Sources Sought Notice.docx

SUBJECT*

Off-Site Ophthalmology Surgery Services

GENERAL INFORMATION

SET-ASIDE

CONTRACTING OFFICE ADDRESS

Department of Veterans Affairs Birmingham VA Medical Center 700 South 19th Street Birmingham AL 35233

POINT OF CONTACT*

Contract Specialist Wyona Davis wyona.davis@va.gov

PLACE OF PERFORMANCE

Ralph H. Johnson VAMC

109 Bee Street

Charleston SC

ADDITIONAL INFORMATION

EMAIL DESCRIPTION

DESCRIPTION

This is a SOURCES SOUGHT for the Ralph H. Johnson Department of Veterans Affairs Medical Center in Charleston, SC. Information collected during this Sources Sought may be used in a set aside. If a solicitation is issued, the Government will do so in accordance with Federal Acquisition Circular (FAC) 2024-05. The North American Industry Classification System (NAICS) number is 621493. The NAICS size is $19 Million.

Any contractor that believes they are capable and desires to claim preference for small business status must be registered with the SBA at http://web.sba.gov/pro-net/ and meet the requirements of FAR 19.102. Any contractor that believes they are capable and desires to claim preference for veteran owned small business status must be registered with the SBA at https://veterans.certify.sba.gov/ as an SDVOSB or VOSB.

Contractors that deem themselves capable of meeting the requirement shall provide the below information to, Contract Specialist at Wyona Davis at wyona.davis@va.gov no-later-than Monday, August 26, 2024, at 10:00 AM, CST, referencing 36C24724Q0040. Responses shall include:

(1) Business Name and Address

(2) GSA/FSS/NAC Contract Number, if applicable

(3) Point of Contact Name, Phone Number and E-mail Address

(4) SAM UEI and NAICS code

(5) Business Size SMALL or LARGE

(6) Type of Business: service-disabled veteran owned, veteran owned small business, 8a, HUBZone, woman-owned, etc.

· Contractor must be registered with https://www.sam.gov

· To be considered SDVOSB/VOSB, must be registered with SBA at https://veterans.certify.sba.gov/

· Place of Performance is:

Within a 5 mile radius of Ralph H. Johnson VAMC 109 Bee Street Charleston, SC 29401

DRAFT PWS

The Contractor shall furnish off-site clinical space which includes all necessary supporting staff including surgical technicians, anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), nurses and administrative personnel necessary to provide Ophthalmology Surgery Services to eligible beneficiaries of the Department of Veterans Affairs, Ralph H. Johnson VA Health Care System (hereinafter referred to as VAHCS). The Ralph H. Johnson VAHCS will provide the Ophthalmology physicians and Ophthalmology Residents that will cover the range of Ophthalmological surgical services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by the American Academy of Ophthalmology.

All services shall be performed at the Contractor’s facility. Contractor’s facility must be within a five mile radius of The Ralph H. Johnson VAHCS. Contractor shall provide off-site clinical space which will include materials, supplies, implants equipment and qualified supervision specified herein. Contractor must be accredited with Joint Commission and have deemed CMS Status.

Place of Performance: Services shall be provided offsite at the Contractor’s facility.

Pricing Instructions: Offerors must accept pricing listed in the columns on the Price Schedule for each Contract Line-Item Number (CLIN) (with the exception of CLIN 58-59* please insert pricing for these CLINS). The current CMS rates are used in for each CLIN for the base and all option years. The Contractor shall furnish services described in the contract performance work statement and special contract requirements listed herein for the Ralph H. Johnson VA Medical Center, Charleston South Carolina. Unit prices for individual CPT Codes will be 100% of Medicare as prescribed in the Ambulatory Surgery Center Fee Schedule for South Carolina (South Carolina) Pricing for this contract is based on actual services provided, less the professional cost, in accordance with contract percentage of current published Centers for Medicare Services (CMS) rates. 42 CFR 415.70, Limits on compensation for physician services in providers is applicable to this contract.

Adjustments in pricing during the term of the contract shall be limited to published changes in CMS rates. The burden of notifying the VA Contracting Officer of any changes in Medicare rates lies with the Contractor. The Contractor’s notification to the VA Contracting Officer should include a list detailing the new Medicare rates and published documentation that substantiates that these rates are currently effective or will be effective at a future date. Within seven (7) calendar days of being properly notified of the change(s) in Medicare rates by the Contractor, the VA Contracting Officer will attempt to verify the change(s) with the Centers for Medicare and Medicaid Services (CMS). If the change(s) cannot be verified, the VA Contracting Officer will notify the Contractor of this determination and will work with the Contractor to identify the issue(s) preventing verification. If the change(s) can be verified, the VA Contracting Officer will implement the corresponding adjustments within fourteen (14) calendar days of verification unless the effective date has not yet arrived. In the latter case, the VA Contracting Officer will implement the change(s) on the effective date unless the effective date falls within the fourteen (14) calendar days that VA Contracting Officer is afforded to implement the change(s) after verification. The VA Contracting Officer reserves the right to retain any of the remaining fourteen (14) calendar days between verification and implementation regardless of the effective date of the change(s). Please note CLINs 58-59* will not be altered by Medicaid/Medicare changes. CLINs 58-59* will remain the same price throughout the term of the base and all four options of the contract.

The Contractor is not entitled to retroactive payment rate adjustments prior to implementation of the change(s) in Medicare rates by the VA Contracting Officer. “Piecemeal” changes to Medicare rates, such as only seeking per-procedure rate adjustments for select codes or a select group of codes, will not be permitted under any circumstance. The Contractor shall accept all Medicare rate changes for the period in which they are effective. VA reserves the right to adjust the Per-Procedure rates under this contract at any time should Medicare rates change regardless of whether the Contractor notified the VA Contracting Officer of the change(s). The Contractor will be given a notice of such actions at least seven (7) calendar days prior to the effective date of the change(s). Should there be any disagreement with the VA Contracting Officer’s proposed changes; the Contractor must submit a response outlining those areas in which the Contractor disagrees. This response must be provided to the Contracting Officer within seven (7) calendar days of notification of the anticipated change. The VA Contracting Officer reserves the right to make the final determination with regard to any change. Should the VA Contracting Officer implement any change(s) in Medicare rates under this contract, the Contractor shall accept all corresponding adjustments in which they are effective.

If for some reason a code on the schedule has expired or is for any other reason unusable, offerors shall annotate the Price per Code block with “N/A” or otherwise notate the replacement code.

Ambulatory Surgical Center (ASC) Payment System Schedule Updated Price Adjustment in Medicare Rates: Rates for the Ambulatory Surgical Center (ASC) Payment Schedule are updated on a calendar year basis and become effective on January first of any given year. Orders: Orders shall be placed against this (FFP – IDIQ) contract at the time of contract award, and as needed during the term of the contract. Task Orders shall specify the estimated quantities of services for the period of performance and shall comply with FAR 52.216-18 and 52.216-19. A task orders will be funded by the Contracting Officer and issued to the contractor. Ordering Procedures: VA staff will review consults and schedule patients according to the consult management policy and scheduling directives of the VA. VA staff will call the patients to schedule their appointment utilizing the VA scheduling package. A list of patients and their appointment times will be faxed to the contractor one (1) week prior to the day of appointment so they are aware of the expected patient load for the week. The guaranteed minimum for the initial fiscal year in which this contract is awarded is $10,000.00. The maximum total value of the contract, inclusive of the base year and all options exercised, shall not exceed $7,500,000.00 The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

Pricing is based on the application of Medicare reimbursement rules. For routine care, it is expected that Ralph H. Johnson VAHCS patients will have prescriptions filled at VA pharmacies. All spreadsheets must be submitted in Microsoft Excel and without protected/locked portions or other methods which prevent or do not facilitate expeditious pricing validation. PDF files and similarly constructed files are not acceptable.

Indicate source for CMS rate proposed (Identify source and Internet link): CMS Physician Fee Look-up Tool Overview of the Medicare Physician Fee Schedule Search | CMS Period of Performance:

Base Year - 10/13/2024 - 10/12/2025 Option Year 1 – 10/13/2025 - 10/12/2026 Option Year 2 – 10/13/2026 - 10/12/2027 Option Year 3 – 10/13/2027 - 10/12/2028 Option Year 4 – 10/13/2028 - 10/12/2029

Annual Cost

Total for each performance period: $__________ Total for base +4: $__________

Performance Work Statement for Ambulatory Eye Surgery Facility Services

1. GENERAL:

1.1. Services Provided: The Contractor shall furnish off-site clinical space which includes all surgical technicians, anesthesiologists, CRNAs, nurses and administrative personnel necessary to provide Ophthalmology surgery services to eligible beneficiaries of the Department of Veterans Affairs, Ralph H. Johnson Health Care System (hereinafter referred to as VAHCS). The Ralph H. Johnson VAHCS’s physician(s)’ and Ophthalmology Residents care shall cover the range of Ophthalmological Surgical services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by the American Academy of Ophthalmology.

1.2. Place of Performance: Contractor shall furnish services at a suitable, fully-equipped and staffed (other than the surgeon) outpatient eye surgery facility.

1.3. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority

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:

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. ACGME: Accreditation Council for Graduate Medical Education

1.5.2. ACLS: Advanced Cardiac Life Support

1.5.3. BLS: Basic Life Support

1.5.4. CDC: Centers for Disease Control and Prevention

1.5.5. CEU: Certified Education Unit

1.5.6. 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.

1.5.7. CME: Continuing Medical Education

1.5.8. CMS: Centers for Medicare and Medicaid Services

1.5.9. 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.

1.5.10. 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.

1.5.11. COS: Chief of Staff

1.5.12. CPARS: Contractor Performance Assessment Reporting System

1.5.13. 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.

1.5.14. DEA: Drug Enforcement Agency

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

1.5.16. FSMB: Federation of State Medical Boards

1.5.17. 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.

1.5.18. HHS: Department of Health and Human Services

1.5.19. HIPAA: Health Insurance Portability and Accountability Act

1.5.20. ISO: Information Security Officer

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

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

1.5.23. POP: Period of Performance

1.5.24. PPD: Purified Protein Derivative

1.5.25. PWS: Performance Work Statement

1.5.26. QA/QI: Quality Assurance/Quality Improvement

1.5.27. QASP: Quality Assurance Surveillance Plan

1.5.28. QM/PI: Quality Management/Performance Improvement

1.5.29. VAMC: VA Medical Center

1.5.30. 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.

1.5.31. VHA: Veterans’ Health Administration

1.5.32. VISN: Veterans Integrated Services Network

1.5.33. VistA: Veterans Information Systems Technology Architecture

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License: Ralph H. Johnson VAHCS’s ophthalmology physicians will cover the range of surgical Ophthalmology services covered in this contract and shall have a current license to practice medicine where services are being performed, as required by the Credentialing and Privileging department of Veteran Healthcare Administration. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Providers 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: Contractor’s Clincal Staff shall be Board Certified /Board Eligible and be currently certified in Basic Life Support (BLS) Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must always be kept up to date. Documentation verifying current certification shall be provided for each year of contract performance.

2.1.3. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Ralph H. Johnson VAHCS is responsible to ensure that proposed VA physician(s) possess the requisite credentials enabling the granting of privileges. No services shall be provided by any Ralph H. Johnson VAHCS physician(s) prior to obtaining approval by the Ralph H. Johnson VAHCS, Professional Standards Board, Medical Executive Board and Health Care System Director.

2.1.3.1. 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.

2.1.4. Technical Proficiency:

2.1.4.1. VA Provider(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read, and write English fluently. Upon request of the CO/COR providers must be able to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed.

2.1.4.2. Contractor’s Clincal Staff shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all Contractor’s 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.

2.1.5. Training (ACLS, BLS, EHR and VA MANDATORY): For informational purposes for the benefit of the Contractor’s Clincal Staff shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the Contractor’s Clincal Staff as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

ACLS/BLS

Active Threat Training

VA 24638

Blood Administration: Complications

VA 8563

Electronic Health Record (EHR)

· Module 1, Overview of the EHR: VA 4626778

· Module 2, Referral Entry and Initial Clinical Review: VA 4626779

· Module 3, Office of Community Care (OCC) Clinical Processing: VA 4626780

· Module 4, OCC Administrative Scheduling: VA 4626781

· Module 5, Closing the Referral: VA 4626782

· Module 6, Processing the RFS: VA 4626783

1 Hour

1 Hour

45 Minutes

1 Hour

30 Minutes

1 Hour

Government Ethics

VA 3812493

Hospice and Palliative Care for VA Clinicians

VA 3852303

Military Sexual Trauma (MST) for Medical Providers

VA 30925

(Test-out possible: VA31277)

Moderate Sedation In-Service Training

VA 32979

(Test out possible: VA 31266)

PACT Act 2022 Toxic Exposure Screening (TES)

VA 4634995

Patient Abuse

VA 1723349

Patient Rights

NFED 4651430

Patient Safety

VA 4647013

Prevention/Management of Disruptive Behavior/Violence Prevention Level I

VA 37659

Prevention of Workplace Harassment/No Fear Act

VA 20152

VA 45224

2 Hours 1 Hour

Suicide Prevention: Suicide Risk Management Training for Clinicians

VA 4554119

SUX Infection Control and Blood Borne Pathogens

VA 2051167

VA Core Values Training (ICARE Recommitment)

VA 3901227

VA Privacy and Information Security Awareness and Rules of Behavior

VA 10203

VHA MRI Safety Training Level 1 Training (if applicable: all who enter MRI suites)

VA 9696

VHA Privacy and HIPAA Focused Training

VA 20152

VISTA Imaging This course is located at:

http://vaww.visn23.med.va.gov/education/customcontent/CPRS/VID2/index.html?UID Once complete. Clinicians self-certify in TMS.

VA 4184270

Mission Act Eligibility Overview View short video located at link below:

https://youtu.be/z9ac0FqO8To

2.1.6. STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.): Contractor shall provide proof of the following for Contractor’s Clincal Staff within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Contractor shall provide statement that all required infection control testing is current, and that the contractor is compliant with OSHA regulations concerning occupational exposure to blood borne pathogens. The Contractor shall also notify the VA of any significant communicable disease exposures and the VA will also notify the contractor of the same, 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. Tests shall be current within the past year.

2.1.6.1. TUBERCULOSIS TESTING: If requested, Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s Clincal Staff 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.

2.1.6.2. MEASLES, MUMPS, & RUBELLA TESTING: If requested, Contractors shall provide proof of immunity for all Contractor’s Clincal Staff {This is applicable to all health care workers}.

2.1.6.3. VARICELLA: If requested, Contractors shall provide proof of immunity for all Contractor’s Clincal Staff {This is applicable to all health care workers}.

2.1.6.4. ACELLULAR PERTUSSIS: If requested, Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor’s Clincal Staff {This is applicable to all health care workers}.

2.1.6.5. INFLUENZA: If requested, Contractors shall provide proof that all Contractor’s Clincal Staff have received the annual Influenza vaccine unless it is contraindicated. If the Contractor’s Clincal Staff 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}.

2.1.6.6. Not Used

2.1.6.7. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: If requested, Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s Clincal Staff {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.

2.1.6.8. The VA 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 by CDC: Infection control in healthcare personnel : infrastructure and routine practices for occupational infection prevention and control services OCT 2019) https://stacks.cdc.gov/view/cdc/82043. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.7. 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 facilities). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.8. DEA: Contractor shall provide copy of current DEA certificate, if required.

2.1.9. Conflict of Interest:

2.1.9.1. The Contractor and all Contractor’s Clincal Staff 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.

2.1.9.2. 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. 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 (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document. Those involved with the scheduling activities for Surgical Services (Ophthalmology services MSA, Chief Ophthalmology) or other providers or staff involved with scheduling activities must sign a conflict-of-interest statement.

2.1.10. Citizenship related Requirements:

2.1.10.1. 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;

2.1.10.2. 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.

2.1.10.3. 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.

2.1.10.4. 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.

2.1.10.5. 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.

2.1.11. 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.

2.1.11.1. 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.

2.1.11.2. 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 Facility 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. Clinical/Professional performance monitoring and review of all VA clinical personnel for quality purposes will be managed by the Ralph H. Johnson VAHCS 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 Clincal Staff 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 Clincal Staff shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.7. No Employee status: The Contractor shall be responsible for protecting Contractor’s Clincal Staff 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 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.

2.9.2. 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 30 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.

2.9.2.1. 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 30 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.

2.9.2.2. For temporary substitutions where the key person shall not be reporting to work for 1 consecutive work days 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.

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

2.9.2.4. 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 Clincal Staff 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: Normal business hour for Ralph H. Johnson VAHCS is 7:30 AM to 4:30 PM. All surgeries are performed at the contractor’s Ambulatory Surgical Center. Surgery is generally scheduled on Tuesdays and Thursdays at the Contractor’s Facility and scheduled in concert with the contractor’s surgical schedulers.

3.2. Clinic or OR Schedule: Clinic on Wednesdays, OR times per OR block schedule and emergency OR coverage 24/7/365.

3.2.1. Patients must be seen by a Contractor’s Clincal Staff off-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. Written documentation associated with each visit shall be available to the VA within 24 hours of each visit.

3.2.2. When requested, such written documentation shall be provided to the VA within two (2) hours.

3.2.3. Professional services shall be provided by Ralph H. Johnson VAHCS attending physicians,

3.2.4. Contractor’s Clincal Staff 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 07:30am thru 04:30pm.

3.2.5. Off-hours Coverage: No provision for the Contractor to provide off-hours coverage is required.

3.2.6. On-call: No provision for the Contractor to provide on-call coverage is required.

3.3. 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.

3.4. Cancellations: Clinic cancelations will be requested and approved by the Chief of Surgical Services no later than 45 days prior to clinic date.

4. CONTRACTOR RESPONSIBILITIES

4.1. All services shall be performed off-site at the Contractor’s facility. Contractor shall provide professional and technical services to include materials, supplies, equipment, and qualified supervision specified herein.

4.2. Clinical Personnel Required:

4.2.1. The Contractor shall provide Contractor’s staff/physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.2.2. VAMC stalff/physician(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices.

4.3. Management and Supervision:

4.3.1. The Contractor shall be responsible for supervising the daily administrative and Anesthesia services provided under this contract by the Contractor’s staff.

4.3.2. The Contractor shall have written policies and procedures regarding staff credentials and Privileging.

4.3.3. The Ralph H. Johnson VAHCS will provide to the Contractor policies, procedures, and processes necessary to allow cooperative functioning between the agency and Ralph H. Johnson VAHCS. Updates and refreshers will be provided to the Contractor upon request and when policy procedures or process changes.

4.3.4. The Contractor shall complete background investigations to ensure that employees do not have a record of criminal offenses or substantiated incidents of patient abuse; and, if required to perform their duties, employees are properly licensed and insured to operate motor vehicles.

4.4. Standards of Care: The Ralph H. Johnson VAHCS will provide the Ophthalmology physician(s)’ and Ophthalmology Residents that will cover the range of Ophthalmological Surgical services. The contract physician(s)’ care shall cover the range of Anesthesiology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:

4.5. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

4.6. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and,

4.7. The requirements contained in this PWS

4.8. Anesthesiology: Anesthesia conversion rate is the Medicare rate and is currently $20.24 per unit. This rate is the same for all procedures listed in the schedule of services. Anesthesia fees are determined by a base number of units for a procedure and time units (1 unit for every 15 mins) this total is then multiplied by the unit value to get the charge or the payment.

4.9. EDUCATION AND SUPERVISION OF HEALTH PROFESSIONS TRAINEES (HPTS): Education and Supervision of HPTs: Per the guidelines dictated by the VA Office of Academic Affiliations (OAA) Directives and health professions education (HPE) accrediting agencies, the VAMC Physicians performing the services at the Contractor’s facility will be responsible for the education and supervision of health professions trainees. VAMC physicians shall be responsible for:

4.9.1. Education of HPTs: Contractor shall provide an academic environment conducive to the training and professional development of HPTs rotating through the Ophthalmology section of Surgical Service in accordance with current VA, accrediting agency, and JC equivalent compliance guidelines. VAMC physicians shall meet the educational objectives of the training program as outlined in the program letter of agreement. Contractor may provide practice-based learning opportunities and/or didactic teaching to HPTs.

4.9.2. Supervision of HPTs: VAMC physicians shall provide supervision of HPTs in accordance with current VA, accrediting agency, and JC equivalent compliance guidelines. VAMC Physicians shall ensure HPT supervision in accordance with VHA Directive 1400.01, Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents, and VHA Handbook 1400.04, Supervision of Associated Health Trainees. VAMC physicians shall be responsible for overseeing HPTs’ acquisition and demonstration of knowledge, skills, attitudes, and professionalism while the HPT participates in patient care. VAMC physicians shall be responsible for periodic evaluation of HPTs and the training program as required by accrediting agencies and program letters of agreement. VAMC physicians shall be responsible for ensuring that all notes and encounters are completed, clearly demonstrate the involvement of the supervising practitioner, and comply with VA standards, equivalent to JC compliance guidelines, standard commercial practice and guidelines established by VHA Directive 1400.01 and VHA Handbook 1400.04. The VAMC physicians shall also perform any administrative duties relative to documentation of HPT training, as required and directed by the VA COS or designated representative.

4.10. Medical Records

4.10.1. Authorities: Contractor’s Clincal Staff providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and…