Q522--Teleradiology Services - IDIQ POP: 09/01/2026-08/31/2031 Total SDVOSB Set-aside This is not a request for a Quote.

Department of Veterans Affairs VA Pittsburgh Healthcare System. PERFORMANCE WORK STATEMENT (PWS) Teleradiology Services-Imaging GENERAL: The Pittsburgh Department of Veterans Affairs has a requirement to provide Veterans within the service area with Teleradiology Services. BACKGROUND: Physician personnel shortages in the Radiology Services of the Pittsburgh VAMC have created a significant need to provide preliminary and final radiology interpretation for exams performed on off tours and in some cases for exams performed during routine tours to cover leave and staff vacancies. The use of Radiology Services outsourcing should provide a highly cost-effective and expeditious alternative to meet an ongoing need within the VA Healthcare System. The Pittsburgh VAMC uses an electronic image management and distribution system called VISTA Imaging. In conjunction with Vista Imaging, the facility uses Powerscribe and ISite radiology to complete Imaging Dictations. WORK STATEMENT: Contractor shall provide professional teleradiology services for radiology examinations performed at the Pittsburgh VAMC. Contract services will include off-campus film interpretation via network connection to the VA informatics system. Interpretation will include immediate communication of results both when an interpretation is requested STAT or with a critical emergent test result. Contractor must be a U.S. based corporation capable of final interpretation and reporting services via the Contractor s secure Teleradiology network. Interpretation services will be conducted by board certified Radiologists. Contractors shall provide all professional personnel and technical support, medical and other equipment, telecommunication, supplies, and supervision necessary to perform, implement and administer these teleradiology services to meet the specific medical needs of the Pittsburgh VAMC. The Contractor is responsible for all Contractor personnel, Subcontractors, agents, and anyone acting for or on behalf of the Contractor. Records Management Language for Contracts When Federal agencies acquire goods or services, they need to determine what Federal records management requirements should be included in the contract. Federal contractors often create, send, or receive Federal records. Federal contracts should provide clear legal obligations describing how the contract employees must handle Federal records.  Agency records officers, procurement counsel, and acquisitions officers must discuss how to integrate records management obligations into their existing procurement processes. NARA has developed the following language to be included as an agency-specific term and condition in Federal contracts for a variety of services and products. The majority of contracts should include language on records management obligations, but each contract should be evaluated individually. For example, the data-rights paragraph (Paragraph 10 below) may not be appropriate for all contracts. Instead, agencies may be better served by one of the established data-rights clauses in the Federal Acquisition Regulations.  This language should not replace specific records management requirements included within Federal information system contracts.   RECORDS MANAGEMENT OBLIGATIONS A.  Applicability This clause applies to all Contractors whose employees create, work with, or otherwise handle Federal records, as defined in Section B, regardless of the medium in which the record exists.   B.  Definitions Federal record as defined in 44 U.S.C. § 3301, includes all recorded information, regardless of form or characteristics, made or received by a Federal agency under Federal law or in connection with the transaction of public business and preserved or appropriate for preservation by that agency or its legitimate successor as evidence of the organization, functions, policies, decisions, procedures, operations, or other activities of the United States Government or because of the informational value of data in them.   The term Federal record: includes [Agency] records.  does not include personal materials. applies to records created, received, or maintained by Contractors pursuant to their [Agency] contract. may include deliverables and documentation associated with deliverables. C.  Requirements Contractor shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. chs. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.  In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.  In accordance with 36 CFR 1222.32, Contractor shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.  [Agency] and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of [Agency] or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of  any unlawful or accidental removal, defacing, alteration, or destruction of records, Contractor must report to [Agency]. The agency must report promptly to NARA in accordance with 36 CFR 1230. The Contractor shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Contractor shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Contractor shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government s behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to [Agency] control or the Contractor must hold it until otherwise directed. Items returned to the Government shall be hand carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4). The Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Contractor (and any sub-contractor) is required to abide by Government and [Agency] guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information. The Contractor shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with [Agency] policy.  The Contractor shall not create or maintain any records containing any non-public [Agency] information that are not specifically tied to or authorized by the contract.  The Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.  The [Agency] owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which [Agency] shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Contractor rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20. Training.  All Contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take [Agency]-provided records management training. The Contractor is responsible for confirming training has been completed according to agency policies, including initial training and any annual or refresher training.  [Note: To the extent an agency requires contractors to complete records management training, the agency must provide the training to the contractor.]  D.  Flowdown of requirements to subcontractors The Contractor shall incorporate the substance of this clause, its terms and requirements including this paragraph, in all subcontracts under this [contract vehicle], and require written subcontractor acknowledgment of same.  Violation by a subcontractor of any provision set forth in this clause will be attributed to the Contractor.  Records Management Language for Contracts | National Archives All services SHALL be performed within the territorial borders of the United States. I. Teleradiology Services: 1. The Contractor shall be responsible for management of all aspects of the contract, and this includes the following: Electronically distribute appropriate studies to board certified Radiologists for primary diagnosis. Provide professional radiology services, offsite from Pittsburgh VAMC. The most frequent regular usage of teleradiology services will be Monday-Thursday 8pm-8:00 am, and Friday 8pm through Monday 8:00 am, but 24-hour coverage is expected. Some interpretations will be requested STAT and other interpretations will be requested routine. Imaging procedures will include plain film cases, US cases, CT cases, CTA cases, and MRI cases. Provide configuration of the physical, operational, and procedural environment within the Pittsburgh VA Medical Center facilities radiology department and installation for the system to include broadband connectivity and assist VA Pittsburgh Healthcare System (VAPHS) facility in site preparation and support during transition. The images will be sent by VA's Teleradiology System (ISite Radiology) to the Business Partner through a VA approved Business Partner Gateway (BPG). Radiologists shall be available for telephone consultation regarding examinations and provide recommendations for appropriate procedures to referring clinicians. VA Technologists performing procedures to be interpreted may consult the Radiologist/contractor with questions regarding protocol of exams, possible contrast allergy questions or for direction regarding abnormal laboratory values, or questions regarding premedication. Relevant prior studies will be made available to the teleradiologist. Interpretations must compare current and prior studies. Radiologists will have access to CPRS, or to a health summary or be able to contact the ordering physician to obtain clinical information such as history, progress notes, medications, and laboratory values, as well as reports of prior radiologic examinations. The Radiologist providing the preliminary interpretation shall also perform the final interpretation and communicate any change in that interpretation to the referring or treating clinician and the practitioner contacted, date and time of this communication must be documented in the final report. If the study is technically limited or incomplete, and cannot be interpreted with certainty, the teleradiologist shall notify the referring clinician so that the study may be repeated. If this is not feasible, cannot be done immediately, or is not likely to be productive, the study must be reported, and the technical limitations of the interpretation described in the report. Documentation. All film interpretations will either meet or exceed established standards of timeliness, accuracy, content, and signature. Only VAPHS approved abbreviations will be used for documentation of the patient health record. (1) Routine interpretations: Completed and verified reports for routine studies are available in CPRS/Vista Imaging Information System within 48 hours of exam registration. (2) STAT interpretations: Provide preliminary report by fax to referring clinicians within 45 minutes of the teleradiologist receiving the request for interpretation. If the exam is a critical/emergent rest result, results also must be communicated by telephone to the referring physician. Final report will be verified within 48 hours of exam registration and available in CPRS/VISTA Imaging Information System. Each report (routine and stat interpretations) shall identify the films reviewed, objective findings, the Radiologist s impression of the patient s condition, and recommendation for treatment. Any incomplete report will be dedicated, transcribed, and verified within 24 hours of notification at no additional cost to Pittsburgh VAMC. Additional requirements apply if any exam demonstrates a critical/emergent test result, as defined in a Medical Center Memorandum, as excerpted, and listed as diagnoses #1 - #8 re-listed in this PWS under 1(a) (4).) Reporting Imaging Test Results/Critical Results . In the case of a critical finding, results must also be communicated by telephone to the referring physician or a licensed clinician who can address the critical finding. This communication must be documented in the report and includes the name of the clinician receiving the report, date, and time communicated. (3) All reports are to be in accordance with American College of Radiology (ACR) standards. Interpretations must include the following information: patient s full name, SSN, date of birth, reason for study, exam case number (accession number), date of study, date of interpretation, requesting physician, description of the exam, (body of the report), impression, name of interpreter and signature of Radiologist providing interpretation. The report shall list pertinent positive and negative findings. (i) Preliminary reports are to be provided by fax to referring clinicians within 45 minutes of receipt of exam. If the exam is a critical/emergency test result, the report also must be communicated by phone to the referring physician. Preliminary written reports must be kept until the final report is verified and until they are no longer needed for quality assurance and peer review purposes. Preliminary reports need not be entered in the medical record, however, any significant discrepancies between the preliminary and final report must be documented in the final report and the treating team notified with date and time of notification in the final report. (ii) Final written reports shall be transcribed and verified by the teleradiologist (electronically signed) within 48 hours of exam registration. (iii) The facility or Contractor providing teleradiology interpretation may temporarily store copies of reports and images but must delete or destroy all copies after the contract has expired, excepting records required for billing and reimbursement purposes. (4) Reporting Imaging Test Results/Critical Results Critical Test results in Imaging are defined as those interpretation findings which, if left untreated, could be life threatening or place the patient at serious risk. These results will require urgent intervention or change in patient management. Emergent Test results are findings that are associated with a high likelihood of short-term poor outcome and require immediate intervention or close monitoring. The Radiologist will communicate results of critical/emergent exams to the ordering practitioner or surrogate practitioner immediately upon interpretation as outlined below. Critical/Emergent Test results for Imaging Service will include, but not be limited to: Ectopic Pregnancy Testicular or Ovarian Torsion Pneumoperitoneum-not postoperative Acute Intracranial Hemorrhage Unstable Cervical Spine Fracture Thoracic or Lumbar Spine Fracture with cord compression Aortic Dissection Mediastinal or Retroperitoneal Hematoma Intracranial Mass with New Herniation Acute Pulmonary Embolism or Acute above the Knee DVT Hemoperitoneum Acute laceration of the Liver, Spleen or Kidney Acute cord compression Appendicitis Abscess requiring medical/surgical attention or intervention Bowel Necrosis Portal Venous Gas Acute Arterial Embolism/Occlusion Tension Pneumothorax Significantly Mal-positioned line or tube or unexpected foreign body Communication of critical/emergent imaging results will be direct. Direct Communication is defined as non-electronic dialogue between the diagnostic practitioner and ordering practitioner or another appropriate licensed provider by telephone. Documentation of communication of critical/emergency results will be included in the imaging report. This will include the name of the practitioner contacted, as well as date and time of communication. Electronic Communication (view alerts) may be used to communicate important/abnormal study findings that require attention by the ordering practitioner, but not necessarily in an immediate time frame. (ii) In addition, all reports (normal and abnormal) must have a diagnostic code which is dictated and transcribed along with the report or inserted at the time of report verification. Inline below are the diagnostic codes which must be used as they are used by the VHA.] Some of the diagnostic codes will generate view alerts which can convey important study findings that may require a change in patient management, but not necessarily within an immediate timeframe. The list of diagnostic codes used will be provided at time of contract award. Value Label 1200 1200 No AAA 1201 1201 AAA Present 1202 Unsat for AAA Screen 1000 No Alert Required 1001 Significant Abnormality 1002 Critical Abnormality 1003 Possible Malignancy (iii) A method has been established to relay the results of abnormal exams performed off routine business hours. The AOD will be contacted by the contractor and the AOD will facilitate communication with either the ER attending or responsible clinician on call. In all cases, should there be difficulty in reaching the clinician responsible, the ER attending Medical Officer of the Day will serve as point of contact. All Radiologists providing preliminary or final reports will be required to read the abnormal reporting policy, sign that the policy was reviewed and is understood, prior to providing interpretations. The contractors shall distribute the policies, obtain signed policies, and ensure that the process outlined in MCP TX-144 is followed by Radiologists reading for Pittsburgh VAMC. The contractor will distribute these to all Radiologists and obtain signed receipt and acknowledgement of understanding for Radiologists providing interpretation. Signed acknowledgement must be submitted prior to contract implementation. A schedule for teleradiology service days will be submitted monthly and approval is required by Radiology Manager or Imaging Chief. The names of the VETPRO credentialed Radiologists and dates of their scheduled coverage must be received by the VA in advance from the contractor no later than the 20th workday of the month prior to the work schedule. Contractor must all at least 3 months after receipt/completion of all required documentation for any new Radiologist to be credentialed and privileged prior to scheduling. Contractors will be responsible for transcription services, report corrections, and sign reports electronically. Again, ALL reports must be signed by the interpreting Radiologist within 48 hours of exam registration. Contractor will install, secure, and maintain external communication systems required for image study delivery to remote Radiologists. Configure, install, and maintain Virtual Private Network all remote workstation software on the remote reading Radiologist workstation. These connections must comply with specifications in VA Handbook 6500. The remote Connection to the VA will be through a VA approved Business Partner Gateway (BPG). Teleradiologists performing work under this contract may also connect remotely to the VA using the Citrix Access Gateway VPN. Contractors must ensure that their own specific computers are capable of diagnostic interpretation and at the same time adhere to all VA security requirements. The extension of the network is fully functional, and Radiologists must have clinical privileges at the Pittsburgh VA Medical Center. Contractors will access current and prior comparison studies (if comparison studies exist) utilizing a secure VA Business Partner Gateway or similarly functional, rapid, and secure technology. Contractors shall provide and maintain the means for enabling this access. Contractor should install and maintain external communication systems required for secure, VA-compliant image and data delivery to its teleradiologists and will configure, install, and maintain all remote workstation software at its teleradiologists reading stations and will ensure security to VA Data. Contractor will expeditiously provide all requested information to VAPHS Information Security Officer (ISO) and Information Resources Management (IRM). Implement a Vista Rad/Vista Imaging/Philips ISite compatible DICOM appliance for transfer of images from Philips ISite Radiology to the DICOM server. Contractor Proposal shall include the specific hardware and software to be utilized by the contractor. Provide training on the new workflow for location activated. This training course will be no more than four hours. Provide maintenance on all contractor-provisioned equipment and installed systems. The contractor shall make provisions for the proper maintenance and functioning of all imaging, teleradiology and associated equipment, facilities and fixtures as may reasonably be required by Physicians to perform services hereunder. Provide security as required by Health Insurance Portability and Accountability Act of 1996 (HIPAA) and maintain the security and integrity of patient information in accordance with applicable VA regulations and HIPAA. Contractor will be required to follow all U.S. Laws and VA regulations regarding sensitive information, patient confidentiality, and information security, as set forth in; Privacy Act of 1974, Computer Security Act of 1987, Clinger Cohen Act of 1996, OMB A-130 Appendix IIIk and VA, VHA Directives 6500, and all other applicable regulations. See FAR clauses 52.224-1 and 52.224-2 included herein. Develop a project implementation strategy with the Pittsburgh VAMC to include preparing building, establishing telecommunications VISTA interface, policies and procedures transfer, credentialing, privileging and training staff, reporting procedures, operational readiness, and phase in schedule. The Contractor shall provide a system that maintains a minimum of 99% up time performance rate (excludes downtime related to VA s network problems, Internet traffic or ISP provider problems used by Contractor). Failure to provide this will result in contract termination. Contractor shall provide hardware and selected software to be utilized at contractor site to include: (1) Facsimile, telephone, networking and other telecommunications equipment to be utilized at contractor facility. (2) all supplies, services, maintenance, repairs and upgrades required at contractor facility to provide services as described above. (3) equipment hardware, software and supplies must be compatible with the VA s software (Vista Imaging, Powerscribe, Philips ISite Radiology) and hardware used during performance of this contract including critical patches and antivirus updates. Contractor shall provide proof of installation of critical patches and/or antivirus updates to the VA upon request. (4) network and security system must be compatible with the VA s network and security system. Contractor s system must be able to receive DICOM images to the Contractor server via secure VA facility-initiated VPN connection over the Internet. q. Contractor shall provide peer review data (quality assurance cross reads) on a quarterly basis for each Radiologist providing interpretations to Pittsburgh VA Medical Center. A copy will be provided to VAPHS for review. r. Contractor shall be responsible for ensuring that all providers/subcontractors complete training required by Pittsburgh VA Medical Center (Ethics, Cybersecurity, Privacy, etc.). The VAPHS will require documentation of completion. s. Contractor shall appoint one Radiologist to serve as a trainer for other Radiologists assigned to VAPHS. 2. The Pittsburgh VAMC will be responsible for: (a) The Pittsburgh VA Medical Center will be responsible for credentialing doctors to work in a timely fashion. An application package will be provided by the VA to be completed by the candidate. This includes Curriculum vitae, current references, signed release of information from candidate, and statement that candidate does not have any physical or mental health condition that would adversely affect his/her ability to carry out assigned duties, and additional credentialing and privileging forms. Candidate will also be required to make application through the VET-PRO Internet process. Candidates will need to be enrolled in VET-PRO by the Credentialing and Privileging Coordinators. The website address is: http://fcp.vetpro.org/ (b) Prepare site for installation of the system. Obtain VA Authorization for installation of a separate network connection, located inside the hospital but outside the firewall, and a network connection of the DICOM store and Forward device that will be installed inside the Pittsburgh VAMC. The VA will establish accounts and authorize radiology module privileges for the use by contractors. IF REQURED c through e. (c) Floor space, workspace, and power adequate for a PC tower computer, monitor and keyboard at customer site. (d) 19" Rack space equivalent to 6u in computer room (to accommodate the server and IPS) and an outlet. (e) Physical space in computer/Telco room for installation of Contractor-provided router and any remoter connectivity devices typically used by communications provider. (f) Physical security for computer systems. (g) Access to server and object forge devices for the installation of Category 5 cabling, if required. (h) Availability of technician for two hours of assistance. (i) IRM designated staff for testing and approval of installed remote connectivity solution. (j) Provide pertinent historical and demographic information on each patient sufficient for Contractor to perform its services. 3. PROCEDURE FOR TRANSMISSION OF IMAGES: Patient images along with exam Request forms for each patient will be transmitted via the VA's PAC System (VISTA IMAGING) through a data line provided by the Contractor. The request forms will include patient information, along with CPT codes. The Contractor shall interpret an exam and provide the Radiologist's final report and transmit using hardware/software provided by Contractor. Contractors shall use the same transcription services used at the Pittsburgh VAMC (CPRS/VISTA/Powerscribe Imaging Information System). Request(s) for stat interpretation or routine interpretation will be noted on the request form. CONTRACTOR REQUIREMENTS The Contractor shall provide all services specified in this contract for any person determined eligible by the Chief Medical Director, or Designee, regardless of the race, color, religion, sex, or national origin of the person for whom such services are ordered. The Contractor shall not subcontract as a means of circumventing this provision. Contractor must have a minimum of three years of experience providing off routine teleradiology interpretations for VA Medical Centers. The Contractor must be able to demonstrate consistent coverage (> 99% uptime for 3-year period). MEDICAL RECORDS STANDARDS: The Contractor shall maintain up-to-date medical records based on the Medical Record Compliance Standard as stated above. Utilization of CPRS is required. Medical center staff will provide technical training on the use and operation of CPRS during the start-up early operation stage and as updates become available. Medical center staff will provide at least annual Privacy Act training to appropriate contractor staff. The contractor, contractor employees, and subcontractors shall be subject to the Privacy Act of 1974 and HIPAA of 1996. The Contractor is not authorized to release any medical record information. The VAPHS is the sole entity authorized to release this information upon written request submitted via facsimile or mail from the patient. The VAPHS will provide the Contractor with access to pertinent patient medical information, within the existing privacy rules and regulations for the purpose of providing coordinated comprehensive primary care. Contractors shall ensure the confidentiality of all patient information and shall be held liable in the event of the breach of confidentiality. GUIDELINES: The Contractor will perform the functions required under this contract in accordance with the rules of medical ethics, Federal, State and local laws, rules and regulations, Joint Commission, and American College of Radiology (ACR.) for communication and teleradiology. The Contractor shall not participate nor be a party to any activities which are in conflict with Federal and/or State guidelines. In the event the Contractor encounters said conflicting situations, the Contractor shall notify the COTR or the Contracting Officer to resolve such issues. The Contracting Officer will document and be responsible for resolution of any such situations. Neither the VA nor the Contractor will be responsible for any delays or failures to perform due to causes beyond each party's control. The VA and the Contractor may, upon mutual consent, modify the timing and schedule of services. The Contractor shall be following Joint Commission standards and shall submit a copy of either their Joint Commission accreditation OR comparable statement with their proposal. Complications review, double reading, and other appropriate monitors must be conducted and report forwarded to Pittsburgh VAMC quarterly. Failure to provide required documentation would be a breach of the contract and subject to the contract being revoked. Any occurrence of a sentinel event or potential sentinel event involving a VA patient will be reported to the facility as soon as the event is detected. Comprehensive review of the case will be provided to the appropriate VA facility. 4. QUALITY MONITORING PROGRAM: The Contractor shall have a quality monitoring program and shall agree to comply with the requirements for meeting the JCAHO program as outlined by the VA radiology programs. Quarterly data will be provided to the VAPHS Pittsburgh Manager/Supervisor for each Radiologist credentialed at Pittsburgh VA Medical Center. Contractor must perform quality assurance cross reads and monitor appropriate communication of critical/emergency results as per MCM TX-144. Both sets of data will be provided to VAPHS quarterly. QUALITY CONTROL: The Contractor's facilities, methodologies, and quality control procedures may be examined by the VA Contracting Officer or his (her) designee at any time during the life of the contract. Quality Assurance Surveillance Plan (QASP): This QASP shall be changed at the sole discretion of the Government throughout the life of the contract via a unilaterally awarded modification. Performance Objective SOW Paragraph Performance Measure 1. Prompt delivery of interpretations and return of films. 1.c. and 1.d.. Zero tolerance for late reports 2. Availability of Radiologist. 1.a. Zero tolerance for non-availability 3. Maintains patient privacy/confidentiality. Special Contract Requirements Standard is zero breaches of privacy 4. Maintains appropriate Federal, state licensure/ certification requirements Special Contract Requirements Mandatory prior to performance of duties 5. All documentation will meet or exceed standards, to include but not limited to accuracy, content and signature. 1.d. Zero tolerance for violations 6. Timeliness Patient Records. Reports are to be completed and verified within 48 hours of exam registration. Stat reports must be faxed to requesting clinician within 45 minutes of when the contractor receives request. All critical/emergent exam results must be called to requesting clinician and this is documented in the final report (clinician name, date, and time). 1.f. 95% Compliance Acceptable Quality Level COTR will monitor Zero tolerance for violations. 7. Adheres to all HIPAA requirements. Special Contract Requirements Standard is zero breaches of HIPAA requirements. 8. Adequate Coverage 1.a. 100% Acceptable Quality Level COTR will monitor Zero tolerance for violations. (a) The Government will periodically evaluate the Contractor s performance by appointing a representative(s) to monitor performance to ensure services are received. The Government may inspect each task as completed or increase the number of quality assurance inspections if deemed appropriate because of repeated failures or because of repeated customer complaints. Likewise, the Government may decrease the number of quality assurance inspections if performance dictates. VAPHS Quality Assurance Personnel will validate any complaints and report to the Government Contracting Officer who will then take necessary action to enforce contract compliance. (b) If any of the services do not conform to contract requirements, the Government may require the Contractor to perform the services again in conformity with contract requirements, at no increase in contract amount. When the defects in services cannot be corrected by re-performance, the Government may result in contract termination. CONTRACTOR STANDARDS: Contractor is responsible for developing and maintaining written policies and procedures for licensure and certifications, competency evaluations, orientation, and continuing education, that are appropriate for the scope of care and services provided by employees and subcontractors under this contract. SPECIAL CONTRACTOR RESPONSIBILITIES: The Contractor must possess all licenses, permits, accreditation and certificates as required by law. The Contractor must perform the required work in accordance with Joint Commission, VHA and other regulatory standards. Joint Commission standards may be obtained from the Joint Commission on Accreditation of Healthcare Organizations, One Renaissance Blvd, Oakbrook Terrace, IL 60181. Requirement Timeline Peer Review (FPPE/OPPE) Quarterly Invoices Monthly VA Cyber Security Awareness and Rules of Behavior Yearly at beginning of Option Year Contractor Rules of Behavior Yearly at beginning of Option Year VA privacy training Yearly at beginning of Option year SUBCONTRACTOR PROVIDED SERVICES: All personnel that provide services under this contract and are not employees of the Contractor will be regarded as Subcontractors. The Contractor shall be responsible and accountable for the quality of care delivered by all of its Subcontractors. The Contractor shall hold the Subcontractor accountable for the requirements for availability and accessibility of services as outlined in this contract. The Contractor shall use a systematic approach to monitoring the availability and accessibility of services of the Subcontractor as they relate to the quality-of-care monitoring. CONTRACTOR EQUIPMENT/SOFTWARE: Upon completion or termination of the contract VPN software will be removed from contractor s equipment. Any network accounts will be disabled. All VA data gathered, created, received, or processed during the performance of the contract will be returned to the VA or certificate of destruction provided. No data will be retained by the contractor or its subcontractors. CONTRACTOR NETWORK ACCESS: The VA network is protected from unauthorized access by assigning a distinct Access and Verify code to each user of the network. Each Contractor staff person, hereinafter referred to as user , must agree to the VA standard user application. Violation of the agreement as a whole or in part may result in permanent revocation of access for the user. REGULATORY INFORMATION: The Food and Drug Administration classifies VistARad as a medical device. As such, it may not be changed except as directed by the Vista Imaging SD&D group. Modifications to this software may result in an adulterated medical device under 21CFR820, the use of which is a violation of US Federal Statutes. To ensure compliance the VA will implement measures, including but not limited to, security policies, anti-virus devices, anti-intrusion devices, and periodically monitor the equipment. Any attempt to defeat or circumvent any of these measures may constitute a breach of this contract and result in revocation. II. SPECIAL CONTRACT REQUIREMENTS 1. SERVICES: The services specified herein of this Work Statement may be changed by written modification to this contract. The modification will be prepared by the VA Contracting Officer. The services to be performed by the contractor will be performed in accordance with VA policies. (already mentioned) 2. RESPONSIBILITY OF THE CONTRACTOR: The Contractor must obtain authorization from the Contracting Officer for any services required outside the scope of work provided herein. 3. TERM OF CONTRACT AND PRICING: Pricing will be based on a flat fee for type of procedure. One invoice will be submitted to Pittsburgh VAMC for interpretations performed for radiology monthly, listing all studies interpreted, time and date of receipt by the contractor and time and date of final interpretation provided by the contractor for each. 4. HOURS OF WORK: The Contractor as defined herein shall furnish the services covered by this contract. The Contractor is required to furnish teleradiology services 24 hours a day / 7 days a week. 5. QUALIFICATIONS: The Contractor shall be responsible to ensure that Contractor personnel providing work under this contract are fully trained and completely competent to perform the required work. Prospective providers must present appropriate credentialing information including, but not limited to, the following: (a) Possess the M.D. (medical doctor) or O.D. (Doctor of Osteopathic Medicine) degree (b) Board certification in Diagnostic Radiology by the American Board of Radiology (c) licensure in state of practice (d) Clinical practice experience of at least two years (e) General Liability and Malpractice insurance (f) Barrier free office environment, equipment, and space to meet JCAHO, Federal and State standards (g) The contractor must be a U.S. based corporation capable of final interpretation and reporting services via the Contractor s secure Teleradiology network. Interpretation services will be conducted by board certified. The contractor shall provide all professional personnel and technical support, medical and other equipment, telecommunications, supplies, and supervision necessary to perform, implement and administer these teleradiology services to meet the specific medical needs of the VA Pittsburgh Medical Center. The Contractor is responsible for all Contractor personnel, Subcontractors, agents, and anyone acting for or on behalf of the Contractor. Services provided under the contract are not to be performed outside of the United States. Contracting to Radiologists outside of the territories of the USA is prohibited. No subcontracting to locum tenens is allowed. The qualifications of such personnel shall also be subject to review by the VA Chief of Staff and/or Chief, Imaging Service and approved by the VA Facility Director at Pittsburgh VA Medical Center. Credentials will be updated annually during the term of the contract to ensure there has been no lapse in licensure, insurance coverage, etc. No changes of employee will be allowed without prior authorization by the Contracting Officer in WRITING, 15 days in advance. VA reserves the right to approve the assignment of individual personnel furnished by the Contractor to perform the functions specified in the contract. Residents are not permitted to provide preliminary or final interpretations. The Contractor is required to maintain records that document competence/performance levels of Contractor personnel working on this contract in accordance with JCAHO, and other regulatory body requirements. The Contractor will provide a current copy of the competence assessment checklist and semi-annual performance evaluation to the COTR for each Contractor's personnel working on this contract. VA may request the personnel records of any employee providing services under this contract for competency review. The VA reserves the right to request copies of current certifications and/or licenses at any time during the duration of the contract. 6. LIABILITY Radiologists are responsible for the accuracy of their reports. Transcriptions must be corrected by the Radiologist before report verification. Radiologists are responsible for the accuracy of preliminary reports and notifications made directly to clinicians. Residents are not permitted to provide preliminary or final reports. Radiologists must carry their own malpractice insurance. Coverage for malpractice claims is required when final reports are provided, and when notifications or preliminary reports are communicated directly to non-Radiologist clinicians. 7. PERSONNEL POLICY: (a) General: The Contractor shall assume full responsibility for the protection of its personnel furnishing services under this contract in accordance with the personnel policy of the Contractor, such as providing worker's compensation, professional liability insurance, health examinations, income tax withholding, and social security payments. (b) Worker's compensation and employer's liability: (c) In accordance with FAR clause 28.307-2, the following applies: The Contractor is required to comply with applicable Federal and State workers compensation and occupational disease statues. If occupational diseases are not compensable under those statues, they shall be covered under the employer's liability, except when contract operations are so commingled with the Contractors commercial operations that it would not be practical. Employer's liability coverage of at least $100,000 is required except for states that do not permit workers' compensation to be written by private carriers. 1. General Liability: $500,000 per occurrence 2. Professional Medical Liability: One (1) million 8. EXCHANGE OF DATA: Patient medical records shall be exchanged as needed by both facilities and remain confidential. 9. INSURANCE - EVIDENCE OF COVERAGE: Before commencing work under this contract, the Contractor shall furnish certification to the Contracting Officer that the coverage required has been obtained and such Policy shall state "THIS POLICY MAY NOT BE CHANGED OR CANCELED WITHOUT WRITTEN NOTICE TO THE VA". Said policy must bear an appropriate "loss payable clause" to the United States as its interest may appear. Such evidence of insurance will not be waived. 10. CONTRACT MONITORING: Radiology Service will appoint a Contracting Officer Representative (COR) upon award of this contract. Pursuant to the Delegation of Authority to be issued, the COR will be responsible for verifying contract compliance. Monitors of Clinical Performance: Peer review of interpretations may be performed periodically. Errors in interpretation or incompleteness in documented communication of urgent findings may be aggregated and compared to other Radiologists. Complaints and compliments regarding interactions with other care givers, availability and responsiveness and usefulness of consultations may be reviewed. Timeliness of teleradiology STAT results notification, and report verification will be monitored. Radiologists are expected to participate in focus reviews and morbidity and mortality reviews of those incidents in which they provided care. The COTR s will periodically evaluate workload accomplished during the contact period to ensure necessary services are consistently provided. After contract award, any incident of contractor noncompliance shall be forwarded immediately to the Contracting Officer. 12. CONFIDENTIALITY: The Contractor understands and agrees that the information in the medical records of all patients is confidential. Strict confidentiality is to be maintained, Rules of Confidentiality expected to be conformed with are delineated in 38 USC. 3301, 38 USC 4132, 5 USC 552 (a) et. seq. The Contractor and its personnel shall be held liable in the event of breach of confidentiality. Any person, who knowingly or willingly discloses confidential information from the authorizing VA facility, may be subject to fines. The Contractor will be HlPAA compliant. (a) The contractor will comply with all confidentiality rights regarding patient information contained in patient medical records. Any disclosure of protected health information will be limited to that portion of the medical record needed to fulfill the specific purpose of the disclosure. (b) Unless expressly authorized by the patient or the patient s duly appointed and authorized representative, the VAPHSs will not release any records regarding psychiatric care, alcoholism/alcohol abuse, drug abuse, HIV virus or HIV virus test results. The VAPHSs will be solely responsible for securing, verifying, and approving authorization for the reproduction of records regarding psychiatric care, alcoholism/alcohol abuse, drug abuse HIV virus or HIV virus test results. (c) The contractor assumes no responsibility for any losses or liability that result, directly or indirectly, from inaccurate information, incorrectly dated material, insufficient or improper authorization, or any type of faulty medical record documentation furnished by the VAPHS. (d) The contractor will not provide copies of health information to any person other than the authorized requesting party. (e) Upon request, the contractor s representative will undergo all HIPAA/confidentiality related training and comply with all rules and regulations regarding protected health information. (f). Contractor represents and warrants that it complies with applicable electronic data transmission standards required by the U.S. government agencies for transmission of protected health information. (g). The contractor maintains an Errors and Omissions liability insurance policy which insures against a negligent act, error, or omission and the oral or written publication of material that violates a person s rights of privacy. The contractor also maintains a Commercial General Liability Policy. Evidence of coverage will be provided to the VAPHSs credentialing departments upon request. 13. ACCESS TO RECORDS: Contractor personnel who obtain access to hardware or media which may store drug or alcohol abuse data, sickle cell anemia treatment records, records or tests or treatment for or infection with HIV, medical quality assurance records, or any other sensitive information protected under 38 USC §4132 or §3305, as defined by the Department of Veterans Affairs, shall not access the records unless absolutely necessary to perform their contractual duties. Any individual who has access to these data will disclose them to no one, including other personnel of the Contractor not involved in the performance of the contractual duty for which access was obtained. Violation of these statutory provisions, as stated in department regulations by the Contractor's personnel, may involve imposition of criminal penalties. 14. COMPUTER SYSTEM SECURITY: The Contractor shall provide VHA with the full assurance that security measures have been implemented which are consistent VA Departmental Standards. In accordance with the Federal Information Security Management Act (FISMA), the Privacy Act of 1974, as amended, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as applicable, and Public Law 109-461, §5725, contractor access to VA information and information systems must be maintained at the highest level of protection in order to thwart unauthorized disclosure of sensitive information (as defined in VA Handbook 6500, Information Security Program). Federal Acquisition Regulation part 2.101 provides the following definition of contract. Contract means a mutually binding legal relationship obligating the seller to furnish the supplies or services (including construction) and the buyer to pay for them. It includes all types of commitments that obligate the Government to an expenditure of appropriated funds and that, except as otherwise authorized, are in writing. In addition to bilateral instruments, contracts include (but are not limited to) awards and notice of awards; job orders or task letters issued under basic ordering agreements; letter contracts; orders, such as purchase orders, under which the contract becomes effective by written acceptance or performance; and bilateral contract modifications. Contracts do no not include grants and cooperative agreements covered by 31 U.S.C. 8301, et. seq." Per OMB M-07-19, FY 2007 Reporting Instructions for FISMA and Agency Privacy Management, there are five primary categories of contractors as they relate to securing systems and information: 1) service providers, 2) contractor support, 3) Government owned, contractor operated facilities, 4) laboratories and research centers, and 5) management and operating contracts. The requirements document provides standardized security/privacy requirements for VA contractors that support activity involving access to, and use of, sensitive information across the Department. The requirements apply to:  (1) All VA or contracted services and information resources located and operated at contract facilities, at other government agencies that support VA mission requirements, or any other third-party using VA sensitive information in order to perform a VA authorized activity.  (2)  All contracts in which VA sensitive information is used, stored, generated, transmitted, or exchanged by VA, a contractor, subcontractor or a third party, or on behalf of any of these entities, regardless of format (e.g., paper, microfiche, electronic or magnetic portable media) or whether it resides on a VA owned system or contractor/subcontractor's system operating for or on behalf of VA. To obtain a copy of the requirements document clink on the following hyperlink:  Security and Privacy Requirements for IT Contracts http://www.iprm.oit.va.gov/docs/Security_and_Privacy_Requirements_for_IT_Contracts_Attachment.pdf 15. PROCEDURES FOR ACCESS: Access requirements to VA information systems by Contractors and Contractor personnel shall meet or exceed those requirements established for personnel as described in VHA Directives. A written and signed request for user access by VHA Management, or designee(s), constitutes management approval (sponsorship) to initiate a request for access to any sensitive automated information system. Access shall be granted to non-VA users only if the purpose of access meets criteria of the Privacy Act and VA Confidentiality regulations and transfer. Contractors personnel will be required to sign before starting work under this contract and abide by the VA National Rules of Behavior Agreement. 16. TELECOMMUNICATIONS AND SECURE CONNECTION (a) The contractor will secure and maintain the communications link between the contractor s facility and the VAPHSs facilities at the contractor s expense. These expenses may be included in contractor s proposal as a separate item. (b) The contractor shall make provisions for the proper maintenance and functioning of all imaging, teleradiology and associated equipment, facilities and fixtures as may reasonably be required by Physicians to perform services hereunder. (c) The connectivity/functionality MUST be approved and verified by the VA prior to acceptance. Contractor shall be responsible for any costs associated with connectivity to VA System, to include configuring the system for connectivity to VA. (d) Transmission must be secure through a VPN connection approved by the Department of Veterans Affairs. (e) Data transmission security must be always maintained. VAPHS personnel must be notified immediately of any equipment malfunctions that would hinder the transmission of images. 17. SECURITY REQUIREMENTS FOR CONTRACTOR EMPLOYEES a. Contractor(s) shall ensure the confidentiality of all patient and employee information and shall be held liable in the event of breach of confidentiality according to federal regulations contained in HIPPA. Any person who knowingly or willingly discloses confidential information from the VA Medical Center, may be subject to fines of up to $50,000.00 and may be subjected to civil litigation from the patient. b. Background Investigations: Contractor(s) personnel performing work under this contract shall satisfy all requirements for appropriate security eligibility in dealing with access to sensitive information systems belonging to or being used on behalf of the Department of Veterans Affairs. To satisfy the requirements of the Department of Veterans Affairs a Minimum Background Investigation shall be conducted prior to performing work under this contract. The level of access and the individual s capability to perform work under this contract will be the determining factor in deciding if a higher investigative requirement is needed. The Contractor(s) shall ensure that those requirements are fully satisfied within 30 days of initiation of such investigations. c. The investigation history for Contractor(s) personnel working under this contract must be maintained in the databases of either with the Office of Personnel Management (OPM) or the Defense Industrial Security Clearance Organization (DISCO). Should the Contractor(s) use another vendor other than OPM or Defense Security Service (DSS) to conduct the investigation, the investigative company must be certified by OPM/DSS to conduct Contractor(s) investigations. The Contractor shall maintain a Drug-free Workplace in accordance with Federal regulations. The Contractor shall establish and maintain a drug-free workplace program. The administration of this program will be the responsibility of the contractor, as well as the establishment of disciplinary actions. d. All costs associated with obtaining clearances for Contractor(s) provided personnel shall be the responsibility of the Contractor(s). Further, the Contractor(s) shall be responsible for the actions of those individuals they provide to perform work for the VA under this contract. If damages arise from work performed by Contractor(s) provided personnel, under the auspices of this contract, the Contractor(s) shall be responsible for all resources necessary to remedy the incident. e. Records: Contractor(s) personnel who obtain access to hardware or media which may manipulate or store drug or alcohol abuse data, sickle cell anemia treatment records, records or tests or treatment for or infection with HIV, medical quality assurance records, or any other sensitive information protected under 38 U.S.C. §4132 or §3305, as defined by the Department of Veterans Affairs, shall not have access to the records unless absolutely necessary to perform their contractual duties. Any individual who has access to these data will disclose them to no one, including other employees of the Contractor(s) not involved in the performance of the contractual duty for which access was obtained. Violation of these statutory provisions, as stated in department regulations by the Contractor(s) s employees may involve imposition of criminal penalties. f. System of Records: The Veterans Administration system(s) of records to which the Contractor(s) personnel will have access to maintain is Patient Medical Records VA (24VA136). g. System Security: The Contractor(s) shall provide VHA with full assurance that security measures have been implemented which are consistent with VA Departmental Standards. h. Procedures for User Access: Access requirements to VA information systems by Contractor(s) and Contractor(s) personnel shall meet or exceed those requirements established for VHA employees as described in VHA Directives (and others) and in any subsequent VHA policy statements. A written and signed request for user access by VHA Management, or designee(s), constitutes management approval (sponsorship) to initiate a request for access to any sensitive automated information system. Access shall be granted to non-VA users only if the purpose for access meets criteria of the Privacy Act and VA Confidentiality regulations and transfer. i. Contractor(s) shall sign and abide by the VA National Rules of Behavior. 18. KEY PERSONNEL AND TEMPORARY EMERGENCY SUBSTITUTIONS: The Contractor shall assign to this contract key personnel to perform services. a. During the first ninety (90) 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 Contracting Officer, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (b) below. After the initial 90-day period of the contract, the Contractor shall submit the information required to the Contracting Officer at least 15 days prior to making any permanent substitutions. b. 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 Contracting Officer. Proposed substitutes shall have comparable qualifications to those of the people being replaced. The Contracting Officer will notify the Contractor within 15 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. 19. DEFINITIONS/ACRONYMS: The following terms, when used in this contract, will be construed and/or interpreted as follows: Contracting Officer: A person with the authority to enter, administer, and/or terminate contracts and make related determinations and findings. COR: (Contracting Officer s Representative) A person who takes 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. Any indication of non-compliance shall be promptly reported to the Contracting Officer so that appropriate action can be taken. COTR: (Contracting Officer s Technical Representative) Covered Services: The term, covered services, means those specific services as listed in the contract or for which the Pittsburgh VA Medical Center has provided prior written agreement to pay the Contractor. CPT: (Current Procedural Terminology) A coding system developed by the American Medical Association and a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. The purpose of the terminology is to provide a uniform language that will accurately describe medical, surgical, and diagnostic services, and thereby provide an effective means for reliable nationwide communication among physicians, patients, and third parties. JCAHO Joint Commission on Accreditation of Healthcare Organizations. Service Location: Any location at which a patient obtains any healthcare service covered by the contractor pursuant to the terms of this contract. Third Party: Any entity or funding source, other than the enrolled patient or his/her responsible party, which is, or may be, liable to pay for all or part of the cost of medical care of the patient. VAPHS: Veterans Affairs Medical Center VHA: Veterans Health Administration VISN: Veterans Integrated Service Network VISTA: Veterans Health Information Systems & Technology Architecture (Formerly known as DHCP). End of Performance Work Statement (PWS). Page 51 of 17