dollar thresholds listed in the Schedule of Services effective for the periods stated are estimated only and are not purchased by the resultant contract. Except as this contract otherwise provides, if the VA’s requirement does not result in orders in the quantities or dollar amount described that fact must not constitute the basis for an equitable price adjustment.

Pricing Instructions: Enter the unit cost and total annual cost on the table below for all line-item numbers (LINs). Offerors shall identify by title/position or level of experience the key personnel submitted in the table in section 2.9 of the Performance Work Statement (PWS).

The Contractor shall propose a minimum of two (2) key personnel Cardiothoracic Physician Surgeons to be credentialed and be available for simultaneous scheduling to meet the requirements of the contract. The two (2) key personnel surgeons must begin the onboarding process upon contract award and must both begin providing services on the start date of the Period of Performance of the base year to ensure coverage for all hours indicated within the schedule of services.

One (1) physician surgeon is required to be available on-site for scheduled elective procedures (Operating Room) and patient evaluations at clinics on Mondays and Wednesdays from 7:00am to 3:30pm (15.5 hours coverage). One (1) physician surgeon will be on call during weeknights Mondays and Wednesdays from 3:30pm to 7:00am, and weekdays Tuesday, Thursday, Friday, weekends, and holidays from 7:00am – 7:00am (24 hour daily coverage) for emergency cases and Cath Lab procedures; as needed, surgeon will be called to be onsite as stand by for specific/elective Cath Lab procedures during the week; in addition, this physician needs to https://www.aats.org/ attend scheduled meetings on Friday mornings from 7:30–8:30 am for discussion of cases.

Contractor’s key personnel must be available on-site within one (1) hour of notification for back-up and/or emergency cases.

LINs

LIN

DESCRIPTION OF

SERVICES

ESTIMATED

QUANTITY UNIT UNIT PRICE

ESTIMATED

AMOUNT

Base Year: 07/01/2026 – 06/30/2027

884.00 HR $__________ $__________

On-site Board Certified /Board Eligible Cardiothoracic Surgeon Services for onsite elective procedures and patient evaluation at clinics every week on Mondays & Wednesdays, from 7:00am to 3:30pm, and Friday meetings from 7:30am – 8:30am, excluding Federal holidays.

Contract Period: Base POP Begin: 07-01-2026 POP End: 06-30-2027 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists)

1,612.00 HR $__________ $__________

On-call Board Certified/Board Eligible Cardiothoracic Surgeon

Services for on-call evening/overnight coverage on Monday & Wednesday after clinical hours (3:30pm-7:00am)

Contract Period: Base POP Begin: 07-01-2026 POP End: 06-30-2027

6,504.00 HR $__________ $__________

On-call Board Certified/Eligible Cardiothoracic Surgeon Services for 24-hour coverage on Tuesday/Thursday/Friday, weekends, and holidays during non-clinical days (7:00am – 7:00am)

Contract Period: Base POP Begin: 07-01-2026 POP End: 06-30-2027

40.00 HR $_________

Call back Board Certified/Board Eligible Cardiothoracic Surgeon Services (services rendered outside regular working hours and any emergency callback services with direct patient contact while on call)

Contract Period: Base POP Begin: 07-01-2026 POP End: 06-30-2027 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists)

Estimated Total for Base Year: $____________ Option Year One (1): 07/01/2027 – 06/30/2028

Services for onsite elective procedures and patient evaluation at clinics every week on Mondays & Wednesdays, from 7:00am to 3:30pm, excluding holidays. (Inclusive of emergency call-back services and Friday meetings)

Contract Period: Option 1 POP Begin: 07-01-2027 POP End: 06-30-2028

Services for on-call evening/overnight coverage on Monday & Wednesday after clinical hours (3:30pm-7:00am)

Contract Period: Option 1 POP Begin: 07-01-2027 POP End: 06-30-2028 for 24-hour coverage on Tuesday/Thursday/Friday, weekends, and holidays during non-clinical days (7:00am – 7:00am)

Contract Period: Option 1 POP Begin: 07-01-2027 POP End: 06-30-2028

Services (services rendered outside regular working hours and any emergency callback services with direct patient contact while on call)

Contract Period: Option 1 POP Begin: 07-01-2027 POP End: 06-30-2028 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists)

Estimated Total for Option Year One (1): $____________ Option Year Two (2): 07/01/2028 – 06/30/2029

Services for onsite elective procedures and patient evaluation at clinics every week on Mondays & Wednesdays, from 7:00am to 3:30pm, excluding holidays. (Inclusive of emergency call-back services and Friday meetings)

Contract Period: Option 2

POP Begin: 07-01-2028 POP End: 06-30-2029 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except

Services for on-call evening/overnight coverage on Monday & Wednesday after clinical hours (3:30pm-7:00am)

Contract Period: Option 2 POP Begin: 07-01-2028 POP End: 06-30-2029 for 24-hour coverage on Tuesday/Thursday/Friday, weekends, and holidays during non-clinical days (7:00am – 7:00am)

Contract Period: Option 2 POP Begin: 07-01-2028 POP End: 06-30-2029

Services (services rendered outside regular working hours and any emergency callback services with direct patient contact while on call)

Contract Period: Option 2 POP Begin: 07-01-2028 POP End: 06-30-2029 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists)

Estimated Total for Option Year Two (2): $____________ Option Year Three (3): 07/01/2029 – 06/30/2030

Services for onsite elective procedures and patient evaluation at clinics every week on Mondays & Wednesdays, from 7:00am to 3:30pm, excluding holidays. (Inclusive of emergency call-back services and Friday meetings)

Contract Period: Option 3 POP Begin: 07-01-2029 POP End: 06-30-2030

Services for on-call evening/overnight coverage on Monday & Wednesday after clinical hours (3:30pm-7:00am)

Contract Period: Option 3 POP Begin: 07-01-2029 POP End: 06-30-2030 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except for 24-hour coverage on Tuesday/Thursday/Friday, weekends, and holidays during non-clinical days (7:00am – 7:00am)

Contract Period: Option 3 POP Begin: 07-01-2029 POP End: 06-30-2030

Services (services rendered outside regular working hours and any emergency callback services with direct patient contact while on call)

Contract Period: Option 3 POP Begin: 07-01-2029 POP End: 06-30-2030 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists)

Estimated Total for Option Year Three (3): $____________ Option Year Four (4): 07/01/2030 – 06/30/2031

Services for onsite elective procedures and patient evaluation at clinics every week on Mondays & Wednesdays, from 7:00am to 3:30pm, excluding holidays. (Inclusive of emergency call-back services and Friday meetings)

Contract Period: Option 4 POP Begin: 07-01-2030 POP End: 06-30-2031

Services for on-call evening/overnight coverage on Monday & Wednesday after clinical hours (3:30pm-7:00am)

Contract Period: Option 4 POP Begin: 07-01-2030 POP End: 06-30-2031

On-call Board Certified/Eligible Cardiothoracic Surgeon Services for 24-hour coverage on Tuesday/Thursday/Friday, weekends, and holidays during non-clinical days (7:00am – 7:00am)

Contract Period: Option 4 POP Begin: 07-01-2030 POP End: 06-30-2031

Services (services rendered outside regular working hours and any emergency callback services with direct patient contact while on call)

Contract Period: Option 4 POP Begin: 07-01-2030 POP End: 06-30-2031 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists)

Estimated Total for Option Year Four (4): $____________

ESTIMATED

GRAND TOTAL

B.3 PERFORMANCE WORK STATEMENT

1. GENERAL:

1.1. Services Provided: The contractor shall provide Board Certified /Board Eligible Cardiothoracic Surgeon Physician services to deliver onsite Open-Heart Surgery- Cardiothoracic Surgery services, which shall include, but not be limited to, initial patient evaluation at inpatient, outpatient, and Emergency Department (ED) settings, and surgical procedures in Operating Room and post-operative care settings, including tasks related to Cardiothoracic Surgery Consult (operation not recommended), Permanent Pacemaker Implant (in emergency cases), Pacemaker Lead Extraction (back up), Pericardial Window and/or Pericardiectomy Procedures, back-up for Interventional Cardiology and structural cardiovascular procedures cases in accordance with the terms and conditions contained herein to beneficiaries of the Department of Veterans Affairs (VA) and VA Caribbean Healthcare System (VACHS), San Juan Puerto Rico.

1.2. Place of Performance: Contractor shall furnish services at the VA Caribbean Healthcare System at 10 Casia Street, San Juan, Puerto Rico 00921.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority, Federal Acquisition Regulation (FAR) Overhaul Part 12, Acquisition of Commercial Products and Commercial Services in combination with FAR Overhaul Part 15, Contracting by Negotiation.

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. 8153

1.4.2. VHA Directive 1003.04: VHA Patient Advocacy

1.4.3. VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider

Group Practice

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

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

1.4.6. VHA Directive 1100.20: Credentialing of Health Care Providers

1.4.7. VHA Directive 1100.21: Privileging

1.4.8. VHA Directive 1192.01: Seasonal Influenza Vaccination Program for VHA Health

Care Personnel

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

1.4.10. VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents

1.4.11. VHA Directive 1605.01: Privacy and Release of Information

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

1.4.13. VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports

1.4.14. VHA Handbook 1400.04: Supervision of Associated Health Trainees https://www.va.gov/vapubs/ https://www.va.gov/vhapublications/index.cfm https://www.va.gov/vhapublications/index.cfm

1.4.15. 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. AATS: American Associate for Cardiothoracic Surgery: https://www.aats.org/

1.5.2. ACGME: Accreditation Council for Graduate Medical Education

1.5.3. ACLS: Advanced Cardiac Life Support

1.5.4. AOD: Admitting Officer of the Day

1.5.5. AB: Antibiotics

1.5.6. BLS: Basic Life Support

1.5.7. CDC: Centers for Disease Control and Prevention

1.5.8. CDR: Contract Discrepancy Report

1.5.9. CEU: Certified Education Unit

1.5.10. Clinical Privileging: Clinical 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, and within available resources.

1.5.11. CME: Continuing Medical Education

1.5.12. CMS: Centers for Medicare and Medicaid Services

1.5.13. 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.

1.5.14. 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. 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. COTR: Contracting Officer Technical Representative

1.5.17. CPARS: Contractor Performance Assessment Reporting System

1.5.18. CPT: Codification of Surgical Procedures

1.5.19. 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.

1.5.20. CT: Cardiothoracic

1.5.21. CV: Curriculum Vitae

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

1.5.22. DEA: Drug Enforcement Agency

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

1.5.24. EPA: Economic Proce Adjustment

1.5.25. FAPIIS: Federal Awardee Performance and Integrity Information System

1.5.26. FAR: Federal Acquisition Regulations

1.5.27. FC: Federal Acquisition Regulation Companion

1.5.28. FOIA: Freedom of Information Act

1.5.29. FPPE: Focused Provider Practice Evaluation

1.5.30. FSC: Financial services Center

1.5.31. FSMB: Federation of State Medical Boards

1.5.32. FTE: Full Time Equivalent. VA’s standard definition is for full time working the equivalent of 80 hours every two weeks, 2080 hours per year. However, providers may propose using their standard FTE definition.

1.5.33. GAO: Government Accountability Office

1.5.34. HCA: Head of Contracting Activity

1.5.35. HHS: Department of Health and Human Services

1.5.36. HIPAA: Health Insurance Portability and Accountability Act

1.5.37. ICARE: Integrity, Commitment, Advocacy, Respect, Excellence

1.5.38. IDIQ: Indefinite Delivery Indefinite Quantity

1.5.39. ISO: Information Security Officer

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

1.5.41. M/M: Mortality and Morbidity

1.5.42. NPI: National Provider Identifier: 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).

1.5.43. NSO: National Surgery Office

1.5.44. O/E: Observed vs. Expected

1.5.45. OIG: Office of the Inspector General

1.5.46. OPPE: Ongoing Provider Practice Evaluation

1.5.47. OR: Operating Room

1.5.48. PATS-R: Patient Advocate Program Reports

1.5.49. PCE: Personal Consumption Expenditures

1.5.50. PIA: Privacy Impact Assessment

1.5.51. PPIRS: Past Performance Information Retrieval System

1.5.52. POP: Period of Performance

1.5.53. PPD: Purified Protein Derivative

1.5.54. PWS: Performance Work Statement

1.5.55. QA/QI: Quality Assurance/Quality Improvement

1.5.56. QASP: Quality Assurance Surveillance Plan

1.5.57. QM/PI: Quality Management/Performance Improvement

1.5.58. SAM: System for Award Management

1.5.59. tPA: Tissue Plasminogen Activator

1.5.60. VA: Department of Veteran Affairs

1.5.61. VAMC: VA Medical Center

1.5.62. VASQIP: Veterans Affairs Surgical Quality Improvement Program

1.5.63. VAT: Video-Assisted Thoracoscopy

1.5.64. VETPro: is VHA’s mandatory credentialing software platform to document the credentialing of VHA health care providers. This system facilitates completion of a uniform, accurate, and complete credentials file.

1.5.65. VHA: Veterans’ Health Administration

1.5.66. VAHCS: VA Caribbean Healthcare System

1.5.67. VISN: Veterans Integrated Services Network

1.5.68. VISTA: Veterans Information Systems Technology Architecture

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: The Contractor’s physician(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 key personnel working on this contract shall be full and unrestricted licenses. Contractor’s physician(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 physician(s) shall be Board Certified /Board Eligible by the American Board of Thoracic Surgery and be currently certified in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) or equivalency. 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. Experience: Cardiothoracic Surgeon must have a minimum of four (4) years of continuous work experience within the last five (5) years to ensure the physician’s experience is current and relevant.

2.1.4. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive

1100.21 referenced above. The Contractor is responsible for ensuring that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor’s physician(s) prior to obtaining approval by the Facility Medical Executive Board and Medical Center Director.

2.1.4.1. If a Contractor’s physician(s) and/or other contract provider(s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.5. Technical Proficiency: Contractor’s physician(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. Spanish language is a preferred element but not a requirement. 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 physician(s) and Contractor’s physician(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.6. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the facility. Contractor’s physician(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 credentials 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 physician(s).

2.1.7. Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) as required by the VA.

Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training (The following training is mandatory per VHACO for Contracted Key Personnel)

Frequency (once a year, etc.) Annual Hours

Government Ethics Annually 1 Prevention of Workplace Harassment/No Fear Act

Every two (2) years 1

VA Core Values Training (ICARE Recommitment)

Annually 0.5

VA Privacy and Information Security Awareness and Rules of Behavior

Annually 1

VHA Privacy and HIPAA Focused Training

Annually 1

ACLS/BLS Every two (2) years 4 Patient Safety Once 1 Patient Rights Once 1 Patient Abuse Every two (2) years 1

Prevention/Management of Disruptive Behavior/Violence Prevention Level I

Annually 1

EHR 1 1

Vista Imaging 1 1

2.1.8. STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS,

ETC.): Contractor shall provide proof of the following for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.8.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician(s) upon hire in accordance with CDC guidance.

(This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.

2.1.8.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.8.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.

2.1.8.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.

2.1.8.5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

2.1.8.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO

BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician(s) {This is applicable to all health care workers};

provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.8.7. The facility shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control.

Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.9. 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). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.10. DEA: Contractor shall provide copy of current DEA certificate.

2.1.11. Conflict of Interest: The Contractor and all Contractor’s physician(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.

2.1.12. Citizenship related Requirements:

2.1.12.1. The Contractor certifies that the Contractor shall comply with 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;

2.1.12.2. 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.

2.1.12.3. 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.

2.1.12.4. 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.

2.1.12.5. 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.

2.1.13. 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.

2.1.13.1. 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 physician(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.

2.1.13.2. 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 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 physician(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 physicians are prohibited from referring VA patients to contractor’s or their own practice(s)

2.6. Inherent Government Functions: Contractor and Contractor’s physician(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 physician(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 physician(s). When a Contractor or Contractor’s physician(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 physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.9. Key Personnel:

2.9.1. The VA Full Time Equivalency (FTE) for the services required is 0.38.

2.9.2. The minimum number of Board Certified/Board Eligible

Cardiothoracic Surgeon physician(s) required to be credentialed and available for simultaneous scheduling is two (2) to meet the on-site, on-call, and call-back requirements of this task order. The two

(2) key personnel surgeons shall both start on the effective date.

2.9.3. One (1) Board Certified/Board Eligible Cardiothoracic Surgeon physician(s) is required to be on site for scheduled elective clinical procedures and patient evaluations at the clinic on Mondays and Wednesdays from 7:00am to 3:30pm, as well as available as standby for Cath Lab procedures requiring stent placement.

2.9.4. The contractor’s physician surgeon shall provide on-call evening/overnight coverage on Mondays and Wednesdays from 3:30pm to 7:00am (15.5 hours coverage) after clinic hours. The contractor’s physician surgeon shall be on-call weekdays Tuesday, Thursday, Friday, weekends, and holidays (24 hours daily coverage) for emergency cases and Cath Lab procedures (7:00am 0 7:00am.

2.9.5. As needed, the surgeon will be called to be on-site as stand by for specific/elective Cath Lab procedures during the week. In addition, this physician needs to attend scheduled meetings on Friday mornings from 7:30am–8:30am for discussion of cases as needed.

Contractor’s key personnel must be available on-site within one (1) hour of notification for back-up and/or emergency cases.

Key Personnel Official Title NPI

2.9.6. 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. In the event a scheduled physician is unable to complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) immediately of the schedule change. The replacement physician shall be a Board Certified/Board Eligible Cardiothoracic Surgeon that has completed VA credentialing.

2.9.7. 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 15 calendar day(s) after the occurrence of any of these events and provide the information required below.

After 90 days, the Contractor shall submit the information required below to the CO at least 30 calendar days prior to making any permanent substitutions.

2.9.7.1. 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 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.

2.9.7.2. 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.

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

Substitutes

2.9.7.4. 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’s physician(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: VA business days/hours of operation are Monday to Friday 6:00am

– 5:00pm.

Clinic or OR Schedule: Clinic schedule for evaluation of new patients: Monday and Wednesdays 7:00am – 3:30pm; Operating Room schedule Monday and Wednesdays 7:00 – 3:30pm. Clinic is closed on weekdays Tuesdays, Thursdays and Fridays and weekends.

3.1.1. Patients must be seen by a Contractor’s physician(s) on-site at the facility in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.1.2. Contractor’s physician(s) shall be available and present in clinic during normal facility clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are Mondays and Wednesdays 7:00am – 3:30pm.

3.1.2.1. On Call Coverage: Contractor must make a minimum of one (1) physician available on-call during all hours when the facility clinic is closed, including evenings, weekends and holidays.

3.1.2.2. On-call contractor’s physician(s) must be available at all times for phone consultations with VA residents and physicians within 30 minutes, and available onsite as needed, for emergency consultations, procedures or as back up for cardiac laboratory procedures, within 60 minutes. For this coverage, a time sheet is needed to reflect time spent onsite, reflecting a two

(2) hour block. This timesheet may include up to 30 minutes of travel, discussion of case and support to Cardiac Laboratory physician, until procedure is completed. If cardiac laboratory procedure converts to a surgical procedure, corresponding fee for service will be applied.

3.1.2.3.