Performance Work Statement for Electrophysiologist and Pacer Technician Services

Pennsylvania

02/23/2022 02:46 PM EST

03/08/2022 11:00 AM EST

VETERANS AFFAIRS, DEPARTMENT OF - VETERANS AFFAIRS, DEPARTMENT OF - 244-NETWORK CONTRACT OFFICE 4 (36C244)

ALL QUESTIONS ARE DUE 5 DAYS BEFORE OFFER DUE DATE!!

Performance Work Statement for Electrophysiologist and Pacer Technician Services

1. GENERAL:

1. 1. Services Provided: The Contractor shall provide a Board Certified or Board Eligible Physician Electrophysiologist and Certified Pacemaker Technicians on site at the LVAMC in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Lebanon VA Medical Center. 

1. 1. Place of Performance - Contractor shall furnish services at the Lebanon VA Medical Center, 1700 South Lincoln Avenue, Lebanon, PA 17042.

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

1. 1. Policy/Handbooks the contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1. 1. 1.   VA Directive 1663:  Health Care Resources Contracting - Buying  https://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2
      2. VHA Directive 2010-018 “Facility Infrastructure”

www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2227

1. 1. 1. VHA Directive 1192 “Seasonal Influenza Prevention Program”

https://www.publichealth.va.gov/docs/flu/VHA_Directive_1192_Sep

1. 1. 1.   VHA Handbook 1100.17: National Practitioner Data Bank Reports - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135
      2.   VHA Handbook 1100.18 Reporting and Responding to State Licensing Boards - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364
      3.   VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910
      4.   VHA Handbook 1400.01 Resident Supervision  http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2847
      5.  VHA Handbook 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 
      6. Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm

1. 1.  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. CDC: Centers for Disease Control and Prevention
      2. CEU: Certified Education Unit
      3. CME: Continuing Medical Education
      4. 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. 1. 1. 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. 
      2. COS: Chief of Staff
      3. CPARS: Contractor Performance Assessment Reporting System
      4. 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.
      5. DEA: Drug Enforcement Agency
      6. EHR: Electronic Health Record - electronic health record system used by the VA
      7. FSMB: Federation of State Medical Boards
      8. HHS: Department of Health and Human Services
      9. HIPAA: Health Insurance Portability and Accountability Act
      10. ISO: Information Security Officer
      11. POP: Period of Performance
      12. PPD: Purified Protein Derivative
      13. PWS: Performance Work Statement
      14. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for 8independent 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.
      15. QA/QI: Quality Assurance/Quality Improvement
      16. QM/PI: Quality Management/Performance Improvement
      17. QASP: Quality Assurance Surveillance Plan
      18. 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).
      19. 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. 1. 1. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.

1. 1. 1. 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. 1. 1. VETPro: a federal web-based credentialing program for healthcare providers.

1. 1. 1. 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 Lebanon VA Medical Center.

1. QUALIFICATIONS:

1. 1. Staff/Facility

1. 1. 1. EP Physician License - The Contractor’s 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 when services are performed onsite on VA property.

All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contractor’s 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.

1. 1. 1. Board Certification - All Contractor’s physician(s) shall be Board Certified or Board Eligible by the American Board of Internal Medicine in Electrophysiology http://www.abim.org/, and be currently certified in Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) or equivalency. 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. 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 Contractor’s physician(s) prior to obtaining approval by the Lebanon VA Medical Center Professional Standards Board, Medical Executive Board and Medical Center Director. 
         1. If a Contractor’s 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. Pacemaker Technician Certification - Pacemaker Technicians shall be fully trained and certified in pacemaker interrogation.
      3. Technical Proficiency - Contractor’s physician(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 Contractor’s physician(s) and Contractor’s physician(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.
      4. 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. Contractor’s 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 Contractor’s physician(s).
      5. Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor’s physician(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor.

Training (The following training is mandatory per VHACO for Contracted Physicians)

Frequency (once a year, etc.)

Annual Hours

Mandatory Training for Transient Clinical Staff

Once a year

.5

VA Privacy and Information Security Awareness and Rules of Behavior

Once a year

.5

VHA Privacy and HIPAA Focused Training

Once a year

.5

BLS or ACLS

Every two years

2

1. 1. 1. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians 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.
         1. TUBERCULOSIS TESTING:  Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physician (s) {This is applicable to all health care workers}. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results.  The TST or IGRA testing shall be repeated annually.
         2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.
         3. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}.
         4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}.
         5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}.

VHA Supplemental Contract Requirements for Combatting COVID-19

1. Contractor employees who work in or travel to VHA locations must comply with the following:

a. Documentation requirements:

1) If fully vaccinated, contractors shall show proof of vaccination.

i. NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS-319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

2) If unvaccinated, contractors shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test that includes an affiliated telehealth service.

3) Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Contracting Officer Representatives (CORs) or other hospital personnel.

4) Documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

2. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

a. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

3. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

4. For indefinite delivery contracts: Contractor agrees to comply with VHA Supplemental Contract Requirements for any task or delivery orders issued prior to this modification when performance has already commenced.

1. 1. 1. 1. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS:  Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physician (s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.
         2. 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. 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.
      3. DEA- Contractor shall provide copy of current DEA certificate.
      4.  Conflict of Interest: The Contractor and all Contractor’s physician(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.
      5.  Citizenship related Requirements:
         1. The Contractor certifies that the Contractor shall comply with all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;
         2. 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.
         3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.
         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.
         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.
      6.  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.
         1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp  to ensure that the proposed Contractor’s physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service.  CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.
         2. 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. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the LVAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.
   3. Non- Personal Healthcare Services: The parties agree that the Contractor and all Contractor’s physician(s) shall not be considered VA employees for any purpose.
   4. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees.
   5. Prohibition Against Self-Referral: Contractor’s physicians are prohibited from referring VA patients to contractor’s or their own practice(s)
   6. Inherent Government Functions:  Contractor and Contractor’s physician(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.
   7. No Employee status: The Contractor shall be responsible for protecting Contractor’s physician(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:
      1. Workers’ compensation
      2. Professional liability insurance
      3. Health examinations
      4. Income tax withholding, and
      5. Social security payments.

1. 1. Tort Liability: The Federal Tort Claims Act does not cover Contractor or Contractor’s physician(s). When a Contractor or Contractor’s physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier.  Any settlement or judgment arising from a Contractor’s (or Contractor’s physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.
   2. Key Personnel:

1. 1. 1. The VA Full Time Equivalency (FTE) for the services required is 0.4 FTE for Electrophysiology Physician Services and 0.8 FTE for Pacemaker Technician Services. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.
      2. The minimum number of Board Certified or Board Eligible Electrophysiology physicians required to be on site daily is 1 as defined in paragraph Hours of Operation in this section.

1. 1. 1. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor’s personnel due to sick leave, personal leave, vacations and additional coverage as required.  In the event a scheduled physician is unable to complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) at the Lebanon VA Medical Center immediately of the schedule change.

1. 1. 1. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 60 calendar day (s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 60 calendar days prior to making any permanent substitutions.
         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 60 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. For temporary substitutions where the key person shall not be reporting to work for three 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.
         3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility.  Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives.  Standards for conduct shall mirror those prescribed by current federal personnel regulations.  Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor’s physician (s), s/he may request, without cause, immediate replacement of said Contractor’s physician (s). The CO and COR shall deal with issues raised concerning Contractor’s physician (s) conduct.  The final arbiter on questions of acceptability is the CO.
         4. 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 Contractor’s physician (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.   
2. Hours of Operation
   1. VA Business Hours:
      1. Patients must be seen by a Contractor’s physician(s) and technicians on-site at Lebanon VA Medical Center in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion.  Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.
      2. Contractor’s physician(s) and technicians shall be available and present in clinic during normal Lebanon VA Medical Center clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff.  Currently, normal clinic hours are 2 days per week, 8 hours/day, beginning at 0800 and ending at 1630 excluding a 30 minutes lunch break, or until visits/workload is completed.
   2. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

• New Year’s Day
• President’s Day
• Martin Luther King’s Birthday
• Memorial Day
• Juneteenth
• Independence Day
• Labor Day
• Columbus Day
• Veterans Day
• Thanksgiving
• Christmas
• Any day specifically declared to be a national holiday. 
  1. Cancellations:
     1. Unless a state of emergency has been declared or clinics are otherwise cancelled by the LVAMC, the Contractor shall be responsible for providing services.

1. CONTRACTOR RESPONSIBILITIES

1. 1. Clinical Personnel Required: The Contractor shall provide physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties. 

1. 1. 1. Contractor’s physician(s) and technicians shall be responsible for signing in and out when in attendance.  Time sheets will be used by the COR to confirm hours/day and services provided against the contractor’s invoices. 

1. 1. Standards of Care: The Contractor’s physician(s)’ care shall cover the range of EP Cardiology and Pacemaker services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized national standards as established by:
      1. The American College of Cardiology (ACC): https://www.acc.org/guidelines. 
      2. VA Standards: VHA Directive 2006-041 “Veterans’ Health Care Service Standards” (expired but still in effect pending revision) https://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1443

1. 1. 1. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/hap_requirements.aspx
      2. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8  and;
      3. The requirements contained in this PWS.

1. 1. Medical Records

1. 1. 1. Authorities:  Contractor’s physician(s)  providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).
      2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA for Covered Entity to disclose Protected Health Information to:  a health care provider for treatment.  Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA10P2).  Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.
      3. Disclosure: Contractor’s physician(s) and technicians may have access to patient medical records:  however, Contractor shall obtain permission from the VA before disclosing any patient information.  Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.01, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.
      4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791  and all guidelines provided by the VAMC.  
      5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements. The Contractor may respond to requests for records contained in their non-VA record system, but all requests for VA records will be forwarded to Portland VA Health Care System Release of Information Office (ROI) for response. The ROI office may be contacted via phone at 503-220-8262 extension 55196, and fax at 503-721-1054.

1. 1. Direct Patient Care: 95% of time direct patient care. Contractor shall be responsible for providing patient care in the Pacemaker Clinic and Electrophysiology/Arrhythmia Clinic.
      1. Scope of Care: Electrophysiologist (s) to perform the requirements herein described to include but not limited to: Attend, operate, and supervise Arrhythmia, and Pacemaker clinics; Technicians will review data within the encrypted VA based system from National ICD Alert Center for triage purposes and contact the Attending Cardiologist for alerts that require immediate interpretation.   Designated VA Representative will be Jason Reese, MD, Chief of Cardiology.  Technicians will update device clinic records, data and demographics and take appropriate action for all pacemaker alerts from the National ICD Alert Center and provide necessary training for Lebanon VA Medical Center Technicians to review alerts. 

1. 1. 1. Clinic Responsibilities: Contractor’s Physician(s) and Technicians shall be present at the scheduled Clinic start times as documented by physical presence in the clinic at the scheduled start time.

1. 1. 1. Medications: Contractor’s Physician(s) and Technicians shall follow all established medication policies and procedures.  No sample medications shall be provided to patients.
      2. Discharge education: Provide discharge education and follow up instructions that are coordinated with the next care setting for all emergency department patients.

1. 1. 1. ADMINISTRATIVE: estimated 5% of time not involved in direct patient care for documentation.

1. 1. 1. 1. QA/QI documentation: The Contractor’s physician(s) and technicians shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.

1. 1. 1. 1. Patient Safety Compliance and Reporting: Contractor’s physician(s) shall follow all established patient safety and infection control standards of care.  Contractor’s physician(s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care.  All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.

1. 1. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)

1. 1. 1. Quality Management/Quality Assurance Surveillance: Contract personnel shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted. 
      2. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients.  The CO is final authority on validating complaints.  If the Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel.  This does not preclude refusal in the event of incidents involving physical or verbal abuse.
      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.  The CO and COR shall deal with issues raised concerning Contractor’s conduct.  The final arbiter on questions of acceptability is the CO.
      4. Performance Standards:
         1. Measure: Provider Quality Performance

Performance Requirement:

Standard: OPPE documentation for all (100%) staff providing services under the contract. All staff (100%) meet Standards.

Acceptable Quality Level: __100%__meet Standards

Surveillance Method: Ongoing Provider Performance Evaluation (OPPE) data pertinent to care performed for each provider working under this contract.  Review done by Chief of Cardiology LVAMC.  OPPE data will review the following elements:

                A.  Patient Care Performance

                B.  Medical/Clinical knowledge

                C.  Practiced Based Learning and Improvement

                D.  Interpersonal and Communication Skills

                E.  Professionalism

                F.  System Based Practice

Frequency: Semi-annually

1. 1. 1. 1. Measure: Qualifications of Key Personnel

Performance Requirement: All Contractor’s physician(s) shall be Board Certified or Board Eligible in accordance with ACC Standards.

Standard: All (100%) Contractor’s physician(s) s are board certified.

Acceptable Quality Level: 100%

Surveillance Method: Random Inspection of qualification documents by Credentialing.

Frequency: Annually

1. 1. 1. 1. Measure: Scope of Practice/Privileging

Performance Requirement: Contractor’s physician(s) perform within their individual scopes of practice/privileging.

Standard: All (100%) Contractor’s physician(s) perform within their scope of practice/privileges 100% of the time.

Acceptable Quality Level: 100% Contractor’s physician(s) perform within their scope of practice/privileges 100% of the time.

Surveillance Method: Review of progress notes by Chief of Cardiology, LVAMC.

Frequency: Semi-annually

1. 1. 1. 1. Measure: Patient Access

Performance Requirement: The Contractor shall provide Contractor’s physician(s) in accordance with the operating hours and VA clinical schedule outlined in this PWS.

Standard: All (100%) Contractor’s physician(s) are on time and available to perform services.

Acceptable Quality Level: Contractor’s physician(s) are on-time and available to perform services 100%of the time

Surveillance Method: Periodic Sampling of Time and Attendance Sheets reviewed by COR.

Frequency: Weekly

1. 1. 1. 1. Measure: Patient Safety

Performance Requirement: Patient safety incidents shall be reported using Patient Safety Report. All incidents reported immediately (within 24 hours.)

Standard: All (100%) of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.

Acceptable Quality Level: 100%of patient safety incidents are reported using Patient Safety Report within 24 hours of incident.

Surveillance Method: Direct Observation reported by staff and/or patients to the COR.

Frequency: Daily

1. 1. 1. 1. Measure: Maintains licensing, registration, and certification

Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.

Standard: All (100%) licensing, registration(s) and certification(s) for Contractor’s physician(s) shall be provided as they are renewed. Licensing and registration information kept current.

Acceptable Quality Level: 100% licensing, registration(s) and certification(s) for Contractor’s physician(s) shall be provided as they are renewed. Licensing and registration information kept current.

Surveillance Method: Review of records by LVAMC Credentialing Department.

Frequency: Annually

1. 1. 1. 1. Measure: Mandatory Training

Performance Requirement: Contractor shall complete all required training on time per VAMC policy.

Standard: All (100%) of required training is complete on time by Contractor’s physician(s) 

Acceptable Quality Level: 100%completions,

Surveillance Method: Annual review of Talent Management System training account by COR.

Frequency: Annually

1. 1. 1. 1. Measure: Privacy, Confidentiality and HIPAA

Performance Requirement:

Standard: All (100%) Contractor’s physician(s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPAA

Acceptable Quality Level: 100%compliance

Surveillance Method: Non-compliance reported directly to the COR.

Frequency: Daily

1. 1. 1. Registration with Contractor Performance Assessment Reporting System
         1. As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates Contractor past performance on all contracts that exceed the Simplified Acquisition Threshold and shares those evaluations with other Federal Government contract specialists and procurement officials.  The FAR requires that the Contractor be provided an opportunity to comment on past performance evaluations prior to each report closing.  To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Seal Logistics Center in Portsmouth, New Hampshire.  CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS.  CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS).  FAPIIS is a web-enabled application accessed via CPARS for Contractor responsibility determination information.
         2. Each Contractor whose contract award is estimated to exceed the Simplified Acquisition Threshold requires a CPARS evaluation.    A government Focal Point will register your contract within thirty days after contract award and, at that time, you will receive an email message with a User ID (to be used when reviewing evaluations).   Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690.
         3. For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete.  For contracts exceeding one year, the contracting officer will evaluate the Contractor’s performance annually.  Interim reports will be filed each year until the last year of the contract, when the final report will be completed.  The report shall be assigned in CPARS to the Contractor’s designated representative for comment.  The Contractor representative will have sixty (60) days to submit any comments and re-assign the report to the CO.
         4. Failure for the Contractor’s representative to respond to the evaluation within those sixty (60) days, will result in the Government’s evaluation being placed on file in the database with a statement that the Contractor failed to respond; the Contractor’s representative will be “locked out” of the evaluation and may no longer send comments.
2. GOVERNMENT RESPONSIBILITIES
   1. VA Support Personnel, Services or Equipment: VA support staff assigned to the assist the Contract employees in the Cardiology Services Clinic at the Lebanon VA Medical Center will be equal to: 1 RN FTEE, 1 LPN FTEE, and 2 Clerical Support FTEE.
   2. Contract Administration/Performance Monitoring: After award of contract, all inquiries and correspondence relative to the administration of the contract shall be addressed to: (enter contract administration if not already listed in another area- list the title (not name) and contact information for COR, Clinical point of contact, and any other relevant personnel involved).
      1. CO RESPONSIBILITIES:

CO –/Address/Phone/email

1. 1. 1. 1. The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract.  The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration.  Only the Contracting Officer is authorized to make commitments or issue any modification to include (but not limited to) terms affecting price, quantity or quality of performance of this contract.
         2. The Contracting Officer shall resolve complaints concerning Contractor relations with the Government employees or patients.  The Contracting Officer is final authority on validating complaints.  In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.
         3. If contracted services do not meet quality and/or safety expectations, the best remedy will be implemented, to include but not limited to a targeted and time limited performance improvement plan; increased monitoring of the contracted services; consultation or training for Contractor personnel to be provided by the VA; replacement of the contract personnel and/or renegotiation of the contract terms or termination of the contract.
      2. COR Responsibilities:

The COR for this contract is: Christopher Small, Business Manager/ 717-272-6621 xt.4112/ christopher.small@va.gov.

1. 1. 1. 1. The COR shall be the VA official responsible for verifying contract compliance. After contract award, any incidents of Contractor noncompliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.
         2. The COR will be responsible for monitoring the Contractor’s performance to ensure all specifications and requirements are fulfilled.  Quality Improvement data that will be collected for ongoing monitoring includes but is not limited to: enter data that may be collected.
         3. The COR will maintain a record-keeping system of services by electronic filing. The COR will review this data monthly when invoices are received and certify all invoices for payment by comparing the hours documented on the VA record-keeping system and those on the invoices.  Any evidence of the Contractor's non-compliance as evidenced by the monitoring procedures shall be forwarded immediately to the Contracting Officer.
         4. The COR will review and certify monthly invoices for payment. If in the event the Contractor fails to provide the services in this contract, payments will be adjusted to compensate the Government for the difference.
         5. All contract administration functions will be retained by the VA.
2. SPECIAL CONTRACT REQUIREMENTS
   1. Reports/Deliverables: The Contractor shall be responsible for complying with all reporting requirements established by the Contract.  Contractor shall be responsible for assuring the accuracy and completeness of all reports and other documents as well as the timely submission of each.  Contractor shall comply with contract requirements regarding the appropriate reporting formats, instructions, submission timetables, and technical assistance as required.  

1. 1. 1. The following are brief descriptions of required documents that must be submitted by Contractor: upon award; weekly; monthly; quarterly’; annually, etc. identified throughout the PWS and are provided here as a guide for Contractor convenience.  If an item is within the PWS and not listed here, the Contractor remains responsible for the delivery of the item. 

What

Submit as noted

Submit To

Quality Control Plan: Description and reporting reflecting the contractor’s plan for meeting of contract requirements and performance standards

Upon proposal and as frequently as indicated in the performance standards.

Contracting Officer

VA Directive 1663 Appendix B Other than Cost and Price Information Supporting Proposed Physician Rate

Upon proposal, to submit EPA request, upon change in key personnel

Contracting Officer

Copy of Contractor Certification Statement if non-subcontracting possibilities exist.

Upon proposal and as updated

Contracting Officer

Copies of all licenses, board certifications, NPI, to include primary source verification of all licensed and certified staff

Upon proposal and upon renewal of licenses and upon renewal of option periods or change of key personnel.

Contracting Officer with proposal; renewal submitted to VETPRO system.

Certification that staff list have been compared to OIG list

Upon proposal and upon new hires.

Contracting Officer

Proof of Indemnification and Medical Liability Insurance

Upon proposal and upon renewals.

Contracting Officer

Certificates of Completion for Cyber Security and Patient Privacy Training Courses

Before receiving an account on VA Network and annual training and new hires.

Contracting Officer

BLS or ACLS Certification

Upon award and every two years after award.

COR

Contingency plan for replacing key personnel to maintain services as required under the terms of the contract

Upon proposal and as updated

COR

1. 1. Billing:
      1. Invoice requirements and supporting documentation: Supporting documentation and invoice must be submitted no later than the 20th workday of the month. Subsequent changes or corrections shall be submitted by separate invoice. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4 (g), all invoices must include:
         1. Name and Address of Contractor
         2. Invoice Date and Invoice Number
         3. Contract Number and Purchase/Task Order Number
         4. Date of Service
         5. Contractor’s physician(s) (Name of Contractor’s employee)
         6. Hourly Rate
         7. Quantity of hours worked
         8. Total price
   2. Vendor Electronic Invoice Submission Methods
      
      Invoices will be electronically submitted to the Tungsten website at http://www.tungstennetwork.com/uk/en/ Tungsten direct vendor support number is 877-489-6135 for VA contracts.  The VA-FSC pays all associated transaction fees for VA orders. During Implementation (technical set-up) Tungsten will confirm your Tax Payer ID Number with the VA-FSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to your Certifying Official for approval and payment. To successfully submit an invoice to VA-FSC please review “How to Create an Invoice” within the how to guides. All invoices submitted through Tungsten to the VA-FSC should mirror your current submission of Invoice, with the following items required. Clarification of additional requirements should be confirmed with your Certifying Official (your CO or buyer). The VA-FSC requires specific information in compliance with the Prompt Pay Act and Business Requirements. For additional information, please contact:

Tungsten Support

Phone: 1-877-489-6135

Website: http://www.tungsten-network.com/uk/en/

Department of Veterans Affairs Financial Service Center

Phone: 1-877-353-9791 Email: vafscched@va.gov

1. 1. Payment Adjustments
      1.  Invoices will be prorated for partial days/hours worked.  The contractor shall be paid only for actual work performed onsite. The government may adjust payments by 15-minute increments.  Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed.
         1. The contract shall be adjusted at the end of the period of performance in accordance with actual performance.
   2. Payments in full/no billing VA beneficiaries: The Contractor shall accept payment for services rendered under this contract as payment in full. VA beneficiaries shall not under any circumstances be charged nor their insurance companies charged for services rendered by the Contractor, even if VA does not pay for those services.  This provision shall survive the termination or ending of the contract. 
      1. To the extent that the Veteran desires services which are not a VA benefit or covered under the terms of this contract, the Contractor must notify the Veteran that there will be a charge for such service and that the VA will not be responsible for payment.
      2. The Contractor shall not bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against, any person or entity other than VA for services provided pursuant to this contract.  It shall be considered fraudulent for the Contractor to bill other third-party insurance sources (including Medicare) for services rendered to Veteran enrollees under this contract.