Statement of Work- Medical Staff Professional Support Services.pdf

DRAFT

Statement of Work (SOW)

Medical Staff Professional Support Services

1. PROJECT TITLE: The Indian Health Service (IHS)/Albuquerque Area, Albuquerque Service

Unit (ASU) has a requirement for medical provider credentialing services located in

Albuquerque, New Mexico. The Government contemplates to award a single award resulting from this solicitation.

2. BACKGROUND/PURPOSE: An effective, timely, and accurate credentialing and privileging service to ensure the ASU provides safe patient care. The purpose is to ensure that clinical staff

(physicians, advance practice providers, allied health professionals, etc.) remain properly credentialed, privileged, and compliant with relevant regulatory, payer, and organizational standards, the contractor shall provide medical staff credentialing and privileging support services.

3. SCOPE: The services sought includes the appropriate credentialing and privileging of medical and allied professional staff of permanent, contractors, students, volunteers, and telehealth providers. Services provided must meet the requirements specified in the medical staff bylaws, Accreditation Association for Ambulatory Health Care (AAAHC) accreditation standards and all other applicable Federal, State and other regulatory agencies. Awardee must be familiar with credentialing and privileging requirements for family medicine, pediatrician, internal medicine physicians, advanced practice nurses, dentists, psychologists, psychiatrists, and telehealth providers.

4. HOURS: Requires 32 hours per week/52 weeks a year, Monday through Friday 0800-1630, excluding all federal holidays.

5. APPLICABLE DOCUMENTS: ASU Medical Staff Bylaws; Governing Board Bylaws;

AAAHC requirements; CMS requirements

6. TASKS: The Contractor shall provide:

a. Knowledge and familiarity with electronic credentialing software programs, such as

MD Staff

b. Clear communication on all credentialing activities with the facility Clinical Director, Albuquerque Area Credentialing Consultant, and CEO

c. Coordinates the initial and reappointment application process for all credentialed providers and reviews supporting documentation.

d. Initiates and accepts all applications and verifies education, training, licensure, specialty boards, National Practitioner Data Bank reports, and professional references.

e. Ensures the clinical privileges requested are consistent with education and training requirements within their specific specialty. Assists in development and maintenance of privileging forms, templates, and criteria (in consultation with medical staff leadership) consistent with bylaws, regulatory, and accrediting standards.

f. Assembles all verified information and prepares the credentialing file for the Medical

Executive Committee and Governing Board, within the timeframes dictated by the bylaws of the organization.

g. Monitor and track the expiration dates of professional licensure, DEA licensure, prescribing licensure, basic life support certification, and obtaining primary source verification on all initial applications, reappointment applications and upon renewal of license. Notifies the medical staff leadership on any adverse findings.

h. Notifies each credentialed staff member approximately 3 months before the expiration of the individual’s term of appointment of the need to begin and complete the reappointment process.

i. Provide monthly performance reports including credentialing volume, cycle times, backlog, outstanding tasks, risk areas, and recommended process improvements to the

Clinical Director.

j. Support internal or external audits of credentialing files; provides files, documentation, and explanations as required. Assist in regulatory reviews (CMS or

AAAHC) as needed.

k. Follows the Privacy Act and service unit bylaws, rules, and regulations pertaining to confidentiality and protection of the material and maintenance of the files.

7. GOVERNMENT-FURNISHED EQUIPMENT AND INFORMATION: Because the work will be done remotely, there will be no Government furnished equipment. The Government will provide access to the credentialing software program. The contractor will provide any computer workstations necessary to complete the work.

8. PLACE OF PERFORMANCE: The contractor will be working remotely.

9. PERIOD OF PERFORMANCE: The period of performance is for a one-year base period, plus four one-year option periods if exercised.

10. SECURITY: The work stated in this SOW requires IT clearance for access to email and credentialing software program. The contractor does not need access to the facility or to patient health information.

11. The contractor will comply with the following listed regulations:

a. Privacy Act, 5 U.S.C. 552a- Office of Privacy and Civil Liberties | Privacy Act of

b. Health Insurance Portability and Accountability Act (HIPAA)- eCFR :: 45 CFR Part

164 -- Security and Privacy

c. CFR 42 Part 2- eCFR :: 42 CFR Part 2 -- Confidentiality of Substance Use Disorder

Patient Records

12. Indemnification and Governing Law- Indemnification, Liability, Statue of Limitations: Any provisions in the Terms of Service (TOS) related to indemnification and filing deadlines are hereby waived, and shall not apply except to the extent expressly authorized by law. Liability for any breach of the TOS as modified by this amendment, shall be determined under the Federal https://www.justice.gov/opcl/privacy-act-1974 https://www.justice.gov/opcl/privacy-act-1974 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164 https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164 https://www.ecfr.gov/current/title-42/chapter-I/subchapter-A/part-2 https://www.ecfr.gov/current/title-42/chapter-I/subchapter-A/part-2

Tort Claims Act, or other governing federal authority. Federal statute of limitations provisions shall apply to any breach or claim.

Governing Law: Any arbitration, mediation or similar dispute resolution provision in the TOS is hereby deleted. The TOS and this amendment shall be governed by and interpreted and enforced in accordance with the laws of the United States of America without reference to conflict of laws. To the extent permitted by federal law, the laws of the State of New Mexico will apply in the absence of applicable federal law.