PWS-Teleradiology_services_vr1.doc

TELERADIOLOGY SERVICES

1. GENERAL.

1.1. Description of Work.

1.1.1. The Contractor shall provide the non-personal services of off-site radiological interpretations for routine non-emergency daytime and routine and emergency after-hours coverage via teleradiology and transcribe all reports into the universal military Composite Healthcare System (CHCS) at Munson Army Health Center (MAHC), Ft. Leavenworth, Kansas. For the period of 1 September 2017 to 30 September 2017, plus two subsequent option periods ending 30 September 2019, if exercised. The contract employees performing this service are hereafter referred to as Contract Service Providers (CSP).

1.1.1.1. The Contractor shall determine the number of radiologists required to perform the services and meet the standards in this purchase order.

1.1.1.2. Licensure. Any contract service provider (radiologist) that is going to interpret/diagnose films under this purchase order shall have and maintain a current, active, valid, and unrestricted license to practice medicine in the State, District of Columbia, or territory of the United States where the images are read, IN ADDITION TO a current, active, valid, and unrestricted Kansas license, if the reading location is other than Kansas. If the radiologist is located in Kansas and will read films in Kansas, a Kansas license only is sufficient. In the event a radiologist changes locations at any time during performance of any contract resulting from this solicitation, that radiologist will no longer be able to read films until a license is obtained from the new location and the license is presented to the Credentialing Office at MAHC (this applies if the radiologist is not already in possession of that location’s license).

1.1.1.3. Contract physicians shall be of a quality meeting or exceeding currently recognized national standards as established by the Joint Commission (TJC) (formerly known as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)), the standards of the American Hospital Association, American Board of Radiology, and the American Osteopathic Board of Radiology. In addition, physicians shall be certified by the Food and Drug Administration (mammography purposes).

1.1.2. Services shall be performed by using secure broadband connections to transmit radiology images and data between MAHC and the Contractor’s facility.

1.1.3. This purchase order is a NON-PERSONAL SERVICES purchase order under which the personnel rendering the services are not subject, either by the purchase order’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the government and its employees.

1.1.4. Performance Requirement Summary. The following performance objectives and measures will be used to evaluate Contractor performance and compliance under the contract. This information will be used to prepare annual past performance evaluations.

Monitored by Department and COR.

8. Combating Trafficking in persons (awareness program).

Report within 24 hours.

Report within 24 hours.

1.1.5. The inspection and acceptance point for all services rendered under this contract will be by the Chief of the Department (DC). The performance by the CSP, the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance and review for acceptance by the COR or designated representative. Any services rendered by the CSP to patients or interaction with military/civilian personnel deemed unprofessional/threatening/dangerous by the DC will be considered as grounds for immediate removal of the CSP and termination under termination under t clause 52.212-4 (m) Termination for Cause. Quality Assurance procedures established by the MTF shall be used for continuous monitoring. Other performance evaluation factors will be monitored that are not quantified by numerical measurements which include: prescribing medications not on the health center formulary; Contractor providing personnel not meeting the minimum qualification standards; no inappropriate prescriptions; patient customer service comments; CSP and Contractor relationship with health center staff/Government contracting personnel; compliance with health center policy and procedures. Services provided by the CSP shall be reviewed and rated in accordance with the MTF by-laws and TJC standards. A poor rating shall be grounds for immediate removal of the CSP.

1.1.6. The contractor shall comply with OTSG/MEDCOM Policy Memo 13-062, Policy for Reporting Incidents of Sexual Assault and Sexual Harassment under the Sexual Assault Prevention and Response Program (SHARP), 12 Nov 2013. The SHARP reporting requirements apply only to knowledge obtained by contractor personnel while performing services under this contract.

1.1.6.1. The contractor shall require all Contract Service Providers (CSP) with knowledge of an incident of sexual assault occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

1.1.6.2. The contractor shall require all CSPs with knowledge of an incident of sexual harassment occurring on a Government facility, to include a Government leased facility, where the contractor is providing services under this contract, to report the incident to the contractor who shall immediately (within 24 hours) report the incident in writing to the government's COR. All incidents shall be reported whether they involve contractor personnel or Government personnel, or other individuals.

1.2. Qualifications and Requirements.

1.2.1. CSPs shall meet the following Qualifications.

1.2.1.1. The CSPs must be a Doctor of Medicine (MD) or Osteopathy (DO) who has successfully completed an approved residency program in radiology and is board certified in radiology.

1.2.1.2. The CSPs must be certified by the American Board of Radiology, American Osteopathic Board of Radiology, or equivalent, in Diagnostic Radiology.

1.2.1.3. Licensure is outlined in paragraph 1.1.1.2. above and each CSP performing services under this purchase order shall be licensed as such.

1.2.1.4. The CSPs must have a minimum of two years experience as a practicing radiologist in the field of radiology, in the last three years. Residency time counts as practicing experience; however, time spent in an administrative capacity as a claims reviewer, medical school instructor, medical director, etc. does not qualify as practicing time.

1.2.1.5. The CSPs shall be capable of interpreting studies on all ages of patients.

1.2.1.6. The CSPs shall be certified as current and maintain such certification at all times to be compliant with the American College of Radiology standards for reading all modalities of radiographic images. The standards may be changed by the FDA and American College of Radiology at any time and the Contractor shall remain current to meet all requirements. This includes meeting the minimum required number of reads per month/year.

1.2.1.7. The CSPs must meet Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards as required by MAHC.

1.2.1.7. Each CSP must be able to obtain privileges at MAHC as appropriate through recommendation of the credentials committee.

1.2.1.8. Each radiologist shall have sufficient skills, knowledge and experience to perform the specific tasks (see paragraph 5. of this PWS) for Radiologists.

1.2.2. The Contractor shall ensure all CSPs performing under this purchase order shall meet the following Requirements.

1.2.2.1. Each CSP shall be required to meet Continuing Medical Education (CME) requirements in AR 351-3 or as determined by the radiologist’s State of licensure, whichever is more stringent. The Government will not reimburse for these costs.

1.2.2.2. All radiology exam reads must be performed in the United States, District of Columbia, or territory of the United States.

1.3. Administrative.

1.3.1. The Contractor shall provide adequate pre-credentialed replacement radiologist to prevent any lapses in coverage. The MAHC credentialing process can take up to 30 days. Any lapse in coverage will be considered as cause for immediate grounds for termination of the purchase order, at the discretion of the Government.

1.3.2. Orientation and Training.

1.3.2.1. The Contractor shall ensure its personnel are knowledgeable of the policies and procedures of their specific place of duty and of the medical activity. The Contractor shall ensure that its employees receive any training required by the MTF as a precondition/condition to performance. Such training may include instruction on automation processing, quality assurance policies and local in-service and safety briefings. This training shall be conducted during the scheduled duty hours of the contract personnel.

1.3.2.2. Record Keeping. The Government will ensure all contract personnel are trained on Army medical record keeping.

1.3.2.2.1. Electronic Medical Record Keeping Systems. The Government will provide training to contract personnel in the Electronic Medical Record Keeping Systems and other procedures that the medical activity's staff is required to use. Access to such patient data systems is an "Automated Data Processing Sensitive" position requiring compliance with AR 25-2 and AR 380-67. Refer to the Additional Information section “ADP Security Requirements” in this purchase order for further guidance.

1.3.2.3. The Contractor may use non-compete provisions in its employment agreements to prevent the loss of personnel by the Contractor during the period of performance of this purchase order. However, the Contractor shall not use non-compete provisions in its employment agreements that would prevent its personnel from being employed by or from accepting offers of employment from the new contractor of the follow-on contract. It would hinder the Government’s ability to accomplish the mission of providing medical care to its beneficiaries.

1.3.2.4. Status Reports. The Contractor shall submit status reports to the COR or Contracting Officer (KO) as requested for use in monitoring contractor performance. Such reports may include, but are not limited to, personnel recruitment status, quality control/assurance, projected losses, billing/invoicing, etc.

1.3.2.4.1. Quality Control/Assurance (QC/A). The Contractor is required to implement a Quality Control/Assurance plan as approved by MAHC, and then provide a monthly QC/A report to MAHC. This report shall confirm that quality control measures are being performed per PWS paragraph 5.17.

1.3.2.4.2. Monthly Report. The Contractor shall provide a monthly status report stating the number of STAT reads and Routine reads that were processed in accordance with the PWS.

1.3.2.5. Security.

1.3.2.5.1. Safeguarding Material. The Contractor shall be responsible for safeguarding all Government property provided for Contractor use. The Contractor shall safeguard information of a confidential or sensitive nature. Neither the Contractor nor any of its contract personnel shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the likelihood of the possibility of breach of security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974. However, the Contractor may be required to provide testimony or deposition in lawsuits or other administrative, civil, or criminal proceedings.

1.3.2.6. Contracting Officer’s Representative (COR). The COR will be appointed in writing by the KO after the contract is awarded. The KO will provide a copy of this designation and COR contact information to the Contractor.

1.3.2.7. Billing. The Government will only pay for those reads actually worked and provided. The Contractor shall only submit payment requests units actually worked and provided. Submitting a payment request for more than the amount due based on units actually worked and provided may constitute fraud or a false claim and may result in administrative or criminal action or both.

1.3.2.8. Business-to-Business. Upon award of the purchase order, Contractor shall immediately contact ____________ CIO/IAM, at _________or email: _________________to set up the Business-To-Business Interchange for Teleradiology Services. See Attachment 2, Business-to-Business (B2B) Partners and 3rd Party Vendors.

1.3.2.9. Contractor Employees Who Require Access to Government Information Systems (IS). All Contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DoD Information Assurance Awareness prior to access to the IS and then annually thereafter.

1.3.2.10. For Information assurance (IA)/information technology (IT) training. All Contractor employees and associated subcontractor employees must complete the DoD IA awareness training before issuance of network access and annually thereafter. All Contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of employment.

1.3.3. Data Breach Response and Notification.

1.3.3.1. The Contractor shall adhere to the reporting and response requirements for PII set forth in Memorandum, Office of the Secretary of Defense, Subject: Safeguarding Against and Responding to the Breach of Personally Identifiable Information (PII), June 5, 2009, ALARACT 050/2009, DoD 5400.11-R, and any amendments.

1.3.3.2. The contractor or its subcontractor shall immediately notify __________________________ or email: ______________ upon discovery that a suspected or actual breach of PII has occurred. The notification shall include, to the greatest extent possible, the identification of each individual who’s PII has been or possibly has been breached. In addition, the contractor or its subcontractor shall provide __________________ or email: __________________with any other available information that must be included in required breach reporting and notifications. The contractor shall provide this information at the time of the initial notification to the Government or promptly thereafter as information becomes available.

1.3.3.3. The Government will determine whether a breach of PII has occurred, and whether breach notification to affected individuals is required. If breach notification to affected individuals is required, the Government will determine if the contractor shall make the required notification. If the contractor is to notify the impacted population, it shall submit the notification letters ________________________________________________________ for review and approval.

1.3.4. Antiterrorism/Operations Security (AT/OPSEC) Requirements.

1.3.4.1. Antiterrorism (AT) Level I Training. This text is for Contractor employees with an area of performance within an Army controlled installation, facility or area. All Contractor employees, to include subcontractor employees, requiring access to Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 30 calendar days after starting performance under this contract or effective date of incorporation of this requirement into the contract, whichever is applicable. The Contractor shall submit certificates of completion for each affected Contractor employee and subcontractor employee, to the COR or to the KO within

15 calendar days after completion of training by all Contractor and subcontractor personnel. AT level I awareness training is available at the following website: https://atlevel1.dtic.mil/at.

1.3.4.2. Access and General Protection/Security Policy and Procedures. This standard language text is for Contractor employees with an area of performance within an Army controlled installation, facility or area. Contractor and all associated subcontractors employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The Contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, Headquarter Department of the Army (HQDA) and/or local policy. In addition to the changes otherwise authorized by clause 52.212-4, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in Contractor security matters or processes.

1.3.4.3. Reserved.

1.3.4.4. Contractor Employees Who Require Access to Government Information Systems (IS). All Contractor employees with access to a government info system must be registered in the ATCTS (Army Training Certification Tracking System) at commencement of services, and must successfully complete the DoD Information Assurance Awareness prior to access to the IS and then annually thereafter.

1.3.4.5. For Contracts that Require an OPSEC Standing Operating Procedure/Plan. The Contractor shall develop an OPSEC Standing Operating Procedure (SOP)/Plan within 90 calendar days of contract award, to be reviewed and approved by the responsible Government OPSEC officer, per AR 530-1, Operations Security. This SOP/Plan will include the government's critical information, why it needs to be protected, where it is located, who is responsible for it, and how to protect it. In addition, the Contractor shall identify an individual who will be an OPSEC Coordinator. The Contractor will ensure this individual becomes OPSEC Level II certified per AR 530-1.

1.3.4.6. For Contracts that Require OPSEC Training. Per AR 530-1, Operations Security, new Contractor employees must complete Level I OPSEC training within 30 calendar days of their reporting for duty. All Contractor employees must complete annual OPSEC awareness training.

1.4. Hours of Performance.

NOTE: The provider shall commence services no later than 30 days after notification of successful privileging. Should the 30th day fall on a non-scheduled workday, the provider shall commence services on the next regularly scheduled workday.

1.4.1. The Contractor shall provide coverage as follows for both routine (Non-STAT) and emergency (STAT) reads:

Monday – Friday = 0800 (8:00 AM) – 1600 (4:00 PM) – Non-emergency routine reads

Federal Holidays = 0

Note: All times listed = MAHC (Central Standard Time)

Eastern Standard Time

- 2 hours

Central Standard Time

- 0 hours

Mountain Standard Time =

- 1 hours

Pacific Standard Time

- 2 hour

1.4.1.1. Federal holidays and Training holidays. Tele-radiology Services are not required on Federal Holidays.

1.4.2. The diagnosing radiologist shall be available for telephonic consultation with MAHC staff during coverage time and during normal business hours. The Contractor shall provide telephone numbers and POC information where the radiologist(s) can be reached in the event that consultation is required. The diagnosing radiologist shall respond to any request for consultation within 30 minutes of initial notification.

1.5. Conduct.

1.5.1. The Contractor is responsible for the conduct of his/her employees. All services shall be provided in accordance with established standards, principles, and ethics of the profession and applicable professional specialty organizations, and shall ensure the highest regard to patient dignity.

1.5.2. The Contractor shall ensure that its personnel abide by federal and local MTF regulations and requirements concerning the nature of limited privileged communication between patients and the Government Provider as may be necessary for security and personnel reliability programs. The Contractor shall also ensure that its personnel abide by federal and local MTF regulations concerning the confidentiality of patient records, as embodied in federal statutes including the Privacy Act of 1974 and the Health Insurance Portability & Accountability Act (HIPAA) of 1996. All regulations referenced are available for review from the COR or MTF. All medical records and reports are and will remain the property of the Government.

1.5.3. The Contractor shall ensure that its personnel abide by MTF bylaws, TJC, DoD and Medical Department regulations with regard to Utilization Review and Quality Assurance directives, including, but not limited to, in-service training, maintenance of records, performance evaluation, and release of medical information.

1.5.4. Inquiries. Contractor shall ensure that its personnel do not respond to any media inquiries. Any inquiries from the media shall be immediately relayed to the COR, who will relay them to the MTF Commander. There shall be no interviews, comments, or any other response without the knowledge and approval of the MTF Commander. Other than routine inquiries from external agencies, all other inquiries and complaints shall be brought to the attention of the Government.

1.6. Conflict of Interest.

1.6.1. The Contractor shall not bill the patient for services rendered under this purchase order and shall ensure that its personnel do not do so. The Contractor is prohibited from receiving compensation of any kind for patients treated, procedures performed, or any other actions performed, except under the terms and conditions of this purchase order, at the rate specified.

1.6.2. Confidentiality of Information. Unless otherwise specified, all financial, statistical, personnel, and/or technical data which are furnished, produced or otherwise available to the Contractor during the performance of this purchase order are considered confidential business information and shall not be used for purposes other than performance of work under this purchase order. The Contractor shall not release any of the above information without prior written consent of the KO and shall ensure that its employees do not do so. The Contractor shall not use patient care rendered pursuant to this purchase order part of a study, research project, or publication and shall ensure that its employees do not do so.

1.7. License and Credentials Review or Privileging.

NOTE. Upon award of the purchase order, the Contractor shall immediately contact the MAHC Credentials Office or the COR. The credentialing manager is _______________ at XXX-XXX-XXXX or email; ________________________.

1.7.1. The Contractor shall submit a curriculum vitae (CV) or résumé (as appropriate) of the proposed radiologist(s) to the COR not later than (NLT) 15 days after award for review prior to beginning the credentialing process.

1.7.2. The MTF Commander must grant privileges to radiologists for whom privileging is required prior to radiologists providing any services. The privileging process shall be in accordance with all requirements in ARs 40-66 and 40-68, as amended. The privileges granted by the MTF will be sufficient to allow for performance of all specific tasks identified in this purchase order. Information on the credentialing/privileging process is contained in chapter 4 of AR 40-68. Any failure to meet these requirements is considered nonperformance and the basis for termination for cause.

1.7.3. Credentialing/Privileging Process.

1.7.3.1. Each CSP, except as otherwise stated in the purchase order, must obtain privileges from the MTF Commander, prior to beginning work. The privileging process shall be IAW all requirements in AR 40-68, Clinical Quality Management. The privileges granted by the MTF must be sufficient to allow for performance of all specific tasks identified in this purchase order. If a CSP is not privileged sufficiently to perform all the specific tasks in this purchase order, the CSP will not be allowed to provide services under this purchase order and the Contractor must provide another CSP. Information on the credentialing/privileging process is in chapters 8 and 9 of Army Regulation 40-68 located on the internet at http.//www.army.mil/usapa/epubs/pdf/r40_68.pdf.

1.7.3.2. The Contractor is responsible for completing the entire credentials packet and returning it in hard copy format NLT 30 days after completion of the Government’s review of the candidate’s (CV) or résumé (as appropriate) unless otherwise specified by the KO. Fax copies are NOT acceptable unless approved in advance by the Credentials Office. DO NOT submit an incomplete package without first coordinating with the Credentials Office. The MTF will not assist the Contractor in obtaining any needed information. Additionally, the Contractor shall provide all necessary information. Do not instruct the individual CSPs to bring or otherwise provide information unless approval is granted by the Credentials Office. Incomplete packages delay the credentialing process resulting in delay of the radiologist’s start date.

1.7.3.3. Prime Source Verification is the responsibility of the Contractor. The Contractor shall provide either an original letter from the educational institution or certifying body attesting to the successful completion of specialty training or certification. Attestation of telephonic verification on Contractor letterhead is also acceptable and shall reflect the following information.

Date of verification

Name of individual and agency contacted

City, State, Phone Number and verification made (i.e., degree (type and dates))

Internship (type and dates)

Residency (name and dates of specific program)

Fellowship (name and dates of specific program)

Board certification (date certified and expiration date if applicable)

Licensure/certification/registration (current, inactive, expired) to include date granted, expiration date, and confirmation that the licensure/certification/registration is in good standing.

1.7.3.4. The Contractor shall verify successful credentialing/privileging with the Credentials Office prior to the arrival of any radiologist. Again, radiologists may NOT begin work until the credentialing/privileging process is complete.

1.7.3.5. The Contractor shall, on a continuing basis, verify all information submitted to the MTF for the purpose of credentialing/privileging. During the term of the purchase order, the Contractor shall notify the Credentials office upon becoming aware of any information that may compromise the radiologist’s credentials at the MTF. This includes, but is not limited to, information linking the radiologist with chemical dependency, a felony or malpractice. The information will be reviewed by the Credentialing Committee and may result in the rescinding of privileges.

1.7.3.6. For Contractor information, the credentialing committee meets periodically throughout the month, usually weekly on Thursday morning. Prior to documents appearing before the committee, they must be reviewed by various departments. In order for the committee to consider submissions on the date scheduled, the Contractor must submit accurate, completed packets by the time specified in the contract. Documents cannot arrive in the credentials office the day before the board meets and be expected to be presented to the board.

1.7.4. The Contractor shall not employ any individual to provide direct healthcare services whom, within five years prior to employment.

1.7.4.1. Has had his/her clinical privileges limited, suspended, or revoked by any healthcare facility, public or private, anywhere in the world.

1.7.4.1.1. This prohibition does not apply to any individual whose clinical privileges, although originally limited, suspended or revoked by a healthcare facility, were subsequently fully reinstated by the healthcare facility.

1.7.4.1.2. Limitation of clinical privileges, as used in this paragraph, refers to a partial withdrawal/reduction of clinical privileges as a result of a determination that or pending investigation to determine whether an individual has engaged in unprofessional conduct or substandard medical practice or is incompetent to perform certain medical practices.

1.7.4.2. Is the subject of a current or pending hearing or appeal brought by any healthcare facility, public or private, anywhere in the world, which may result in the limitation, suspension, or revocation of the individual's clinical privileges.

1.7.5. Requirements for privileging or for licensing verification are the same for replacement CSPs as for those they are replacing.

1.7.6. The MTF Commander is the sole authority that can revoke or otherwise restrict the privileges of any CSP who he/she determines is not qualified to perform the purchase order services.

1.7.7. Once privileges are granted, subsequent actions taken concerning the privileges of CSP, including any limitation on privileges, will be governed by the procedures in AR 40-68. Action that suspends, revokes, places in abeyance, or otherwise restricts the privileges of the radiologist results in that radiologist not being authorized to perform under the contract. Such action does not excuse the Contractor from performing. A replacement CSP must be provided according to the terms of this purchase order.

1.7.8. Adverse actions on radiologist privileges, once the Commander takes action, may be appealed locally by the radiologist under the provisions of AR 40-68, but may not be appealed by the Contractor.

1.8. Relationship of the Parties, Professional Liability Responsibility and Procedures.

1.8.1. This purchase order is a non-personal services call; therefore, the Government will not be liable for malpractice allegations against a radiologist based upon performance of this purchase order. The Contractor shall be required to carry malpractice insurance for its radiologist(s), at a level acceptable to the KO, prior to commencement of services. Evidence of insurance shall be provided per contract. If an apparent successful offeror, the Contractor shall provide evidence of insurability concerning medical liability insurance prior to award. Upon award, the Contractor shall provide evidence of insurance demonstrating the required coverage prior to commencement of performance. In accordance with Federal Acquisition Regulation (FAR) Clause 52.237-7, the Contractor shall indemnify the Government for any liability producing act or omission by the Contractor, its radiologist(s) and agents occurring during contract performance. If the Contractor uses subcontractors in the performance of this purchase order, the Contractor is required to ensure that its subcontracts for provisions of healthcare services contain the requirements of FAR 52.237-7, including the maintenance of medical liability insurance.

1.8.2. Contractor agrees to be solely responsible for any liability producing acts or omissions arising from the Contractor’s performance. Contractor shall indemnify the Government against all claims by third parties for death or bodily injury (including sickness or disease) to the extent that such a claim arises in any way from Contractor performance under this purchase order. In the event of litigation/investigation of a claim or malpractice, the Contractor shall ensure his employees’ full cooperation with Government authorities and designated officials in investigation of claim and/or preparation of litigation.

1.8.3. Responsibility and Procedures.

1.8.3.1. If any suit or action is filed or any claim is made against a radiologist, which occurred as a result of work performed by the radiologist under this purchase order, the radiologist shall immediately notify the Contractor and the KO and the chief of the appropriate services and promptly furnish them copies of all pertinent papers received.

1.8.3.2. The Contractor shall cooperate with the Government, without further compensation, in the processing, review, settlement, or defense of the suit, action, or claim; and, authorize Government representatives to settle or defend the claim and to represent the Contractor in, or take charge of, any litigation involved in such an action. The Contractor may, at the Contractor’s own expense, participate in defense of such claim or litigation.

1.9. Quality Management.

1.9.1. Quality Control Plan (QC). The Contractor is required to follow the current QC program in place at the MTF to ensure that the medical services are provided at a level of quality that meets MTF standards.

1.9.2. Quality Assessment and Improvement (QA&I). The Government will monitor the Contractor's performance under this purchase order using the QA&I procedures established by the medical activity and pursuant to the Contract Terms and Conditions - Commercial Items clause, paragraph entitled Inspection/Acceptance. Additionally, the Contractor's performance is subject to scheduled and unscheduled review by the QA&I Committee as defined by the medical activity Quality Assurance (QA) Plan and AR 40‑68.

1.9.3. The Contractor shall have an internal quality control procedure which will ensure the Contractor's performance/medical care evaluation will be at a level commensurate with standards of the medical profession and the American College of Radiology.

1.10. Contractor Representation.

1.10.1. The Contractor shall designate and provide, in writing, Contractor representative contact information for this purchase order at least five working days prior to performance start date to the KO and COR.

1.10.2. The Contractor's representative shall, at no additional cost, converse with the COR, via phone, at a minimum, Quarterly and when requested by the COR to discuss any problems that the Contractor's personnel may be experiencing during the performance of this purchase order. Problems experienced by the Government with the Contractor's performance will be discussed and resolved. Unresolved problems will be referred to the KO for resolution.

1.10.3. The Contractor shall provide points of contact (POC) information for administration of the contract during normal business hours and after normal business hours. The POC for other than normal business hours will be contacted only in the event of emergencies. Accordingly, the named individual(s) shall possess sufficient corporate authority to effectively deal with emergency situations and the telephone number provided shall be functioning at all times other than normal business hours. If there are different POCs for different conditions, such as weekdays, weekends, holidays, clearly provide such information.

2. DEFINITIONS/ACRONYMS.

2.1. Definitions. Following is a list of basic definitions.

2.1.1. Ancillary Personnel. This includes all CSPs with the exception of Medical Doctors (MD) and Doctors of Osteopathy (DO).

2.1.2. Armed Forces Health Longitudinal Technology Application (AHLTA). This contains the MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF. In addition, it contains the electronic medical records for MHS beneficiaries.

2.1.2. Backup Personnel. Pre‑approved Radiologists designated to move into the position of the primary Radiologists to perform required services for the duration of his/her absence.

2.1.3. Beneficiaries of The Military Healthcare System. Those individuals entitled to care at the MTF in accordance with AR 40‑3.

2.1.4. Clinical Privileges. Authorization by the Government to provide specific patient care and treatment services in the organization, within well defined limits, based on the individual's license, education, training, experience, competence, judgment and physical and mental health.

2.1.5. Composite Healthcare System (CHCS). An automated medical information system which will provide integrated support for the functional work centers of inpatient and outpatient care facilities, patient administration, patient appointments and scheduling, nursing, laboratory, pharmacy, radiology, and clinical dietetics.

2.1.6. Contracting Officer (KO). A person with the authority to enter into, administer, and/or terminate contracts/task orders and make related determinations and findings.

2.1.7. Contracting Officer’s Representative (COR). A Government employee selected and designated in writing by the KO to act as his/her designated representative in administering a contract. A COR has no authority to change or modify the terms of a contract.

2.1.8. DMHRSi. Defense Medical Human Resource System - Internet. A system that allows time keeping for all employees.

2.1.9. Fill Rate. Ratio of hours (or shifts, as specified in the CLIN) ordered divided by hours (or shifts) worked. Scheduled absences authorized per contract terms are excluded from fill rate calculations.

2.1.10. Military Time is on a 24‑hour clock, e.g..

8.00 a.m.

9.10 a.m.

Noon

8.00 p.m.

9.10 p.m.

Midnight

12.01 a.m.

2.1.11. Military Dates are written by placing the day of the month, followed by the first three letters of the month, followed by the last two digits of the year, e.g..

January 2, 2014 ‑ 2 Jan 14

January 10, 2014 ‑ 10 JAN 14

2.1.12. Physician. Medical CSPs possessing a doctorate degree as a Medical Doctor (MD) or Doctor of Osteopathy (DO).

2.1.13. Privileging Process. Process established by the MTF and AR 40‑68 for granting clinical privileges to Radiologists.

2.1.14. Quality Assessment and Improvement. Those actions taken by the Government to check services to determine if they meet the requirements of the Joint Commission, U.S. Army Medical Command, quality assurance and risk management program, and ensure that the Contractor and its Radiologists comply with the terms and conditions of the contract.

2.1.15. Quality Control. Those actions taken by a Contractor to control the performance of services to ensure that they meet the requirements of the contract.

2.1.16. Replacement Personnel. Radiologists selected to fill a position for the duration of the contract period that was previously occupied by another Radiologist.

2.1.17. TRICARE. A regionalized, tri‑service, Contractor‑supported, DoD‑managed healthcare system.

2.2. Acronyms/Abbreviations. Following is a list of basic acronyms/abbreviations used in this purchase order.

ADP

Automated Data Processing

AHLTA

Armed Forces Health Longitudinal Technology Application

AR

Army Regulation

BCLS

Basic Cardiac Life Support.

BLS

Basic Life Support

CFR

Code of Federal Regulations

CHAMPUS

Civilian Health and Medical Program of the Uniformed Services

CHCS

Composite Health Care System

CLIN

Contract Line Item Number

CME

Continuing Medical Education

CMR

Contract Manpower Report

CONUS

Continental United States

COR

Contracting Officer’s Representative

CPARS

Contractor Performance Assessment Reporting System

CPR

Cardiopulmonary Resuscitation

CV

Curriculum Vitae

DA

Department of the Army

DCCS

Deputy Commander for Clinical Services

DEA

Drug Enforcement Administration

DoD

Department of Defense

DODI

Department of Defense Instruction

DMHRSi Defense Medical Human Resource System - Internet

ECFMG

Educational Commission for Foreign Medical Graduates

EFT

Electronic Funds Transfer

EKG

Electrocardiogram

ETS

Expiration Term of Service

FAR

Federal Acquisition Regulation

FBI

Federal Bureau of Investigation

FL

Form Letter

FPP

Family Practice Physician

FTE(s)

Full Time Equivalent(s)

HCAA

Health Care Acquisition Activity

HHS

Health and Human Services

HIPAA

Health Insurance Portability & Accountability Act of 1996

IAW

In Accordance With

IRC

Installation Record Check

IV

Intravenous

JC

Joint Commission

LOSS

Line of Sight Supervision

KO

Contracting Officer

MEDCOM

Medical Command

MEDDAC

Medical Department Activity

MTF

Medical Treatment Facility

NACI

National Agency Check with Inquiries

NCOIC

Noncommissioned Officer in Charge

NP

Nurse Practitioner

OCONUS

Outside the Continental United States

OIC

Officer in Charge

OSHA

Occupational Safety and Health Administration or Act

PA

Physician Assistant

PAD

Patient Administration Division

PALS

Pediatric Advance Life Support

Pam

Pamphlet

PAR

Performance Assessment Report

PCF

Practitioner's Credentials File

PCO

Procurement KO/Procuring KO

PCS

Permanent Change of Station

PL

Public Law

POC

Point of Contact

PWS

Performance Work Statement

QA

Quality Assurance

QA&I

Quality Assessment & Improvement

OBGYN

Obstetrics and Gynecology

QC

Quality Control

RN

Registered Nurse

RFQ

Request for Quotation

RFP

Request for Proposal

RPO

Radiation Protection Officer

SF

Standard Form

SRP

Soldier Readiness Processing

TAB

Therapeutic Agents Board

TDY

Temporary Duty

TO(s)

Task Order(s)

USC

United States Code

USPS

United States Postal Service

VPN

Virtual Private Network

WRCO

Western Regional Contracting Office

WRMC

Western Regional Medical Command

USPS

United States Postal Service

3. GOVERNMENT PROPERTY AND TRAINING.

3.1. MAHC, if applicable, will provide training on use of Digital Imaging Network Picture Achieves Communication Systems (DINPACS).

3.2. MAHC, if needed, will provide training on use of CHCS, the general military computer system.

3.4. MAHC will establish and maintain computer network and VPN connectivity with the Contractor during the life of this purchase order. Images are furnished to Contractor by computer network.

3.5. In case DINPACS or the VPN becomes unavailable, the Chief, Department of Radiology, will use the following procedures as backup if deemed necessary:

3.5.1. The Government will furnish all x-rays and Standard Forms 519B for diagnostic radiological interpretations.

3.5.2. All x-rays and accompanied forms will remain the property of and subject to the exclusive control of the U.S. Government. All reports and documents prepared by the Contractor in fulfillment of this agreement will become the property of the U.S. Government.

3.5.3. The Government will package and ship film in manufacturer x-ray cases for delivery to the Contractor facility using Contractor provided pre-addressed labels.

3.5.4. The Government will provide with each shipment of film to the Contractor a standard packing list, which will be provided by the Contractor.

4. CONTRACTOR-FURNISHED PROPERTY.

4.1. The Contractor shall provide all services/supplies necessary to perform the required interpretations and provide the required reports.

5. SPECIFIC TASKS. The CSPs shall perform all procedures and duties that are normal to the scope of that CSP’s particular specialty and for which privileges are granted by the MTF. These are essentially the same duties as those required of any Medical Services Corps Officer or Government Civil Service Radiologists of similar experience and in similar duty assignments. Specific tasks include, but are not limited to:

5.1. STAT Requests/Comparisons. The CSPs shall read, interpret, and transcribe STAT diagnostic studies (including a written preliminary report to the ordering clinician) within 60 minutes of transmission from MAHC. The Contractor shall make the interpreting radiologist immediately available for MAHC personnel to discuss the findings of all STAT studies. All preliminary results “wet reads” must be included in the final report. Any discrepancy in the interpretation that would possible affect patient care must also be verbally reported to the ordering clinician at the time the final report is completed so the clinician knows that there is a discrepancy. All studies (i.e., 100%) must be completed within 60 minutes of transmission.

5.1.1. Any discrepancy in the interpretation that would possibly affect patient care must also be verbally reported to the ordering clinician at the time the final report is completed, so the clinician knows that there is a discrepancy. All studies (i.e., 100%) shall be completed within 60 minutes of transmission from MAHC. Due to critical nature of STAT studies as they relate to direct patient care, this requirement is absolute and allows for no deviation, unless due to acts of God (See FAR Clause 52.212-4 (f) Excusable Delays).

5.2. Routine (Non-STAT) Requests/Comparisons. The CSPs shall read, interpret, and transcribe all routine diagnostic studies (including a written preliminary report to the ordering clinician) within 24 hours of transmission from MAHC. A final report shall be generated by the CSP within 24 hours of transmission from MAHC Department of Radiology. All preliminary results “wet reads” must be included in the final report. The Contractor/radiologist shall be capable of interpreting the complete spectrum of all modalities (including plain films, MRIs, CTs, Ultrasounds (US), Digital Mammography and relevant previous exams for comparison).

5.2.1. All studies shall have a final report generated by the Contractor within 24 hours of submission from MAHC. No more than a 1% discrepancy in meeting this standard.

5.3. The Contractor is responsible for making direct contact with the ordering clinician or clinician nurse by telephone upon discovery of any abnormal, life threatening, or significant findings. If the findings are after hours, and the exam status is routine, and is not associated with the Emergency Department, then the Contractor is to contact the Department of Radiology in the same as manner mentioned above.

5.4. Provide unlimited advice and opinions for each study upon request by MAHC including Peer Reviews in support of diagnostic interpretations of radiological examinations and procedures in conjunction with patient care and treatment as provided by MAHC.

5.5. The Contractor shall keep their receiving computers operational at all hours to accommodate incoming transmissions. MAHC is not required to notify the Contractor when studies have been pushed. The Contractor shall check their system at intervals of their choosing to comply with the primary mission of providing “STAT” interpretations within 60 minutes of transmission from MAHC and final report within 24 hours of transmission from MAHC. If the machine that incoming transmissions are designated to be sent to, becomes inoperable, the Contractor shall notify the MAHC POC immediately with the replacement machine(s)’ interface information.

5.6. Generation of Written Reports (Diagnostic Studies). The Contractor shall generate written reports of diagnostic studies performed by the Radiologists’ Services under the purchase order, including patient lay summaries. The Contractor shall forward such reports and/or lay summaries directly to MAHC. The Medical Facility will have the sole responsibility for sending and tracking any reports and/or summaries directly to patients within the designated time guidelines as required. The Contractor shall maintain all reports and/or lay summaries on file for a period of no less than six months. The Contractor shall not be responsible for any further storage or retention of any images once forwarded to MAHC by the Contractor.

5.6.1. Prepare all reports as may be required in support of services rendered and as required by the MTF, Federal law, or Army regulation. Maintain a log of discrepant interpretations comparing preliminary reads to final reading/reports for Quality Assurance purposes ensuring discrepancies are minimized. Upon request, these reports shall be made available within two business days.

5.6.1.1. The contract transcriptionist shall transcribe the reports onto a secure internet website. The Government transcriptionist will then access the secure website and transfer the report into CHCS.

5.7. Some exams may consist of more than one x-ray/study but shall only be billed as one study when there is only one Current Procedural Terminology (CPT) code.