Independent Medical Examinations for the Public Safety Officer's Benefits Program

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Contract Opportunity

PUBLIC SAFETY OFFICERS' BENEFITS (PSOB) OFFICE

BUREAU OF JUSTICE ASSISTANCE

PUBLIC SAFETY OFFICER'S BENEFITS PROGRAM

INDEPENDENT MEDICAL EXAMINATION (IME) SERVICES

REQUEST FOR INFORMATION

This Request for Information (RFI) is being released pursuant to the Federal Acquisition Regulations (FAR) Part 10 Market Research. The information collected through the process is considered to be market research as described by FAR 2.101 and in accordance with FAR 10.002. This is NOT a Request for Proposals (RFP), and nothing shall be construed herein or through the Sources Sought process to commit or obligate the Government to further action. In addition, vendors responding to this RFI shall bear all risks and expenses of any resources used to provide the requested information. The submission of capability information in response to this market survey is purely voluntary.

The Department of Justice (DOJ), the Office of Justice Programs (OJP) is issuing this RFI to identify qualified and responsible business having an interest in and possessing the resources and expertise to provide the services of licensed Medical Specialists in order to provide the PSOB Office with a formal written report of the medical findings and conclusions regarding the public safety officer's injury and/or death related to the PSOB death, disability, and educational assistance programs.

The applicable North American Industry Classification System (NAICS) code assigned to these proposed services is 621111. The anticipated contract type is Firm Fixed Price. The anticipated period of performance is a base year plus four (4) option years commencing January 1, 2025. The anticipated place of performance will be the Contractor site.

This acquisition is considered Full & Open.

The incumbent for this task is QTC Medical Services, Inc., Contract 15PBJA20P00000001 end date October 31, 2024.

1. INTRODUCTION

Enacted in 1976, the Public Safety Officers' Benefits (PSOB) Act assists in the recruitment and retention of qualified public safety officers in America; establishes the value communities place on the contributions of those who are willing to serve their communities in potentially dangerous circumstances; and offers peace of mind to men and women seeking careers in public safety. A unique effort of the US Department of Justice; local, state, tribal, and federal public safety agencies; and national organizations, PSOB provides benefits including death, educational assistance, and disability to those eligible for the Program.

The PSOB Office at the Bureau of Justice Assistance (BJA), Office of Justice Programs (OJP), US Department of Justice is responsible for implementing the PSOB Program. In addition to reviewing and processing more than 1,000 cases each year, the Office works with national law enforcement, firefighter, and other first responder groups, educating public safety agencies regarding the Program and offering support to families and colleagues of fallen law enforcement officers, firefighters, and other first responders. Additionally, PSOB appeals, at the Hearing Officer, BJA Director, and U.S. Court of Appeals for the Federal Circuit level have reached unprecedented numbers.

1. SCOPE

The Contractor shall secure the services of a licensed Medical Specialists in order to provide the PSOB Office with a formal written report of the medical findings and conclusions regarding the public safety officer's injury and/or death. Because death claims may require medical determinations, BJA may submit such claims to the Medical Specialist for an expert medicolegal review prior to determining whether or not a public safety officer's death is compensable under the PSOB Act. BJA will make the final administrative determination for each death or disability claim as to whether a PSOB benefit is to be paid.

For death and disability claims, based on specific case information provided by the PSOB Office, the Medical Specialist will review the public safety officer's medical profile which will include the medical records that resulted in a line of duty injury and / or death. BJA may also submit medical evidence, testimony, and other information provided at the appeal level on death or disability claims to the Medical Specialist for expert medicolegal review. The Medical Specialist agrees not to disclose the medical opinion or release any medical records or information pertaining to PSOB cases to anyone other than the representatives of the PSOB Program. Medical Specialists may conduct research and draft documents and memoranda related to the PSOB Program, law, regulations, and related issues as requested by the BJA Director.

All Medical Specialists will complete a review of the relevant PSOB law and regulations as provided by the PSOB Office.

The work shall be performed on an as needed basis, however the estimated volume of these programs, per fiscal year, is as follows: Death: 350 claims; Disability: 100 claims.

The PSOB Act and Regulations are available online at https://psob.bja.ojp.gov/law-and-regulations/.

1. TASKS

The Contractor shall provide the following Independent Medical Examination services including:

TASK AREA 1 – Record Reviews:

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  • The Contractor shall review all medical and medical-related records provided by the claimant, physicians, and/or representative(s). A Record Review generally takes 4 hours of service under Medicare CPT (Current Procedural Terminology) / HCPCS (Healthcare Common Procedure Coding System) Code 99358 "Prolonged Evaluation and Management Service before and/or after Direct Patient Care", and is performed by either a General Physician or a Neurologist.
  
  
  
  

TASK AREA 2 – Independent Medical Examinations:

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  • The Contractor shall review all medical records as well as conduct an in-person examination (at an agreed upon location between the medical specialist and the claimant) of a claimant. The location shall be accessible and conducted within a reasonable distance to the claimant. An Independent Medical Examination generally takes 4 to 5 hours of service under Medicare CPT/HCPCS Code 99455 "Work-Related or Medical Disability Evaluation Services", and is performed by either a General Physician or a Neurologist.
  
  
  
  

TASK AREA 3 – Vocational Assessments:

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  • The Contractor shall provide in-person examinations, at an agreed upon location between the medical specialist and the claimant, which assesses whether or not a claimant is able to perform any type of gainful work. A Vocational Assessment generally takes 2 to 3 hours of service under Medicare CPT/HCPCS Code H2014 "Skills Training and Development", and is performed by either a General Physician or a Neurologist.
  
  
  
  

TASK AREA 4 – Functional Capacity Examinations:

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  • The Contractor shall provide in-person examinations (or review of the records) at an agreed upon location between the medical specialist and the claimant, which determines if claimant is able to function or perform in everyday life need(s). A Functional Capacity Examination generally takes 4 hours of service under Medicare CPT/HCPCS Code 97750 "Physical Medicine and Rehabilitation Tests and Measurements", and is performed by a General Physician, an ENT (Ear, Nose, and Throat Specialist Doctor, or a Rheumatologist.
  
  
  
  

TASK AREA 5 – Legal Nurse Reviews:

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  • The Contractor shall provide reviews of all medical records by a licensed legal nurse. A Legal Nurse Review generally takes 1 to 2 hours of service under Medicare CPT/HCPCS Code G0299 "Direct Skilled Nursing Services of a Registered Nurse (RN)".
  
  
  
  

TASK AREA 6 – Psychological Testing:

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  • The Contractor shall perform psychological testing at an agreed upon location between the licensed psychologist / psychiatrist and the claimant, which assesses whether or not a claimant is able to perform any type of gainful work. A Psychological test generally takes 2 hours of service under Medicare CPT/HCPCS Code 90791 "Psychological Diagnostic Evaluation", and is performed by either a licensed Psychologist or a licensed Psychiatrist.
  
  
  
  

TASK AREA 7 – Medical Diagnostic Testing by Current Procedural Terminology (CPT) costs:

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  • The Contractor shall perform medical diagnostic testing at an agreed upon location between the licensed medical practitioner and the claimant. A Medical Diagnostic Test carries with it a less specific determination of the type of test performed, and is to be considered a 1 unit hour of service under the Medicare CPT/HCPCS Code which best matches the type of testing performed. This service is provided by the type of doctor both available and approved to provide services by the COR on a case-by-case basis.
  
  
  
  

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