Directed Medical Services (DMS)

Questions & Answers / Clarifications

This document is a template for submitting questions related to RFI - OAA-26-00215 - Directed Medical Services (DMS).

This document is a template and does not contain specific questions or answers. It outlines the expected format for submitting inquiries:

• Question Title
• Section Number
• Question Detail
• Government Response (to be filled by the government)

This document serves as a guide for bidders to submit their questions. The actual content of the RFI and any subsequent clarifications or answers will be provided separately. Bidders should use this template to formulate their inquiries regarding the Directed Medical Services opportunity.

Performance Work Statement (PWS)

To manage and provide Directed Medical Services nationwide for the Division of Federal Employees’ Compensation (DFEC) program. These services are crucial for adjudicating workers' compensation claims by providing medical diagnoses, disability assessments, and impairment evaluations.

The contractor will manage and provide a nationwide consortium of medical specialists to perform:

• Second Opinion Examinations (SECOP): Medical file review and claimant examination to assess causality, disability, impairment, diagnosis, and appropriateness of treatment.
• Independent Medical Examinations (IME): Similar to SECOP, used to resolve conflicts in medical opinions.
• Case File Reviews: Review of medical files without physical examination to address causality, disability, impairment, diagnosis, etc.

The contractor must manage a network of specialists, arrange timely scheduling, handle electronic document transfer via SFTP, provide secure website access if needed, and ensure timely delivery of comprehensive, unbiased medical reports.

• Timeliness: Strict deadlines for report submission (e.g., SECOP reports within 7 days of examination, IME reports within 14 days, Case File Reviews within 7-30 days depending on type). Liquidated damages apply for late submissions.

• Quality: Reports must be comprehensive, unequivocal, unbiased, well-reasoned, consistent with findings, and responsive to all questions posed by the claims examiner.

• Reporting: Weekly and monthly reports to the COR detailing referral status, timeliness, and issues.

• Quality Control: Contractor must maintain an effective quality control program and submit a Quality Control Plan.

• Period of Performance: One 12-month base period (March 28, 2026 – March 27, 2027) and four 12-month option periods.

• Place of Performance: Nationwide within the United States, its Possessions, Territories, and Trust Territories.

• Staffing: Must provide qualified physicians (MD, DO, DPM, Psy.D.) who are board-certified, actively practicing, and licensed. Retired physicians are prohibited.

• Security: Strict compliance with Federal information security standards, Privacy Act of 1974, and DOL cybersecurity guidelines. Background investigations for all personnel are required.

• Data Handling: All products and information are government property. Sensitive information must be protected, and PII breaches must be reported within one hour.

• Pricing: Fixed Unit Rate contract with tiered pricing incentives for timely report submission. Liquidated damages apply for late deliverables.

• Key Personnel: Contract Manager/Alternate Contract Manager are required.

• Transition: Contractor must provide Transition-In and Transition-Out plans.

Other / Unclassified

This document is a Request for Information (RFI) from the Department of Labor (DOL), Office of Workers’ Compensation Programs (OWCP) to conduct market research on Directed Medical Services (DMS). It is NOT a solicitation for proposals.

• Purpose: To understand current nationwide provider coverage and industry common practices for DMS.
• Industry Outreach: DOL will conduct one-on-one meetings with interested vendors from April 8, 2026, to April 13, 2026, via Microsoft Teams.
• Vendor Preparation: Vendors must prepare to discuss their answers to specific questions posed in the RFI (referenced as "Industry Day Questions-Medical Provider Network-Medical Bill Processing (MPN-MBP).pdf"). A PowerPoint presentation or other visual aid may be used.
• Scheduling: One-hour slots are available between 10:00 am and 3:00 pm EDT, with the last session starting by 2:00 pm EDT. No sessions between 12:00 pm and 1:00 pm EDT.
• Registration: Limited to the first 15 registrants on a first-come, first-served basis. Register by emailing Kristen Hines (Hines.Kristen.A@dol.gov) with a copy to Tyrone Wells (wells.tyrone@dol.gov) between April 8, 2026, and April 13, 2026.
• Cost: No cost associated with these virtual sessions.
• Contacts: Kristen Hines (Hines.Kristen.A@dol.gov) and Emily Pyatigorsky (Pyatigorsky.emily@dol.gov) for questions.
• Attachments: Includes a draft PWS, Questions Template, Directed Medical Services Data CY24, and Pricing Sheet.

Form / Attachment / Pricing Sheet

This document is an Excel file containing data related to "Active Cases," "Number of Referrals," and "IME (Specialty-Location)." It appears to provide statistical information that may be relevant for bidders to understand the scope and potential scale of services related to medical services and independent medical examinations.

• Active Cases: A list of zip codes with the corresponding number of active cases. The total number of active cases is listed as 202,629.
• Number of Referrals: Data broken down by "Second Opinion Type," "Case Review Type," and "IMEs" (Independent Medical Examinations), detailing the number of referrals for each category and page count ranges.
• IME (Specialty-Location): A list of cities, states, 5-digit zip codes, PDS Specialty List, and the corresponding number of referrals for Independent Medical Examinations.

This data provides insight into the volume and geographical distribution of medical cases and referrals. Bidders can use this information to assess the potential workload, understand the geographic areas of service, and identify specialized medical needs (e.g., Orthopedic Surgery, Neurology, Psychiatry) that may be relevant to the opportunity. The page count data for referrals and IMEs may also help in estimating resource requirements.

Form / Attachment / Pricing Sheet

This document is a pricing sheet for medical services related to the Division of Federal Employees Compensation. It outlines the pricing structure for various CLINs (Contract Line Items) across different medical specialties and geographic locations.

• CLIN 0001 & 0003: Second Opinion Examinations and Schedule Award/Impairment Ratings. Pricing is broken down by state/location and medical specialty (Orthopedic surgery, Pulmonary Medicine, Otolaryngology, Neurology, Psychiatry, Other Specialists). It includes both Tier 1 (Base Price) and Tier 2 (Incentive Price).
• CLIN 0002: IME (Independent Medical Examination) examination. Similar to CLIN 0001 & 0003, with pricing by state/location, specialty, and tiers.
• CLIN 0004: Supplemental Reports. Includes a price per report for both Tier 1 and Tier 2.
• CLIN 0005: File Review Surgical. Pricing is per review, with different rates based on page count (0-100, 101-300, 301-600, 601-1,000, 1,001+ pages).
• CLIN 0006: File Review-Impairment Rating. Similar to CLIN 0005, with pricing per review based on page count.
• CLIN 0007: File Review Other. Similar to CLIN 0005 and 0006, with pricing per review based on page count.
• CLIN 0008: Travel/Transportation. Notes that the Not-to-Exceed (NTE) value is in the summary tab (not provided here).
• CLIN 0009: Other Direct Cost. Includes sub-categories for Claimant No-Show/Government Cancellations, Interpreter Services, Diagnostic Tests, and all other ancillary services. The NTE value is noted to be in the summary tab.

This document is critical for bidders to understand the pricing structure and potential costs associated with providing medical services. Bidders must use this sheet to determine their proposed pricing for each CLIN, considering the specified specialties, locations, and service types. All prices listed are currently $0.00, indicating that specific pricing needs to be filled in by the bidder or may be subject to further negotiation or clarification.