Board Certified /Board Eligible Neurology Physician Services on-site in accordance with the specifications contained herein to beneficiaries of theDepartment of Veterans Affairs and the Robley Rex VA Medical Center in Louisville, Kentucky
PERFORMANCE WORK STATEMENT FOR ONSITE NEUROLOGY SERVICES
GENERAL:
Services Provided: The Contractor shall provide Board Certified /Board Eligible Neurology Physician Services on-site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Robley Rex VA Medical Center in Louisville, Kentucky. The Contractor s qualified Neurology physician(s) shall provide inpatient (approximately 12 inpatients per month) coverage, and outpatient services, with a minimum of (4) 6-hour clinic session days per week, and/or a maximum of (6) 6-hour clinic sessions days per week; and provide coverage for other Neurology outpatient clinics during times of staffing shortages or absences and emergencies as needed. Clinic session days will be negotiated and mutually agreed upon between Contractor and Medical Center. Services will be rendered at the Robley Rex Veterans Affairs Medical Center (VAMC), 800 Zorn Avenue, Louisville, KY 40206. Contract will have the option of seeing outpatients thru the Telehealth process, Contractor must agree to abide by the VA regulations, in order to proceed with this option. In addition to the Contractor providing inpatient and outpatient services, the Contractor shall provide 24/7 on-call services. Contract physicians shall meet or exceed currently recognized national standards as established by The Joint Commission (TJC), and the standards of the American Hospital Association (AHA). In addition, physicians shall comply with all Veterans Health Administration s (VHA) regulations and directives. The Contractor shall provide sufficient personnel who meet all requirements herein and who can be relied on to perform in strict accordance with the contract. The Contractor shall provide physicians who are competent, qualified, and adequately trained to perform assigned duties.
The Contractor shall be available to provide both inpatient and outpatient consultation services for the diagnosis and treatment of Neurology diseases. For inpatient services, the contractor will be available seven (7) days per week, 24 hours a day. Outpatient services should be offered as needed to meet demand, but no fewer than (4) 6-hour clinic session days per week, and a maximum of (6) 6-hour clinic session days per week. It is expected that a provider will be designated for each clinic for the life of the contract to provide continuity of care. The goal is for all new appointments for outpatient services to be scheduled and seen within 30 days or sooner if clinically indicated. Follow-up clinic appointments are to be seen per established guidelines.
The Contractor will provide on-call information to cover on-call services, including contact numbers, to the VA s Medical Service Office no later than three working days prior to the end of each month. This information will be published on the VA s monthly call schedule.
Place of Performance The Robley Rex Department of Veterans Affairs (VA) Medical Center (VAMC) (also known as the Louisville VAMC) located at 800 Zorn Avenue, Louisville, KY 40206.
Authority: Title 38 USC 8153, Health Care Resources (HCR) Sharing Authority.
Policy/Handbooks:
1.4.1. - VA Directive 1663: Health Care Resources Contracting - Buying http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=347
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
- VHA Handbook 1100.17: National Practitioner Data Bank Reports - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135
- VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364
1.4.5. - VHA Handbook 1100.19 Credentialing and Privileging - http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910
1.4.6. VHA Handbook 1907.01 Health Information Management and Health Records: http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=2791
1.4.7. - Privacy Act of 1974 (5 U.S.C. 552a) as amended http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm
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.
ASH: American Society of Neurology
ACGME: Accreditation Council for Graduate Medical Education
ACLS: Advanced Cardiac Life Support
AOD: Admitting Officer of the Day
BLS: Basic Life Support
CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation
CDC: Centers for Disease Control and Prevention
CDR: Contract Discrepancy Report
CEU: Certified Education Unit
CME: Continuing Medical Education
CMS: Centers for Medicare and Medicaid Services
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.
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.
COS: Chief of Staff
CPARS: Contractor Performance Assessment Reporting System
CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.
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.
DEA: Drug Enforcement Agency
ED: Emergency Department
FSMB: Federation of State Medical Boards
Full Time Equivalent (FTE): VA s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.
HHS: Department of Health and Human Services
HIPAA: Health Insurance Portability and Accountability Act
HR: Human Resources
ISO: Information Security Officer
Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.
MOD: Medical Officer of the Day
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).
NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org
Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors
NP: Nurse Practitioner
NPPES: National Plan and Provider Enumeration System
PA: Physician Assistant
PALS: Pediatric Advanced Life Support
POP: Period of Performance
PPD: Purified Protein Derivative
PW S: Performance Work Statement
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.
QA/QI: Quality Assurance/Quality Improvement
QM/PI: Quality Management/Performance Improvement
QASP: Quality Assurance Surveillance Plan
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.
Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers.
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.
VetPro: a federal web-based credentialing program for healthcare providers.
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 Robley Rex (Louisville, KY) VA Medical Center.
QUALIFICATIONS:
Staff/Facility
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.
Board Certification - All contract Neurology provider(s) shall be Board Certified /Board Eligible by the American Board of Internal Medicine (ABIM) in Neurology, and be currently certified in Basic Life Support (BLS) and 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.
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 provider(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract provider(s)prior to obtaining approval by the Robley Rex VAMC Professional Standards Board, Medical Executive Board and Medical Center Director.
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.
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 s physicians shall have knowledge of professional care theories, principles, practices, and procedures to perform assignments of Neurological patient/critically ill patient population. Contractor s physician shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific to the critical care/Neurology population. Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract provider(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.
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 contract physician(s).
Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the Contractor s physician(s) as required by the VA.
Privacy and HIPAA Training (TMS # 10203)
Once a year
Approx. 30min 1hour
Privacy and Information Security (TMS #101076)
Once a year
Approx. 30 min 1hour
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.
TUBERCULOSIS TESTING: Contractor shall provide proof of a negative reaction to PPD testing for all contract physician(s). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive PPD results. The PPD test shall be repeated annually.
RUBELLA TESTING: Contractor shall provide proof of immunization for all Contractor s physician(s) for measles, mumps, rubella or a rubella titer of 1.8 or greater. If the titer is less than 1.8, a rubella immunization shall be administered with follow-up documentation to the COR.
OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide generic self-study training for all contract physician(s); provide their own Hepatitis B vaccination series at no cost to the VA if they elect to receive it; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.
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.
DEA Contractor shall provide copy of current DEA certificate.
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.
Citizenship related Requirements:
The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals;
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.
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.
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.
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.
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.
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.
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.
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 VAMC 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.
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.
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.
Prohibition against Self-Referral: Contractor s physicians are prohibited from referring VA patients to contractor s or their own practice(s).
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.
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:
Workers compensation
Professional liability insurance
Health examinations
Income tax withholding, and
Social security payments.
Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract provider(s). When a Contractor or contract provider(s)has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.
Key Personnel:
The VA Full Time Equivalency (FTE) for the services required is 2.0. FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.
The minimum number of Board Certified /Board Eligible Neurology providers required to be on-site daily is (1) provider, but only when called or scheduled, as defined in paragraph Hours of Operation in this section.
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 Robley Rex (Louisville, KY) VAMC immediately of the schedule change.
Personnel Substitutions: During the entirety of performance, the Contractor shall make NO unplanned substitutions of key personnel as credentialing/privileging is required. If a substitution is necessitated by illness, death or termination of employment, temporary emergency privileges may be granted on a case by case basis, with approval of the Medical Center Director. If an emergency substitution is necessary the Contractor shall notify the CO, in writing, before the occurrence of any of these events and provide the information required below. For planned substitutions, the Contractor shall submit the information required below to the CO at least 180 calendar days prior to making any permanent substitutions.
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. After receipt of all the required information of the decision on the proposed substitutes the CO will notify the Contractor once the background investigation and privileging processes have been completed. The contract will be modified to reflect any approved changes of key personnel.
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.
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.
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.
VA HOURS OF OPERATION/SCHEDULING:
VA Business Hours:
Patients must be seen by a Contractor s physician(s) on-site at the Robley Rex VAMC in a timely manner in accordance with VA Rules and Regulations on wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure.
Inpatient Consultations services requested for Neurology Services will be the responsibility of the contractor and services are expected to be provided within 24 hours of the initiation of the consult or sooner if the condition warrants. The contractor will provide on-call coverage 24 hrs. a day, including holidays. Coverage will include inpatient follow-up visits for any unstable inpatient, and for consultation with the Robley Rex VAMC s medical staff regarding the appropriate medical care of veterans presenting with Neurology diseases. Response to initial call is expected within 30 minutes. Consultation services are expected to be made on-site at the Robley Rex VAMC in a timely manner as agreed upon with consulting physician unless the requesting provider determines that an initial telephone consultation is sufficient. For all inpatient consultations, an on-site visit is required. Consults requested must be addressed in a timely manner. Urgent consults will be seen immediately. Consulting provider must be within 30 miles of VA Hospital. The requesting provider is responsible for contacting the providing contractor about the need for inpatient services. Documentation and coding will be in accordance with documentation guidelines published by the Centers for Medicare and Medicaid Services (CMS), and all applicable coding standards. The consultation will be completed using an inpatient consult note in CPRS that directly links the response to the original consult, and the completion of an event capture card; hand delivered to the Medicine Administration office. When responding to inpatient services, the contractor provider will document their presence on the designated attendance log.
Outpatient Consultations services requested for Neurology Services - Consults will be received and reviewed by the RRVAMC Neurology staff within 2 working days of the consult date. The reviewer is responsible for determining the clinically indicated date. The goal is for all new and follow-up appointments, for outpatient services to be scheduled and seen within 30 days or sooner (of Patient s Preferred Date), if clinically indicated. There will be a minimum of (4) clinics per week and a maximum of (6) clinics per week. Clinic hours are Monday- Friday, 8am 4pm. Documentation will be in accordance with documentation guidelines published by the Centers for Medicare and Medicaid Services (CMS), and all applicable coding standards. Outpatient consults will be completed using a consult note in CPRS that directly links the response to the original consult and completing the associated encounter form within 24 hours of patient visit. Follow-up visits will be completed using a follow-up notes and completing the associated encounter form within 24 hours of patient visit.
It is required by the Medical Center policy, that cancellation of clinics must be made with 90-day notice, and submitted to the VA s Medical Service Office, at the Robley Rex VAMC. Cancellation of clinics with less than a 90-day notice shall occur only due to weather, acts of war, or national disasters that are out of control of the VHA or the contract physician. All clinic reduction and cancellation requests shall be in compliance with Medical Center Policy.
Contractor s physician(s) shall be available and present in clinic during normal Robley Rex VAMC clinic hours, Robley Rex VAMC which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are 8am 430pm.
On-Call Coverage: Contractor must make the Contractor s physician(s) available on-call 24 hours a day, 7 days a week, 365 days a year.
On-call Contractor s physician(s) must be available at all times for phone consultations with VA physicians.
Patients must be seen within 30 minutes of the page when medically indicated.
Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:
New Year s Day
President s Day
Martin Luther King s Birthday
Memorial Day
Independence Day
Labor Day
Columbus Day
Veterans Day
Thanksgiving
Christmas
Any day specifically declared by the President of the United States to be a national holiday.
Cancellations:
Unless a state of emergency has been declared, the Contractor shall be responsible for providing services.
CONTRACTOR RESPONSIBILITIES
Clinical Personnel Required: The Contractor shall provide contractor s physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.
Contractor s physician(s) shall be responsible for signing in and out when in attendance. Sign in log will be used by the COR to confirm hours/day and services provided against the contractor s invoices.
Standards of Care: The contract physician(s) care shall cover the range of Neurology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:
American Society of Neurology
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
The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx
The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;
The requirements contained in this PWS
.
MEDICAL RECORDS
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. B' 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).
HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order 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 (24VA19). 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.
Disclosure: Contract provider(s)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 1605.1, 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.
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.
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. In the case of the VA authorizing the Contractor to release patient information, the Contractor in compliance with VA regulations, and at his/her own expense, shall use VA Form 3288, Request for and Consent to Release of Information from Individual s Records, to process Release of Information Requests. In addition, the Contractor shall be responsible for locating and forwarding records not kept at their facility. The VA s Release of Information Section shall provide the Contractor with assistance in completing forms. Additionally, the Contractor shall use VA Form 10-5345, Request for and Authorization to Release Medical Records or Health Information, when releasing records protected by 38 U.S.C. 7332. Treatment and release records shall include the patient s consent form. Completed Release of Information requests will be forwarded to the VA Privacy Officer at the following address: Stephanie.Coomer@va.gov.
Direct Patient Care estimated 95% of the time involved in direct patient care.
Per the qualification section of this PWS, the Contractor shall provide the following staff:
Board Certified /Board Eligible Neurology Physicians.
The Contractor shall provide treatment for Neurology disorders for outpatients seen in the Neurology clinics at least as minimum of (4) 6-hour clinics per week and a maximum of (6) 6-hour clinics per week. The Contractor shall be available to provide consultative services in Neurology for inpatients 7 days per week, 24 hours a day including Holidays.
The Contractor will provide inpatient consultation physician services within 24 hours of the initiation of the consult or sooner if the condition warrants. The contractor will provide on-call coverage 24 hours a day, 7 days a week, including holidays. Coverage will include inpatient follow-up visits for any unstable inpatient, and for consultation with the Robley Rex VAMC s medical staff regarding the appropriate medical care of veterans presenting with Neurology diseases. Response to initial call is expected within 30 minutes.
The Contractor will provide on-call consultative coverage during the day, evenings, weekends, and Federal holidays. The Contractor will provide on-call information, including contact numbers, to the VA s Medical Service Office via email no later than three working days prior to the end of each month. This information will be published on the VA s monthly call schedule. Any non-emergent change in the on-call schedule must be communicated during normal administrative hours to the Louisville VAMC Medicine Service office in advance. The physician on call be available by phone/pager during this time. He/she is required to respond telephonically within 30 minutes of receiving a call, and must be prepared to provide on-site consultation and/or assistance at the VAMC.
Neurology services provided in satisfaction of this contract provide no less than:
Approximately (120) inpatient consultations per year and/or approximately (12) inpatient consultations per month.
Approximately (2044) outpatient encounters (amongst entire neurology section) per year and/or approximately (170) outpatient encounters per month.
The Contract physician is fully responsible for all care rendered to the patient, as well as the clinical outcome. Contract physicians are required to utilize Computerized Patient Record System (CPRS) and Veterans Health Information Systems and Technology Architecture (VISTA) for retrieval of information and documentation of services. The Contractor shall provide physicians who shall:
Sign notes at the time of the clinic visit. Perform all documentation requirements, per VHA Handbook 1400.01, dated December 19, 2012.
Perform requested consultations for inpatients within twenty-four (24) hours of request or sooner as dictated by the acuity of the patient s medical condition. Contractor will document inpatient encounters to assure that billing at the attending level can be performed.
Assure that outpatient encounters/and or inpatient event captures documented and completed in CPRS at the time of the visit.
Be in compliance with all VA National and VISN directives concerning consult management and clinic scheduling practices as noted.
Adhere to documentation levels that are standard in the medical community (CMS).
Participates in the review and response to patient complaints and/or congressional inquiries.
Scope of Care: Contractor s physician(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Neurology care, including, but not limited to:
Clinic and Surgical Care: Contractor s physician(s) shall provide clinical Neurology services. Contractor s physician(s) shall be present on time for any scheduled clinics as documented by physical presence in the clinic at the scheduled start time.
Approximate case load is as follows:
Number of patients per clinic: 15 Patient slots shall be scheduled for every outpatient clinic. Number of in-patient visits per month: Approximately (10) in-patient visits each month.
Medications: Contractor s physician(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.
Discharge education: Contractor s physician(s) shall provide discharge education and follow up instructions that are coordinated with the next care setting for all Neurological clinical patients.
ADMINISTRATIVE: estimated 5% of time not involved in direct patient care.
Quality Improvement Meetings: N/A
Staff Meetings: N/A
QA/QI documentation: The Contractor s physician(s) shall complete the appropriate QM/PI documentation pertaining to all procedures, complications and outcome of examinations.
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.
PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)
Quality Management/Quality Assurance Surveillance: Contractor s physician(s) 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.
The Contractor shall furnish the Chief of Staff, on an annual basis, provider-specific information on all Contractor s physician(s) providing services at the facility. This information shall be furnished using Proficiency Report Form 10-2623a, which will be provided to the contractor by the VA. This confidential, provider-specific information shall be used to identify opportunities for improvement and provide the appropriate data to support the decision of re-appointment/re-privileging.
Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that 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.
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.
Performance Standards:
Measure: Response Timeliness
Performance Requirement: Contractor shall be available 24/7 via telephone for inpatient consultation services. Response is expected within 30 minutes of a call.
Standard: 100%
Acceptable Quality Level: 90%
Surveillance Method: COR will investigate reported complaints, as received.
Frequency: Quarterly
Measure: Medical Record Documentation
Performance Requirement: Outpatient consults and follow-up visits will be completed using appropriate CPRS note and associated encounter within 24 hours of visit.
Standard: 100%
Acceptable Quality Level: 90%
Surveillance Method: COR and/or designee will monitor
Frequency: Quarterly
Measure: Timeliness of on-call schedule information
Performance Requirement: Contractor will provide a complete on-call coverage roster at least 3 working days prior to the end of each month. The roster should be sent via email to the COR and/or designee. Standard: 100%
Acceptable Quality Level: 90%
Surveillance Method: COR and/or designee will track receipt and maintain emails containing the on-call rosters monthly.
Frequency: Quarterly
Measure: Patient Satisfaction
Performance Requirement: Cancellations will be requested at least 90 days prior to the clinic date. Standard: 100%
Acceptable Quality Level: 100%
Surveillance Method: COR will monitor all clinic cancellations. Frequency: Quarterly
Measure: Mandatory Training
Performance Requirement: Contractor shall complete training required to maintain computer access. Completion is required prior to due date.
Standard: All (100%) of required training is complete on time by contract provider(s). Acceptable Quality Level: 100% completion, no deviations
Surveillance Method: COR will monitor compliance using TMS reports. Frequency: Quarterly
Registration with Contractor Performance Assessment Reporting System
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 $150,000, 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.
Each Contractor whose contract award is estimated to exceed $150,000 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.
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.
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.
GOVERNMENT RESPONSIBILITIES
VA Support Personnel, Services or Equipment: The VA will provide nursing personnel support during scheduled clinic hours.
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).
CO RESPONSIBILITIES:
CO - Name/Address/Phone/email
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.
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.
In the event that 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.
COR Responsibilities:
The COR for this contract is: Title/Address/Phone/email
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.
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.
The COR will maintain a record of services using a log book that will be in an accessible area, 24/7, within the service, for the Contract providers, and the COR will run a clinic workload report. 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.
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.
All contract administration functions will be retained by the VA.
SPECIAL CONTRACT REQUIREMENTS
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.
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 is 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
Call schedule roster
Monthly
COTR
Physician services contingency plan
Upon award of contract
COTR
Billing:
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:
Name and Address of Contractor
Invoice Date and Invoice Number
Contract Number and Purchase/Task Order Number
Date of Service
Contractor s physician(s)
Hourly Rate
Quantity of hours worked
Total price
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. In order 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
Payment Adjustments:
Invoices will be for hours worked. The contractor shall be paid only for actual work performed onsite. Contract providers shall be responsible for reporting time worked accurately. The Contract shall be paid for actual hours performed.
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.
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.
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.
Charlene Neal
charlene.neal2@va.gov
charlene.neal2@va.gov
