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Revision 05/10/2023Page 1 of 31 Performance Work Statement for Onsite Nephrology Services GENERAL: Services Provided: The Contractor shall provide Multiple Board Certified /Board Eligible Nephrology P... Revision 05/10/2023Page 1 of 31 Performance Work Statement for Onsite Nephrology Services GENERAL: Services Provided: The Contractor shall provide Multiple Board Certified /Board Eligible Nephrology Physicians and multiple certified, licensed physician extenders (i.e., advanced practice registered nurses or physician assistants) on site in accordance with the specifications contained herein. Nephrology services include the full range of nephrology care for inpatient and outpatient VA Beneficiaries, including consultation, diagnosis, therapy and treatment, prognosis, and dialysis treatment of kidney disease patients of the Department of Veterans Affairs (VA) and the VA Sierra Nevada Health Care system (VASNHCS). The contractor providers workload will include a minimum of eight half day physician telemedicine clinic (performed on-site at VASNHCS); inpatient consultation and rounding; weekend rounding as needed; on call coverage 24-hours/day, 364-day/year. The Contractor will provide the following hours annually: Normal hours: 3080 hours (2080 physicians and 1000 physician extender). Night On-call hours: 3920 hours (over a 52- week period) Weekend On-call hours: 2496 (over a 52-week period) Holiday On-call hours: 240 hours (over a 52-week period) Place of Performance: Contractor shall furnish services at the Sierra Nevada Healthcare System located at 975 Kirman Avenue, Reno, NV 89502-0993. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority Policy/Directives/Handbooks. The contractor shall be subject to the following policies, including any subsequent updates during the period of performance. The policies listed below can be accessed electronically at the following: VA Publications VHA Publications VA Directive 1663: Health Care Resources (HCR) Contracting Buying Title 38 U.S.C. 8153 1.4.2. VHA Directive 1003.04: VHA Patient Advocacy VHA Directive 1053: Chronic Kidney Disease Prevention, Early Recognition, and Management VHA Directive 1065: Productivity and Staffing Guidance for Specialty Provider Group Practice VHA Directive 1088(1): Communicating Test Results to Providers and Patients VHA Directive 1100.18: Reporting and Responding to State Licensing Boards VHA Directive 1100.20: Credentialing of Health Care Providers VHA Directive 1100.21: Privileging VHA Directive 1220(1): Facility Procedure Complexity Designation Requirements to Perform Invasive Procedures In Any Clinical Setting VHA Directive 1400.01: Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents VHA Directive 1605.01: Privacy and Release of Information VHA Directive 1907.01: VHA Health Information Management and Health Records VHA Handbook 1042.01: Criteria and Standards for VA Dialysis Programs VHA Handbook 1100.17: National Practitioner Data Bank (NPDB) Reports VHA Handbook 1400.04: Supervision of Associated Health Trainees: Privacy Act of 1974 (5 U.S.C. 552a) as amended: http://www.justice.gov/oip/foia_updates/Vol_XVII_4/page2.htm VA/DoD Clinical Practice Guidelines for the Management of Chronic Kidney disease Acronyms/Definitions: Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern. ACGME: Accreditation Council for Graduate Medical Education ACLS: Advanced Cardiac Life Support AOD: Admitting Officer of the Day BLS: Basic Life Support CCNE: Commission on Collegiate Nursing Education: www.aacn.nche.edu/accreditation CDC: Centers for Disease Control and Prevention CDR: Contract Discrepancy Report CEU: Certified Education Unit CME: Continuing Medical Education CMS: Centers for Medicare and Medicaid Services CO: Contracting Officer: The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings. COR: Contracting Officer s Representative: A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken. COS: Chief of Staff CPARS: Contractor Performance Assessment Reporting System Credentialing: Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health care provider to provide care or services in or for the VA health care system. Credentials are documented evidence of licensure, education, training, experience, or other qualifications. DEA: Drug Enforcement Agency ED: Emergency Department EHR: Electronic Health Record - electronic health record system used by the VA FSMB: Federation of State Medical Boards FTE: Full Time Equivalent: VA s definition for full time-working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included. HHS: Department of Health and Human Services HIPAA: Health Insurance Portability and Accountability Act HR: Human Resources ISO: Information Security Officer Medical Emergency: a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part. MOD: Medical Officer of the Day NPI: National Provider Identifier: NPI is a standard, unique 10-digit numeric identifier required by HIPPA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers) NKF National Kidney Foundation NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org Non-Contract Provider: any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors NP: Nurse Practitioner NPPES: National Plan and Provider Enumeration System OPPE/FPPE- Ongoing professional practice evaluation/ Focused professional practice evaluation PA: Physician Assistant PALS: Pediatric Advanced Life Support POP: Period of Performance PPD: Purified Protein Derivative PWS: Performance Work Statement Clinical Privileging: Clinical Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual s license, based upon the individual s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific, and within available resources. QA/QI: Quality Assurance/Quality Improvement QM/PI: Quality Management/Performance Improvement QASP: Quality Assurance Surveillance Plan VHA: Veterans Health Administration VISN: Veterans Integrated Services Network VistA Veterans Information Systems Technology Architecture VETPro: is VHA s mandatory credentialing software platform to document the credentialing of VHA health care providers. This system facilitates completion of a uniform, accurate, and complete credentials file. QUALIFICATIONS: Staff/Facility License: The Contractor s physician(s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia) when services are performed onsite on VA property. All licenses held by the key personnel working on this contract shall be full and unrestricted licenses. Contractor s physician(s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract. Board Certification: All contract Nephrology provider(s) shall be Board Certified /Board Eligible physicians by either the American Board of Internal Medicine in Nephrology http://www.abim.org/specialty/nephrology.aspx , or the American Osteopathic Board of Internal Medicine https://certification.osteopathic.org/internal-medicine/ . They must also be currently certified in either Basic Life Support (BLS) OR Advanced Cardiac Life Support (ACLS) or equivalency. All continuing education courses required for maintaining certification must always be kept up to date . Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance. Credentialing and Privileging: Credentialing and privileging is to be done in accordance with the provisions of VHA Directive 1100.20 and VHA Directive 1100.21 referenced above. The Contractor is responsible to ensure that proposed physician(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any Contractor s physician(s) prior to obtaining approval by the Facility Medical Executive Board and Medical Center Director. If a Contractor s physician(s) and/or other contract provider(s) are not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government. Technical Proficiency: Contractor s physician(s) shall be technically proficient in the skills necessary to fulfill the government s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor s physicians shall have knowledge of professional care theories, principles, practices, and procedures to perform assignments of Nephrology patient/critically ill patient population. Contractor s physician shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific to the critical care/nephrology population Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for Contractor s physician(s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contractor s physician(s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s). Training (ACLS, BLS, EHR and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contractor s physician(s) as required by the VA. Other training may become required. VA will communicate any changes to the training requirement to the contractor. List all Training required here (TMS courses, EHR, etc.) and associated time. Remove this instruction from final RFP. Training (The following training is mandatory per VHACO for Contracted Physicians) Frequency (once a year, etc.) Annual Hours ACLS/BLS Every 2 years 1.0 VA Privacy and Information Security Awareness and Rules of Behavior Annually 1.0 VHA Privacy and HIPAA Focused Training Annually 1.0 STANDARD INFECTION CONTROL MEASURES (PPD, IMMUNIZATIONS, ETC.): Contractor shall provide proof of the following for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor s physician(s) upon hire in accordance with CDC guidance. (This is applicable to all health care workers). A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians {This is applicable to all health care workers}. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians {This is applicable to all health care workers}. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season. {This is applicable to all health care workers}. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor s physician(s) {This is applicable to all health care workers}; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident. The facility shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel (as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal. DEA: Contractor shall provide copy of current DEA certificate. Conflict of Interest: The Contractor and all Contractor s physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest and fully outlined in response to the subject attachment in Section D of the solicitation document. Citizenship related Requirements: The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals; While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all E-Verify requirements consistent with Executive Order 12989 and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed Contractor s physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed. Clinical/Professional Performance: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Directive 1100.20 and VHA Directive 1100.21. Clinical/Professional performance monitoring and review of all clinical personnel covered by this contract for quality purposes will be provided by the facility COS and/or the Chief of the Service or his designee. The national OPPE/FPPE nephrology performance form shall be used to evaluate each contracted physician s performance on a recurring basis. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract. Non- Personal Healthcare Services: The parties agree that the Contractor and all Contractor s physician(s) shall not be considered VA employees for any purpose. Indemnification: The Contractor shall be liable for, and shall indemnify and hold harmless the Government against, all actions or claims for loss of or damage to property or the injury or death of persons, arising out of or resulting from the fault, negligence, or act or omission of the Contractor, its agents, or employees. Prohibition against Self-Referral: Contractor s physicians are prohibited from referring VA patients to contractor s or their own practice(s). Inherent Government Functions: Contractor and Contractor s physician(s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy. No Employee status: The Contractor shall be responsible for protecting Contractor s physician(s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract: Workers compensation Professional liability insurance Health examinations Income tax withholding, and Social security payments. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract provider(s). When a Contractor or contract provider (s)has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier. Key Personnel: The VA Full Time Equivalency (FTE) for the services required is 1.5 FTE. The minimum number of Board Certified /Board Eligible Nephrology providers required to be on site daily is 1.5 FTE, Monday thru Friday as defined in paragraph Hour of Operations in the section. The Contractor shall be responsible for providing coverage to the VA during periods of vacancies of the Contractor s personnel due to sick leave, personal leave, vacations, and additional coverage as required. In the event a scheduled physician is unable to complete an assigned shift, the contractor shall provide replacement physician coverage within 2 hours and notify the Contracting Office Representative (COR) immediately of the schedule change. Personnel Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar day(s) after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 30 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction, or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any Contractor s physician(s), s/he may request, without cause, immediate replacement of said Contractor s physician(s). The CO and COR shall deal with issues raised concerning Contractor s physician(s) conduct. The final arbiter on questions of acceptability is the CO. Contingency Plan: Because continuity of care is an essential part of the Facility s medical services, The Contractor shall have a contingency plan in place to be utilized if the Contractor s physician(s) leaves Contractor s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract. VA HOURS OF OPERATION/SCHEDULING VA Business Hours: The clinic operations of the Nephrology Section, Medical Service is Monday through Friday from 8:00am to 4:30pm. The VASNHCS Medical Specialty Clinic closed on all Federal Holidays. Patients must be seen by a contractor s physician(s) on-site at the facility in a timely manner in accordance with VA Rules and Regulations on clinic wait times and consult completion. Contractor shall notify the COR at least monthly about any obstacles to meeting this performance measure. Contractor s physician(s) shall be available and present in clinic during normal facility clinic hours, which will be established, and may be revised, as deemed appropriate for patient care by the Chief of Staff. Currently, normal clinic hours are 8:00am to 4:30pm excluding weekends and Federal Holidays. Off-hours Coverage: On-call coverage is required. The on-call schedule is on 24-hour/7 days a week basis, consisting of 16 hours per 24-hour day. Monday through Friday and 24 hours per day on weekends (Saturdays and Sundays) and all Federal holidays. When the Contractors provider is on-call, they shall remain with a thirty-minute arrival time to VASNHCS. All calls shall be responded to within fifteen minutes. On-call volume is estimated to be three to five calls per month and will be from the Administrator of the Day (AOD) at the VASNHCS. On-call Contractor s physician(s) must always be available for phone consultations with VA residents and physicians. On-call providers must be available within 15 minutes by phone and on-site within 60 minutes. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs: New Year s Day President s Day Martin Luther King s Birthday Memorial Day Juneteenth Independence Day Labor Day Columbus Day Veterans Day Thanksgiving Christmas Any day specifically declared to be a national holiday. Cancellations CONTRACTOR RESPONSIBILITIES Clinical Personnel Required: The Contractor shall provide contractor s physician(s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties. Contractor s physician(s) shall be responsible for signing in and out when in attendance. Time sheets will be used by the COR to confirm hours/day and services provided against the contractor s invoices. Standards of Care: The Contractor s physician(s) care shall cover the range of Nephrology services as would be provided in a state-of-the-art civilian medical treatment facility and shall be of a quality that meets or exceeds community standards. Care shall be compliant with all related VHA kidney health policies, recognized TJC standards, and generally consistent with guidance available at : The professional standards of the Joint Commission (TJC): http://www.jointcommission.org/standards_information/standards.aspx The standards of the American Hospital Association (AHA): http://www.hpoe.org/resources?show=100&type=8 The National Kidney Foundation (https://www.kidney.org/professionals/guidelines/guidelines_commentaries) ; VA Handbook 1042.01 Criteria and Standards for VA Dialysis VA Directive 1053 Prevention, Early Recognition and Management of Chronic Kidney Disease VA/DoD Clinical Practice Guidelines for the Management of Chronic Kidney Disease Kidney Disease: Improving Global Outcomes (KDIGO: https://www.KDIGO.org National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDIGO; https://www.kidney.org/professionals/ guidelines). The requirements contained in this PWS MEDICAL RECORDS Authorities: Contractor s physician(s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the 5 U.S.C.552a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA). HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment of VA patients. Based on this exception, a BAA is not required for this contract. Health records generated by this contract or provided to the Contractors by the VA are covered by the VA Privacy Act system of records entitled Patient Medical Records-VA (24VA10A7). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services provided to VA patients are captured in the VA electronic health record system as required by VA policy as discussed in ...