VA263-16-R-0748-00001002.pdf

D.9

VA263-16-R-0748

Interventional Radiology Physicians Solicitation - Questions and Answers

Question 1: Does this requirement involve teleradiology services in order to perform Consultations? If so would the Contractor be required to provide secure lines of communication or specialized software in order to effectively facilitate the review of radiological documents (i.e. X-Rays/Sonograms)? In addition, would the contractor be responsible for ensuring that consultations are in compliance with all Hippocratic laws such as standards for information transactions and data elements (42 U.S. Code § 1320d–2)?

Answer 1:

No teleradiology services are required. All services will be performed on-site at Minneapolis VA Medical Center, Minneapolis, Minnesota.

The Contractor must comply with documentation requirements and ensure that all consultations comply with all Hippocratic laws such as standards for information transactions and data elements.

Question 2: What activities are involved in the two, half-day consultation clinics?

Answer 2: Interviewing and examining referred patients to determine if they are candidates for Interventional Radiology procedures.

Question 3: What are the diagnostic radiologist responsibilities in regards to vascular ultrasound (ex. UEV for DVT, LEV for DVT) and CTA?

Answer 3: Diagnostic Radiologists are responsible for Vascular ultrasound for DVT, carotids, AAA screening, and shared responsibility for venous studies; CTA for PE and cardiac studies. The IR Physicians are responsible for all other vascular ultrasound and CTAs.

Question 4: Does the call include any Diagnostic Radiology responsibilities? Does the call include diagnostic radiology procedures, for example CT or ultrasound guided procedures?

Answer 4: Interventional Radiology call includes everything requiring a needle (including paracentesis, thoracentesis, abscess drainage, chest tube placement, G-tube replacement, joint aspiration, and lumbar punctures under fluoro guidance).

Question 5: All of our IR doctors treat stroke. Treatment of intracranial aneurysms and intracerebral tumors is not performed by IR doctors. Can you please clarify this?

Answer 5: See Revised PWS Section 4.3.6.1. Treatment of Intracerebral Thrombosis, Intracerebral AVM, Intracerebral Aneurysm and Intracerebral Tumors have been removed from Scope of Care.

Question 6: Surgeons perform percutaneous cholesystectomy (removal of gallbladder). IR doctors perform percutaneous cholecystostomy. Can you please clarify? Please clarify the specific type and number of CME hours required for each doctor.

Answer 6: See Revised PWS Section 4.3.6.1. correcting Cholesystectomy to Cholecystostomy.

15 hours of CME are required for each physician in vascular US every 3 years to maintain departmental accreditation with the IAC.

75 hours of CME are required for each physician in IR every 3 years to maintain personal MOC in IR with the ABR.

Question 7: If we deliver a hardcopy and a .pdf version of our response, do you still require a copy on CD-ROM?

Answer 7: Yes, a CD-ROM is required with the hard copy proposals. See 52.212.1 Proposal Preparation Instructions requiring a CD-ROM.

Question 8: Can you provide the following for each of the past two years?

a. IR volumes by CPT

b. Overnight call volume

c. Weekend call volume

Answer 8:

a. See Reports following Answer 19 below.

b. Approximately 2-3 times per year. Note: In 2016, one GI bleed and one emergent nephrostomy placement (PNT) occurred.

c. 50% of weekends, but these are frequently simple cases such as thoracentesis

(very rarely both days unless a lytics case is going).

Question 9: COVERAGE FOR VA PROVIDER:

At the top of page 11, it talks about the VA provider working Thursdays and Fridays. Then, it indicates she has 83.2 hours of leave. Please clarify. Does that mean we are expected to provide (per page 18) 2 MDs every Monday, Tuesday and Wednesday plus another 10 or 11 days on Thursdays or Fridays to cover her leave?

Answer 9: Yes, that means the Contractor is expected to provide 2 MDs every Monday, Tuesday and Wednesday, plus another 10 or 11 days on Thursdays or Fridays to cover her leave.

Question 10: - STROKE RELATED CARE:

A. Please describe in more detail the VA's desire for stroke related neuro-interventional procedures as listed in the PWS:

• Diagnostic Cerebral and Extracranial Angiography

• Treatment of Intracerebral Thrombosis

• Treatment of Intracerebral Aneurysm

• Treatment of Intracerebral AVM

• Treatment of Intracerebral Tumor

B. What is the volume of these procedures performed for Mpls VA veterans?

C. Does the VA expect 24/7 coverage for each of these procedures?

D. Does the VA expect clinic hours related to these patients?

E. Does the VA expect a provider to perform these services at any day/time or can we propose a designated day/time for them?

F. Please speak to the acuity of the patients.

G. Please describe the coverage available from other key providers who would be involved in the care of these patients including:

• Neurosurgery and OR availability

• Neurology

• Neuro Critical Care

H. Is the stroke-related coverage part of the 3,827 hours or in addition to them?

Answer 10: See Answer to Question 5.

Question 11: Would the VA entertain any exceptions to having 2 providers on Mondays, Tuesdays and Wednesdays? During three weeks of the year (known well in advance), it may be difficult for us to provide 2 providers.

Answer 11: Yes, only during those three weeks, with the concurrence of the Contracting Officer Representative and Contracting Officer.

Question 12: The training referenced on page 14 section 2.1.6 - are these hours part of the 3,827 and billable?

Answer 12: Yes, if on-site and patient care duties allow. Otherwise, it must be done off-site and, therefore, not billable.

Question 13: Is prostate artery embolization a procedure that the VA desires/expects?

Answer 13: Yes.

Question 14: Is the VA willing to entertain a proposal for call which has 2 providers covering 3 sites, the VA being 1 of the 3? On page 20, section 3.1.4.3, it indicates call may not be taken concurrently with another site.

Answer 14: Call must be dedicated to the VA. Proposals with providers covering call concurrently with another site will not be accepted.

Question 15: Neuro IR: How many cases are done annually?

a. What type and number of each case is done at the VAMC?

b. If we don’t provide Neuro Interventional Service will our proposal not be considered?

Answer 15: See Answer to Question 5.

Question 16: Is there any possibility the March 1st start date will not be possible?

Answer 16: The March 1, 2018 date is firm. It is the VA’s intention and desire to avoid a break in IR Physician Services.

Question 17: If our proposal is accepted can we back out before signing the agreement?

Answer 17: Your signature on a proposal binds your company to perform (See FAR Part 2 “Offer” defined). However, you may provide written notice to withdraw your proposal at any time before you receive notice from the Contracting Officer that your proposal has been accepted for award (See FAR Parts 15.208(e) and 15.504).

Question 18: What are the ramifications if we breach the contract during the 4 year commitment?

Answer 18: It depends on the circumstances related to the “breach”. See FAR Part 49 that establishes the policies and procedures relating to the complete or partial termination of contracts for convenience of the Government or for default.

Question 19: Is a hard copy proposal submittal required?

Answer 19: A hard copy proposal with CD-ROM is required. An electronically submitted proposal will be accepted in addition to the hard copy proposal with CD-ROM.