Presolicitation Notice – R– Medical Record Peer Review
Notice Type: Presolicitation Notice
Posted Date:
Office Address:
Subject: R-- Medical Record Peer Review
Classification Code: R - Professional, administrative, and management support services
Solicitation Number: VA26317Q0740
Contact:
Description:
This is a PRESCOLICITATION NOTICE only. No proposals are being requested or accepted with this notice. THIS IS NOT A SOLICITATION FOR PROPOSALS OR PRICING AND NO CONTRACT SHALL BE AWARDED FROM THIS NOTICE. This notice shall not be construed as a solicitation or as an obligation on the part of the
The solicitation will be posted on the Federal Business Opportunities (FBO) website on approximately
Contracting Office Address:
Point of contact:
SCOPE OF CONTRACT
The Contractor shall provide all necessary personnel, facilities and resources to perform External Clinical Peer Review Services in accordance with specifications contained herein, on an as needed basis, for the
DESCRIPTION/SPECIFICATIONS/WORK STATEMENT
GENERAL INFORMATION
Clinical peer reviews are conducted to improve the delivery of healthcare processes through evaluation of patient care, safety and actual clinical performance of practitioners. External clinical peer reviews performed by the Contractor shall provide an honest, unbiased, professional review of care. Reviews shall be utilized to assist in the determination of quality of patient care provided.
Clinical Care to be reviewed shall primarily occur in Medicine (including subspecialties such as Nephrology, Cardiology, Pulmonary, Gastroenterology, Hematology/Oncology, Infectious Diseases, Neurology, and Dermatology) and Surgery (including such subspecialties Orthopedics, Podiatry, anesthesia, Thoracic, Ophthalmology, Urology, Otolaryngology, and Plastic Surgery), but may also be required in
DEFINITIONS
a. Physicians: Medical Doctors and Doctors of Osteopathy who have an active, current, full and unrestricted license to practice within an individual profession in a state, territory, or commonwealth within
b. Non-physician Providers: Non-physician providers, such as Chiropractors, Clinical Pharmacists, and Psychologists who have an active, current, full and unrestricted license to practice within an individual profession in a state, territory, or commonwealth within
c. Clinical Peer Reviewers: Physicians and non-physician providers who have education and clinical expertise in the same specialty as the practitioner involved in the care.
d. Clinical Peer Review Process: Evaluation of clinical care provided by physicians and provider(s) to determine the quality of care provided based on clinically recognized community standards.
e. Clinical Peer Review Form: Review information shall be documented on the (VISN 23) Midwest Health Care Network External Clinical Peer Review Form (Attachment 2).
STATEMENT OF WORK
CONTRACTOR PERFORMANCE
The Contractor shall perform external clinical peer review services as requested by the VISN 23 Contracting Officer's Representative (COR). The
The Contractor shall evaluate medical care according to clinically recognized community standards and/or practices including, but not limited to, clinical practice guidelines. Reviews shall be completed by physicians and providers from the same discipline/specialty as the practitioner(s) who provide care.
The Contractor shall retrospectively review medical records to address any questions or areas of concern the
The Contractor shall use the
The Contractor shall complete each requested review as shown in the schedule in the time frame specified after receipt of request and complete substantiating information in the format shown in attachment 2 to this document.
PLACE OF PERFORMANCE
The review process may be accomplished outside VISN 23; however, the Contractor shall provide a point of contact at the reviewing facility. This individual shall receive the medical records and external clinical peer review form, select appropriate clinical peer reviewer(s), ensure all sections of the clinical peer review form are complete and legible, and hand deliver or forward the information using a form of mail delivery that is mutually agreed upon by the VISN and the contractor.
CONFIDENTIALITY REQUIREMENTS
The information obtained during the review is considered confidential and privileged pursuant to 38 U.S.C. 5705 and 38 C.F.R. 17.541.
CONTRACTOR PERSONNEL REQUIREMENTS
Physicians performing external clinical peer reviews shall be board certified in the specialty in which clinical care is being reviewed, and maintain a current, valid and unrestricted license to practice within an individual profession in a state, territory, or commonwealth of
The Contractor shall maintain current credentialing on all physicians performing reviews under the contract.
APPENDIX C VA INFORMATION AND INFORMATION SYSTEM SECURITY/PRIVACY LANGUAGE
GENERAL
Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as
ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS
A contractor/subcontractor shall request logical (technical) or physical access to
All contractors, subcontractors, and third-party servicers and associates working with
VA INFORMATION CUSTODIAL LANGUAGE
Information made available to the contractor or subcontractor by
Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from
The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of
The contractor/subcontractor shall not make copies of
If
If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.
The contractor/subcontractor must store, transport, or transmit
Except for uses and disclosures of
Notwithstanding the provision above, the contractor/subcontractor shall not release
For service that involves the storage, generating, transmitting, or exchanging of
SECURITY INCIDENT INVESTIGATION
The term security incident means an event that has, or could have, resulted in unauthorized access to, loss or damage to
To the extent known by the contractor/subcontractor, the contractor/subcontractor s notice to
With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement.
In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with
LIQUIDATED DAMAGES FOR DATA BREACH
Consistent with the requirements of 38 U.S.C. --5725, a contract may require access to sensitive personal information. If so, the contractor is liable to
The contractor/subcontractor shall provide notice to
Each risk analysis shall address all relevant information concerning the data breach, including the following:
(1) Nature of the event (loss, theft, unauthorized access);
(2) Description of the event, including:
(a) date of occurrence;
(b) data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code;
(3) Number of individuals affected or potentially affected;
(4) Names of individuals or groups affected or potentially affected;
(5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text;
(6) Amount of time the data has been out of
(7) The likelihood that the sensitive personal information will or has been compromised (made accessible to and usable by unauthorized persons);
(8) Known misuses of data containing sensitive personal information, if any;
(9) Assessment of the potential harm to the affected individuals;
(10)Data breach analysis as outlined in 6500.2 Handbook, Management of Security and Privacy Incidents, as appropriate; and
(11)Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised.
d) Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the
(1) Notification;
(2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports;
(3) Data breach analysis;
(4) Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution;
(5)One year of identity theft insurance with
(6)Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs.
TRAINING
All contractor employees and subcontractor employees requiring access to
(1) Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to
(2) Successfully complete the VA Cyber Security Awareness and Rules of Behavior training and annually complete required security training;
(3) Successfully complete the appropriate
(4) Successfully complete any additional cyber security or privacy training, as required for
b) The contractor shall provide to the contracting officer and/or the COTR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required.
c) Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete.
6) VA HANDBOOK 6500.6 MARCH 12, 2010
APPENDIX D CONTRACTOR RULES OF BEHAVIOR
This User Agreement contains rights and authorizations regarding my access to and use
of any information assets or resources associated with my performance of services under
the contract terms with the
covers my access to all
systems and resources ("Systems"), and
incorporates Rules of Behavior for using
resources under the contract.
GENERAL TERMS AND CONDITIONS FOR ALL ACTIONS AND ACTIVITIES UNDER
THE CONTRACT:
a. I understand and agree that I have no reasonable expectation of privacy in
accessing or using any
b. I consent to reviews and actions by the
staff designated and authorized by the
OIG regarding my access to and use of any information assets or resources associated
with my performance of services under the contract terms with the
may include monitoring, recording, copying, inspecting, restricting access, blocking,
tracking, and disclosing to all authorized OI&T,
directed by the VA CIO without my prior consent or notification.
c. I consent to reviews and actions by authorized
Information Security Officers solely for protection of the
not limited to monitoring, recording, auditing, inspecting, investigating, restricting access,
blocking, tracking, disclosing to authorized personnel, or any other authorized actions by
all authorized OI&T,
d. I understand and accept that unauthorized attempts or acts to access, upload,
change, or delete information on Federal Government systems; modify Federal
government systems; deny access to Federal government systems; accrue resources for
unauthorized use on Federal government systems; or otherwise misuse Federal
government systems or resources are prohibited.
e. I understand that such unauthorized attempts or acts are subject to action that may
result in criminal, civil, or administrative penalties. This includes penalties for violations
of Federal laws including, but not limited to, 18 U.S.C. --1030 (fraud and related activity in
connection with computers) and 18 U.S.C. --2701 (unlawful access to stored
communications).
f. I agree that OI&T staff, in the course of obtaining access to information or systems
on my behalf for performance under the contract, may provide information about me
including, but not limited to, appropriate unique personal identifiers such as date of birth
and social security number to other system administrators, Information Security Officers
(ISOs), or other authorized staff without further notifying me or obtaining additional written
or verbal permission from me.
g. I understand I must comply with
handbooks. I understand that copies of those directives and handbooks can be obtained
from the Contracting Officer's Technical Representative (COTR). If the contractor
believes the policies and guidance provided by the COTR is a material unilateral change
to the contract, the contractor must elevate such concerns to the Contracting Officer for
resolution.
h. I will report suspected or identified information security/privacy incidents to the COTR
and to the local ISO or Privacy Officer as appropriate.
GENERAL RULES OF BEHAVIOR
a. Rules of Behavior are part of a comprehensive program to provide complete
information security. These rules establish standards of behavior in recognition of the fact that
knowledgeable users are the foundation of a successful security program. Users must
understand that taking personal responsibility for the security of their computer and the
information it contains is an essential part of their job.
b. The following rules apply to all
(1) Follow established procedures for requesting, accessing, and closing user accounts
and access. I will not request or obtain access beyond what is normally granted to users or
by what is outlined in the contract.
(2) Use only systems, software, databases, and data which I am authorized to use,
including any copyright restrictions.
(3) I will not use other equipment (OE) (non-contractor owned) for the storage, transfer,
or processing of
been reviewed and approved by local management and is included in the language of the
contract. If authorized to use OE IT equipment, I must ensure that the system meets all
applicable 6500 Handbook requirements for OE.
(4) Not use my position of trust and access rights to exploit system controls or access
information for any reason other than in the performance of the contract.
(5) Not attempt to override or disable security, technical, or management controls
unless expressly permitted to do so as an explicit requirement under the contract or at the
direction of the COTR or ISO. If I am allowed or required to have a local administrator
account on a government-owned computer, that local administrative account does not
confer me unrestricted access or use, nor the authority to bypass security or other controls
except as expressly permitted by the VA CIO or CIO's designee.
(6) Contractors use of systems, information, or sites is strictly limited to fulfill the terms
of the contract. I understand no personal use is authorized. I will only use other Federal
government information systems as expressly authorized by the terms of those systems. I
accept that the restrictions under ethics regulations and criminal law still apply.
(7) Grant access to systems and information only to those who have an official need to
know.
(8) Protect passwords from access by other individuals.
(9) Create and change passwords in accordance with VA Handbook 6500 on systems
and any devices protecting
security settings for the particular system in question.
(10) Protect information and systems from unauthorized disclosure, use, modification, or
destruction. I will only use encryption that is FIPS 140-2 validated to safeguard
information, both safeguarding
my access to and use of any information assets or resources associated with my
performance of services under the contract terms with the
(11) Follow VA Handbook 6500.1, Electronic Media Sanitization to protect
information. I will contact the COTR for policies and guidance on complying with this
requirement and will follow the COTR's orders.
(12) Ensure that the COTR has previously approved
dissemination, including e-mail communications outside of the
make any unauthorized disclosure of any
means of communication including but not limited to e-mail, instant messaging, online chat,
and web bulletin boards or logs.
(13) Not host, set up, administer, or run an
use of any information assets or resources associated with my performance of services
under the contract terms with the
writing by the COTR.
(14) Protect government property from theft, destruction, or misuse. I will follow
directives and handbooks on handling Federal government IT equipment, information, and
systems. I will not take
from the COTR.
(15) Only use anti-virus software, antispyware, and firewall/intrusion detection software
authorized by
requirement and will follow the COTR's orders regarding my access to and use of any
information assets or resources associated with my performance of services under the
contract terms with
(16) Not disable or degrade the standard anti-virus software, antispyware, and/or
firewall/intrusion detection software on the computer I use to access and use information
assets or resources associated with my performance of services under the contract terms
with
significant alert messages to the COTR.
(17) Understand that restoration of service of any
the system.
(18) Complete required information security and privacy training, and complete required
training for the particular systems to which I require access.
ADDITIONAL CONDITIONS FOR USE OF NON- VA INFORMATION TECHNOLOGY
RESOURCES
a. When required to complete work under the contract, I will directly connect to the
network whenever possible. If a direct connection to the
will use
b. Remote access to non-public
publicly-available IT computers, such as remotely connecting to the internal
from computers in a public library.
c. I will not have both a
wireless network card, modem with phone line, or other network device physically
connected to my computer at the same time, unless the dual connection is explicitly
authorized by the COTR.
d. I understand that I may not obviate or evade my responsibility to adhere to
requirements by subcontracting any work under any given contract or agreement with
that any subcontractor(s) I engage shall likewise be bound by the same security requirements
and penalties for violating the same.
STATEMENT ON LITIGATION
This User Agreement does not and should not be relied upon to create any other right or
benefit, substantive or procedural, enforceable by law, by a party to litigation with the United
States Government.
Performance Requirements Summary Matrix
REQUIRED SERVICE
(Performance Requirement)
STANDARD
(Performance Standards)
MAXIMUM ALLOWABLE
Degree of Deviation (AQL)
METHOD OF SURVEILLANCE
(Quality Assurance)
MAXIMUM PAYMENT
Percentage for Meeting/
Exceeding the AQL (Incentives)
Medical and Dentistry Specialist Selection
The Contractor adheres to the established medical specialist qualifications and selection criteria as appropriate on a case-by-case basis.
Professional licensure
Clinical specialty/sub-specialty
Conflict of interest
No Deviation
95% performance review of each
Incentive: Outstanding performance review at the end of the contract period for meeting all mandated performance requirements.
Disincentive: Less than satisfactory performance review at the end of the contract period for not meeting all mandated performance requirements.
Medical Review Analysis/Special Projects Format
The Contractor will provide these deliverables in accordance with the established OPM format
The Contractor will maintain the ability to provide these deliverables in a secure electronic HIPAA compliant format in addition to traditional hard copy capability.
No Deviation
95% performance review of each
Incentive: Outstanding performance review at the end of the contract period for meeting all mandated performance requirements.
Disincentive: Less than satisfactory performance review at the end of the contract period for not meeting all mandated performance requirements.
Medical Review Analysis/Special Project Content
Each Medical Review Analysis will include the following:
Detailed Case Synopsis (comprehensive with inclusion of patient specific clinical information from the medical record)
Accurate assessment and response to each Medical Inquiry Question(s) in accordance with Health Plan definitions/policy statements
Credible medical/scientific literature and clinical practice guidelines cited to support determinations
Provision of all aforementioned references (hard copy) upon written request by the COR for medical and dental case reviews
Medical advisory opinion is consistent with prior and/or similar medical opinions rendered (when a standard of good medical practice has changed, the medical review acknowledges the change and appropriate references are cited and provided in hard copy- upon written request by the COR)
Credible medical/scientific literature and clinical practice guidelines cited to support determinations
Provision of all aforementioned references (100% hard copy)- for total references cited in excess of ten references, a mutually agreed upon number of hard copy references will be submitted with the reviewers report
with prior and/or similar medical
opinions rendered (when a standard of
good medical practice has changed, the medical review acknowledges the change and appropriate references are cited and provided in hard copy as noted above)
No Deviation
95% performance review of each
Incentive: Outstanding performance review at the end of the contract period for meeting all mandated performance requirements.
Disincentive:
Less than satisfactory performance review at the end of the contract period for not meeting all mandated performance requirements.
Rejected for quality
An
Quality of Deliverable Product
The Contractor will maintain a 95% satisfactory quality level of performance for all deliverable products
No Deviation
95% performance review with written report submission as noted in the Quality Control Section below
Incentive: 100% payment of the established flat fee.
Disincentive: The deliverable product will be subject to non-payment as noted above.
Timeliness of deliverables
The contractor shall deliver 95% of all deliverable written redacted products in accordance with the established timelines:
21 calendar days for routine medical and dental cases
14 calendar days for expedite/priority medical and dental cases
10 calendar days after the redacted copy is sent electronically for all written signed copies and accompanying medical records and accessories
Cited references will be submitted to OPM within 1 to 2 business days following receipt of the relevant work order
No Deviation without prior approval from the COR
95% performance review
Incentive: Outstanding performance review at the end of the contract period for meeting all mandated performance requirements.
Disincentive:
Less than satisfactory performance review at the end of the contract period for not meeting all mandated performance requirements.
Deliverables not meeting established timeliness with prior notification and acceptance by the COR will be subject to a 50% reduction in payment from the flat rate if late greater than 2 business days at the discretion of the COR.
Deliverables not meeting established timeliness without prior notification and acceptance by the COR will be subject to a 75% reduction in payment from the established flat rate.
Quality Control
The Contractor will maintain a database for OPM that tracks Medical Reviewers, Medical Reviews and Special Projects for the following minimum parameters:
Individual Medical specialist activity for OPM:
-Number of cases
reviewed by category
(Routine and Expedite)
Number of cases
rejected for quality issues or
timeliness issues
-corrective action taken for all
rejected cases and timeliness
issues
Medical Reviews/Special Projects by specialty or case topic
During the Base Year the Contractor shall submit quarterly written Quality Control Reports that reflects the efforts of the Quality Review Team; then bi-annually unless otherwise directed by the COR. Content of the written report will be mutually agreed upon.
No Deviation without prior approval from the COR
Quarterly Quality Control Review written report during the Base year then Bi-annual unless otherwise directed by the COR
Incentive: Outstanding performance review at the end of the contract period for meeting all mandated performance requirements.
Disincentive: Less than satisfactory performance review at the end of the contract period for not meeting all mandated performance requirements.
SCHEDULE OF SUPPLIES/SERVICES
(Continuation of Standard Form 1449, block 20)
BASE PERIOD:
Item No.
Description
Est. Quantity
Unit
Unit Price
Total
0001
Focused Peer Review (STND)-(See Below)
250
EA
$
$
0002
Focused Peer Review (EXP) (See Below)
50
EA
$
$
0003
Comprehensive Peer Review (STND) (See Below)
50
EA
$
$
0004
Comprehensive Peer Review (EXP) (See Below)
50
EA
$
$
0005
Comprehensive Medical Advisory Opinion
50
EA
$
$
0006
Non-Protected Administrative Case Review
150
EA
$
$
0007
Expert Medical Opinion
50
EA
$
$
0008
Ad Hoc Peer Review Committee Member
50
EA
$
$
OPTION YEAR ONE:
Item No.
Description
Est. Quantity
Unit
Unit Price
Total
0001
Focused Peer Review (STND)-(See Below)
50
EA
$
$
0002
Focused Peer Review (EXP) (See Below)
10
EA
$
$
0003
Comprehensive Peer Review (STND) (See Below)
10
EA
$
$
0004
Comprehensive Peer Review (EXP) (See Below)
10
EA
$
$
0005
Comprehensive Medical Advisory Opinion
10
EA
$
$
0006
Non-Protected Administrative Case Review
30
EA
$
$
0007
Expert Medical Opinion
10
EA
$
$
0008
Ad Hoc Peer Review Committee Member
50
EA
$
$
OPTION YEAR TWO:
Item No.
Description
Est. Quantity
Unit
Unit Price
Total
0001
Focused Peer Review (STND)-(See Below)
50
EA
$
$
0002
Focused Peer Review (EXP) (See Below)
10
EA
$
$
0003
Comprehensive Peer Review (STND) (See Below)
10
EA
$
$
0004
Comprehensive Peer Review (EXP) (See Below)
10
EA
$
$
0005
Comprehensive Medical Advisory Opinion
10
EA
$
$
0006
Non-Protected Administrative Case Review
30
EA
$
$
0007
Expert Medical Opinion
10
EA
$
$
0008
Ad Hoc Peer Review Committee Member
50
EA
$
$
OPTION YEAR THREE:
Item No.
Description
Est. Quantity
Unit
Unit Price
Total
0001
Focused Peer Review (STND)-(See Below)
50
EA
$
$
0002
Focused Peer Review (EXP) (See Below)
10
EA
$
$
0003
Comprehensive Peer Review (STND) (See Below)
10
EA
$
$
0004
Comprehensive Peer Review (EXP) (See Below)
10
EA
$
$
0005
Comprehensive Medical Advisory Opinion
10
EA
$
$
0006
Non-Protected Administrative Case Review
30
EA
$
$
0007
Expert Medical Opinion
10
EA
$
$
0008
Ad Hoc Peer Review Committee Member
50
EA
$
$
OPTION YEAR FOUR:
Item No.
Description
Est. Quantity
Unit
Unit Price
Total
0001
Focused Peer Review (STND)-(See Below)
50
EA
$
$
0002
Focused Peer Review (EXP) (See Below)
10
EA
$
$
0003
Comprehensive Peer Review (STND) (See Below)
10
EA
$
$
0004
Comprehensive Peer Review (EXP) (See Below)
10
EA
$
$
0005
Comprehensive Medical Advisory Opinion
10
EA
$
$
0006
Non-Protected Administrative Case Review
30
EA
$
$
0007
Expert Medical Opinion
10
EA
$
$
0008
Ad Hoc Peer Review Committee Member
50
EA
$
$
TOTAL ESTIMATED COSTS FOR BASE AND ALL OPTION YEARS $__________
Explanation Notes:
STND: Standard Review-Price: These must be completed within 21 days.
EXP: Expedited Review Price: These must be completed within 10 days.
DEFINITIONS:
FOCUSED PEER REVIEW: Evaluates and addresses specific elements of the case and answers questions posed by the client.
COMPREHENSIVE PEER REVIEW: Evaluates all aspects of the clinical care provided to the patient.
MEDICAL ADVISORY OPINION: Review of medical care activities for the purpose of assisting
ADMINISTRATIVE CASE REVIEW: Non-protected review of medical care activities for anticipated administrative or personnel actions.
EXPERT MEDICAL OPINIONS: Review and documentation of medical findings related to a disability claim for
AD HOC PEER REVIEW COMMITTEE MEMBER: Participate virtually as a medical specialty expert committee member, with use of review information and documentation provided related to case(s) being presented for discussion.
Link/URL: https://www.fbo.gov/spg/VA/VABHHCS568/VABHHCS568/VA26317Q0740/listing.html
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