VA244-17-R-1154-001.docx

VA244-17-R-1154

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.

DUNS:

DUNS+4:

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. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

VA244-17-R-1154

04-23-2018 Heather Krah 412-822-3773 06-01-2018

2 PM

00244 Department of Veterans Affairs Network Contracting Office 4 1010 Delafield Road Pittsburgh PA 15215-1802 621111 $11 Million X N/A X VA Pittsburgh Healthcare System University Drive Division University Drive Pittsburgh PA 15240 00244 Department of Veterans Affairs Network Contracting Office 4 1010 Delafield Road Pittsburgh PA 15215

Austin Payment Center Department of Veterans Affairs PO Box 149971 Austin TX TX

(877) 353-9791

(512) 460-5545 See CONTINUATION Page Neurophysiology Services See continuation page for schedule of services.

See CONTINUATION Page X X X Table of Contents

D.1 ATTACHMENT 1 CREDENTIALING.

D.2 ATTACHMENT 2 QUALITY MANAGEMENT SYSTEM.

D.3 ATTACHMENT 3 QASP.

D.4 ATTACHMENT 4 CONTRACT PHYSICIAN HEALTH REQ.

D.5 ATTACHMENT 5 IMMIGRATION FORM.

D.6 ATTACHMENT 6 SAMPLE QUESTIONNAIRE COVER LETTER.

D.7 ATTACHMENT 7 NEUROPHYSIOLOGY PERFORMANCE QUESTIONNAIRE

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:

b. GOVERNMENT: Contracting Officer 36C244 SHAWN SMITH 412-822-3785 Department of Veterans Affairs Network Contracting Office 4 1010 Delafield Road

Pittsburgh PA 15215-1802

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

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.

Austin Payment Center Department of Veterans Affairs PO Box 149971 Austin TX TX ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 Price Cost Schedule The Contractor shall furnish all personnel to provide services necessary to perform Surgical Neurophysiologist Physician Services (onsite at the VAMC or offsite remotely at the contractor’s place of business) and onsite Neurodiagnostic Technologist to eligible beneficiaries of the Department of Veterans Affairs Medical Center, VA Pittsburgh Healthcare System, University Drive, Pittsburgh, PA 15240 (hereinafter referred to as VAMC). The Contractor shall specify/ identify in their proposal if Neurophysiologist Physician Services are going be performed on site at the VA or off site at the Contractor place of Business. The base period of the contract shall cover a period of five (5) years and five (5) one-year option periods. The contract physician(s)’ care shall cover the range of Neurophysiology services to support the operative surgeries for the medical specialties Neurosurgery, Vascular Surgery, Orthopedic Surgery, and Cardiac 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 American Board of Neurophysiologic Monitoring/American Clinical Neurophysiology Society.

http://abnm.info/ http://www.acns.org/practice/guidelines Period of Performance: 10/1/2018 – 9/30/2028 Place of Performance: VA Pittsburgh Healthcare System, University Drive C, Pittsburgh, PA 15240 Pricing Instructions:

The offeror is instructed to propose pricing per case for each CLIN and, if necessary, associated sub-CLINs.

The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and/or Section D- Contract Documents, Exhibits, or attachments, VA Directive 1663 Appendix B.

The Contractor shall propose a minimum of 2 physicians and 6 technologists to be credentialed and be available for scheduling to meet the requirements of the contract.

Ordering Procedures:

For the purpose of this contract, the Contractor will be issued a task order annually. When services are required under this task order the Operating Room Program Support Clerk will contact the contractor one day prior to any scheduled procedure.

Note: The Government shall order the below specified minimum contract value of services and may order up to and including the below specified maximum contract value of services through task orders under this basic IDIQ contract throughout the duration of the contract to include all option periods (if applicable). The maximum amount under this contract is not guaranteed.

IDIQ contract Minimum $52,000.00 IDIQ contract Maximum $1,210,950.00

Contract Period: Base POP Begin: 10-01-2018 POP End: 09-30-2023

Contract Period: Base POP Begin: 10-01-2018 POP End: 09-30-2023

Contract Period: Base POP Begin: 10-01-2019 POP End: 09-30-2020

Contract Period: Base POP Begin: 10-01-2020 POP End: 09-30-2021

Contract Period: Base POP Begin: 10-01-2021 POP End: 09-30-2022

Contract Period: Base POP Begin: 10-01-2022 POP End: 09-30-2023

Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024

Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025

Contract Period: Option 3 POP Begin: 10-01-2025 POP End: 09-30-2026

Contract Period: Option 4 POP Begin: 10-01-2026 POP End: 09-30-2027

Contract Period: Option 5 POP Begin: 10-01-2027 POP End: 09-30-2028

VA244-17-R-1154

Page 1 of Page 1 of

B.3 PERFORMANCE WORK STATEMEMENT

The Contractor shall furnish all personnel to provide services necessary to perform Board Certified Neurophysiologist Physician Services (either onsite at the VAMC or remotely at the contractor’s place of business) and onsite Board Certified Neurodiagnostic Technologist services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Pittsburgh, Healthcare System, University Drive, Pittsburgh, Pennsylvania 15240 (hereinafter referred to as VAMC). The contract Board Certified Neurophysiologist physician (s)’ care shall cover the range of Neurophysiology services to support the operative surgeries for the medical specialties Neurosurgery, Vascular Surgery, Orthopedic Surgery, and Cardiac 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 American Board of Neurophysiologic Monitoring/American Clinical Neurophysiology Society.

http://abnm.info/ https://www.acns.org/practice/guidelines Place of Performance: Services shall be provided onsite, VAMC Pittsburgh Healthcare System, University Drive, Pittsburgh, Pennsylvania 15240

Performance Work Statement for either Onsite or remote Board Certified Neurophysiologist Physician Services and onsite Board Certified Neurodiagnostic Technologist

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Certified Neurophysiologist Physician Services (either onsite or remotely at the contractor’s place of business) and onsite Board Certified Neurodiagnostic Technologist in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the VA Pittsburgh Healthcare System.

1.1. Place of Performance - Pittsburgh, Healthcare System, University Drive, Pittsburgh, Pennsylvania 15240.

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

1.3. Definitions/Acronyms- 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.

1.3.1. ABNM: American Board of Neurophysiologic Monitoring. http://abnm.info

1.3.2. ABNS: American Board of Neurological Surgery http://www.abns.org/content/default.asp

1.3.3. ABPN: American Board of Psychiatry and Neurology http://www.abpn.com

1.3.4. IONM – Intraoperative neurophysiological monitoring

1.3.5. SSEPs - Somatosensory evoked potentials (SSEPs)

1.3.6. TcMEPs – Transcranial motor evoked potentials

1.3.7. EMGs - Electromyography

1.3.8. EEG - Electroencephalography

1.3.9. ACGME: Accreditation Council for Graduate Medical Education

1.3.10. ACLS: Advanced Cardiac Life Support

1.3.11. AOD: Admitting Officer of the Day

1.3.12. BLS: Basic Life Support

1.3.13. CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation

1.3.14. CDC: Centers for Disease Control and Prevention

1.3.15. CDR: Contract Discrepancy Report

1.3.16. CEU: Certified Education Unit

1.3.17. CME: Continuing Medical Education

1.3.18. CMS: Centers for Medicare and Medicaid Services

1.3.19. Contracting Officer (CO) – 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.

1.3.20. Contracting Officer’s Representative (COR) – 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.

1.3.21. COS: Chief of Staff

1.3.22. CPARS: Contractor Performance Assessment Reporting System

1.3.23. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.3.24. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.3.25. DEA: Drug Enforcement Agency

1.3.26. ED: Emergency Department

1.3.27. FSMB: Federation of State Medical Boards

1.3.28. HHS: Department of Health and Human Services

1.3.29. HIPAA: Health Insurance Portability and Accountability Act

1.3.30. HR: Human Resources

1.3.31. ISO: Information Security Officer

1.3.32. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.3.33. MOD: Medical Officer of the Day

1.3.34. 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).

1.3.35. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.3.36. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.3.37. NP: Nurse Practitioner

1.3.38. NPPES: National Plan and Provider Enumeration System

1.3.39. PA: Physician Assistant

1.3.40. PALS: Pediatric Advanced Life Support

1.3.41. POP: Period of Performance

1.3.42. PPD: Purified Protein Derivative

1.3.43. PWS: Performance Work Statement

1.3.44. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.3.45. QASP: Quality Assurance Surveillance Plan

1.3.46. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.3.47. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in Michigan and Indiana.

1.3.48. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.3.49. VetPro: a federal web-based credentialing program for healthcare providers.

1.3.50. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA medical Center, for purposes of this contract, this term shall mean the VA Pittsburgh Healthcare System Medical Center.

1.3.51. VAPHS - VA Pittsburgh Healthcare System

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License - Contract 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. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract 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 contract Neurophysiologist physician(s) shall be board certified by Certification in American Board of Psychiatry and Neurology http://www.abpn.com . The Neurodiagnostic Technologist must have a minimum of American Board of Registered Electroneurodiagnositc Technologist (ABRET) certification (http://www.abret.org) for Neurophysiologic Intraoperative Monitoring (CNIM).This technical certification is intended for technologists who work under supervision by a neurophysiologist or neurologist. 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. Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract physician(s) prior to obtaining approval by the (VA Pittsburgh Healthcare System) Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.3.1. If a contract physician(s) is 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 – Contract Board Certified neurophysiologist physician(s) and Board Certified neurodiagnostic Technologist(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract physician(s) and contract 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. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contract 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 contract physician(s).

2.1.6. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contract Board Certified neurophysiologist physician (s) and Board Certified neurodiagnostic Technologist (s) as required by the VA on an annual basis. VA Privacy and Information Security Awareness and Rules of Behavior and HIPAA and Privacy training courses taken on an annual basis.

2.1.7. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for Board Certified neurophysiologist physician(s) and Board Certified neurodiagnostic technologist (s) 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.

2.1.7.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract Board Certified neurophysiologist physician (s) and Board Certified neurodiagnostic technologist (s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.

2.1.7.2. RUBELLA TESTING: Contractor shall provide proof of immunization for all contracts Board Certified neurophysiologist physician (s) and Board Certified neurodiagnostic technologist (s) for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.

2.1.7.3. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract Board Certified neurophysiologist physician (s) and Board Certified neurodiagnostic technologist (s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC 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.

2.1.8. 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 the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.9. DEA (as required) - Contractor shall provide copy of current DEA certificate.

2.1.10. Conflict of Interest: The Contractor and all contract Board Certified neurophysiologist physician(s) and Board Certified neurodiagnostic technologist(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 (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.11. Citizenship related Requirements:

2.1.11.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non- immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;

2.1.11.2. 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.

2.1.11.3. 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 service 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.

2.1.11.4. 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.

2.1.11.5. 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.

2.1.12. 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.

2.1.12.1. 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 contract physicians (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.

2.1.12.2. 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 Direction: 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 Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract will be provided by the VAMC COS and/or the Chief of the Service or his designee. A 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 contract Board Certified neurophysiologist physician (s) and Board Certified neurodiagnostic technologist (s) shall not be considered VA employees for any purpose.

2.4. Inherent Government Functions: Contractor and Contract Board Certified neurophysiologist physician (s) and Board Certified neurodiagnostic technologist (s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.5. No Employee status: The Contractor shall be responsible for protecting Contract Board Certified neurophysiologist physician (s) and Board Certified neurodiagnostic technologist (s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.5.1. Workers’ compensation

2.5.2. Professional liability insurance

2.5.3. Health examinations

2.5.4. Income tax withholding, and

2.5.5. Social security payments.

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract Board Certified neurophysiologist physician(s) and Board Certified neurodiagnostic technologist (s). When a Contractor or contract Board Certified neurophysiologist 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 contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.7. Key Personnel:

2.7.1. The number of required Board Certified Neurophysiologist physician(s) available (either onsite or remotely at the contractor’s place of business) and Board Certified Neurodiagnostic Technologist onsite on a daily basis is based upon the surgical case workload for the day and 2.00 (1.00 Board Certified Neurophysiologist and 1.00 Board Certified Neurodiagnostic Technologist as defined in paragraph Hours of Operation in this section.

2.8. Emergency Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel for both the Board Certified Neurophysiologist physician (s) and the Board Certified Neurodiagnostic technologist(s) unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar days 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 15 calendar days prior to making any permanent substitutions.

2.8.1. 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.

2.8.2. For temporary substitutions where the key person shall not be reporting to work for three

(3) 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.

2.8.3. 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 contract physician (s), s/he may request, without cause, immediate replacement of said contract physician (s).

2.8.4. The CO and COR shall deal with issues raised concerning Contract physician (s) conduct. The final arbiter on questions of acceptability is the CO.

2.9. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the Board Certified Neurophysiologist contract physician (s) and Board Certified Neurodiagnostic Technologist(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: 6:30 am – 7:00 pm Monday - Friday

3.2 Work Schedule: 6:30 am – 7:00 pm Monday – Friday

3.3 Services Required: Board Certified Neurophysiologist and Board Certified Neurodiagnostic Technologist Per-Case

3.3.1. Patient history and procedure details must be reviewed by a contract Board Certified Neurophysiologist physician (s) (either onsite or remotely at the contractor’s place of business). The patient must be seen by a Board Certified Neurodiagnostic Technologist(s) onsite at (VA Pittsburgh Healthcare System) preoperatively before surgery begin in accordance with VA Rules and Regulations on surgical operation times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.

3.3.2. Contract Board Certified Neurophysiologist Physician (s) shall be immediately available within 2.00 minutes to support Board Certified Neurodiagnostic Technologist(s) present in the operating room. Simultaneous care of patients with 1:1 ratio is required. The Intraoperative Neurophysiological Monitoring (IONM) data interpretation shall be performed in real time by a Board Certified neurophysiologist either in the operating room (onsite), or remotely at the contractor’s location. The contractor will be required to utilize their own secure internet connection e.g. (USB 4G device) with wireless and encryption capabilities. Data from the neurophysiology monitoring is transmitted via contractor’s VPN (Virtual Private Network). Non- identifying patient information is transferred through the VPN system. Contractor must be compliant with ALL HIPAA rules. The Board Certified neurophysiologist interprets the neurophysiology patient data in “real time” and conveys these findings to the Board Certified neurodiagnostic technologist in the operating room who in turn will relay this information to the surgeon. The Board Certified neurophysiologist will interpret and communicate baseline results before start of the procedure. The Board Certified neurophysiologist will be available for direct discussion with surgeons when requested during the procedure. The operating hours may be revised, as deemed appropriate for patient care by the Chief of Staff (COS). Currently, normal operating room hours are 6:30 am – 7:00 pm.

The contractor shall provide comprehensive neurophysiology services for operative procedures listed in the Schedule of Services and Prices/Costs (the Schedule) at the VAPHS, University Drive, Pittsburgh, PA 15240. Services shall be performed in accordance with the requirements specified in this contract, and in accordance with the technical/logistical approach presented by the contractor and agreed to by VAPHS. The contractor’s group performing services will be responsible for a full spectrum of direct intraoperative monitoring, analysis, and reporting of findings to surgical staff as well as documentation in the patient medical record. The VAPHS requires that intraoperative feedback be provided during the actual performance of the procedure being monitored; such ‘real time’ feedback will be delineated in the contractor’s technical/logistical approach. The services to be performed by the contractor will be under the direction of the operating surgical team working under the oversight of the Chief, Surgery Service of VAPHS. Contract monitoring of authorized procedures shall be accomplished through records reviewed by the Contracting Officer’s Representative (COR). The Chief, Surgery Service will be responsible for monitoring the professional components of the contract via a designated clinical representative. In the event that contracted services do not meet quality and/or safety expectations, the Chief, Surgery Service or designated clinical representative will notify the COR who will then notify the Contracting Officer as noted in 5.2.

The VAPHS Operating Room Program Support Clerk will contact the contractor between the hours of 12:00 Noon and 3:00 p.m. Monday through Friday (or the contractor may contact the VAPHS Operating Room Program Support Clerk at (412) 360-6360), the day before scheduled procedure(s), to determine the need for neurophysiology services for scheduled cases. The VAPHS will make every effort to provide at least a 2-day notice for scheduled cases.

The contractor group must be available for emergency coverage 24 hours per day, 7 days per week. The VAPHS will not pay for on-call or standby time, and will only pay for actual services performed. For emergent or unscheduled cases during weekday nights, weekends, or holidays, the VAPHS Operating Room staff will contact the designated contractor staff person via an on-call pager. The contractor group must be available “on- call” to provide monitoring services within one hour of actual contact by VA Pittsburgh Healthcare System, except where inclement weather, natural disaster, or other force major prevents responding in such a time period. Anticipated volume of emergency cases is one

(1) Per month.

PHYSICIAN SERVICES: All services provided by the group must be overseen in real time by a VA credentialed physician.

NEUROPHYSIOLOGIST SERVICES: The Board Certified neurophysiologist will directly supervise the work of all Board Certified neurodiagnostic technologist staff and will provide supervision of monitoring services intraoperatively. The Board Certified neurophysiologist will provide diagnostic evaluation, intraoperative neurophysiological monitoring. The Board Certified neurophysiologist will prospectively determine monitoring modalities for each case and communicate this to the Board Certified neurodiagnostic technologist, and the Board Certified neurophysiologist will determine when specific cases require additional on-site staffing. The Board Certified neurophysiologist providing coverage during a case will make judgments regarding intraoperative readings during that case and will remain in communication with the assigned Board Certified neurodiagnostic technologist intraoperatively regarding his/her clinical findings. The Board Certified neurophysiologist will provide all necessary direction to the Board Certified neurodiagnostic technologist during the entirety of each surgical procedure and will complete and will fax a formal Intraoperative Case Report to the Surgical Service Line Business Manager within 2 weeks of the procedure. The Intraoperative Case Report will then be scanned into the patient’s electronic medical record by the VAPHS medical record staff. Significant abnormalities noted during procedures should be documented in the electronic health record on the same calendar day as a brief summary to support post-operative clinical care coordination. The contractor’s Board Certified neurophysiologist shall provide this documentation by faxing it to the Surgical Service Line Business Manager. The documentation of significant abnormalities noted during the procedures will be scanned into the patient’s electronic medical record by the VAPHS medical record staff. The Board Certified neurophysiologist will also be required to participate in any VAPHS quality improvement activities as requested.

NEURODIAGNOSTIC TECHNOLOGIST SERVICES: Under supervision, Board Certified neurodiagnostic technologist staff will perform multiple modality evoked potentials on patients in the operating room at the VAPHS. The Board Certified neurodiagnostic technologist will be responsible for setting up all necessary OR equipment and supplies for neurophysiological intraoperative monitoring and the placement of suitable electrodes on predetermined measured positions on the patient’s body. The Board Certified neurodiagnostic technologist will be sufficiently knowledgeable to test equipment prior to use and to make any adjustments in the equipment settings that are required. The Board Certified neurodiagnostic technologist will select predetermined electrode combinations as well as non- standard assortments as necessary. The Board Certified neurodiagnostic technologist will obtain standard recordings and report on-going status of patient’s nervous system to the surgeon. The Board Certified neurodiagnostic technologist will also maintain constant communication with a supervisory Board Certified neurophysiologist during each operative procedure and will accept direction from the Board Certified neurophysiologist. Under the direction of the Board Certified neurophysiologist supervisor the Board Certified neurodiagnostic technologist will relay information to the surgeon. The Board Certified neurodiagnostic technologist will recognize artifacts in the data and differentiate them from evoked potential patterns and take appropriate steps to eliminate them. They will obtain patient medical information when requested and will translate test results from computer files to a hard copy report for physician interpretation. The Board Certified neurodiagnostic technologist staff will also be responsible for removing electrodes post procedure and returning equipment if owned by VAPHS to specified locations or remove the contractor’ supplied equipment from the operating room upon completion of each procedure.

At all times during procedures in the operating room, the ratio of Board Certified neurodiagnostic technologist to patient will be 1 to 1.

EQUIPMENT: VAPHS will not procure, or provide separate compensation for contractor’s use of, any equipment required to perform services under this contract. Contractor may utilize *existing VAPHS monitoring equipment and software, or may provide and utilize its own equipment and software if preferred, so long as its efficacy and reliability can be evidenced. VAPHS will provide hardware and expendable supplies used in the VAPHS operating room for the VAPHS equipment owned (*Neuro 5 – Cube).

3.3.3. Off-hours Coverage: Contractor must make the contract Board Certified Neurophysiologist physician (s) and Board Certified Neurodiagnostic Technologist (s) available on-call during all hours when the (VA Pittsburgh Healthcare System) operating room is closed, including evenings, weekends and holidays. The Contractor must ensure it is not providing concurrent on-call duty to both VA and other community health care facilities for the same period of time.

3.3.3.1. On-call contract Board Certified Neurophysiologist physician(s) must be available at all times for phone consultations with VA residents and physicians.

3.3.3.2. Physician must be available by phone within 15 minutes, available to provide clinical service within 60 minutes.

3.4. 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

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared by the President of the United States to be a national holiday.

3.5. Cancellations: Unless a state of emergency has been declared or surgeries are otherwise cancelled by the VA Pittsburgh Healthcare System, the Contractor shall be responsible for providing services.

3.5.1. Absences – The payment for any leave, including sick leave, holiday, or vacation time is the responsibility of the Contractor and is not reimbursable under this contract. Appropriate coverage as per contract terms and conditions must be supplied by the Contractor. The Contractor’s Board Certified neurophysiologist and Board Certified neurodiagnostic technologist must be present at the VAPHS and must be actually performing the required services or performing administrative duties associated with this contract.

4 CONTRACTOR RESPONSIBILITIES

4.1 Clinical Personnel Required: The Contractor shall provide contract Board Certified Neurophysiologist physician (s) and Board Certified Neurodiagnostic Technologist (s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.2 Standards of Care: The contract Board Certified Neurophysiologist physician (s)’ care shall cover the range of Neurosurgery, Orthopedic, Cardiac Surgery, and Vascular 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 TJC, VA and national standards as established by:

4.2.1 Certification in American Board of Psychiatry and Neurology http://www.abpn.com

4.2.2 Neurophysiologic Intraoperative Monitoring (CNIM) from the American Board of Registered Electroneurodiagnostic Technologist (http://www.abret.org).

4.2.3 This technical certification intended for technologists who work under supervision by a…