Read the full stored bill text
GOVERNMENT OF THE DISTRICT OF COLUMBIA
Office of the Chief Financial Officer
John A. Wilson Building * 1350 Pennsylvania Avenue, NW * Suite 203 * Washington, DC 20004
Phone: (202) 727-2476 * Fax: (202) 727-1643 * www.cfo.dc.gov
Page 2
Guidelines on the OCFO’s Katrina Relief Efforts
September 15, 2005
Glen Lee
Chief Financial Officer
The Honorable Phil Mendelson
Chairman
Council of the District of Columbia
1350 Pennsylvania Avenue, NW, Suite 504
Washington, DC 20004
Dear Chairman Mendelson:
Pursuant to D. C. Official Code §2-352.02a, enclosed for consideration and approval by the
Council of the District of Columbia is proposed contract CFOPD-26-C-023 with Myers and
Stauffer LC. The proposed contract is in the not to exceed amount of $1,482,399.00 for the
period of the contract award date through November 30, 2026.
Under the proposed contract, Myers and Stauffer LC shall provide audit services on behalf of
Department of Health Care Finance to assure that payments made to health care services providers
participating in the Medicaid Program are in compliance with Federal and District laws and rules.
As always, I am available to discuss any questions you may have regarding the proposed contract
action. In order to facilitate a response to any questions concerning the proposed contract action,
please have your staff contact Dorothy Whisler Fortune, Director of the Office of Contracts for
the Office of the Chief Financial Officer at (202) 442-8078.
Sincerely,
Glen Lee
cc: Nyasha Howard, Secretary, Council of the District of Columbia
June 17, 2026
Sincererererererererererererrrrerreleeeeee y,,,,
Glen
Lee
COUNCIL CONTRACT SUMMARY
Pursuant to Section 202(c) of the Procurement Practices Reform Act of 2010, as amended; D.C.
Official Code §2-352.02(c), the following contract summary is provided.
The proposed contractor, the names of the contractor’s principals, contract amount, unit and
method of compensation, contract term, type of contract and source selection method:
x Proposed Prime Contractor: Myers and Stauffer LC
x Proposed Contractor’s Principal(s): Mark Korpela
x Subcontractor: F.S. Taylor & Associates, P.C.
x Contract Amount: The proposed contract amount for the base period is $1,482,399.00.The
proposed amount for each option period is as follows: Option Period 1 is
$1,919,492.00, Option Period 2 is $2,207,592.00, Option Period 3 is $1,792,840.00, Option
Period 4 is $1,739,773.00. The contract amount for the option periods differs from the
contract amount for the base period due to the change in contractor unit prices in the option
periods and the District’s projected usage.
x Unit and method of compensation: United States Dollars (USD) in accordance with
Section B, Pricing, of the contract.
x Contract Term: The contract has a base period of the contract award date through
November 30, 2026 with four (4), one (1) year options.
x Contract Type: Firm Fixed Price
x Source Selection Method: Competitive Sealed Proposals
The goods or services to be provided, the methods of delivering goods or services, and any
significant program changes reflected in the proposed contract:
The purpose of this contract action is for Myers and Stauffer LC to provide medical audit services
on behalf of Department of Health Care Finance to assure that payments made to health care
services providers participating in the Medicaid Program are in compliance with Federal and
District laws and rules.
The Medicaid Program was established in accordance with applicable provisions of Title XIX ofthe
Social Security Act to provide medical and other services to medically needy and indigentpersons.
The public and private providers of health care services who participate in the MedicaidProgram
(“Providers”) are entitled to reimbursement determined for specific health care servicesrendered to
Medicaid recipients in accordance with the prescribed methodologies set forth in theDistrict of
Columbia State Plan for Medical Assistance (“State Plan”) (Accessible at
http://dhcf.dc.gov/page/medicaid-state-plan) under Section 4.19 - General Program Administration,
Payment for Services and Title 29 D.C. Municipal Regulations (DCMR).
(3)(A) The selection process, including the number of offerors, the evaluation criteria, and the
evaluation results, including price, technical or quality, and past-performance components:
This was a competitive request for proposals procurement. There were four (4) proposals
submitted in response to the solicitation. One proposal was determined to be non-responsive and
therefore rejected, and another proposal was deemed late and therefore not considered.
The Technical Proposal was worth 85 points; and the Pricing Proposal was worth 15 points for a
total of 100 points. Under the provisions of the “Small, Local, and Disadvantaged Business
Enterprise Development and Assistance Act of 2005”, as amended, D.C. Official Code §2-218.01
et seq. (the Act), the District applied preferences in evaluating proposals from certified businesses.
The maximum total preference to which a certified business enterprise is entitled under the Act is
twelve (12) points on a 100-point scale for proposals submitted in response to a request for
proposals. Therefore, when preference points are applicable, the maximum attainable total shall be
112.
The two responsive proposals were evaluated based on technical approach, technical expertise,
experience and past performance, and price. Myers and Stauffer LC received the highest score.
(3)(B) If the contract was awarded on a sole-source basis, include the date on which a
competitive procurement for the goods or services to be provided under the contract was last
conducted, the date of the resulting award, and a detailed explanation of why a competitive
procurement is not feasible.
The contract was not awarded on a sole-source basis.
(3A) A description of any bid protest related to the award of the contract, including whether the
protest was resolved through litigation, withdrawal of the protest by the protestor, or
voluntary corrective action by the District, and the identity of the protestor, grounds alleged
in the protest and any deficiencies identified by the District as a result of the protest:
There was no protest filed related to the award of this contract.
(3B) A description of any other contracts the proposed contractor is currently seeking or holds
with the District:
The proposed contractor is currently seeking no other contract with the District and holds no other
contracts with the District.
(4) The background and qualifications of the proposed contractor, including its organization,
financial stability, personnel, and performance on past or current government or private-
sector contracts with requirements similar to those of the proposed contract:
Myers and Stauffer LC has work with the D.C. Department of Health Care Finance since the early
2000s providing professional medical auditing and consulting services. Myers and Stauffer LC has
worked with publicly sponsored health care programs for more than 48 years. Myers and Stauffer
LC has more than 1,000 professionals, who work full time with local, state, and federal health care
programs.
Myers and Stauffer LC has received good performance reviews for work previously provided to the
District for medical auditing and consulting services. The personnel that Myers and Stauffer LC
has provided to perform the services have been approved by the District and based on a DUNS
Report dated June 8, 2026, Myers and Stauffer LC has demonstrated its financial stability.
(4A) A summary of the subcontracting plan required under D.C. Code § 2-218.01 et seq.,
including a certification by the District that the subcontracting plan meets the minimum
requirements and the dollar volume of the portion of the contract to be subcontracted, in
both total dollars and as a percentage of the total contract amount:
Myers and Stauffer LC has a 35% subcontracting plan with F.S. Taylor & Associates, P.C. that
meets the requirements under D.C. Code § 2-218.01 et seq. in both dollars and as a percentage of
the contract amount.
(5) Performance standards and expected outcomes of the proposed contract:
The contract shall be performed as defined in Section C of the contract.
(5A) The amount and date of any expenditure of funds by the District pursuant to the contract
before its submission to the Council for approval:
There have been no expenditures to date.
(6) A certification that the proposed contract is within the appropriated budget authority for the
agency for the fiscal year and is consistent with the financial plan and budget adopted in
accordance with D.C. Official Code §§ 47-392.01 and 47-392.02:
The funding certification is included in this Council package.
(7) A certification that the proposed contract is legally sufficient, including whether the proposed
contractor has any currently pending legal claims against the District:
Legal Sufficiency is provided in this Council package.
(8) A certification that the Citywide Clean Hands Database indicates that the proposed
contractor is current with its District taxes. If the Citywide Clean Hands Database indicates
that the proposed contractor is not current with its District taxes, (1) a certification that the
contractor has worked out and is current with a payment schedule approved by the District
or (2) a certification that the contractor will be current with its District taxes after the
District recovers any outstanding amount pursuant to D.C. Official Code §2-353.01(a)(9).
The Clean Hands compliance document is included in this Council package.
(8A) A certification from the proposed contractor that it is current with its federal taxes, or has
worked out and is current with a payment schedule approved by the federal government:
The Contractor has certified that it is current with its federal taxes.
(8B) A certification that the proposed contractor has not been determined to be in violation of
D.C. Official Code § 1-1163.34a, and a certification from the proposed contractor that it
currently is not and will not be in violation of D.C. Official Code § 1-1163.34a:
The Contractor has certified that it has not been determined to be in violation of D.C. Official Code
§ 1-1163.34a, and that it currently is not and will not be in violation of D.C. Official Code § 1-
1163.34a.
(9) The status of the proposed contractor as a certified local, small, or disadvantaged business
enterprise, as defined in the Small, Local, and Disadvantaged Business Enterprise
Development and Assistance Act of 2005, effective October 20, 2005 (D.C. Law 16-33; D.C.
Official Code § 2-218.01 et seq.):
Myers and Stauffer LC is not a Certified Business Enterprise (CBE). Myers and Stauffer LC has
one (1) CBE subcontractor, F.S. Taylor & Associates, P.C., working on this proposed contract. The
CBE certification is included in the Council package.
(10) Other aspects of the proposed contract that the CPO considers significant:
None.
(11) A statement indicating whether the proposed contractor is currently debarred from
providing services or goods to the District or federal government, the dates of the
debarment, and the reasons for debarment:
Myers and Stauffer LC do not appear on the Federal Excluded Parties List System (EPLS) or the
District Excluded Parties List.
(11A) Any determination and findings issued in relation to the contract’s formation, including
any made using the privatization procedures under D.C. Code § 2-352.05:
All determination and findings issued in relation to the contract formation are included in this
package.
(12) Where the contract, and any amendments or modifications, if executed, will be made
available online:
The contract and all amendments and modifications shall be available online at the following
website address: https://dc.cobblestonesystems.com/public/default.aspx
(13) Where the original solicitation, and any amendments and modifications will be made
available online:
The original solicitation and any amendments and modification shall be available online at the
following website address: KWWSV
GFFREEOHVWRQHV\VWHPVFRPJDWHZD\VROLFLWDWLRQVHDUFK
_______________________________
Dorothy Whisler Fortune, Esq. CPPO
Director
Office of Contracts
___________________________________________________________________________________________ __________
hh i l
1101 4th Street, SW
Washington, DC 20024
Date of Notice: June 8, 2026 L0016603383Notice Number:
FEIN: **-***4042
Case ID: 19018189
Government of the District of Columbia
Office of the Chief Financial Officer
Office of Tax and Revenue
MYERS AND STAUFFER, LC
700 W 47TH ST STE 1100
KANSAS CITY MO 64112-2050
Branch Chief, Collection and Enforcement Administration
Authorized By Melinda Jenkins
To validate this certificate, please visit MyTax.DC.gov. On the MyTax DC homepage, click the
“Validate a Certificate of Clean Hands” hyperlink under the Clean Hands section.
CERTIFICATE OF CLEAN HANDS
As reported in the Clean Hands system, the above referenced individual/entity has no outstanding
liability with the District of Columbia Office of Tax and Revenue or the Department of Employment
Services. As of the date above, the individual/entity has complied with DC Code § 47-2862, therefore
this Certificate of Clean Hands is issued.
TITLE 47. TAXATION, LICENSING, PERMITS, ASSESSMENTS, AND FEES
CHAPTER 28 GENERAL LICENSE
SUBCHAPTER II. CLEAN HANDS BEFORE RECEIVING A LICENSE OR PERMIT
D.C. CODE § 47-2862 (2006)
§ 47-2862 PROHIBITION AGAINST ISSUANCE OF LICENSE OR PERMIT
1101 4th Street SW, Suite W270, Washington, DC 20024/Phone: (202) 724-5045/MyTax.DC.gov
C
As reported in the Clea
reported in the Cle
iability with the District o
ility with the Di
vices. As of the date abov
ices. As of the date abov
ertificate of Clean Hands
ertificate of Clean Hand
TITLE 47. TAXATION, L
TLE 47. TAXATION,
CHAP
CHAP
PTER II. CLEAN HAND
PTER II. CLEAN HAN
D.C. CO
D.C. CO
PROHIBITION AGAINS
ROHIBITION AGAIN
441 4th St. NW, Suite 900 South, Washington, D.C. 20001 (202) 442-5988 FAX (202) 478-1373
GOVERNMENT OF THE DISTRICT OF COLUMBIA
Department of Health Care Finance
Office of the Chief Financial Officer
MEMORANDUM
TO: Dorothy Fortune
Director and Chief Procurement Officer
Office of Contracts
THRU: Delicia V. Moore
Associate Chief Financial Officer
Human Support Services Cluster
FROM: Darrin Shaffer
Agency Fiscal Officer
Department of Health Care Finance
DATE: June 3, 2026
SUBJECT: Certification of Funding for Myers DQGStauffer LC Contract
The Office of the Chief Financial Officer hereby certifies that the sum of $1,482,399.00 is included in the District’s
Local Budget and Financial Plan for Fiscal Year 2026 to fund costs associated with the Department of
Health Care Finance’s (DHCF) Myers DQG Stauffer LC contract. This certification supports the Myers DQG
Stauffer LC contract cost from July 01, 2026 through November 30, 2026. The fund allocation is as follows:
Vendor: Myers DQGStauffer LC Contract Number: CFOPD-26-C-023
Agency DIFS Fund DIFS Cost Center DIFS Program DIFS Account Total
HT0 1010001 10002 150002 7132001 $815,319.45
HT0 4025002 10002 150002 7132001 $667,079.55
FY26 Contract Total $1,482,399.00
Upon approval of the District’s Local Budget and Financial Plan by the Council and the Mayor and completion of
the thirty-day Congressional layover, funds will be sufficient to pay for fees and costs associated with the contract.
There is no fiscal impact associated with the contract.
Should you have any questions, please contact me on (202) 442-9079.
cc: Crystal Farmer-Linder, Contract Specialist, OCFO
Frederick Hoeflinger, Reimbursement Officer, OCFO/DHCF
Darrin A Shaffer
Digitally signed by Darrin A Shaffer
Date: 2026.06.03 11:35:38 -04'00'
GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
Office of the General Counsel
MEMORANDUM
TO: Glen Lee
Chief Financial Officer
THRU: Erin Law
Interim General Counsel
FROM: Treva Saunders
Associate General Counsel,
Personnel and Procurement
DATE: June 11, 2026
SUBJECT: Certification of Legal Sufficiency
Contract No.: CFOPD-26-C-023
Contract Action: Initial Award
Contractor: Myers and Stauffer LC
Contract NTE Amount: $1,482,399.00
Contract Purpose: To provide Medicaid audit services for the Department of
Health Care Finance.
This is to Certify that this Office has reviewed the above-referenced contract and that we
have found it to be legally sufficient. The proposed contractor has certified that it does not have
any currently pending legal claims against the District.
________________________________________
Treva Saunders
______________________ ______________________
T S d
ancial Officer
eneral Counsel
311 Online Agency Directory Online Services Accessibility
To find support and resources for federal workers, visitbfedsupport.dc.gov.
What are you lookin
Office of Contracting and Procurement
Amharic (ٝק٢)
Chinese (ކ)
French (Français)
Korean (߭)
Spanish (Español)
Vietnamese (Ti˨ng Vi˰t)
Monday to Friday, 8:30 am to 4:30 pm
441 4th Street, NW, Suite 330 South, Washington, DC 20001
Phone: (202) 727-0252
Fax: (202) 727-9385
TTY: (202) 123-4567
Email: ocp@dc.gov
Ask the Director
Agency Performance
Office of Contracting and Procurement
Listen
Excluded Parties List
Pursuant to the DC Code § 2-359.07, the District of Columbia may debar or suspend contractors from
consideration for award of contracts or subcontracts. This Excluded Parties List categorizes parties that have
been suspended or debarred by the Chief Procurement Officer. While they are debarred or suspended, the District
Mayor Muriel Bowser
Menu
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 1/11
will not solicit offers from, award contracts to, renew, or otherwise extend contracts with, or consent to
subcontracts with entities or individuals that appear on the Excluded Parties List. For questions regarding the
Excluded Parties List, please contact the OCP Customer Contact Center at 202-724-4477.
Select this link to access the federal excluded parties list: sam.gov
CURRENT EXCLUDED PARTIES LIST- Updated May 8, 2026.
b
List is updated as needed.
b
EXCLUDED PARTIES LIST BY INDIVIDUAL
Name of
Individual
Principal Address Ac Ɵon Date ExpiraƟon
Date
Agency
InsƟtuƟng the
AcƟon
Reason for the AcƟon
Robert Terrell 2585 Rhode Island
Ave., NE, Washington,
DC 20018
May 8, 2026 May 7, 2027 OCP Indictment under 18 U.S.C. § 1343
and 18 U.S.C. § 1957
Sherry Hooks 4708 8th St, NE
Washington, DC
20017
April 8, 2026 April 7, 2027 OCP Submission of false documents. b
Alfonzo
Duckett
4915 Just Street NE
Washington, DC
20019
December 2,
2025
December 2,
2030
OCP Failure to disclose DC Government
employment status while
performing as a District contractor.
Clementina
Maduforo
2911 Mills Ave., NE
Washington, DC
20010
September
18, 2025
September
17, 2030
OCP Submission of false documents;
mulitple legal violations
Rosa I.
Williams
4445 Crain Highway
White Plains, MD
20695
September
18, 2025
September
17, 2023
OCP Revocation of operator
registration; multiple legal
violations
Brandon A.
Williams
4445 Crain Highway
White Plains, MD
20695
September
18, 2025
September
17, 2030
OCP Revocation of operator
registration; multiple legal
violations
Yelake
Meseretu
204 Beacon Pl., NE
Washington, DC
20011
August 4,
2025
August 3,
2026
OCP Indictment under 18 U.S.C § 371,
18 U.S.C. §§ 201(b)(1) & 2 and 18
U.S.C. §§ 1343 and 1346 & 2
Donald
McWhirter
1735 Saint Margaret’s
Road
February 28,
2025
February 28,
2030
OCP Conviction under 18 U.S.C. §
201(b)(1) & (2)
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 2/11
Name of
Individual
Principal Address Ac Ɵon Date ExpiraƟon
Date
Agency
InsƟtuƟng the
AcƟon
Reason for the AcƟon
Annapolis, MD 21409
Duane King 2200 Pennsylvania
Ave., NW, Suite 400E
Washington, DC
20037
February 28,
2025
February 28,
2030
OCP Conviction under 18 U.S.C. §
201(b)(1) & (2)
Allieu Kamara 5035 C Street, SE
Washington, DC
20019
October 16,
2024
October 16,
2029
OCP Conviction under 18 U.S.C. § 1349
and 18 U.S.C §201(b)(1)
Ifediora Oli 2126 Queensguard
Rd.
Silver Spring, MD
20906
August 19,
2024
August 19,
2029
OCP Conviction under 18 U.S.C. § 1349
and 18 U.S.C. § 1519
Obinna Ogbu 2605 Summer Hill
Drive
Silver Spring, MD
20904
August 19,
2024
August 19,
2029
OCP Conviction under 18 U.S.C. § 1349
Melanie
Carter
1629 K Street, NW
Suite 300
Washington, DC
20006
November 9,
2022
November 8,
2027
OCP , DCPS Breach of Contract; Negligence
Mohammad
Sidker
8118 Spring Hill Farm
Drive, McLean, VA
22102
August 4,
2021
August 4,
2026
OCP Conviction under 15
U.S.C.b§b2615(b)(1) and 15 U.S.C. §
2689
b
EXCLUDED PARTIES LIST BY COMPANY
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 3/11
Name of Company Principal Address Ac Ɵon
Date
ExpiraƟon
Date
Agency
InsƟtuƟng
the AcƟon
Reason for the AcƟon
District Logistics, LLC 2585 Rhode Island
Ave., NE, Washington,
DC 20018
May 8, 2026 May 7, 2027 OCP Indictment under 18 U.S.C.
§ 1343 and 18 U.S.C. §
1957
Light Weight
Technologies, LWT LLC
4708 8th St, NE
Washington, DC 20017
April 8, 2026April 7, 2027OCP Submission of false
documents.b
Houzmazoo Network,
LLC
4915 Just Street NE
Washington, DC 20019
December 2,
2025
December 2,
2030
OCP Owner failed to disclose
DC Government
employment status while
performing as a District
contractor.
IJS Limited, LLC dba
EJ’s Pest Control
2911 Mills Ave., NE
Washington, DC 20010
September
18, 2025
September
17, 2030
OCP Submission of false
documents; mulitple legal
violations
Heaven Bound
Cremation Services,
LLC
4445 Crain Highway
White Plains, MD
20695
September
18, 2025
September
17, 2030
OCP Revocation of permit;
multiple legal violations
Heaven Bound
Cremation Services of
DC, LLC
200 Massachusetts
Ave., NW, Suite 700
Washington, DC 20001
September
18, 2025
September
17, 2030
OCP Multiple legal violations
General Merchandise
Supplies Unlimited, LLC
2221 Adams Place, SE,
Washington, DC 20018
February 28,
2025
February 28,
2030
OCP Criminal conviction of
principal
American Business
Supplies, LLC
2200 Pennsylvania
Ave., NW, Suite 400E,
Washington, DC 20037
February 28,
2025
February 28,
2030
OCP Criminal conviction of
principal
Mission Ready, Inc. 5035 C Street SE
Washington, DC 20019
December
13, 2024
December
13, 2029
OCP Criminal conviction of
principal
District Services
Management, LLC.
5035 C Street, SE
Washington, DC 20019
October 17,
2024
October 17,
2029
OCP Criminal conviction of
principal
Life Deeds, Inc. 5035 C Street SE
Washington, DC 20019
October 9,
2024
October 9,
2029
OCP Criminal conviction of
principal
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 4/11
Highbury Global Group,
Inc.
2126 Queensguard Rd.
Silver Spring, MD
20906
August 19,
2024
August 19,
2029
OCP Criminal conviction of
principal
The Nupath Company 2605 Summer Hill
Drive
Silver Spring, MD
20904
August 19,
2024
August 19,
2029
OCP Criminal conviction of
principal
Rome Charters, LLC 1629 K Street, NW
Suite 300
Washington, DC 20006
November 7,
2022
November 6,
2027
OCP , DCPS Breach of Contract;
Multiple Legal Violations
District
Properties.Com,Inc.
6500 Chillum Place,
NW
Washington, DC 20012
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
Relux Homes, Inc. 6723 Curran Street,
McLean, VA 22101
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
NaylorDC Investment,
LLC
5415 Connecticut
Avenue NW, Suite L25,
Washington, DC 20015
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
Rupsha 2011, LLC 5100 Wisconsin
Avenue NW, Suite 515,
Washington, DC 20016
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
Rupsha 2013, Inc. 5415 Connecticut
Avenue NW, Suite L25,
Washington, DC 20015
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
Rupsha 2007, LLC 6500 Chillum Place
NW, Washington, DC
20012
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
Rupsha 2006, LLC 6500 Chillum Place
NW, Washington, DC
20012
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
Rupsha 2012, Inc. 6660 Tennyson Drive,
McLean, VA 22101
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 5/11
52nd Street
Development, Inc.
6500 Chillum Place
NW, Washington, DC
20012
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
Rupsha 2008, LLC 6500 Chillum Place
NW, Washington, DC
20012
August 4,
2021
August 4,
2026
OCP Criminal conviction of
principal
b
PAST EXCLUDED PARTIES LIST
b
PAST EXCLUDED PARTIES LIST BY INDIVIDUAL
Name of Individual Principal Address Ac Ɵon Date Termina Ɵon
Date
Acar, Yusuf 4550 Broad Branch Road, NW
Washington, DC 20008-1005
May 28, 2009 and
June 14, 2010
May 27, 2012
Adewumni, Ebeneezer 9418 Annapolis Rd., Suite 204
Lanham, MD 20706
August 4, 2016 August 3, 2018
Akinleye, Monreti 3613 Georgia Avenue, NW;
Washington, DC 20010
March 22, 2005 March 21, 2008
Akinleye, Olushola 3613 Georgia Avenue, NW;
Washington, DC 20010
March 22, 2005 March 21, 2008
Akinyoyenu, Titilayo Akintomide;
a/k/a Tommy Akin, a/k/a Tomi
4047 Minnesota Avenue, NE;
Washington, DC 20019
May 11, 2015 June 20, 2019
Bansal, Sushil 900 17th Street, NW; Suite 900
Washington, DC 20006
May 28, 2009 and
August 18, 2010
May 27, 2012
Borbor, Tamba 810 7thStreet NE; Second Floor
Washington, DC 20002
October 5, 2018 October 5, 2020
Brumfield, Shauna 20 Todd Place NE, APT 2, Washington,
DC 2002
May 2, 2019 May 1, 2024
Chambers, Robert X. 20 Queen Street Cape May, NJ 08204-
1624
February 6, 2008 February 5,
2011
Christian Carter 3711 Grant Place NE, Washington, DC
20019
April 5, 2016 April 4, 2021
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 6/11
Name of Individual Principal Address Ac Ɵon Date Termina Ɵon
Date
Crowder, Amber 1838 Woodmont Place SE,
Washington, DC 20020
May 2, 2019 May 1, 2024
Forney, Keith 2119 Newport Place NW, Washington,
DC 20019
May 9, 2019 May 8, 2024
Gregorio, Florentino 711-A Edgewood Street, NW;
Washington, DC 20017
November 28, 2000 February 13,
2003
Gregorio, Florentino 711-A Edgewood Street, NW;
Washington, DC 20017
July 7, 2003 October 6, 2003
Gregorio, Florentino 711-A Edgewood Street, NW;
Washington, DC 20017
February 12, 2004 August 27,
2004
Hajaji, Mido 1200 G Street NW, Suite 800
Washington, DC 20005
October 21, 2025 January 30,
2026
Hajhassan, Emad O. 3807 Bell Manor Ct., Falls Church, VA
22041
April 18, 2019 April 18, 2024
Hristov, Tihomir 1200 G Street NW, Suite 800
Washington, DC 20005
October 21, 2025 January 30,
2026
Irono, Emmanuel 1508 East Capitol Street NE,
Washington, DC 20003
February 25, 2021 February 24,
2026
Izzard, John Ervin 115 Blackbird Hill Lane Laurel, MD
20724
March 22, 2005 March 21, 2007
James, Akiuber Ndoromo: aka "Akube
Wuromori Ndoromo"
3636 16th Street, NW; Apt # B1235
Washington, DC 20010-8144
February 6, 2008 February 5,
2011
Jeffrey L. Jones 2925 O Street, SE; Washington DC
20020
March 22, 2005 March 21, 2008
Sonja Mattress 4274 Foote Street NE; Unit 3
Washington, DC 20019
May 11, 2015 May 11, 2016
Mir, Sarosh 900 17th Street, NW; Suite 910
Washington, DC 20006
May 10, 2010 May 9, 2013
Postell, Kenneth D. 400 5th Street, NW; Washington, DC
20001-2719
February 6, 2008 June 6, 2008
Rodriguez, Jose 2237 33rd Street, NE; Washington, DC
20118
April 25, 2003 October 25,
2003
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 7/11
Name of Individual Principal Address Ac Ɵon Date Termina Ɵon
Date
Shrensky, Lewis 2237 33rd Street, NE; Washington, DC
20118
April 25, 2003 October 25,
2003
Villegas, Fernando J. 1250 Eye Street, Suite 503
Washington, DC 20005
March 22, 2005 March 21, 2008
Wallace, Mark 1101 Pennsylvania Avenue, NW,
Washington DC 20004
November 26, 2010 November 25,
2013
Young, Leonard H. 7003 Tarquin Avenue Temple Hills,
MD 20748
February 6, 2008 February 5,
2011
b
b
PAST EXCLUDED PARTIES LIST BY COMPANY
b
Name of Company Principal Address Principals Ac Ɵon Date Termina Ɵon
Date
Sky LLC dba U.S. Office
Solutions
2614 28th Street NE
Washington, DC 20018
Yelake Meseretu
Surafel Meseretu
Kirubel Meseretu
August 4, 2025 December 19,
2025
A Simple Solution, LLC 20 Todd Place NE, Apt. 2,
Washington, DC 20002
Shauna Brumfield May 2, 2019 May 1, 2024
Able Towing, Inc. 2708 Virginia Avenue NW,
Washington, DC 20037
b April 18, 2019 April 18, 2024
Advanced Integrated
Technologies Corporation
900 17th Street, NW;
Suite 900, Washington,
DC 20006
Sushil Bansal, President
and Chief Executive
Officer
May 28, 2009 and
August 18, 2010
May 27, 2012
Apex Care Pharmacy 4047 Minnesota Avenue,
NE; Washington, DC
20019
Titilayo Akintomide
Akinyoyenu, a/k/a
Tommy Akin, a/k/a Tomi
May 11, 2015 June 20, 2019
Beale Inc. 3256 Banneker Drive, NE;
Washington, DC 20018
Robin Beale May 7, 2010 May 6, 2011
C & F Construction
Company
711-A Edgewood Street,
NW; Washington, DC
20017
Florentino Gregorio November 28, 2000 February 12,
2003
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 8/11
Name of Company Principal Address Principals Ac Ɵon Date Termina Ɵon
Date
C & F Construction
Company
711-A Edgewood Street,
NW; Washington, DC
20017
Florentino Gregorio July 7, 2003 October 6,
2003
C & F Construction
Company
711-A Edgewood Street,
NW; Washington, DC
20017
Florentino Gregorio February 12, 2004 August 27,
2004
Chambers & Sons Flooring
Inc.
323 E King Street,
Malvern, PA 19355
Robert X. Chambers February 6, 2008 February 5,
2011
Cipher Communications
Inc.
1101 Pennsylvania
Avenue, NW; Washington
DC 20004
Mark Wallace November 26, 2010 November 25,
2013
CloudAI Technologies LLC 1200 G Street NW, Suite
800; Washington, DC
20005
Mido Hajaji
Tihomir Hristov
October 21, 2025 January 30,
2026
Dynamic Corporation 9418 Annapolis Rd., Suite
204 Lanham, MD 20706
Ebeneezer Adewumni August 4, 2016 August 3,
2018
Echelon Community
Services
4274 Foote Street, NE;
Unit 3 Washington, DC
20019
Sonja Mattress May 11, 2015 September 3,
2015
Education Connection, LLC 20 Todd Place NE, Apt. 2,
Washington, DC 20002
Shauna Brumfieldb May 2, 2019 May 1, 2024
FEI Construction Company 1818 New York Avenue,
NE; Suite 201,
Washington, DC 20002
b June 3, 2019 June 2, 2024
Forney Enterprises, Inc. 1818 New York Avenue
NE, Suite 201,
Washington, DC 20002
Keith Forney May 9, 2019 May 8, 2024
Fort Myer Construction
Corporation
2237 33rd Street, NE;
Washington, DC 20118
Rodriguez, Jose April 25, 2003 October 25,
2003
General Services, Inc. aka
General Construction
Services, Inc
3613 Georgia Avenue,
NW; Washington, DC
20010
Monreti Akinleye,
President
March 22, 2005 March 21,
2008
Georgetown-Towing, Inc. 2708 Virginia Avenue NW,
Washington, DC 20037
b April 18, 2019 April 18, 2024
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 9/11
Name of Company Principal Address Principals Ac Ɵon Date Termina Ɵon
Date
Innovative IT Solutions, Inc. 900 17th Street, NW;
Suite 910, Washington,
DC 20006
Mir, Sarosh, President May 28, 2009, May
10, 2010 and
August 18, 2010
May 27, 2012
International Builders, Inc. 1250 Eye Street, Suite 503
Washington, DC 20005
Fernando J. Villegas,
President
March 22, 2005 March 21,
2008
Lawn Restoration Service,
Inc.
2925 O Street, SE;
Washington DC 20020
Jeffrey L. Jones,
President
March 22, 2005 March 21,
2008
Matrix Corporation 4047 Minnesota Avenue,
NE; Washington, DC
20019
Titilayo Akintomide
Akinyoyenu, a/k/a
Tommy Akin, a/k/a Tomi
May 11, 2015 June 20, 2019
Motir Services, Inc.b 1508 East Capitol Street
NE, Washington, DC
20003
Emmanuel Irono February 25, 2021 February 24,
2026
New Beginnings, LLC 810 7th Street NE.,
Second Floor;
Washington, DC 20002
Tamba Borbor October 5, 2018 October 5,
2020
New Columbia Enterprises,
Inc.
3711 Grant Place NE,
Washington, DC 20019
Christian Carter April 5, 2016 April 4, 2021
The Lexx Group LLC 400 5th Street, NW;
Washington, DC 20001-
2719
Kenneth D. Postell,
President
February 6, 2008 June 6, 2008
USA Towing, Inc. 2708 Virginia Avenue NW,
Washington, DC 20037
b April 18, 2019 April 18, 2024
Voice of Social Concern Inc.3636 16th Street, NW; Apt
# B1235 Washington, DC
20010-8144
Akiuber Ndoromo
James: aka "Akube
Wuromori Ndoromo"
February 6, 2008 February 5,
2011
Young Star Tours 7003 Tarquin Avenue,
Temple Hills, MD 20748
Leonard H. Young February 6, 2008 February 5,
2011
Young Transportation 7003 Tarquin Avenue,
Temple Hills, MD 20748
Leonard H. Young February 6, 2008 February 5,
2011
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 10/11
b
b
b
b
+
+
+
+
District News
District Initiatives
About DC
Contact Us
Resources
Accessibility
Privacy and Security
Terms and Conditions
Google Translate Disclaimer
About DC.Gov
5/21/26, 10:45 AM Excluded Parties List | ocp
https://ocp.dc.gov/page/excluded-parties-list 11/11
| AnofficialwebsiteoftheUnitedStatesgovernmentHere'showyouknow
Q KnownIssueswiththeManageContractAwardspage «®) SeeAllAlerts
inSAM.gov.
Show Details
May6,2026
ContractAwardDataProcessingDelayShow Details «&)
May 4,2026
SESAM.cov’ Za x
Home Search Data Bank Data Services Help
< Exclusions
EntityRegistration
Exclusions
ActiveExclusions
Responsibility/Qualification
EntityInformation
MYERS& STAUFFERLC *¥<*2s=tor
UniqueEntityID CAGE/NCAGE
U8JLSDJFHTE7 4EQ52
ExpirationDate
Sep25,2026
PhysicalAddress MailingAddress
700 W 47TH ST 700 W 47TH ST
STE1100 STE1100
Kansas City,Missouri KansasCity,Missouri
64112-2050,UnitedStates 64112-2050,UnitedStates
PurposeofRegistration
AllAwards
Version
CurrentRecord
EXCLUSIONS
There may be instances when an individualor firm has the same or
similarname as your search criteria,but isactuallya differentparty.
Therefore, itisimportant that you verifya potentialmatch with the
excluding agency identifiedinthe exclusion'sdetails.To confirm or
obtainadditionalinformation,contactthefederalagencythattook
theactionagainstthelistedparty.Agencypointsofcontact,
includingnameandtelephonenumber,maybefoundbynavigating
totheAgencyExclusionPOCspagewithinHelp.
ActiveExclusions
TherearenoactiveexclusionrecordsassociatedtothisentitybyitsUniqueEntityID.
Our Website Our Partners
AboutThisSite Acquisition.gov
Our Community USASpending.gov
ReleaseNotes Grants.gov
SystemAlerts MorePartners
Policies CustomerService
TermsofUse Help
Showing1-1of1results
MYERS& STAUFFERLC ActiveRegistration
UniqueEntity10 CAGECodeUUsuLSDIFHTET48952
page resultsperpage
<1 oft > gg
Our Website
AboutThisSite
OurCommunity
ReleaseNotes
SystemAlerts
Policies
TermsofUse
PrivacyPolicy
RestrictedDataUse
FreedomofInformationAct
Accessibility
° 4S WARNING
GSA
PhysicalAddress700W47THST,STE1100,KANSASCITY,MO64112USA
OurPartners
Acquisition.gov
UsASpending.gov
Grants.gov
MorePartners
CustomerService
Help
CheckEntityStatus
FederalServiceDesk
ExternalResources
Contact
Sortby
Relevance
Entity
ExpirationDate‘Sep25,2026
PurposeofRegistrationAllAwards
‘ThisisaU.S.GeneralServicesAdministrationFederalGovernmentcomputersystemthatis"FOROFFICIALUSEONLY"This
systemissubjecttomonitoring.Individualsfoundperformingunauthorizedactivitiesaresubjecttodisciplinaryactionincludingcriminalprosecution.
‘ThissystemcontainsControlledUnclassifiedInformation(CUI).Allindividualsviewing,reproducingordisposingofthisInformationarerequiredtoprotectitnaccordancewith32CFRPart2002andGSAOrderCIO2103.2CUIPolicy.
SAM.gov
An officialwebsiteofthe U.S.GeneralServicesAdministration
££DSLBD HOME (http://dslbd.dc.gov)
Business Certification Information
F. S. Taylor & Associates, P .C.
Certification Information
Categories
Local Business Enterprise (LBE)
Longtime Resident Business (LRB)
Small Business Enterprise (SBE)
Development Enterprise Zone (DZE)
NIGP Codes
Previous Page
Trade Name (Doing Business As):
Description: Provides auditing, accounting, and consulting services
Specialities:
Principal Owner: Rachel A Locus;Terry W Tyler
Contact Name: Rachel Locus
Address: 1420 N STREET NW,WASHINGTON,DC£20005
Phone: 2028980008
Fax: 2028980208
Email: rachel@fstaylor.com
Website: fstaylor.com
Date Established: October 1, 1980
Organization Type: Corporation
Ward: 2
Certification Number: LSZX55652022027
Expiration Date: February 8, 2027
Preference Points: 12
% of Price Reduction: 12%
Show 10 entries Search:
CODE DESCRIPTION
2081000 Accounting/Financial: Bookkeeping, Billing and Invoicing, Budgeting, Payroll, Taxes, etc.
Primary Business Services
Primary Industry
Additional Information
Other Certifications
None
Green Business Network
None
Showing 1 to 10 of 25 entries Previous 1 2 3 Next
CODE DESCRIPTION
2091100 Accounting/Financial: Bookkeeping, Billing and Invoicing, Budgeting, Payroll, Taxes, etc.
9180400 Accounting/Auditing/Budget Consulting
9180405 ACCOUNTING/AUDITING/BUDGET CONSULTING SERVICES
9182000 Business Consulting, Small
9184900 Finance/Economics Consulting
9185800 Governmental Consulting
9187500 Management Consulting
9202100 Data Entry Services
9202200 Data Preparation and Processing Services
Consultant Professional Service Provider: 44%
Previous or Current Contracts with the District Government:
Previous Page
District News
Mayor's Public Schedule (http://mayor.dc.gov/newsroom)
Citywide News (http://newsroom.dc.gov/)
Citywide Calendar (http://calendar.dc.gov/)
Subscribe to Receive Emails
(http://service.govdelivery.com/service/user.html?code=DCWASH)
Subscribe to Text Alerts (https://textalert.ema.dc.gov/index.php?
CCheck=1)
Subscribe to Newsletters
(https://public.govdelivery.com/accounts/DCWASH/subscriber/new?)
District Initiatives
Green DC
(http://green.dc.gov/)
Grade DC
(http://grade.dc.gov/)
Age-Friendly DC
(http://agefriendly.dc.gov/)
Sustainable DC
(http://sustainable.dc.gov/)
Connect DC
(http://connect.dc.gov/)
Great Streets
(http://greatstreets.dc.gov/)
Ready DC
(http://ready.dc.gov/)
About DC
Open DC
(https://ogag.dc.gov/)
Budget
(http://cfo.dc.gov/budget)
Emancipation
(http://emancipation.dc.gov/)
Consumer Protection
(http://consumer.dc.gov/)
Contracts
(http://dc.gov/contracts)
Property Quest
(http://propertyquest.dc.gov/)
Track DC
(http://track.dc.gov/)
Contact Us
Agency Directory (http://directory.dc.gov/)
Call 311 (http://311.dc.gov/)
Contact the Mayor
(http://app.dc.gov/apps/about.asp?
page=atd&type=dsf&referrer=
[$DSF_SERVER_NAME$]&agency_id=1075)
Contact Agency Directors
(https://dslbd.dc.gov/page/contact-
agency-directors)
FOIA Requests (http://foia.dc.gov/)
Report Website Problems
(http://dcforms.dc.gov/webform/problems-
dc-government-website)
Send Feedback (http://feedback.dc.gov/)
Service Request Center (http://311.dc.gov/)
££ Accessibility (http://dc.gov/page/dcgov-accessibility-policy) £££££ Privacy and Security (http://dc.gov/page/privacy-and-security) £££££ Terms and Conditions
(http://dc.gov/page/terms-and-conditions-use) £££££ About DC.Gov (http://dc.gov/page/about-district-government-website) ££
GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
DETERMINATION AND FINDINGS
FOR
PRICE REASONABLENESS
AGENCY: Human Support Services Cluster (HSSC)
CONTRACT NO: CFOPD-26-C-023
CONTRACTOR:
CAPTION:
Myers and Stauffer LC
Medical Audit Services
FINDINGS
1. AUTHORIZATION:
D.C. Municipal Regulations Title 27 §3307 and D.C. Code §2-354.19
2. MINIMUM REQUIREMENTS:
The District of Columbia Office of the Chief Financial Officer, Human Support Services
Cluster (HSSC) (the "District") has a minimum requirement for a contract to provide
audit services on assure that payments made to health care services providers
participating in the Medicaid Program are in compliance with Federal and District laws
and rules, and comply with Federal and District audit requirements.
3. ESTIMATED REASONABLE PRICE AND REASONABLENESS
DETERMINATION:
The estimated contract total price is not to exceed $1,482,399.00
(a) The cost of this contract is of a type generally recognized as ordinary and
necessary for the conduct of the contractor or the performance of the contract.
(b) This contract includes the restraints or requirements imposed by generally
accepted sound business practices, arms-length bargaining, federal and District
laws and regulations, and contract terms and specifications.
(c) This action is an action that a prudent business person would take, considering
responsibilities to the owner of the business, employees, customers, the District,
and the public at large.
(d) There are no significant deviations from the established practices of the contractor
that may unjustifiably increase the contract costs.
(e) There are no other relevant factors that should be noted at this time.
DETERMINATION AND FINDINGS FOR PRICE REASONABLENESS
CONTRACT NO: CFOPD-26-C-040
Page | 2
4. JUSTIFICATION OF REASONABLENESS OF PRICE:
The Contracting Officer has performed an analysis to determine the reasonableness of the
price and the Contracting Officer has found that the price is fair and reasonable.
The Contracting Officer has compared prices of this contract with the independent
District cost estimate and competing prices and has determined the price to be fair and
reasonable.
5. CERTIFICATION BY CONTRACT SPECIALIST:
I hereby certify that to the best of my knowledge and belief, the above reasonableness
findings and cost price analysis are true and complete and the proposed Contractor’s
pricing is reasonable and in the best interest of the Government.
_____________________________________ ____________________
Crystal Farmer-Linder Date
Contract Specialist
DETERMINATION
Based on the above reasonableness findings and cost price analysis, it is hereby
determined that the award of the proposed contract to Myers and Stauffer LC is
reasonable and is in the best interest of the Government of the District of Columbia.
_____________________________________ ______________________
Drakus Wiggins, CPPO, CPPB Date
Contracting Officer
______________________
rakus Wiggins, CPPO, CP
06/08/2026
06/08/2026
______________________
Ct l F
Li d
on behalf of
GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE CHIEF FINANCIAL OFFICER
DETERMINATION AND FINDINGS
FOR
CONTRACTOR’S RESPONSIBILITY
AGENCY: Human Support Services Cluster (HSSC)
CONTRACT NO: CFOPD-26-C-023
CONTRACTOR:
CAPTION:
Myers and Stauffer LC
Medical Audit Service
1. AUTHORIZATION:
27 DCMR §§ 2200.2, 2200.4; D.C. Code §2-353.01
2. MINIMUM REQUIREMENTS:
The District of Columbia Office of the Chief Financial Officer, Human Support Services
Cluster (HSSC) (the "District") is has a minimum requirement for a contract to provide
audit services on to assure that payments made to health care services providers
participating in the Medicaid Program are in compliance with Federal and District laws
and rules, and comply with Federal and District audit requirements.
3. ESTIMATED REASONABLE COST:
The estimated contract total price is not to exceed $1,482,399.00.
4. FACTS WHICH JUSTIFY CONTRACTOR’S RESPONSIBILITY:
The contractor has:
(a) the financial resources adequate to perform the contract or the ability to obtain
those resources;
(b) the ability to comply with the required or proposed delivery or performance
schedule, taking into consideration all of its existing commercial and government
contract commitments;
(c) a satisfactory performance record, as depicted in their past performance
references;
(d) a satisfactory record of integrity and business ethics, as depicted in their past
performance references;
DETERMINATION AND FINDINGS FOR CONTRACTOR’S RESPONSIBILITY
CONTRACT NO: CFOPD-26-C-023
Page | 2
(e) a satisfactory record of compliance with the law, including labor and civil rights
laws and rules, the First Source Employment Agreement Act of 1984, effective
June 29, 1984 (D.C. Law 5-9; D.C. Official Code §§ 2-218.01 et seq.), the Small
and Certified Business Enterprise Development and Assistance Act of 2005, as
amended (D.C. Official Code §§ 2-218.01 et seq.), licensing, and tax laws;
(f) the necessary organization, experience, accounting, operational control, and
technical skills, or the ability to obtain them;
(g) the necessary production equipment, construction equipment, technical
equipment, and facilities, or the ability to obtain them;
(h) not exhibited a pattern of overcharging the District;
(i) no outstanding debt with the District or the federal government in a delinquent
status of more than the greater of one thousand dollars ($1,000) or one percent
(1%) of the contract value, up to twenty-five thousand dollars ($25,000); and
(j) the contractor is otherwise qualified and is eligible to receive an award under
applicable laws and regulations.
5. CERTIFICATION BY THE CONTRACT SPECIALIST:
I hereby certify that the above findings are correct and complete to the best of my
knowledge.
________________________ ___________________
Crystal Farmer-Linder Date
Contract Specialist
DETERMINATION
Based on the above findings, it is hereby determined that the Contractor is responsible in
accordance with the applicable regulations set forth above and award of the proposed
contract withMyers and Stauffer LC is in the best interest of the Government of the
District of Columbia.
___________________________ _________________________
Drakus Wiggins, CPPO, CPPB Date
Contracting Officer
_____________________
akus Wiggins, CPPO, CPP
06/08/2026
____________________
Crystal Farmer
-Linder
on behalf of 06/08/2026
SECTION III
PROPOSED CONTRACT NUMBER CFOPD-26-C-023
X
17 X 18
,
1100 - 4th Street, SW., Suite E610
AWARD/CONTRACT
1. Solicitation Number CFOPD-26-R-023 Page of Pages
1 76 + Attachments
5. Issued By Code 6. Administered By (If other than line 5)
2. Contract Number
Office of the Chief Financial Officer
Office of Contracts
3. Effective Date 4. Requisition/Purchase Request/Project No.
CFOPD-26-C-023 See 20C
Other (See Schedule Section F)
8. Delivery
FOB Destination
Washington, DC 20024
10. Submit Invoices to the Address shown in Line 12 Item
7. Name and Address of Contractor (No. Street, city, country, state and ZIP Code)
Myers and Stauffer LC
10200 Grand Central Ave., Suite 1500
Owings Mills, MD 21117
Attn: Mark Korpela, CFE
mkorpela@mslc.com 410-581-4550/800-505-1698
9. Discount for prompt payment
Code Facility
Office of the Chief Financial Officer
Department of Health Care Finance Office of Management and Administration
(2 copies unless otherwise specified)
11. Ship to/Mark For Code
Office of the Chief Financial Officer
202-442-9071 Washington, DC 20024
Fredrick Hoeflinger, Suite 950N Financial Operations/Accounts Payable
441 4th Street NW https://vendorportal.dc.gov
Washington, DC 20001 1100 4th Street, SW Suite E600
12. Payment will be made by Code
1 Lot
13. Contract Type Requirements with NTE Ceiling 14. Accounting and Appropriation Data
15A. Item 15B. Supplies/Services 15C. Qty 15D. Unit 15E. Unit Price 15F. Amount
(X) Section Description Pages(X) Section Description Pages
NTE $1,482,399.00 NTE $1,482,399.001 Medical Audit Service
Total Amount of Contract NTE $1,482,399.00
16. Table of Contents
PART I - THE SCHEDULE PART II - CONTRACT CLAUSES
28
PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS
C Description/Specifications/Work Statement 19
A
J List of Attachments 75
B Supplies or Services and Price/Cost 2
Solicitation/Contract Form 1 I Contract Clauses 47
PART IV - REPRESENTATIONS AND INSTRUCTIONS
E Inspection and Acceptance 29
D Packaging and Marking
L34 Instructions, conditions & notices to offerorsG Contract Administration Data
F Deliveries or Performance 33 K Representations, Certifications and Other
Statements of Offerors 76
Contracting Officer will Complete Item 17 or 18 as Applicable
CONTRACTOR'S NEGOTIATED AGREEMENT (Contractor is AWARD (Contractor is not required to sign this document.)
required to sign this document and return 1 pdf copies to issuing Your offer on Solicitation Number
Evaluation factors for awardH Special Contract Requirements 40 M
by the following documents: (a) this award/contract, (b) the solicitation, (a) the Government's solicitation and your offer, and (b) this award/
if any, and (c) such provisions, representations, certifications, and contract. No further contractual document is necessary.
continuation sheets for the consideration stated herein. The rights and listed above and on any continuation sheets. This award
office.) Contractor agrees to furnish and deliver all items or perform including the additions or changes made by you which additions or
all the services set forth or otherwise identified above and on any changes are set forth in full above, is hereby accepted as to the items
obligations of the parties to this contract shall be subject to and governed consummates the contract which consists of the following documents:
(Signature of person authorized to sign) (Signature of Contracting Officer)
19B. Name of Contractor 19C. Date Signed 20B. District of Columbia 20C. Date Signed
19A. Name and Title of Signer (Type or print) 20A. Name of Contracting Officer
Drakus Wiggins, CPPO, CPPB
specifications, as are attached or incorporated by reference herein.
(Attachments are listed herein.)
Mark Korpela, Principal
(Si t f
ame of Contractor
k Korpela, Principal
5/14/2026
Contract No. CFOPD-26-C-023
Medical Audit Services
2
V8/16/22
SECTION B
CONTRACT TYPE, SUPPLIES OR SERVICES AND PRICE
B.1 GENERAL INFORMATION
The District of Columbia Office of the Chief Financial Officer, Office of Contract, on behalf
of the Human Support Services Cluster (HSSC) (the "District") is awarding a contract to
provide audit services on behalf of the Department of Health Care Finance (DHCF) to assure
that payments made to health care services providers participating in the Medicaid Program
are in compliance with Federal and District laws and rules, and comply with Federal and
District audit requirements.
B.2 CONTRACT TYPE
B.2.1 The District is awarding of a requirements type contract based on fixed unit prices.
B.3 ALL-INCLUSIVE PRICING
The stated Price Per Unit for each Contract Line Item Number (CLIN) shall be fixed,
inclusive of all of the Contractor’s direct cost, indirect cost, and profit; including travel,
material, and delivery costs. The price shall include all cost associated with the services
described in and required by the Contract. The Total Estimated Price shall represent the price
ceiling, fixed fee, or not to exceed amount of the Contract.
B.3.1 NONPROFIT FAIR COMPENSATION ACT OF 2020, D.C. Code § 2-222.01 et seq.
Nonprofit organizations, as defined in the Act, shall include in their rates the indirect costs
incurred in provision of goods or performance of services under this contract pursuant to the
nonprofit organization's unexpired Negotiated Indirect Cost Rate Agreement (NICRA). If a
nonprofit organization does not have an unexpired NICRA, the nonprofit organization may
elect to instead include in its rates its indirect costs:
(1) As calculated using a de minimis rate of 10% of all direct costs under this contract;
(2) By negotiating a new percentage indirect cost rate with the awarding agency;
(3) As calculated with the same percentage indirect cost rate as the nonprofit organization
negotiated with any District agency within the past two years; however, a nonprofit
organization may request to renegotiate indirect costs rates in accordance with B.3.2; or
(4) As calculated with a percentage rate and base amount, determined by a certified public
accountant using the nonprofit organization’s audited financial statements from the
immediately preceding fiscal year, pursuant to the OMB Uniform Guidance and certified
in writing by the certified public accountant.
B.3.2 If this contract is funded by a federal agency, indirect costs shall be consistent with the
requirements for pass-through entities in 2 C.F.R. § 200.331, or any successor regulations.
B.3.3 The Contractor shall pay its subcontractors which are nonprofit organizations the same
indirect cost rates as the nonprofit organization subcontractors would have received as a
prime contractor.
Contract No. CFOPD-26-C-023
Medical Audit Services
3
V8/16/22
B.4 REQUIREMENTS CONTRACT
B.4.1 The District will purchase its requirements of the items and services included herein from the
Contractor. The estimated quantities stated in the Price Schedule reflect the best estimates
available. The estimate shall not be construed as a representation that the estimated quantity
will be required or that conditions affecting requirements will be stable. The estimated
quantities shall not be construed to limit the quantities which may be required from the
Contractor by the District or to relieve the Contractor of its obligation to fill all such
requirements.
B.4.2 Performance shall be made only as authorized by orders issued in accordance with the Ordering
Clause, in Section G.7. The Contractor(s) shall furnish to the District, when and if ordered, the
services specified in the Schedule.
B.4.3 There is no limit on the number of orders that may be issued.
B.4.4 Any order issued during the effective period of this Contract and not completed within that
period shall be completed by the Contractor (s) within the time specified in the order. The
Contract shall govern the Contractor's and District's rights and obligations with respect to that
order to the same extent as if the order were completed during the Contract's effective period
B.5 PRICE SCHEDULE – REQUIREMENTS
B.5.1 BASE YEAR
B.5.1.1 The Not-to-Exceed Amount if the Contract Base Year is $1,482,399.00
CLIN Item Description Unit Price
001 SSAE-18 SOC 1 Type II Audit $126,230.00
Per Report
002 Audits of Providers Providing Services under §1115
and 1015(c) Waivers
$28,160.00
Per Report
003 Stevie Sellows Fund Audit $20,325.00
Per Report
004 Nursing Home Quality of Care Fund Audit
$20,325.00
Per Report
005 Stand Alone Nursing Facilities - Full Scope $42,300.00
Per Report
006 Stand Alone Nursing Facilities - Limited Scope
$16,175.00
Per Report
007 Stand Alone Nursing Facilities - Desk Review $8,055.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
4
V8/16/22
008 Hospital Based Nursing Facilities - Full Scope $35,000.00
Per Report
009 Hospital Based Nursing Facilities - Limited Scope $16,175.00
Per Report
010 Hospital Based Nursing Facilities - Desk Review $8,055.00
Per Report
011 ICFIID - Full Scope $28,190.00
Per Report
012 ICFIID - Limited Scope $17,000.00
Per Report
013 ICFIID - Desk Review $7,920.00
Per Report
014 CASSIP - Full Scope
$98,465.00
Per Report
015A Hospital DSH Procedures $8,895.00
Per Report
015B DSH Reporting $55,925.00
Per Report
016 Specialty Hospitals (Public and Private) - Full Scope $62,600.00
Per Report
017 Specialty Hospitals (Public and Private) - Limited
Scope
$31,300.00
Per Report
018 Specialty Hospitals (Public and Private) - Desk Review $15,225.00
Per Report
019 D.C. Public Schools - Full Scope Only $28,190.00
Per Report
020 CFSA Healthy Horizon Clinic - Full Scope Only
$29,680.00
Per Report
021 D.C. Charter Schools - Full Scope $28,470.00
Per Report
022 D.C. Charter Schools - Limited Scope $15,925.00
Per Report
023 D.C. Charter Schools - Desk Review $9,075.00
Per Report
024 OSSE - Full Scope Only $28,975.00
Per Report
025 D.C. Fire & Emergency Medical Services Full Scope $31,850.00
Per Report
026 Federally Qualified Health Centers Full Scope $32,020.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
5
V8/16/22
027 Home Health Agencies – Full Scope $30,650.00
Per Report
028 Home Health Agencies – Limited Scope
$15,525.00
Per Report
029 Home Health Agencies – Desk Review $8,305.00
Per Report
030 DRG Hospitals - Full Scope $59,760.00
Per Report
031 DRG Hospitals - Limited Scope
$28,050.00
Per Report
032 DRG Hospitals – Desk $14,700.00
Review Per Report
033 Audit of Providers Subject to Providers Taxes -
hospitals
$27,490.00
Per Report
034 Audit of Providers Subject to Providers Taxes - nursing
homes
$27,490.00
Per Report
035 Audits of Incurred Claims of DC Healthy Families
Program Managed Care Organizations
$69,960.00
Per Report
036 Audit of DC Healthy Families Program Managed Care
Organizations
$124,933.00
Per Report
037A Audit of Incurred Claims of Alliance Manage Care
Organizations
$62,964.00
Per Report
037B Audit of Incurred Claims of Alliance Manage Care
Organizations
$16,740.00
Per Report
038A Audits of Alliance Managed Care Organizations $112,440.00
Per Report
038B Audits of Alliance Managed Care Organizations $29,410
Per Report
039A Audits of Incurred Claims of Immigrant Children's Plan
Managed Case Organizations
$55,968.00
Per Report
039B Audits of Incurred Claims of Immigrant Children's Plan
Managed Case Organizations
$16,740.00
Per Report
040A Audits of Immigrant Children's Plan Managed Case
Organizations
$99,946.00
Per Report
040B Audits of Immigrant Children's Plan Managed Case
Organizations
$29,410.00
Per Report
041 $61,215.00
Contract No. CFOPD-26-C-023
Medical Audit Services
6
V8/16/22
Audits of Incurred Claims of Dual Eligible Special
Needs Program Managed Care Organizations Per Report
042 Audits of Dual Eligible Special Needs Program
Managed Care Organizations
$98,465.00
Per Report
043 Department of Youth and Rehabilitation Services
(DYRS) Full scope only
$28,470.00
Per Report
044 Special Projects Fee $224.00
per hour
B.5.2 OPTION YEAR 1
B.5.2.1 The Not-to-Exceed Amount if the Contract Option Year 1 is $1,919,492.00
CLIN Item Description Unit Price
101 SSAE-18 SOC 1 Type II Audit
$129,333.00
Per Report
102 Audits of Providers Providing Services under §1115
and 1015(c) Waivers
$29,006.00
Per Report
103 Stevie Sellows Fund Audit
$20,936.00
Per Report
104 Nursing Home Quality of Care Fund Audit
$20,936.00
Per Report
105 Stand Alone Nursing Facilities - Full Scope $43,569.00
Per Report
106 Stand Alone Nursing Facilities - Limited Scope $16,661.00
Per Report
107 Stand Alone Nursing Facilities - Desk Review $8,297.00
Per Report
108 Hospital Based Nursing Facilities - Full Scope $36,050.00
Per Report
109 Hospital Based Nursing Facilities - Limited Scope
$16,661.00
Per Report
110 Hospital Based Nursing Facilities - Desk Review $8,297.00
Per Report
111 ICFIID - Full Scope
$29,036.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
7
V8/16/22
112 ICFIID - Limited Scope $17,510.00
Per Report
113 ICFIID - Desk Review $8,157.00
Per Report
114 CASSIP - Full Scope $101,420.00
Per Report
115A Hospital DSH Procedures $9,162.00
Per Procedures
115B DSH Reporting $57,604.00
Per Report
116 Specialty Hospitals (Public and Private) - Full Scope $64,479.00
Per Report
117 Specialty Hospitals (Public and Private) - Limited
Scope
$32,239.00
Per Report
118 Specialty Hospitals (Public and Private) - Desk
Review
$15,683.00
Per Report
119 D.C. Public Schools - Full Scope Only $29,036.00
Per Report
120 CFSA Healthy Horizon Clinic - Full Scope Only $30,571.00
Per Report
121 D.C. Charter Schools - Full Scope $29,324.00
Per Report
122 D.C. Charter Schools - Limited Scope $16,404.00
Per Report
123 D.C. Charter Schools - Desk Review $9,349.00
Per Report
124 OSSE - Full Scope Only
$29,845.00
Per Report
125 D.C. Fire & Emergency Medical Services Full Scope $32,806.00
Per Report
126 Federally Qualified Health Centers Full Scope
$32,981.00
Per Report
127 Home Health Agencies – Full Scope $31,571.00
Per Report
128 Home Health Agencies – Limited Scope
$15,992.00
Per Report
129 Home Health Agencies – Desk Review
$8,555.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
8
V8/16/22
130 DRG Hospitals - Full Scope $61,553.00
Per Report
131 DRG Hospitals - Limited Scope
$28,892.00
Per Report
132 DRG Hospitals – Desk Review $15,141.00
Per Report
133 Audit of Providers Subject to Providers Taxes -
hospitals
$28,315.00
Per Report
134 Audit of Providers Subject to Providers Taxes -
nursing homes
$28,315.00
Per Report
135 Audits of Incurred Claims of DC Healthy Families
Program Managed Care Organizations
$72,059.00
Per Report
136 Audit of DC Healthy Families Program Managed
Care Organizations
$128,682.00
Per Report
137A Audit of Incurred Claims of Alliance Managed Care
Organizations
$64,853.00
Per Report
137B Audit of Incurred Claims of Alliance Managed Care
Organizations
$17,242.00
Per Report
138A Audits of Alliance Managed Care Organizations $115,814.00
Per Report
138B Audits of Alliance Managed Care Organizations
$30,293.00
Per Report
139A Audits of Incurred Claims of Immigrant Children's
Plan Managed Case Organizations
$55,968.00
Per Report
139B Audits of Incurred Claims of Immigrant Children's
Plan Managed Case Organizations
$16,740.00
Per Report
140A Audits of Immigrant Children's Plan Managed Case
Organizations
$102,946.00
Per Report
140B Audits of Immigrant Children's Plan Managed Case
Organizations
$30,293.00
Per Report
141 Audits of Incurred Claims of Dual Eligible Special
Needs Program Managed Care Organizations
$63,052.00
Per Report
142
Audits of Dual Eligible Special Needs Program
Managed Care Organizations
$101,420.00
Per Report
143 Department of Youth and Rehabilitation Services
(DYRS) Full scope only
$29,324.00
Per Report
144 Special Projects Fee $231.00
per hour
Contract No. CFOPD-26-C-023
Medical Audit Services
9
V8/16/22
B.5.3 OPTION YEAR 2
B.5.3.1 The Not-to-Exceed Amount if the Contract Option Year 2 is $2,207,592.00
CLIN Item Description Unit Price
201 SSAE-18 SOC 1 Type II Audit $132,613.00
Per Report
202 Audits of Providers Providing Services under §1115
and 1015(c) Waivers
$29,876.00
Per Report
203 Stevie Sellows Fund Audit $21,562.00
Per Report
204 Nursing Home Quality of Care Fund Audit $21,562.00
Per Report
205 Stand Alone Nursing Facilities - Full Scope $44,877.00
Per Report
206 Stand Alone Nursing Facilities - Limited Scope $17,160.00
Per Report
207 Stand Alone Nursing Facilities - Desk Review $8,546.00
Per Report
208 Hospital Based Nursing Facilities - Full Scope $37,134.00
Per Report
209 Hospital Based Nursing Facilities - Limited Scope $17,160.00
Per Report
210 Hospital Based Nursing Facilities - Desk Review $8,546.00
Per Report
211 ICFIID - Full Scope $29,906.00
Per Report
212 ICFIID - Limited Scope $18,035.00
Per Report
213 ICFIID - Desk Review $8,403.00
Per Report
214 CASSIP - Full Scope $104,463.00
Per Report
215A Hospital DSH Procedures $9,437.00
Per Procedures
215B DSH Reporting $59,331.00
Per Report
216 Specialty Hospitals (Public and Private) - Full Scope
$66,413.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
10
V8/16/22
217 Specialty Hospitals (Public and Private) - Limited
Scope
$33,208.00
Per Report
218 Specialty Hospitals (Public and Private) - Desk
Review
$16,153.00
Per Report
219 D.C. Public Schools - Full Scope Only $29,906.00
Per Report
220 CFSA Healthy Horizon Clinic - Full Scope Only $31,487.00
Per Report
221 D.C. Charter Schools - Full Scope $30,204.00
Per Report
222 D.C. Charter Schools - Limited Scope
$16,896.00
Per Report
223 D.C. Charter Schools - Desk Review
$9,628.00
Per Report
224 OSSE - Full Scope Only $30,741.00
Per Report
225 D.C. Fire & Emergency Medical Services Full Scope $33,791.00
Per Report
226 Federally Qualified Health Centers Full Scope $33,969.00
Per Report
227 Home Health Agencies – Full Scope
$32,517.00
Per Report
228 Home Health Agencies – Limited Scope
$16,471.00
Per Report
229 Home Health Agencies – Desk Review
$8,810.00
Per Report
230 DRG Hospitals - Full Scope
$63,400.00
Per Report
231 DRG Hospitals - Limited Scope
$29,759.00
Per Report
232 DRG Hospitals – Desk $15,595.00
Per Report
233 Audit of Providers Subject to Providers Taxes -
hospitals
$29,163.00
Per Report
234 Audit of Providers Subject to Providers Taxes -
nursing homes
$29,163.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
11
V8/16/22
235 Audits of Incurred Claims of DC Healthy Families
Program Managed Care Organizations
$74,222.00
Per Report
236 Audit of DC Healthy Families Program Managed
Care Organizations
$132,543.00
Per Report
237A Audit of Incurred Claims of Alliance Managed Care
Organization
$66,800.00
Per Report
237B Audit of Incurred Claims of Alliance Managed Care
Organization
$17,759.00
Per Report
238A Audits of Alliance Managed Care Organizations $119,289.00
Per Report
238B Audits of Alliance Managed Care Organizations
$31,201.00
Per Report
239A Audits of Incurred Claims of Immigrant Children's
Plan Managed Case Organizations
$59,378.00
Per Report
239B Audits of Incurred Claims of Immigrant Children's
Plan Managed Case Organizations
$17,759.00
Per Report
240A
Audits of Immigrant Children's Plan Managed Case
Organizations $106,034.00
Per Report
240B Audits of Immigrant Children's Plan Managed Case
Organizations
$31,201.00
Per Report
241 Audits of Incurred Claims of Dual Eligible Special
Needs Program Managed Care Organizations
$64,944.00
Per Report
242 Audits of Dual Eligible Special Needs Program
Managed Care Organizations
$104,463.00
Per Report
243 Department of Youth and Rehabilitation Services
(DYRS) Full Scope Only
$30,204.00
Per Report
244 Special Projects Fee $238.00
per hour
Contract No. CFOPD-26-C-023
Medical Audit Services
12
V8/16/22
B.5.4 OPTION YEAR 3
B.5.4.1 The Not-to-Exceed Amount if the Contract Option Year 3 is $1,792,840.00
CLIN Item Description Unit Price
301 SSAE-18 SOC 1 Type II Audit $135,948.00
Per Report
302 Audits of Providers Providing Services under §1115
and §1915(c) Waivers
$30,771.00
Per Report
303 Stevie Sellows Fund Audit $22,210.00
Per Report
304 Nursing Home Quality of Care Fund Audit
$22,210.00
Per Report
305 Stand Alone Nursing Facilities - Full Scope $46,224.00
Per Report
306 Stand Alone Nursing Facilities - Limited Scope $17,676.00
Per Report
307 Stand Alone Nursing Facilities - Desk Review $8,802.00
Per Report
308 Hospital Based Nursing Facilities - Full Scope
$38,248.00
Per Report
309 Hospital Based Nursing Facilities - Limited Scope $17,676.00
Per Report
310 Hospital Based Nursing Facilities - Desk Review $8,802.00
Per Report
311 ICFIID - Full Scope
$30,804.00
Per Report
312 ICFIID - Limited Scope
$18,577.00
Per Report
313 ICFIID - Desk Review $8,655.00
Per Report
314 CASSIP - Full Scope $107,597.00
Per Report
315A Hospital DSH Procedures $9,720.00
Per Procedures
315B DSH Reporting $61,111.00
Per Report
316 Specialty Hospitals (Public and Private) - Full Scope $68,406.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
13
V8/16/22
317 Specialty Hospitals (Public and Private) - Limited
Scope
$34,204.00
Per Report
318 Specialty Hospitals (Public and Private) - Desk
Review
$16,638.00
Per Report
319 D.C. Public Schools - Full Scope Only $30,804.00
Per Report
320 CFSA Healthy Horizon Clinic - Full Scope Only
$32,432.00
Per Report
321 D.C. Charter Schools - Full Scope $31,110.00
Per Report
322 D.C. Charter Schools - Limited Scope
$17,402.00
Per Report
323 D.C. Charter Schools - Desk Review $9,917.00
Per Report
324 OSSE - Full Scope Only
$31,663.00
Per Report
325 D.C. Fire & Emergency Medical Services Full Scope
$34,804.00
Per Report
326 Federally Qualified Health Centers Full Scope $34,989.00
Per Report
327 Home Health Agencies – Full Scope $33,493.00
Per Report
328 Home Health Agencies – Limited Scope $16,966.00
Per Report
329 Home Health Agencies – Desk Review
$9,074.00
Per Report
330 DRG Hospitals - Full Scope $65,302.00
Per Report
331 DRG Hospitals - Limited Scope
$30,652.00
Per Report
332 DRG Hospitals – Desk $16,063.00
Per Report
333 Audit of Providers Subject to Providers Taxes -
hospitals
$30,039.00
Per Report
334 Audit of Providers Subject to Providers Taxes -
nursing homes
$30,039.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
14
V8/16/22
335 Audits of Incurred Claims of DC Healthy Families
Program Managed Care Organizations
$76,448.00
Per Report
336
Audit of DC Healthy Families Program Managed
Care Organizations
$136,518.00
Per Report
337A Audit of Incurred Claims of Alliance Managed Care
Organization
$68,803.00
Per Report
337B Audit of Incurred Claims of Alliance Managed Care
Organization
$18,292.00
Per Report
338A Audits of Alliance Managed Care Organizations $122,866.00
Per Report
338B Audits of Alliance Managed Care Organizations $32,138.00
Per Report
339A Audits of Incurred Claims of Immigrant Children's
Plan Managed Case Organizations
$61,158.00
Per Report
339B Audits of Incurred Claims of Immigrant Children's
Plan Managed Case Organizations
$18,292.00
Per Report
340A Audits of Immigrant Children's Plan Managed Case
Organizations
$109,214.00
Per Report
340B Audits of Immigrant Children's Plan Managed Case
Organizations
$32,138.00
Per Report
341 Audits of Incurred Claims of Dual Eligible Special
Needs Program Managed Care Organizations
$66,893.00
Per Report
342 Audits of Dual Eligible Special Needs Program
Managed Care Organizations
$107,597.00
Per Report
343 Department of Youth and Rehabilitation Services
(DYRS) Full scope only
$31,110
Per Report
344 Special Projects Fee
$245.00
per hour
Contract No. CFOPD-26-C-023
Medical Audit Services
15
V8/16/22
B.5.5 OPTION YEAR 4
B.5.5.1 The Not-to-Exceed Amount if the Contract Option Year 4 is $1,739,773.00
CLIN Item Description Unit Price
(B)
401 SSAE-18 SOC 1 Type II Audit $139,318.00
Per Report
402 Audits of Providers Providing Services under §1115
and §1915(c) Waivers
$31,695.00
Per Report
403 Stevie Sellows Fund Audit
$22,876.00
Per Report
404 Nursing Home Quality of Care Fund Audit
$22,876.00
Per Report
405 Stand Alone Nursing Facilities - Full Scope $47,610.00
Per Report
406 Stand Alone Nursing Facilities - Limited Scope $18,206.00
Per Report
407 Stand Alone Nursing Facilities - Desk Review
$9,066.00
Per Report
408 Hospital Based Nursing Facilities - Full Scope $39,394.00
Per Report
409 Hospital Based Nursing Facilities - Limited Scope $18,206.00
Per Report
410 Hospital Based Nursing Facilities - Desk Review
$9,066.00
Per Report
411 ICFIID - Full Scope $31,728.00
Per Report
412 ICFIID - Limited Scope $19,135.00
Per Report
413 ICFIID - Desk Review $8,914.00
Per Report
414 CASSIP - Full Scope
$110,824.00
Per Report
415A Hospital DSH Procedures $10,012.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
16
V8/16/22
415B DSH Reporting
$62,943.00
Per Report
416 Specialty Hospitals (Public and Private) - Full Scope $70,457.00
Per Report
417 Specialty Hospitals (Public and Private) - Limited
Scope
$35,230.00
Per Report
418 Specialty Hospitals (Public and Private) - Desk Review $17,136.00
Per Report
419 D.C. Public Schools - Full Scope Only $31,728.00
Per Report
420 CFSA Healthy Horizon Clinic - Full Scope Only $33,405.00
Per Report
421 D.C. Charter Schools - Full Scope $32,044.00
Per Report
422 D.C. Charter Schools - Limited Scope $17,925.00
Per Report
423 D.C. Charter Schools - Desk Review
$10,214.00
Per Report
424 OSSE - Full Scope Only $32,612.00
Per Report
425 D.C. Fire & Emergency Medical Services Full Scope $35,849.00
Per Report
426 Federally Qualified Health Centers Full Scope $36,039.00
Per Report
427 Home Health Agencies – Full Scope $34,497.00
Per Report
428 Home Health Agencies – Limited Scope $17,474.00
Per Report
429 Home Health Agencies – Desk Review $9,348.00
Per Report
430 DRG Hospitals - Full Scope
$67,261.00
Per Report
431 DRG Hospitals - Limited Scope
$31,571.00
Per Report
432 DRG Hospitals – Desk Review $16,547.00
Per Report
433 Audit of Providers Subject to Providers Taxes -
hospitals
$30,940.00
Per Report
Contract No. CFOPD-26-C-023
Medical Audit Services
17
V8/16/22
434 Audit of Providers Subject to Providers Taxes - nursing
homes
$30,940.00
Per Report
435 Audits of Incurred Claims of DC Healthy Families
Program Managed Care Organizations
$78,743.00
Per Report
436 Audit of DC Healthy Families Program Managed Care
Organizations
$140,613.00
Per Report
437A Audit of Incurred Claims of Alliance Program
Managed Care Organizations
$70,869.00
Per Report
437B Audit of Incurred Claims of Alliance Program
Managed Care Organizations
$18,841.00
Per Report
438A Audits of Alliance Managed Care Organizations $126,552.00
Per Report
438B Audits of Alliance Managed Care Organizations
$33,102.00
Per Report
439A Audits of Incurred Claims of Immigrant Children's Plan
Managed Case Organizations
$62,994.00
Per Report
439B Audits of Incurred Claims of Immigrant Children's Plan
Managed Case Organizations
$18,841.00
Per Report
440A Audits of Immigrant Children's Plan Managed Case
Organizations
$112,490.00
Per Report
440B Audits of Immigrant Children's Plan Managed Case
Organizations
$33,102.00
Per Report
441 Audits of Incurred Claims of Dual Eligible Special
Needs Program Managed Care Organizations
$68,899.00
Per Report
442 Audits of Dual Eligible Special Needs Program
Managed Care Organizations
$110,824.00
Per Report
443 Department of Youth and Rehabilitation Services
(DYRS) Full scope only
$32,044.00
Per Report
444 Special Projects Fee $252.00
Per Hour
Contract No. CFOPD-26-C-023
Medical Audit Services
18
V8/16/22
B.5.6 Alternative Prices
1. CLINs Managed Care Organizations Audits D.C. Healthy Families Program, Alliance
Program, and Immigrant Children’s Program. The pricing for the managed care
organizations (MCOs) audits CLINs outlined in the Price Schedules for the Alliance Programs
(CLINs 038A, 138A, 238A, 338A, and 438A) and the Immigrant Children’s Programs (CLINs
040A, 140A, 240A, 340A, and 440A) noted with “A”, are established as the unit price for task
orders being issued separately on differing reporting periods for the individual CLINs. For
example, Base Year CLIN 038A on one task order. However, if the District issues one task
order for the three programs for the Managed Care Organizations Audits D.C. Healthy Families
Program, Alliance Program, and Immigrant Children’s Program to be performed concurrently,
the District can utilized the lower CLIN pricing noted as “B” for the Alliance Programs (CLINs
038B, 138B, 238B, 338B, and 438B) and for the Immigrant Children’s Programs (CLINs
040B, 140B, 240B, 340B, and 440B). For example, Base Year CLINs 036, 038B, and 040B on
one task order.
2. CLINs Audits of Incurred Claims D.C. Healthy Families Program, Alliance Program, and
Immigrant Children’s Program Managed Care Organizations. The pricing for the audits of
incurred claims CLINs outlined in the Price Schedule for the Alliance Programs (CLINs 037A,
137A, 237A, 337A, and 437A) and the Immigrant Children’s Programs (CLINs 039A, 139A,
239A, 339A, and 439A) noted with “A”, are established as the unit price for task orders being
issued separately on differing reporting periods for the individual CLINs. For example, Base
Year CLIN 037A on one task order. However, if the District issues one task order for these
three program audits of incurred claims for the D.C. Healthy Families Program, Alliance
Program, and Immigrant Children’s Program to be performed concurrently, the District can
utilized the lower CLIN pricing noted as “B” for the Alliance Programs (CLINs 037B, 137B,
237B, 337B, and 437B) and the Immigrant Children’s Programs (CLINs 039B, 139B, 239B,
339B, and 439B). For example, Base Year CLINs 035, 037B, and 039B on one task order.
Contract No. CFOPD-26-C-023
Medical Audit Services
19
V8/16/22
SECTION C
DESCRIPTION/SPECIFICATIONS/WORK STATEMENT
C.1 SCOPE
The District of Columbia Office of the Chief Financial Officer, Office of Contract, on behalf of
the Human Support Services Cluster (HSSC) (the "District") is awarding a contract to provide
audit services on behalf of the Department of Health Care Finance (DHCF) to assure that
payments made to health care services providers participating in the Medicaid Program are in
compliance with Federal and District laws and rules, and comply with Federal and District
audit requirements.
C.2 BACKGROUND
C.2.1 The Medicaid Program was established in accordance with applicable provisions of Title XIX
of the Social Security Act to provide medical and other services to medically needy and
indigent persons. The public and private providers of health care services who participate in the
Medicaid Program (“Providers”) are entitled to reimbursement determined for specific health
care services rendered to Medicaid recipients in accordance with the prescribed methodologies
set forth in the District of Columbia State Plan for Medical Assistance (“State Plan”)
(Accessible at http://dhcf.dc.gov/page/medicaid-state-plan) under Section 4.19 - General
Program Administration, Payment for Services.
C.2.2 The Medicaid Program follows the reimbursement requirements set forth in the State Plan and
Title 29 D.C. Municipal Regulations (DCMR). However, if specific guidance is not provided
in the State Plan, authoritative guidance is sought in the following sources:
1. Code of Federal Regulations Title 42 (42 CFR)
2. Medicare Benefit Policy Manual Chapter 15
3. Medicare Provider Reimbursement Manual (PRM) Parts I and II
4. Medicare Statutes and Regulations
5. Generally Accepted Accounting Standards
6. Generally Accepted Auditing Standards
7. Government Auditing Standards (Yellow Book)
8. District of Columbia Statutes and Rules Governing the Medicaid Program
9. Centers for Medicare & Medicaid Services (CMS)
10. Estimated Useful Lives of Depreciable Hospital Assets (American Hospital
Association)
11. Medical Loss Ratio (MLR) Monitoring, Reporting, and Oversight: A Toolkit
Contract No. CFOPD-26-C-023
Medical Audit Services
20
V8/16/22
for States to Ensure Complete and Accurate MLR Reporting (CMS)
12. Statement on Standards for Attestation Engagements (SSAE) No. 18
C.2.3 Providers are required to submit cost reports for purposes of assessing trends in health care
costs and for other purposes as determined by the Medicaid Program. In certain cases cost
reports determine or contribute in determining Providers’ reimbursement. Audits are necessary
to verify costs and other submitted data necessary to establish rates and information used in
analyzing and determining rate methodologies and Medicaid Program costs.
C.2.4 The Medicaid Program uses an outside service organization for providing Medicaid
Management Information Systems (MMIS) services to process claims and assist in reporting of
expenditures to Providers. Due to the magnitude of such services, the District’s Annual
Comprehensive Financial Report requires that an independent auditor conduct an assessment of
the control activities of the service organization providing MMIS services. Statements on
Standards for Attestation Engagements (SSAE) 18, System and Organization Controls (SOC) 1
Type 2 audits are examinations of service organizations’ internal controls to evaluate their
design and effectiveness on financial reporting throughout the district’s fiscal year.
C.3 REQUIREMENTS
C.3.1 The Contractor shall provide audit services to ensure cost reports and other submitted data of
Providers are accurate and reasonable in accordance with reimbursement requirements and
guidance set forth in the State Plan and authoritative sources.
C.3.2 The Contractor shall perform the following general requirements in each audit service:
1. The Contractor shall determine if Providers have implemented and utilized financial,
administrative, and internal control procedures to discharge their cost reporting
responsibilities under the State Plan and Title 29 D.C. Municipal Regulations (DCMR).
2. The Contractor shall determine through cost sampling, AICPA standard procedures, or
other authoritative guidance whether the costs incurred and claimed are allowable under the
State Plan and to recommend adjustments based on tests of reliability and allowability.
3. The Contractor shall provide its findings as to whether the Providers’ cost reports present a
fair basis for reimbursement for services rendered in conformity with the State Plan and
Title 29 D.C. Municipal Regulations (DCMR) and whether the Providers’ cost reports are
prepared on a consistent basis from one period to the next.
4. The Contractor shall determine whether financial operations are in accordance with the
State Plan and Title 29 D.C. Municipal Regulations (DCMR) and whether the financial
report of the Provider is fairly presented.
5. The Contractor shall verify the accuracy and reasonableness of all such information
obtained by examining the records and other supporting evidence, to the extent necessary to
Contract No. CFOPD-26-C-023
Medical Audit Services
21
V8/16/22
prepare an authoritative, objective report.
6. The Contractor shall report and make recommendations concerning the detection and
correction of all improper, unallowable, or unusual costs to the District.
7. The Contractor shall audit Providers, as ordered by the District, in accordance with the
audit requirements contained in the State Plan and Title 29 D.C. Municipal Regulations
(DCMR).
8. The Contractor shall subject the Provider’s cost reports to the verification level chosen by
the District at the time of an audit request. The three (3) levels of verification are as
follows:
a) Full Scope - an audit that includes all procedures necessary for the Contractor to
provide an opinion as to whether the Provider’s cost report as a whole presents a fair
basis for reimbursement, in accordance with the State Plan. A full scope audit
involves examination of detailed support of transactions and specific account
balances. Support shall be obtained for the items listed below:
i. Independent verification of the Provider’s licenses.
ii. Independent verification of the Provider’s vendor purchases, contracts, and other
claimed costs.
iii. Independent verification of the Provider’s staffing levels and pertinent
credentials.
iv. Independent verification of recipient level of care.
v. Independent verification of the patient fund account expenditures.
b) Limited Scope - an audit covering specific areas performed by utilizing procedures
agreed upon by the Contractor and the District to provide limited assurance that
costs claimed are allowable, reasonable, and in accordance with the State Plan. A
limited scope audit involves analytical review and reasonableness testing of
transactions and specific account balances as guided by AICPA standards and other
authoritative guidance.
c) Desk Review - an in-house review of submitted cost reports performed by utilizing
procedures agreed upon by the Contractor and the District.
9. The Contractor shall design and execute desk review procedures, limited scope procedures,
and field audit procedures for full scope verification. The procedures shall be designed for
each designated task and shall be consistent with the scope of work.
10. The Contractor shall, as necessary, plan engagements, conduct entrance and exit
conferences, perform field work if necessary, submit final audit reports with audit
adjustments, review subsequently submitted documentation (including that submitted post-
exit conference) and revise audit reports accordingly.
11. The Contractor shall discuss the scope and conduct of the audit with the Provider being
audited and notify DHCF of the scheduled entrance and exit interviews with each Provider
Contract No. CFOPD-26-C-023
Medical Audit Services
22
V8/16/22
in order for a DHCF representative to be present. At the exit interview the Contractor shall
identify all potential disallowances to the Provider and give a time-frame for the Provider to
submit documentation to prevent any potential disallowances or adjustments.
12. The Contractor shall maintain and organize working papers in a manner agreeable to both
the District and the Contractor and maintain all data, material and working papers in a
location with convenient access to the District.
13. The Contractor shall utilize either Health Financial Systems or KMPG Peat Marwick
Compu-Max MICRO Systems software products or the equivalent approved by CMS for
processing hospital cost reports.
14. Conflict of Interest
a) The Contractor shall not have any conflict of interest as defined in the AICPA Code of
Professional Conduct.
b) Providers posing a potential conflict of interest to the Contractor shall be identified and
a description given of the circumstance of the potential conflict of interest.
c) The Contractor shall also inform the District of any audit staff who seeks employment
with a Provider while an audit is in progress.
d) The Contractor shall refer to and act in accordance with the AICPA Code of
Professional Code whenever a conflict arises during the term of the Contract.
e) In addition, the Contractor shall present to the District the steps the Contractor will take
to eliminate the conflict.
f) The District reserves the right to review the Contractor’s conflict elimination plan.
15. The Contractor shall meet with Providers and DHCF to resolve post exit issues, to resolve
appeals, and to represent DHCF at judicial proceedings.
16. The Contractor shall cooperate and assist in preparation and defense of administrative or
civil litigation arising under the Contract that relates to the performance and results of
Contractor’s performance of auditing and related services including, but not limited to,
providing documents and witnesses. The Contractor shall be available beyond the
termination of this Contract for the defense of any auditing and related services including,
but not limited to, providing documents and witnesses.
17. The Contractor shall complete position papers to support the District’s position regarding
issues on appeals before the District of Columbia Office of Administrative Hearings, or
reimbursement-related lawsuits in the Federal and District Courts, or other administrative
tribunals within the time frame established by the Office of Administrative Hearings, court,
or tribunal.
18. Administrative reviews are an integral part of the audit process. These reviews are normally
filed subsequent to the issuance of the final rate or reimbursement notices and can vary
significantly in the level of effort required. Therefore, the Contractor shall be available to
assist the District in presenting its position before the Office of Administrative Hearings.
C.3.3 The Contractor shall perform audit services of the following types of private providers:
1. Nursing Facilities
Contract No. CFOPD-26-C-023
Medical Audit Services
23
V8/16/22
2. Hospitals
3. Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFIID)
4. Child and Adolescent Supplemental Security Income Program (CASSIP)
5. DC Healthy Families Program Managed Care Organizations
6. DC Alliance Managed Care Organizations
7. Immigrant Children’s Managed Care Organizations
8. Dual Eligible Special Needs Managed Care Organizations
9. Disproportionate Share Hospitals (DSH) Receiving Distributions
10. Federally Qualified Health Centers
11. Home Health Agencies
12. Providers providing services pursuant to authority under authority of §1115 and §1915(c) of
the Social Security Act.
C.3.4 In addition to the general requirements, CASSIP audits shall be annual, full scope audits of the
Provider determining expenditures for medical claims paid and differences between claims
experience, capitation payments, and compliance with the CASSIP contract. The audit shall
also determine the effect of risk corridors on final settlement.
C.3.5 In addition to the general requirements, audits of dual eligible special needs MCO plans shall
be annual, full scope audits of the Provider determining expenditures for medical claims paid
and differences between claims experience, capitation payments, and compliance with the dual
eligible special needs contract. The audit shall also determine the effect of risk corridors on
final settlement.
C.3.6(a) In addition to the general requirements, the Contractor shall perform financial audits on
incurred claims of all Healthy Families Plan MCOs to confirm that amounts paid to providers
for providing Medicaid-covered services to enrollees are in compliance with standards set forth
in 42 CFR §438.8(e)(2).
C.3.6(b) In addition to the general requirements and relying on incurred claims information supplied
by DHCF the Contractor shall perform financial audits annually on all Healthy Families Plan
MCOs to confirm that amounts paid to providers for providing Medicaid-covered services to
enrollees are in compliance with standards set forth in 42 CFR §438.8. The District is required
to provide periodically for the audit of the accuracy, truthfulness and completeness of each
Healthy Families Plan MCO’s financial data, including the Medical Loss Ratio. In addition,
relying on incurred claims data the Contractor will consider each Healthy Families Plan MCO’s
health care quality improvement activities, non-claims costs, premium revenue, taxes and
licensing and regulatory fees, allocation of expenses and credibility adjustments as set forth
in 42 CFR §438.8, determine each Healthy Families Plan MCO’s Medical Loss Ratio and
calculate each Healthy Families Plan MCO’s receivables and liabilities in accordance with the
risk share requirements of contracts between each Health Families Plan MCO and DHCF.
C.3.7(a) In addition to the general requirements, the Contractor shall perform annual financial audits
on incurred claims of all Alliance MCOs to confirm that amounts paid to providers for
providing covered services to enrollees are in compliance with standards set forth in 42 CFR
§438.8(e)(2).
Contract No. CFOPD-26-C-023
Medical Audit Services
24
V8/16/22
C.3.7(b) In addition to the general requirements and relying on incurred claims information supplied
by DHCF the Contractor shall perform financial audits annually on all Alliance MCOs to
confirm that amounts paid to providers for providing covered services to enrollees are in
compliance with standards set forth in 42 CFR §438.8. The District is required to provide
periodically for the audit of the accuracy, truthfulness and completeness of each Alliance
MCO’s financial data, including the Medical Loss Ratio. In addition, relying on incurred
claims data the Contractor will consider each Alliance MCO’s health care quality improvement
activities, non-claims costs, premium revenue, taxes and licensing and regulatory fees,
allocation of expenses and credibility adjustments as set forth in 42 CFR §438.8, determine
each Alliance MCO’s Medicaid Loss Ratio and calculate each Alliance MCO’s receivables and
liabilities in accordance with the risk share requirements of contracts between each Alliance
Plan MCO and DHCF.
C.3.8(a) In addition to the general requirements, the Contractor shall perform annual financial audits
on incurred claims of all Immigrant Children’s Plan MCOs to confirm that amounts paid to
providers for providing Medicaid-covered services to enrollees are in compliance with
standards set forth in 42 CFR §438.8(e)(2).
C.3.8(b) In addition to the general requirements and relying on incurred claims information supplied
by DHCF the Contractor shall perform financial audits annually on all Immigrant Children’s
Plan MCOs to confirm that amounts paid to providers for providing Medicaid-covered services
to enrollees are in compliance with standards set forth in 42 CFR §438.8. The District is
required to provide periodically for the audit of the accuracy, truthfulness and completeness of
each Immigrant Children’s Plan MCO’s financial data, including the Medical Loss Ratio. In
addition, relying on incurred claims data the Contractor will consider each Immigrant
Children’s Plan MCO’s health care quality improvement activities, non-claims costs, premium
revenue, taxes and licensing and regulatory fees, allocation of expenses and credibility
adjustments as set forth in 42 CFR §438.8, determine each Immigrant Children’s Plan MCO’s
Medicaid Loss Ratio and calculate each Immigrant Children’s Plan MCO’s receivables and
liabilities in accordance with the risk share requirements of contracts between each Immigrant
Children’s Plan MCO and DHCF.
C.3.9(a) In addition to the general requirements, the Contractor shall perform annual financial audits
on incurred claims of all Dual Eligible Special Needs Plan MCOs to confirm that amounts paid
to providers for providing covered services to enrollees are in compliance with standards set
forth in 42 CFR §438.8(e)(2).
C.3.9(b) In addition to the general requirements and relying on incurred claims information supplied
by DHCF the Contractor shall perform financial audits annually on all Dual Eligible Special
Needs Plan MCOs to confirm that amounts paid to providers for providing covered services to
enrollees are in compliance with standards set forth in 42 CFR §438.8. The District is required
to provide periodically for the audit of the accuracy, truthfulness and completeness of each
Dual Eligible Special Needs Plan MCO’s financial data, including the Medical Loss Ratio if
included in the Dual Eligible Special Needs Plan MCO’s contract. In addition, relying on
incurred claims data the Contractor will consider each Dual Eligible Special Needs Plan
MCO’s health care quality improvement activities, non-claims costs, premium revenue, taxes
and licensing and regulatory fees, allocation of expenses and credibility adjustments as set forth
in 42 CFR §438.8, determine each Dual Eligible Special Needs Plan MCO’s Medical Loss
Contract No. CFOPD-26-C-023
Medical Audit Services
25
V8/16/22
Ratio if included in the Dual Eligible Special Needs Plan MCO’s contract and calculate each
Dual Eligible Special Needs Plan MCO’s receivables and liabilities in accordance with the risk
share requirements of contracts between each Dual Eligible Special Needs Plan MCO and
DHCF.
C.3.10 In addition to the general requirements, DSH audits shall be in compliance with the CMS final
rule and any subsequent changes regarding audits of the program’s annual DSH payments. The
Contractor shall review DHCF data used to calculate allotments, obtain and test hospitals’ data
to determine DSH limits, test DHCF compliance with required verification procedures, perform
selective claims testing, prepare for DHCF submission to CMS a report of the audit and provide
and maintain for future reference all other required documentation in accordance with CMS
format, requirements and filing deadlines. The Contractor shall also recalculate amounts that
individual hospitals are entitled to and assist DHCF in redistribution of preliminarily distributed
payments.
C.3.11 In addition to the general requirements, for all providers listed in C.3.3 audits shall reconcile
payments with costs and compute settlement amounts.
C.3.12 The Contractor shall perform audit services of the following types of public providers:
1. D. C. Public Schools (DCPS)
2. Child and Family Services Agency’s (CFSA) Healthy Horizon Clinic
3. Department of Youth and Rehabilitation Services (DYRS)
4. D.C. Charter Schools
5. St. Elizabeths Hospital
6. D.C. Fire & Emergency Medical Services (FEMS)
7. Office of the State Superintendent of Education (OSSE)
C.3.13 SSAE-18 SOC 1 Type 2 Audits:
1. The Contractor shall annually perform a Standards for Attestation Engagements 18 Systems
and Organization Controls 1 Type 2 audit of the Medicaid Program and District’s fiscal
agent on the design of policies and procedures placed in operation, as well as the operating
effectiveness of such policies and procedures. In addition to the applicable general audit
requirements, the Contractor shall plan the engagement, meet with DHCF and contract
personnel on site in order to understand and document systems, controls, program changes,
file protection and security of user records, and test systems, conduct entrance and exit
interviews, and timely issue the SSAE 18 SOC 1 Type 2 audit report. The work to be
performed shall include procedures performed on all related vendors of sufficient
materiality to warrant consideration in determining the auditor’s opinion.
2. The SSAE-18 SOC 1 Type 2 audit shall be performed annually in line with the District’s
fiscal year cycle from October 1 to September 30.
C.3.14 The Contractor shall perform audit services of the Stevie Sellows Fund. The Stevie Sellows
Fund Audit is an internal audit of the assessments, collections and disbursements of funds
pursuant to D.C. Official Code § 47-1273, which imposes a provider tax on all intermediate
care facilities for individuals with intellectual disabilities (ICF/IID) operating in the District of
Columbia.
Contract No. CFOPD-26-C-023
Medical Audit Services
26
V8/16/22
C.3.15 The Contractor shall perform audit services of the Nursing Home Quality of Care Fund. The
Nursing Home Quality of Care Fund Audit is an internal audit of the assessments, collections
and disbursements of funds pursuant to D.C. Official Code §§ 47-1261-1269, which imposes a
provider tax on all nursing facilities operating in the District of Columbia.
C.3.16 The Contractor shall perform audits of the financial and other data required for computation of
the provider tax for hospitals.
C.3.17 The Contractor shall perform audits of the financial and other data required for computation of
the provider tax for nursing homes.
C.3.18 Notwithstanding the foregoing, at the option of both DHCF and the Contractor the two may
agree on procedures to be applied to providers as an entity with hours agreed upon depending
on the nature and complexity of the provider, such procedures to be designed to apply to all
types of services and cost accumulating areas of the entity under consideration.
C.3.19 Deadlines
1. The Contractor shall complete audits and services and deliver reports on or before the
required dates indicated, following issuance of a task order, unless additional time is
specified in the task order:
a. SSAE-18 SOC 1 Type 2 examinations before January 1 following the fiscal year under
audit.
b. Hospital audits within five (5) months.
c. ICFIID audits within three (3) months.
d. Nursing Facilities (Stand Alone and Hospital Based) audits within three (3) months.
e. CASSIP audits within four (4) months. Due dates for all other audits and services will
be determined by the District and will be specified in the task order’s scope of work.
f. Healthy Families Plan MCO audits within five (5) months. Due dates for all other audits
and services will be determined by the District and will be specified in the task order’s
scope of work.
g. Alliance MCO audits within five (5) months. Due dates for all other audits and services
will be determined by the District and will be specified in the task order’s scope of
work.
h. Immigrant Children plan MCO audits within five (5) months. Due dates for all other
audits and services will be determined by the District and will be specified in the task
order’s scope of work.
i. Dual Eligible Special Needs MCO audit within five (5) months. Due dates for all other
audits and services will be determined by the District and will be specified in the task
order’s scope of work.
j. DSH audits, reporting, and redistribution calculation within five (5) months.
k. DCPS audits within five (5) months.
l. CFSA Healthy Horizon Clinic audits within five (5) months.
m. DYRS audits within five (5) months.
n. OSSE audits within five (5) months.
Contract No. CFOPD-26-C-023
Medical Audit Services
27
V8/16/22
o. D.C. Chartered Schools within five (5) months
p. D.C. Fire and Emergency Medical Services within five (5) months
q. Federally Qualified Health Centers within five (5) months.
r. Home Health Agencies within five (5) months.
2. The Contractor shall provide written progress reports of ongoing audits and services, in a
form acceptable to the District, every month.
3. The Contractor shall provide a periodic statement of account for each audit assigned and
performed, reflecting the total fee for the audit, the amount billed, the amount received, any
contingency amount, and the outstanding balance.
4. If the number of cost reports and/or Providers increases significantly during the term of the
Contract, the District may revise the required timeframes accordingly through a bilateral
contract modification with the Contractor.
5. The Contractor shall not be held to the Deadlines in the event of a MMIS system failure or
other circumstances covered under the Force Majeure provision of the Contract.
C.3.20 Equitable Adjustments
1. The following Impact Circumstances may potentially affect singularly or collectively the
scope of work and cost of an audit service.
a. Revision in cost data provided subsequent to the verification by the Providers.
b. Sale of facilities, thereby necessitating interim period verification as of the date of
sale.
c. Providers who terminate participation in the Medicaid Program during the year.
d. Providers who change their fiscal year, thereby necessitating a special verification
of a short period cost report.
2. The Contractor may request, for the District’s consideration, an upward equitable
adjustment to a task order based on the justification of an Impact Circumstance that
increases the scope of work and costs.
3. The District may modify a task order for a downward equitable adjustment based on the
justification of an Impact Circumstance that decreases the scope of work and costs.
4. Any Contractor request for an upward equitable adjustment to a task order not based on the
justification of an Impact Circumstance will be denied by the District, unless reasonably
justified.
C.3.21 Business Associate Agreement
The Contractor shall agree to acceptance of and compliance with the Attachment J.3, District of
Columbia Business Associate Agreement.
Contract No. CFOPD-26-C-023
Medical Audit Services
28
V8/16/22
SECTION D
PACKAGING AND MARKING
D.1 PACKAGING
All reports and deliverables that are in “hard copy” and physically transported through the U.S.
mail or private courier services are to be securely packaged using the Contractor’s best
practices.
D.2 MARKING
D.2.1 Unless otherwise specified herein, all reports and deliverables delivered under this contract
must be plainly marked, stating the Contractor’s name, contract number and addressed to the
recipient, including the name of the office or floor, and the recipient’s office telephone number
as noted in the contract.
D.2.2 In case of carload lots, the Contractor shall tag the car, stating Contractor’s name and contract
number. Any failure to comply with these instructions will place the material at the
Contractor’s risk.
D.2.3 Deliveries by rail, water, truck or otherwise, must be within the working hours and in ample
time to allow for unloading and if necessary, the storing of the materials or supplies before
closing time. Deliveries at any other time will not be accepted unless specific arrangements
have been previously made with the contact person identified in the contract at the delivery
point.
Contract No. CFOPD-26-C-023
Medical Audit Services
29
V8/16/22
SECTION E
INSPECTION, ACCEPTANCE AND WARRANTY OF SERVICES
E.1 INSPECTION
E.1.1 All supplies and services provided by the Contractor under this contract shall be subject to
inspection by the Contracting Officer’s Technical Representative (“COTR”) identified in Section
G.1 (b).
E.1.2 Inspection of Supplies
(a) Definition. “Supplies,” as used in this clause, includes, but is not limited to raw
materials, components, intermediate assemblies, end products, and lots of supplies.
(b) The Contractor shall be responsible for the materials or supplies covered by this
contract until they are delivered at the designated point, but the Contractor shall bear all
risk on rejected materials or supplies after notification of rejection. Upon the
Contractor’s failure to cure within ten (10) days after date of notification, the District
may return the rejected materials or supplies to the Contractor at the Contractor’ s risk
and expense.
(c) The Contractor shall provide and maintain an inspection system acceptable to the
District covering supplies under this contract and shall tender to the District for
acceptance only supplies that have been inspected in accordance with the inspection
system and have been found by the Contractor to be in conformi ty with contract
requirements. As part of the system, the Contractor shall prepare records evidencing all
inspections made under the system and the outcome. These records shall be kept
complete and made available to the District during contract performance and for as long
afterwards as the contract requires. The District may perform reviews and evaluations
as reasonably necessary to ascertain compliance with this paragraph. These reviews and
evaluations shall be conducted in a manner that will not unduly delay the contract
work. The right of review, whether exercised or not, does not relieve the Contractor of
the obligations under this contract.
(d) The District has the right to inspect and test all supplies called for by the contract, to the
extent practicable, at all places and times, including the period of manufacture, and in
any event before acceptance. The District will perform inspections and tests in a manner
that will not unduly delay the work. The District assumes no contractual obligation to
perform any inspection and test for the benefit of the Contractor unless specifically set
forth elsewhere in the contract.
(e) If the District performs inspection or test on the premises of the Contractor or
subcontractor, the Contractor shall furnish, and shall require subcontractors to furnish,
without additional charge, all reasonable facilities and assistance for the safe and
convenient performance of these duties. Except as otherwise provided in the contract,
the District will bear the expense of District inspections or tests made at other than
Contractor’ s or subcontractor’ s premises; provided, that in case of rejection, the District
will not be liable for any reduction in the value of inspection or test samples.
(1) When supplies are not ready at the time specified by the Contractor for
Contract No. CFOPD-26-C-023
Medical Audit Services
30
V8/16/22
inspection or test, the Contracting Officer may charge to the Contractor the
additional cost of inspection or test.
(2) Contracting Officer may also charge the Contractor for any additional cost of
inspection or test when prior rejection makes re-inspection or retest.
(f) The District has the right either to reject or to require correction of nonconforming
supplies. Supplies are nonconforming when they are defective in material or
workmanship or otherwise not in conformity with contract requirements. The District
may reject nonconforming supplies with or without disposition instructions.
(g) The Contractor shall remove supplies rejected or required to be corrected. However, the
Contracting Officer may require or permit correction in place, promptly after notice, by
and at the expense of the Contractor. The Contractor shall not tender for acceptance
corrected or rejected supplies without disclosing the former rejection or requirement for
correction, and when required, shall disclose the corrective action taken.
(h) If the Contractor fails to remove, replace, or correct rejected supplies that are required
to be replaced or corrected within ten (10) days, the District may either (1) by contract
or otherwise, remove, replace or correct the supplies and charge the cost to the
Contractor or (2) terminate the contract for default. Unless the Contractor corrects or
replaces the supplies within the delivery schedule, the Contracting Officer may require
their delivery and make an equitable price reduction. Failure to agree to a price
reduction shall be a dispute.
(i) If this contract provides for the performance of District quality assurance at source, and
if requested by the District, the Contractor shall furnish advance notification of the time
(i) when Contractor inspection or tests will be performed in accordance with the terms
and conditions of the contract, and (ii) when the supplies will be ready for District
inspection.
(j) The District request shall specify the period and method of the advance notification and
the District representative to whom it shall be furnished. Requests shall not require
more than 2 business days of advance notification if the District representative is in
residence in the Contractor’ s plant, nor more than 7 business days in other instances.
(k) The District will accept or reject supplies as promptly as practicable after delivery,
unless otherwise provided in the contract. District failure to inspect and accept or reject
the supplies shall not relieve the Contractor from responsibility, nor impose liability
upon the District, for non-conforming supplies.
(l) Inspections and tests by the District do not relieve the Contractor of responsibility for
defects or other failures to meet contract requirements discovered before acceptance.
Acceptance shall be conclusive, except for latent defects, fraud, gross mistakes
amounting to fraud, or as otherwise provided in the contract.
(m) If acceptance is not conclusive for any of the reasons in subparagraph (l) hereof, the
District, in addition to any other rights and remedies provided by law, or under
provisions of this contract, shall have the right to require the Contractor (1) at no
increase in contract price, to correct or replace the defective or nonconforming supplies
at the original point of delivery or at the Contractor’ s plant at the Contracting Officer’s
election, and in accordance with a reasonable delivery schedule as may be agreed upon
between the Contractor and the Contracting Officer; provided, that the Contracting
Officer may require a reduction in contract price if the Contractor fails to meet such
delivery schedule, or (2) within a reasonable time after receipt by the Contractor of
notice of defects or noncompliance, to repay such portion of the contract as is equitable
Contract No. CFOPD-26-C-023
Medical Audit Services
31
V8/16/22
under the circumstances if the Contracting Officer elects not to require correction or
replacement. When supplies are returned to the Contractor, the Contractor shall bear the
transportation cost from the original point of delivery to the Contractor’ s plant and
return to the original point when that point is not the Contractor’ s plant. If the
Contractor fails to perform or act as required in (1) or (2) above and does not cure such
failure within a period of 10 days (or such longer period as the Contracting Officer may
authorize in writing) after receipt of notice from the Contracting Officer specifying
such failure, the District will have the right to return the rejected materials at
Contractor’ s risk and expense or contract or otherwise to replace or correct such
supplies and charge to the Contractor the cost occasioned the District thereby.
E.1.3 Inspection of Services
(a) Definition. “Services” as used in this clause includes services performed, workmanship,
and material furnished or utilized in the performance of services.
(b) The Contractor shall provide and maintain an inspection system acceptable to the
District covering the services under this contract. Complete records of all inspection
work performed by the Contractor shall be maintained and made available to the
District during contract performance and for as long afterwards as the contract requires.
(c) The District has the right to inspect and test all services called for by the contract, to the
extent practicable at all times and places during the term of the contract. The District
will perform inspections and tests in a manner that will not unduly delay the work.
(d) If the District performs inspections or tests on the premises of the Contractor or
subcontractor, the Contractor shall furnish, without additional charge, all reasonable
facilities and assistance for the safety and convenient performance of these duties.
(e) If any of the services do not conform to the contract requirements, the District may
require the Contractor to perform these services again in conformity with contract
requirements, at no increase in contract amount. When the defects in services cannot be
corrected by performance, the District may require the Contractor to take necessary
action to ensure that future performance conforms to contract requirements and reduce
the contract price to reflect value of services performed. If the Contractor fails to
promptly perform the services again or take the necessary action to ensure future
performance in conformity to contract requirements, the District may (1) by contract or
otherwise, perform the services and charge the Contractor any cost incurred by the
District that is directly related to the performance of such services, or (2) terminate the
contract for default.
E.2 ACCEPTANCE
Acceptance of all products and services provided under this contract shall be performed by the
COTR. Acceptance means approval by the COTR of specific services as partial or complete
performance of the contract.
E.3 WARRANTY OF SERVICES
E.3.1 The time period for this warranty provision is the life of the contract plus all active options and
extensions.
Contract No. CFOPD-26-C-023
Medical Audit Services
32
V8/16/22
E.3.2 Warranty Provision:
(a) Notwithstanding inspection and acceptance by the District or any provision concerning
the conclusiveness thereof, the Contractor warrants that all services performed under
this contract will, at the time of acceptance, be free from defects in workmanship and
conform to the requirements of this contract. The Contracting Officer shall give written
notice of any defect or nonconformance to the Contractor within 30 days from the date
of discovery. This notice shall state either:
(1) That the Contractor shall correct or re-perform any defective or nonconforming
services; or
(2) That the District does not require correction or reperformance.
(b) If the Contractor is required to correct or reperform, it shall be at no cost to the District,
and any services corrected or reperformed by the Contractor shall be subject to this
clause to the same extent as work initially performed. If the Contractor fails or refuses
to correct or reperform, the Contracting Officer may, by contract or otherwise, correct
or replace with similar services and charge to the Contractor the cost occasioned to the
District thereby, or make an equitable adjustment in the contract price.
(c) If the District does not require correction or reperformance, the Contracting Officer
shall make an equitable adjustment in the contract price.
Contract No. CFOPD-26-C-023
Medical Audit Services
33
V8/16/22
SECTION F
PERIOD OF PERFORMANCE AND DELIVERABLES
F.1 TERM OF CONTRACT
The term of the contract shall be from the Contract Effective Date to November 30, 2026.
F.2 OPTION TO EXTEND THE TERM OF THE CONTRACT
F.2.1 The District may extend the term of this contract for a period of four (4), one (1) year option
periods, or successive fractions thereof, by written notice to the Contractor before the
expiration of the contract; provided that the District will give the Contractor preliminary
written notice of its intent to extend before the contract expires. The preliminary notice does
not commit the District to an extension. The exercise of this option is subject to the availability
of funds at the time of the exercise of this option.
F.2.2 If the District exercises this option, the extended contract shall be considered to include this
option provision.
F.2.3 The price for the option period shall be as specified in the Section B of the contract.
F.3 DELIVERABLES
F.3.1 The Contractor shall perform the activities required to successfully complete the District’s
requirements and submit each deliverable to the COTR identified in Section G in accordance
with Section C.
F.3.2 The Contractor shall submit to the District, as a deliverable, the report described in Section I.31
that is required by the 51% District Residents New Hires Requirements and First Source
Employment Agreement. If the Contractor does not submit the report as part of the
deliverables, final payment to the Contractor shall not be paid pursuant to Section G.6.
Contract No. CFOPD-26-C-023
Medical Audit Services
34
V8/16/22
SECTION G
CONTRACT ADMINISTRATION
G.1 CONTRACT ADMINISTRATORS
(a) Contracting Officer
i. The Contracting Officer (or “CO”) for this contract is:
Drakus Wiggins
Contracting Officer
Office of the Chief Financial Officer
1100 4th St. SW Suite E620
Washington, DC 20024
Telephone: (202) 442-7121
Fax: 202-442-6454
E-mail address: drakus.wiggins@dc.gov
ii. The Contracting Officer is the only official authorized to legally bind the District and
make changes to the requirements, terms and conditions of this contract. Only the
Contracting Officer can increase, decrease, extend or terminate this contract. All other
changes are unauthorized.
iii. The Contractor shall not comply with any order, directive or request that changes or
modifies the requirements of this contract, unless issued in writing and signed by the
Contracting Officer.
iv. In the event the Contractor effects any change at the instruction or request of any person
other than the Contracting Officer, the change will be considered to have been made
without authority and no adjustment will be made in the contract price to cover any cost
increase incurred as a result thereof.
(b) Contracting Officer Technical Representative (COTR)
i. The COTR for this contract is:
Frederick Hoeflinger
Reimbursement Supervisor
Human Support Services Cluster (HSSC)
441 4th St. N.W., Suite 960-N Washington, DC 20001
(202) 442-9071
Frederick.Hoeflinger@dc.gov
ii. The COTR is responsible for general administration of the contract and advising the
Contracting Officer as to the Contractor’s compliance or noncompliance with the
contract. The COTR has the responsibility of ensuring the work conforms to the
Contract No. CFOPD-26-C-023
Medical Audit Services
35
V8/16/22
requirements of the contract and such other responsibilities and authorities as may be
specified in the contract. These include:
a. Keeping the Contracting Officer fully informed of any technical or contractual
difficulties encountered during the performance period and advising the Contracting
Officer of any potential problem areas under the contract;
b. Coordinating site entry for Contractor personnel, if applicable;
c. Reviewing invoices for completed work and approving invoices if the Contractor’s
costs are consistent with the negotiated amounts and progress is satisfactory and
commensurate with the rate of expenditure;
d. Reviewing and approving invoices for deliverables to ensure receipt of goods and
services.
e. Timely processing of invoices and vouchers in accordance with the District’s payment
provisions; and
f. Maintaining a file that includes all contract correspondence, modifications, records of
inspections and invoice or vouchers.
iii. The COTR does NOT have the authority to:
a. Award, agree to, or sign any contract, delivery order or task order. Only the Contracting
Officer shall make contractual agreements, commitments or modifications;
b. Grant deviations from or waive any of the terms and conditions of the contract;
c. Increase the dollar limit of the contract or authorize work beyond the dollar limit of the
contract,
d. Authorize the expenditure of funds by the Contractor;
e. Change the period of performance; or
f. Authorize the use of District property, except as specified under the contract.
iv. The Contractor will be fully responsible for any changes not authorized in advance, in
writing, by the Contracting Officer; may be den ied compensation or other relief for any
additional work performed that is not so authorized; and may also be required, at no
additional cost to the District, to take all corrective action necessitated by reason of the
unauthorized changes.
G.2 INVOICE PAYMENT
G.2.1 The District will make payments to the Contractor, upon the submission of proper invoices, at
the prices stipulated in this contract, for supplies delivered and accepted or services performed
and accepted, less any discounts, allowances or adjustments provided for in this contract.
G.2.2 The District will pay the Contractor on or before the 30 th day after receiving a proper invoice
from the Contractor. The District reserves the right to conduct post payment reviews or audits.
Contract No. CFOPD-26-C-023
Medical Audit Services
36
V8/16/22
G.2.3 Unless otherwise specified in this contract, and with presentation of a properly executed
invoice:
a) Payment will be made on completion and acceptance of each item for which the price is
stated in the Pricing Schedule in Section B,
b) Payment will be made on completion and acceptance of each percentage or milestone of
work in accordance with the prices stated in the Pricing Schedule in Section B, or
c) Payment may be made on partial deliveries of goods and services accepted by the District if
the Contractor requests it and the amount due on the deliveries warrants it as determined by
the District.
G.3 INVOICE SUBMITTAL
G.3.1 The Contractor shall create and submit payment requests in an electronic format through the
DC Vendor Portal, https://vendorportal.dc.gov
G.3.2 The Contractor shall submit proper invoices on a monthly basis or as otherwise specified in
Section G.4.
G.3.3 To constitute a proper invoice, the Contractor shall enter all required information into the Portal
after selecting the applicable purchase order number which is listed on the Contractor’s profile.
G.4 THE QUICK PAYMENT ACT
G.4.1 Interest Penalties to Contractors
G.4.1.1 The District will pay interest penalties on amounts due to the Contractor under the Quick
Payment Act, D.C. Official Code § 2-221.01 et seq., as amended, for the period beginning
on the day after the required payment date and ending on the date on which payment of the
amount is made. Interest shall be calculated at the rate of at least 1% per month. No interest
penalty shall be paid if payment for the completed delivery of the item of property or
service is made on or before the required payment date. The required payment date shall
be:
G.4.1.1.1 The date on which payment is due under the terms of this contract;
G.4.1.1.2 Not later than 7 calendar days, excluding legal holidays, after the date of delivery of meat or
meat food products;
G.4.1.1.3 Not later than 10 calendar days, excluding legal holidays, after the date of delivery of a
perishable agricultural commodity; or
G.4.1.1.4 30 calendar days, excluding legal holidays, after receipt of a proper invoice for the amount
of the payment due.
Contract No. CFOPD-26-C-023
Medical Audit Services
37
V8/16/22
G.4.1.2 No interest penalty shall be due to the Contractor if payment for the completed delivery of
goods or services is made on or before:
G.4.1.2.1 3rd day after the required payment date for meat or a meat product;
G.4.1.2.2 5th day after the required payment date for an agricultural commodity; or
G.4.1.2.3 15th day after any other required payment date.
G.4.1.3 Any amount of an interest penalty which remains unpaid at the end of any 30-day period
shall be added to the principal amount of the debt and thereafter interest penalties shall
accrue on the added amount.
G.4.2 Payments to Subcontractors
G.4.2.1 The Contractor shall take one of the following actions within seven (7) days of receipt of
any amount paid to the Contractor by the District for work performed by any subcontractor
under the contract:
G.4.2.1.1 Pay the subcontractor(s) for the proportionate share of the total payment received from the
District that is attributable to the subcontractor(s) for work performed under the contract; or
G.4.2.1.2 Notify the CO and the subcontractor(s), in writing, of the Contractor’s intention to withhold
all or part of the subcontractor’s payment and state the reason for the nonpayment.
G.4.2.2 The Contractor shall pay subcontractors or suppliers interest penalties on amounts due to
the subcontractor or supplier beginning on the day after the payment is due and ending on
the date on which the payment is made. Interest shall be calculated at the rate of at least 1%
per month. No interest penalty shall be paid on the following if payment for the completed
delivery of the item of property or service is made on or before the:
G.4.2.2.1 3 rd day after the required payment date for meat or a meat product;
G.4.2.2.2 5th day after the required payment date for an agricultural commodity; or
G.4.2.2.3 15th day after any other required payment date.
G.4.2.3 Any amount of an interest penalty which remains unpaid by the Contractor at the end of any
30-day period shall be added to the principal amount of the debt to the subcontractor and
thereafter interest penalties shall accrue on the added amount.
G.4.2.4 A dispute between the Contractor and subcontractor relating to the amounts or entitlement of
a subcontractor to a payment or a late payment interest penalty under the Quick Payment
Act does not constitute a dispute to which the District is a party. The District may not be
interpleaded in any judicial or administrative proceeding involving such a dispute.
Contract No. CFOPD-26-C-023
Medical Audit Services
38
V8/16/22
G.4.3 Subcontract requirements
G.4.3.1 The Contractor shall include in each subcontract under this contract a provision requiring the
subcontractor to include in its contract with any lower-tier subcontractor or supplier the
payment and interest clauses required under paragraphs (1) and (2) of D.C. Official Code §
2-221.02(d).
G.4.3.2 The Contractor shall include in each subcontract under this contract a provision that
obligates the Contractor, at the election of the subcontractor, to participate in negotiation or
mediation as an alternative to administrative or judicial resolution of a dispute between
them.
G.5 ASSIGNMENT OF CONTRACT PAYMENTS
G. 5.1 The Contractor may assign funds due or to become due as a result of the performance of this
contract to a bank, trust company, or other financing institution.
G.5.2 Any assignment shall cover all unpaid amounts payable under this contract, and shall not be
made to more than one party.
G.5.3 Notwithstanding an assignment of contract payments, the Contractor, not the assignee, is
required to prepare invoices. Where such an assignment has been made, the original copy of
the invoice must refer to the assignment and must show that payment of the invoice is to be
made directly to the assignee as follows:
“Pursuant to the instrument of assignment dated ___________, make payment of this invoice to
(name and address of assignee).”
G.6 FIRST SOURCE AGREEMENT REQUEST FOR FINAL PAYMENT
G.6.1 For contracts subject to the 51% District Residents New Hires Requirement and First Source
Employment Agreement, final requests for payment shall be accompanied by the report or a
waiver of compliance pursuant to Section I.31.
G.6.2 No final payment shall be made to the Contractor until the CFO has received the Contracting
Officer’s final determination or approval of waiver of the Contractor’s compliance with 51%
District Residents New Hires Requirement and First Source Employment Agreement
requirements.
G.7 ORDERING CLAUSE
G.7.1 Any supplies and services to be furnished under this contract must be ordered by issuance of
delivery orders, task orders, or purchase orders by the CO. Such orders may be issued during
the term of this contract.
G.7.2 All orders are subject to the terms and conditions of this contract. In the event of a conflict
between an order and this contract, the contract shall control.
Contract No. CFOPD-26-C-023
Medical Audit Services
39
V8/16/22
G.7.3 If mailed, an order is considered "issued" when the District deposits the order in the
mail. Orders may be issued by facsimile or by electronic commerce methods.
Contract No. CFOPD-26-C-023
Medical Audit Services
40
V8/16/22
SECTION H
SPECIAL CONTRACT REQUIREMENTS
H.1 STAFFING
The Contractor shall not employ or permit the employment of any unfit or unqualified person
or persons not skilled in the tasks assigned to them by the contractor. The Contractor shall at
all times employ sufficient labor to carry out functions and services in the manner and time
prescribed by the Contract. The Contractor shall be responsible to the District for all acts and
omissions of the Contractor’s employees, agents and subcontractors and the Contractor shall
enforce strict discipline among the Contractor’s employees, agents and subcontractors
performing the services under the Contract. Employees, agents and subcontractors of the
Contractor shall, at the written request of the District, and within the District’s sole discretion,
be removed immediately by the Contractor from work relating to the Contract.
H.2 SUBCONTRACTS
The Contractor hereunder shall not subcontract any of the Contractor’s work or services to any
subcontractor without the prior, written consent of the Contracting Officer in consultation with
the COTR. Any such subcontract shall specify that the Contractor and the subcontractor shall
be subject to every provision of this Contract. Notwithstanding any such subcontract approved
by the District, the Contractor shall remain liable to the District for all Contractor's work and
services required hereunder, including any work conducted by a subcontractor.
H.3 CERTIFIED BUSINESS ENTERPRISE SUBCONTRACTING REQUIREMENTS
H.3.1 Beneficiaries of all non-construction contracts for government-assisted projects in excess of
$250,000, unless a waiver has been approved by the Director of the Department of Small and
Local Business Development in accordance with D.C. Code §2-218.51, are required to:
(a) Subcontract at least 35% of the dollar volume to small business enterprises, as defined in
D.C. Code §2-218.32; or
(b) If there are insufficient qualified small business enterprises to completely fulfill the
requirement set forth in H.3.1(a), then the subcontracting requirement may be satisfied by
subcontracting 35% of the dollar volume to any qualified certified business enterprises, as
defined in D.C. Code §§2-218.31-39a; provided, that all reasonable efforts shall be made to
ensure that qualified small business enterprises are significant participants in the overall
subcontracting work.
(c) For each government-assisted project for which a certified business enterprise is utilized to
meet the subcontracting requirements set forth above in H.3.1(a) or H.3.1(b), the certified
business enterprise shall perform at least 35% of the contracting effort with its own
organization and resources.
Contract No. CFOPD-26-C-023
Medical Audit Services
41
V8/16/22
(d) Beneficiaries certified as a small business enterprise, local business enterprise, or
disadvantaged business enterprise shall not have to comply with Sections H.3.1(a) or
H.3.1(b). Nonetheless, Beneficiaries certified as a small business enterprise, local business
enterprise, or disadvantaged business enterprise that does subcontract any portion of the
contract work must submit a subcontracting plan to show the Beneficiary is retaining the
minimum required amount of work with its own organization and resources and to show the
Beneficiary subcontracts with certified business enterprises pursuant to D.C. Code § 2–
218.46.
H.3.2
(a) For each government-assisted project for which a certified business enterprise is selected as
a Beneficiary and is granted points or a price reduction pursuant to D.C. Code §2-218.43 or
is selected through a set-aside program, the certified business enterprise shall perform at
least 35% of the contracting effort with its own organization and resources and, if it
subcontracts, 35% of the subcontracted effort shall be with certified business enterprises. A
certified business enterprise prime contractor that performs less than 35% of the contracting
effort shall be subject to enforcement actions under D.C. Official Code § 2-218.63.
(b) For each government-assisted project for which a certified joint venture is selected as a
Beneficiary and is granted points or a price reduction pursuant to D.C. Code §2-218.43 or is
selected through a set-aside program, the certified business enterprise shall perform at least
50% of the contracting effort with its own organization and resources and, if it subcontracts,
35% of the subcontracted effort shall be with certified business enterprises. If the certified
business enterprise member of the certified joint venture prime contractor performs less
than 50% of the contracting effort, the certified joint venture shall be subject to
enforcement actions under D.C. Official Code § 2-218.63.
(c) For each government-assisted project of $1 million or less for which a certified business
enterprise is selected as a Beneficiary and is granted points or a price reduction pursuant to
D.C. Code §2-218.43 or is selected through a set-aside program, the certified business
enterprise shall perform at least 50% of the on-site work with its own workforce.
H.3.3 Bids or proposals responding to a solicitation, including an open market solicitation, shall be
deemed nonresponsive and shall be rejected if a subcontracting plan is required by law and the
Beneficiary fails to submit a subcontracting plan as part of its bid or proposal and the
Beneficiary fails to submit a plan that meets the criteria set forth in H.3.4. The subcontracting
plan required shall be provided before the District accepts the submission of the bid or
proposal.
H.3.4 A Beneficiary’s subcontracting plan shall specify all of the following:
(a) The name and address of the subcontractor;
(b) A certification number of the small or certified business enterprise, current as of the
solicitation closing date;
(c) The scope of work to be performed by the subcontractor; and
(d) The price to be paid by the Beneficiary to the subcontractor.
Contract No. CFOPD-26-C-023
Medical Audit Services
42
V8/16/22
H.3.5 No Beneficiary shall be allowed to amend the subcontracting plan filed as part of its bid or
proposal except with the consent of the Director of the Department of Small and Local
Business Development. Any reduction in the dollar volume of the subcontracted portion
resulting from such amendment of the plan shall inure to the benefit of the District.
H.3.6 No multiyear contracts or extended contracts, which are not in compliance with D.C. Code §2-
218.46 or this Section H.3 at the time of the contemplated exercise of the option or extension,
shall be renewed or extended, and any such option or extension shall be void.
H.3.7 A Beneficiary shall submit to the Contracting Officer, project manager, and the Director of the
Department of Small and Local Business Development (at compliance.enforcement@dc.gov)
copies of the executed contracts with the subcontracts identified in the subcontracting plan.
Failure to submit copies of the executed contracts shall render the underlying contract voidable
by the District.
H.3.8 The Beneficiary shall provide written notice to the Department of Small and Local Business
Development upon the initiation and completion of a project.
H.3.9 Within 30 days after the end of each quarter, the Beneficiary shall provide a quarterly report to
the Department of Small and Local Business Development (at
compliance.enforcement@dc.gov), the Contracting Officer, and the project manager which
shall include a list of each subcontractor identified in the subcontracting plan and for each
subcontract:
(a) The price to be paid by the contractor to the subcontractor;
(b) A description of the goods procured or the services contracted for;
(c) The amount paid by the contractor to the subcontractor under the subcontract; and
(d) A copy of the fully executed subcontract, if it was not provided in a prior quarterly report.
If not included, the Beneficiary shall not receive credit toward the subcontracting
requirements of this section for that subcontract.
The Beneficiary shall access the DSLBD forms to complete the reporting requirements. The
Beneficiary shall contact DSLBD at (202) 727-3900 or at compliance.enforcement@dc.gov for
instructions on SBE Forms.
H.3.10 Beneficiary shall meet on an annual basis with the Department of Small and Local Business
Development, the Contracting Officer, and the project manager to provide an update of the
subcontracting plan for utilization of small business enterprises and certified business
enterprises. The Department of Small and Local Business development shall provide the
Beneficiary with a 30-day written notice of the meeting.
H.3.11 A Beneficiary and/or certified business enterprise subject to this section, that fails to meet the
requirements of this section shall be subject to penalties set forth in D.C. Code §2-218.63.
H.3.12 For purposes of this Section H.3, the term:
Contract No. CFOPD-26-C-023
Medical Audit Services
43
V8/16/22
(a) “Beneficiary” means a business enterprise that is the prime contractor or developer on a
government-assisted project.
(b) “Government-assisted project” means:
i. A contract executed by an agency on behalf of the District or pursuant to statutory
authority that involves District funds or, to the extent not prohibited by federal law,
funds that the District administers in accordance with a federal grant or otherwise;
ii. A project funded in whole or in part by District funds;
iii. A project that receives a loan or grant from a District agency;
iv. A project that receives bonds or notes or the proceeds thereof issued by a District
agency, including tax increment financing or payment in lieu of tax bonds and notes, or
industrial revenue bonds;
v. A project that receives District tax exemptions or abatements that are specific to the
project and not to the nature of the entity undertaking the project, such as a religious
institution or nonprofit corporation; or
vi. A development project conducted pursuant to a disposition under section 1 of An Act
Authorizing the sale of certain real estate in the District of Columbia no longer required
for public purposes, approved August 5, 1939 (53 Stat. 1211; D.C. Official Code § 10-
801).
H.3.13 Notwithstanding the requirements set forth in this Section H.3, a Beneficiary, and any other
certified business enterprise subject to this section, shall fully comply with the requirements set
forth in D.C. Code §§ 2-218.46, 2-218.51. If there is a conflict between the requirements set
forth in this Section H.3 and D.C. Code §§ 2-218.46, 2-218.51, the requirements set forth in
D.C. Code §§ 2-218.46, 2-218.51 shall govern.
H.4 WARRANTIES
H.4.1 The Contractor warrants and agrees that it is lawfully organized and constituted under all
federal, state and local laws, ordinances and other authorities of its domicile and is otherwise in
full compliance with all legal requirements of its domicile.
H.4.2 The Contractor warrants and agrees that it is of legal authority and capacity to enter into and
perform under the Contract, and that it has the financial ability to perform its obligations under
such Contract.
H.4.3 The Contractor warrants and agrees that it has been duly authorized to operate and do business
in all places where it will be required to do business under the Contract that it has obtained or
will obtain all necessary licenses and permits required in connection with such Contract; and
that it will fully comply with all laws, decrees, labor standards and regulations of its domicile
and wherever performance occurs during the term of such Contract.
Contract No. CFOPD-26-C-023
Medical Audit Services
44
V8/16/22
H.4.4 The Contractor warrants and agrees that it has no present interest and shall not acquire any
interest which would conflict in any manner with its duties and obligations under the Contract.
H.4.5 The Contractor warrants and agrees that all systems analysis, systems design and programming
pursuant to the Contract or for use in its performance there under has been and shall be
prepared or done in a high quality, professional and competent manner using only qualified
personnel.
H.4.6 The Contractor further represents and warrants that all programs implemented in its
performance under the contract shall meet the performance standards required there under and
shall correctly and accurately perform their intended functions on the equipment supplied by
the District or Contractor.
H.4.7 The Contractor warrants and agrees that all services provided by it under the Contract shall be
performed in a prompt, high quality, professional and competent manner using only qualified
personnel.
H.4.8 The Contractor warrants and agrees that it will not take any action inconsistent with any of the
terms, conditions, agreements, or covenants set forth in this Contract without the express
written consent of the District.
H.4.9 The Contractor warrants and agrees that it shall keep all equipment in good condition and
repair, and shall not permit anything to be done that may materially impair the value thereof.
The Contractor shall use such equipment only in the ordinary course of its performance under
the Contract and shall not permit such equipment to be used in violation of any applicable law,
regulation or policy of insurance. The Contractor agrees to develop a maintenance and
replacement schedule subject to approval by the District and agrees to comply with that
schedule.
H.4.10 The Contractor warrants and agrees that it shall not sell, assign, lease, transfer, pledge,
hypothecate, or otherwise dispose of any component of any goods, system proposed in the
Contract or any interest therein, or permit any of it to become a fixture or accession to other
goods or property without the prior written consent of the District.
H.5 DISCLOSURE OF LITIGATION
The Contractor shall provide complete disclosure of any material civil or criminal litigation or
indictment either threatened or pending involving the Contractor. The Contractor shall also
disclose any material litigation threatened or pending for subcontractors, consultants, and/or
lobbyists. For purposes of this section, material refers to any action or pending action that a
reasonable person knowledgeable in the industry would consider relevant or any development
such a person would want to be aware of in order to stay fully apprised of the total mix of
information relevant to the industry and its operations. This is a continuing disclosure
requirement; any litigation commencing after submission of a response to a solicitation or
execution of a contract shall be disclosed in a written statement within fifteen (15) days of its
occurrence. The Contractor shall be required to file with the District comprehensive monthly
reports regarding all threatened or pending litigation involving the Contractor’s District of
Contract No. CFOPD-26-C-023
Medical Audit Services
45
V8/16/22
Columbia operations and all threatened or pending litigation that may be considered material to
the overall operations of the Contractor.
H.6 CONTINUITY OF SERVICES
The Contractor recognizes that the services provided under this contract are vital to the District
of Columbia and must be continued without interruption and that, upon contract expiration or
termination, a successor, either the District Government or another Contractor, at the District’s
option, may continue to provide these services. If another Contractor is awarded a future
contract for performance of the required services, the original Contractor shall cooperate fully
with the District and the new Contractor in any transition activities that the Contracting Officer
deems necessary during the term of the contract. To that end, the Contractor agrees to exercise
its best efforts and cooperation to affect an orderly and efficient transition to a successor.
H.7 BACKGROUND INVESTIGATIONS AND OTHER INTEGRITY REQUIREMENTS
H.7.1 The District may initiate investigations into the backgrounds of any of the Contractor’s officers,
principals, investors, owners, employees, vendors, subcontractors, or subcontractors’ officers,
principals, owners, employees or vendors, or any other associates of the Contractor(s) it deems
appropriate. Such background investigations may include the completion of certain documents,
and fingerprint identification by appropriate law enforcement agencies.
H.7.2 The Contractor agrees that, during the term of the Contract and any renewal thereof, it shall be
obligated to provide such information about its officers, directors, employees and owners, as
well as all information about its subcontractors’ officers, directors, employees and owners, as
the District may prescribe. The Contractor also agrees that the District may conduct
background investigations of such persons.
H.7.3 The District may also require that contractors (1) fully cooperate with official inquiries by
responding to questions truthfully and under oath when required, whether orally or in writing,
(2) provide documents and other information of official interest, and (3) attend integrity
training.
H.7.4 To advise Contractor individuals of the high expectation of integrity, in addition to Attachment
J.2, Doing Business with Integrity, all Contractor personnel, including direct or indirect
employees and any employed by a subcontractor, assigned to the Contract shall be subject to
annually attend the OCFO/OIO Integrity and Ethics Training at the District’s direction. The
training may be in-person and last up to four hours or may be web-based and last up to two
hours.
H.8 DIVERSION, REASSIGNMENT AND REPLACEMENT OF KEY PERSONNEL
The key personnel specified in the contract are considered to be essential to the work being
performed hereunder. Prior to diverting any of the specified key personnel for any reason, the
Contractor shall notify the CO at least thirty (30) calendar days in advance and shall submit
justification, including proposed substitutions, in sufficient detail to permit evaluation of the
Contract No. CFOPD-26-C-023
Medical Audit Services
46
V8/16/22
impact upon the contract. The Contractor shall obtain written approval of the CO for any
proposed substitution of key personnel.
H.9 ADVISORY AND ASSISTANCE SERVICES
This contract is a “non-personal services contract”. The Contractor and the Contractor’s
employees: (1) shall perform the services specified herein as independent contractors, not as
employees of the government; (2) shall be responsible for their own management and
administration of the work required and bear sole responsibility for complying with any and all
technical, schedule, financial requirements or constraints attendant to the performance of this
contract; (3) shall be free from supervision or control by any government employee with
respect to the manner or method of performance of the service specified; but (4) shall, pursuant
to the government’s right and obligation to inspect, accept or reject work, comply with such
general direction of the CO, or the duly authorized representative of the CO as is necessary to
ensure accomplishment of the contract objectives.
H.10 OCFO/OCIO CYBERSECURITY AWARENESS TRAINING
In the OCFO’s ongoing effort to protect OCFO data, networks and computers against cyber
attackers all Contractor personnel, including direct or indirect employees and any employed by
a subcontractor, assigned to the Contract shall take and must pass the OCFO/OCIO
Cybersecurity Awareness Training at the District’s direction. The training is web-based,
designed to heighten cybersecurity awareness so that the OCFO is less likely to become a
victim of cybercrimes. The training is typically completed in one to two hours. The training
shall be taken and must be passed annually by all Contractor personnel, during the term of the
Contract.
Contract No. CFOPD-26-C-023
Medical Audit Services
47
V8/16/22
SECTION I
CONTRACT CLAUSES
I.1 LAWS AND REGULATIONS INCORPORATED BY REFERENCE
To the extent applicable, the provisions of the following acts, together with the provisions of
applicable regulations made pursuant to said acts are hereby incorporated by reference into this
contract; together with the laws and regulations of the District of Columbia:
A. Contract Work Standards Act of August 13, 1962, also known as the Contract Work
Hours and Safety Standards Act of 1962, 76 Stat. 357-360.
B. Buy American Act, Act of March 3, 1983, c.212, Title III, 47 Stat. 1520, as amended.
C. Walsh-Healy Public Contracts Act, Act of June 30, 1936, c.881, 49 Stat. 2036, as
amended. (Applies only when contract is $10,000 or more).
D. Mayor’s Order 85-85, dated June 10, 1985, as amended, entitled: “Compliance with
Equal Opportunity Obligations in Contracts.”
E. Public Law 93-112, Rehabilitation Act of 1973, Section 504, as amended.
F. Mayor’s Order 83-265, dated November 9, 1983 entitled: Employment Agreement
Goals and Objectives for all District of Columbia Projects.”
G. D.C. Law 5-93, dated May 9, 1984, the First Source Employment Agreement Act of
1984.
H. Protecting Pregnant Workers Fairness Act of 2016, D.C. Official Code § 32-1231.01 et
seq. (PPWF Act)
I. Unemployed Anti-Discrimination Act of 2012, D.C. Official Code § 32-1361 et seq.
J. Fair Criminal Record Screening Amendment Act of 2014, effective December 17, 2014
(D.C. Law 20-152)
K. Title I of the Way to Work Amendment Act of 2006, effective June 8, 2006 (D.C. Law
16-118, D.C. Official Code §2-220.01 et seq.), as amended, (“Living Wage Act of
2006”) which applies to all contracts for services in the amount $100,000 or more in a
12-month period. The current living wage rate, the Living Wage Act Fact Sheet which
includes exemption information, and the Living Wage Act Poster may be found at
https://does.dc.gov/service/office-wage-hour-compliance-0 or contact the Department
of Employment Services at (202) 724-7000.
Contract No. CFOPD-26-C-023
Medical Audit Services
48
V8/16/22
I.2 WAIVER
The waiver of any breach of the contract will not constitute a waiver of any subsequent breach
thereof, or a waiver of the contract.
I.3 INDEMNIFICATION
I.3.1 The Contractor agrees to defend, indemnify and hold harmless the District, its officers,
agencies, departments, agents, and employees (collectively the “District”) from and against any
and all claims, losses, liabilities, penalties, fines, forfeitures, demands, causes of action, suits,
costs and expenses incidental thereto (including cost of defense and attorneys’ fees), resulting
from, arising out of, or in any way connected to activities or work performed by the Contractor,
Contractor’s officers, employees, agents, servants, subcontractors, or any other person acting
for or by permission of the Contractor in performance of this Contract. The Contractor assumes
all risks for direct and indirect damage or injury to the property or persons used or employed in
performance of this Contract. The Contractor shall also repair or replace any District property
that is damaged by the Contractor, Contractor’s officers, employees, agents, servants,
subcontractors, or any other person acting for or by permission of the Contractor while
performing work hereunder.
I.3.2 The indemnification obligation under this section shall not be limited by the existence of any
insurance policy or by any limitation on the amount or type of damages, compensation or
benefits payable by or for Contractor or any subcontractor, and shall survive the termination of
this Contract. The District agrees to give Contractor written notice of any claim of indemnity
under this section. Additionally, Contractor shall have the right and sole authority to control the
defense or settlement of such claim, provided that no contribution or action by the District is
required in connection with the settlement. Monies due or to become due the Contractor under
the contract may be retained by the District as necessary to satisfy any outstanding claim which
the District may have against the Contractor.
I.4 TRANSFER
No contract or any interest therein shall be transferred by the parties to whom the award is
made; such transfer will be null and void and will be cause to annul the contract.
I.5 TAXES
(a) The Government of the District of Columbia is exempt from and will not pay Federal
Excise Tax, Transportation Tax, and the District of Columbia Sales and Use Taxes.
(b) Tax exemption certificates are no longer issued by the District for Federal Excise Tax.
The following statement may be used by the supplier when claiming tax deductions for
Federal Excise Tax exempt items sold to the District.
“The District of Columbia Government is Exempt from Federal Excise Tax –
Registration No. 52-73-0206-K, Internal Revenue Service, Baltimore, Maryland.”
Contract No. CFOPD-26-C-023
Medical Audit Services
49
V8/16/22
Exempt from Maryland Sales Tax, Registered with The Comptroller of The Treasury –
Exemption No. 09339
“The District of Columbia Government is Exempt from Sales and Use Tax –
Registration No. 53-600, The District of Columbia Office of Tax and Revenue.”
I.6 OFFICIALS NOT TO BENEFIT
I.6.1 Unless a determination is made as provided herein, no officer or employee of the District will
be admitted to any share or part of this contract or to any benefit that may arise therefrom, and
any contract made by the Contracting Officer or any District employee authorized to execute
contracts in which they or an employee of the District will be personally interested shall be
void, and no payment shall be made thereon by the District or any officer thereof, but this
provision shall not be construed to extend to this contract if made with a corporation for its
general benefit. A District employee shall not be a party to a contract with the District and will
not knowingly cause or allow a business concern or other organization owned or substantially
owned or controlled by the employee to be a party to such a contract, unless a written
determination has been made by the head of the procuring agency that there is a compelling
reason for contracting with the employee, such as when the District’s needs cannot reasonably
otherwise be met. (Procurement Practices Reform Act of 2010, D.C. Law 18-0371, D.C.
Official Code, section 2-359.10, and Chapter 18 of the DC Personnel Regulations)
I.6.2 The Contractor represents and covenants that it presently has no interest and shall not acquire
any interest, direct or indirect, which would conflict in any manner or degree with the
performance of its services hereunder. The Contractor further covenants not to employ any
person having such known interests in the performance of the contract.
I.7 DISPUTES
All disputes arising under or relating to this contract shall be resolved as provided herein.
(a) Claims by a Contractor against the District: Claim, as used in paragraph (a) of this
clause, means a written assertion by the Contractor seeking, as a matter of right, the
payment of money in a sum certain, the adjustment or interpretation of contract terms,
or other relief arising under or relating to this contract. A claim arising under a contract,
unlike a claim relating to that contract, is a claim that can be resolved under a contract
clause that provides for the relief sought by the claimant.
(1) All claims by a Contractor against the District arising under or relating to a
contract shall be in writing and shall be submitted to the Contracting Officer for
a decision. The Contractor’s claim shall contain at least the following:
(i) A description of the claim and the amount in dispute;
(ii) Data or other information in support of the claim;
(iii) A brief description of the Contractor’s efforts to resolve the dispute prior
to filing the claim; and
Contract No. CFOPD-26-C-023
Medical Audit Services
50
V8/16/22
(iv) The Contractor’s request for relief or other action by the Contracting
Officer.
(2) The Contracting Officer may meet with the Contractor in a further attempt to
resolve the claim by agreement.
(3) The Contracting Officer shall issue a decision on any claim within 120 calendar
days after receipt of the claim. Whenever possible, the CO shall take into
account factors such as the size and complexity of the claim and the adequacy of
the information in support of the claim provided by the Contractor.
(4) The Contracting Officer’s written decision shall do the following:
(i) Provide a description of the claim or dispute;
(ii) Refer to the pertinent contract terms;
(iii) State the factual areas of agreement and disagreement;
(iv) State the reasons for the decision, including any specific findings of fact,
although specific findings of fact are not required and, if made, shall not
be binding in any subsequent proceeding;
(v) If all or any part of the claim is determined to be valid, determine the
amount of monetary settlement, the contract adjustment to be made, or
other relief to be granted;
(vi) Indicate that the written document is the contracting officer’s final
decision; and
(vii) Inform the Contractor of the right to seek further redress by appealing
the decision to the Contract Appeals Board.
(5) Failure by the Contracting Officer to issue a decision on a contract claim within
120 days of receipt of the claim will be deemed to be a denial of the claim and
will authorize the commencement of an appeal to the Contract Appeals Board as
authorized by D.C. Official Code § 2-360.04.
(6) If a Contractor is unable to support any part of his or her claim and it is
determined that the inability is attributable to a material misrepresentation of
fact or fraud on the part of the Contractor, the Contractor shall be liable to the
District for an amount equal to the unsupported part of the claim in addition to
all costs to the District attributable to the cost of reviewing that part of the
Contractor’s claim. Liability this paragraph (a)(6) shall be determined within six
(6) years of the commission of the misrepresentation of fact or fraud.
(7) Pending final decision of an appeal, action, or final settlement, a Contractor
shall proceed diligently with performance of the contract in accordance with the
decision of the Contracting Officer.
(b) Claims by the District against a Contractor: Claim as used in paragraph (b) of this
clause, means a written demand or written assertion by the District seeking, as a matter
of right, the payment of money in a sum certain, the adjustment of contract terms, or
Contract No. CFOPD-26-C-023
Medical Audit Services
51
V8/16/22
other relief arising under or relating to this contract. A claim arising under a contract,
unlike a claim relating to that contract, is a claim that can be resolved under a contract
clause that provides for the relief sought by the claimant.
(1) The Contracting Officer shall decide all claims by the District against a
Contractor arising under or relating to a contract.
(2) The Contracting Officer shall send written notice of the claim to the Contractor.
The Contracting Officer’s written decision shall do the following:
(i) Provide a description of the claim or dispute;
(ii) Refer to the pertinent contract terms;
(iii) State the factual areas of agreement and disagreement;
(iv) State the reasons for the decision, including any specific findings
of fact, although specific findings of fact are not required and, if
made, shall not be binding in any subsequent proceeding;
(v) If all or any part of the claim is determined to be valid, determine
the amount of monetary settlement, the contract adjustment to be
made, or other relief to be granted;
(vi) Indicate that the written document is the Contracting Officer’s
final decision; and
(vii) Inform the Contractor of the right to seek further redress by
appealing the decision to the Contract Appeals Board.
(3) The Contracting Officer shall support the decision by reasons and shall
inform the Contractor of its rights as provided herein.
(4) Before or after issuing the decision, the CO may meet with the
Contractor to attempt to resolve the claim by agreement.
(5) The authority contained in this paragraph (b) shall not apply to a claim or
dispute for penalties or forfeitures prescribed by statute or regulation
which another District agency is specifically authorized to administer,
settle, or determine.
(6) This paragraph shall not authorize the Contracting Officer to settle,
compromise, pay, or otherwise adjust any claim involving fraud.
(c) Decisions of the Contracting Officer shall be final and not subject to review unless an
administrative appeal or action for judicial review is timely commenced by the
Contractor as authorized by D.C. Official Code §2-360.04.
(d) Pending final decision of an appeal, action, or final settlement, the Contractor shall
proceed diligently with performance of the contract in accordance with the decision of
the Contracting Officer.
Contract No. CFOPD-26-C-023
Medical Audit Services
52
V8/16/22
I.8 CHANGES
(a) The CO may, at any time, by written order, and without notice to the surety, if any, make
changes in the contract within the general scope hereof. If such change causes an increase
or decrease in the cost of performance of the contract, or in the time required for
performance, an equitable adjustment shall be made. Any claim for adjustment for a
change within the general scope must be asserted within ten (10) days from the date the
change is ordered; provided, however, that the CO, if he or she determines that the facts
justify such action, may receive, consider, and adjust any such claim asserted at any time
prior to the date of final settlement of the contract. If the parties fail to agree upon the
adjustment to be made, the dispute shall be determined as provided in Section I.7
Disputes.
(b) The District shall not require the Contractor, and the Contractor shall not require a
subcontractor, to undertake any work that is beyond the original scope of the contract or
subcontract, including work under a District-issued change order, when the additional work
increases the contract price beyond the not-to-exceed price or negotiated maximum price of
the contract, unless the CO:
(1) Agrees with the Contractor, and if applicable the subcontractor, on a price for the
additional work;
(2) Obtains a certification of funding to pay for the additional work;
(3) Makes a written, binding commitment with the Contractor to pay for the additional
work within thirty (30) days after the Contractor submits a proper invoice; and
(4) Provides the Contractor with written notice of the funding certification.
(c) The Contractor shall include in its subcontracts a clause that requires the Contractor to:
(1) Within five (5) business days of its receipt of notice of the approved additional
funding, provide the subcontractor with notice of the amount to be paid to the
subcontractor for the additional work to be performed by the subcontractor;
(2) Pay the subcontractor any undisputed amount to which the subcontractor is entitled
for the additional work within ten (10) days of receipt of payment from the District;
and
(3) Notify the subcontractor and CO in writing of the reason(s) the Contractor
withholds any payment from a subcontractor for the additional work.
(d) Neither the District, Contractor, nor any subcontractor may declare another party to be in
default, or assess, claim, or pursue damages for delays until the parties agree on a price for
the additional work.
I.9 TERMINATION FOR DEFAULT
A. The District may, subject to the provisions of paragraph C., below, by written notice of
default to the Contractor, terminate the whole or any part of this contract in any one of the
following circumstances: (i) If the Contractor fails to make delivery of the supplies or to
perform the services within the time specified within the project work plan or any extension
Contract No. CFOPD-26-C-023
Medical Audit Services
53
V8/16/22
thereof; or (ii) If the Contractor fails to perform any of the other provisions of this contract, or
so fails to make progress as to endanger performance of this contract in accordance with its
terms and in either of these two circumstances does not cure such failure within a period of
ten (10) days (or such longer period as the Contracting Officer may authorize in writing)
after receipt of notice from the Contracting Officer specifying such failure.
B. In the event the District terminates this contract in whole or part as provided in paragraph A.
above, the District may procure, upon such terms and in such manner as the Contracting
Officer may deem appropriate, supplies or service similar to those so terminated; and the
Contractor shall be liable to the District for any excess costs for similar supplies or services.
Provided, that the Contractor shall continue the performance of this contract to the extent not
terminated under provisions of this clause. The Contractor shall work with any subsequent
contractor to ensure a smooth transfer of information for a period of sixty (60) days.
C. Except with respect to defaults of subcontractors, the Contractor shall not be liable for any
excess costs if the failure to perform the contract arises out of causes beyond the control and
without the fault or negligence of the contractor. Such causes may include, but are not
restricted to, acts of God or of public enemy, acts of the District or Federal Government in
either their sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions,
strikes, freight embargoes, and unusually severe weather; but in every case the failure to
perform must be beyond the control and without the fault or negligence of the Contractor. If
the failure to perform is caused by the default of the subcontractor, and if such default arises
out of causes beyond the control of both the Contractor and the subcontractor, and without
the fault or negligence of either of them, the Contractor shall not be liable for any excess cost
for failure to perform, unless the supplies or services to be furnished by the subcontractor
were obtainable from other sources in sufficient time to permit the Contractor to meet the
required delivery schedule.
D. If this contract is terminated as provided in paragraph A., above, the District in addition to
any other rights provided in this clause, may require the Contractor to transfer title and
deliver to the District, in the manner and to the extent directed by the Contracting Officer, (i)
completed supplies, (ii) such partially completed supplies and materials, information, and
contract rights (herein after called “manufacturing materials”) as the Contractor has
specifically produced or specifically produced or specifically acquired for the performance
being terminated; and the Contractor, shall, upon direction of the Contracting Officer, protect
and preserve property in possession of the Contractor in which the District has an interest.
Payment for completed supplies delivered to and accepted by the District shall be at the
contract price. Payment for manufacturing materials delivered to and agreed upon by the
Contractor and Contacting Officer; failure to agree to such amount shall be a dispute
concerning a question of fact. The District may withhold from amounts otherwise due the
Contractor for such completed supplies or manufacturing materials such sums as the
Contracting Office determines to be necessary to protect the District against loss because of
outstanding liens or claims of former lien holders.
E. If, after notice of termination of this contract under the provisions of this clause, it is
determined for any reason that the Contractor was not in default under the provision of this
clause, or that the default was excusable under the provisions of this clause, the rights and
Contract No. CFOPD-26-C-023
Medical Audit Services
54
V8/16/22
obligations of the parties shall, if the contract contains a clause providing for a termination
for convenience be the same as if the notice of termination had been issued pursuant to such
clause. Section I.10 “Termination for Convenience.”
F. The rights and remedies of the District provided in this clause shall not be exclusive and are
in addition to any rights and remedies provided by law or under this contract.
G. As used in paragraph C., above, the terms “subcontractor” and “subcontractors” means
subcontractor(s) at any tier.
I.10 TERMINATION FOR CONVENIENCE
(a) The District may terminate performance of work under this contract in whole or, from time
to time, in part if the Contracting Officer determines that a termination is in the District’s
interest. The Contracting Officer shall terminate by delivering to the Contractor a Notice of
Termination specifying the extent of termination and effective date.
(b) After receipt of a Notice of Termination, and except as directed by the Contracting Officer,
the Contractor shall immediately proceed with the following obligations, regardless of any
delay in determining or adjusting any amounts due under this clause:
(1) Stop work as specified in the notice.
(2) Place no further subcontracts or orders (referred to as subcontracts in this clause) for
materials, services, or facilities, except as necessary to complete the continued portion
of the contract.
(3) Terminate all contracts to the extent they relate to the work terminated.
(4) Assign to the District, as directed by the Contracting Officer, all rights, title and
interest of the Contractor under the subcontracts terminated, in which case the District
will have the right to settle or pay any termination settlement proposal arising out of
those terminations.
(5) With approval or ratification to the extent required by the Contracting Officer, settle
all outstanding liabilities and termination settlement proposals arising from the
termination of subcontracts. The approval or ratification will be final for purposes of
this clause.
(6) As directed by the Contracting Officer, transfer title and deliver to the District (i) the
fabricated or unfabricated parts, work in process, completed work, supplies, and other
materials produced or acquired for the work terminated, and (ii) the completed or
partially completed plans, drawings, information, and other property that, if the contract
has been
completed, would be required to be furnished to the District.
(7) Complete performance of the work not terminated.
Contract No. CFOPD-26-C-023
Medical Audit Services
55
V8/16/22
(8) Take any action that may be necessary, or that the Contracting Officer may direct,
for the protection and preservation of the property related to this contract that is in the
possession of the Contractor and in which the District has or may acquire an interest.
(9) Use its best efforts to sell, as directed or authorized by the Contracting Officer, any
property of the types referred to in subparagraph (6) above; provided, however, that the
Contractor (i) is not required to extend credit to any purchaser and (ii) may acquire the
property under the conditions prescribed by, and at prices approved by, the Contracting
Officer. The proceeds of any transfer or disposition will be applied to reduce any
payments to be made by the District under this contract, credited to the price or cost of
the work, or paid in any other manner directed by the Contracting Officer.
(c) After the expiration of ninety (90) days (or such longer period as may be agreed to) after
receipt by the Contracting Officer of acceptable inventory schedules, the Contractor may
submit to the Contracting Officer a list, certified as to quantity and quality of termination
inventory not previously disposed of excluding items authorized for disposition by the
Contracting Officer. The Contractor may request the District to remove those items or enter
into an agreement for their storage. Within fifteen (15) days, the District will accept title to
those items and remove them or enter into a storage agreement. The Contracting Officer may
verify the list upon removal of the items, or if stored, within forty-five (45) days from
submission of the list, and shall correct the list, as necessary, before final settlement.
(d) After termination, the Contractor shall submit a final termination settlement proposal to the
Contracting Officer in the form and with the certification prescribed by the Contracting Officer.
The Contractor shall submit the proposal promptly, but no later than one year from the effective
date of termination, unless extended in writing by the Contracting Officer upon written request
of the Contractor within this one-year period. However, if the Contracting Officer determines
that the facts justify it, a termination settlement proposal may be received and acted on after
one year or any extension. If the Contractor fails to submit the proposal within the time
allowed, the Contracting Officer may determine, on the basis of information available, the
amount, if any, due to the Contractor because of the termination and shall pay the amount
determined.
(e) Subject to paragraph (d) above, the Contractor and the Contracting Officer may agree upon
the whole or any part of the amount to be paid because of the termination. The amount may
include a reasonable allowance for profit on work done. However, the agreed amount, whether
under this paragraph (e) or paragraph (f) below, exclusive of costs shown in subparagraph
(f)(3) below, may not exceed the total contract price as reduced by (1) the amount of payment
previously made and (2) the contract price of work not terminated. The contract shall be
amended, and the Contractor paid the agreed amount. Paragraph (f) below shall not limit,
restrict, or affect the amount that may be agreed upon to be paid under this paragraph.
(f) If the Contractor and the Contracting Officer fail to agree on the whole amount to be paid
because of the termination work, the Contracting Officer shall pay the Contractor the amounts
determined by the Contracting Officer as follows, but without duplication of any amounts
agreed on under paragraph (e) above:
Contract No. CFOPD-26-C-023
Medical Audit Services
56
V8/16/22
(1) The contract price for completed supplies or services accepted by the District (or
sold or acquired under subparagraph (b)(9) above) not previously paid for, adjusted for
any saving of freight and other charges.
(2) The total of :
(i) The costs incurred in the performance of the work terminated, including
initial costs and preparatory expense allocable thereto, but excluding any costs
attributable to supplies or services paid or to be paid under subparagraph (f)(1)
above;
(ii) The cost of settling and paying termination settlement proposals under
terminated subcontracts that are properly chargeable to the terminated portion of
the contract if not included in subparagraph (f)(1) above; and
(iii) A sum, as profit on subparagraph f(1) above, determined by the Contracting
Officer to be fair and reasonable; however, if it appears that the Contractor
would have sustained a loss on the entire contract had it been completed, the
Contracting Officer shall allow no profit under this subparagraph (iii) and shall
reduce the settlement to reflect the indicated rate of loss.
(3) The reasonable cost of settlement of the work terminated, including-
(i) Accounting, legal, clerical, and other expenses reasonably necessary for the
preparation of termination settlement proposals and supporting data;
(ii) The termination and settlement of subcontractors (excluding the amounts of such
settlements); and
(iii) Storage, transportation, and other costs incurred, reasonably necessary for the
preservation, protection, or disposition of the termination inventory.
(g) Except for normal spoilage, and except to the extent that the District expressly assumed the
risk of loss, the Contracting Officer shall exclude from the amounts payable to the Contractor
under paragraph (f) above, the fair value as determined by the Contracting Officer, of property
that is destroyed, lost, stolen, or damaged so as to become undeliverable to the District or to a
buyer.
(h) The Contractor shall have the right of appeal, under the Disputes clause, from any
determination made by the Contracting Officer under paragraphs (d), (f) or (j), except that if the
Contractor failed to submit the termination settlement proposal within the time provided in
paragraph (d) or (j), and failed to request a time extension, there is no right of appeal. If the
Contracting Officer has made a determination of the amount due under paragraph (d), (f) or (j),
the District will pay the Contractor (1) the amount determined by the Contracting Officer if
there
Contract No. CFOPD-26-C-023
Medical Audit Services
57
V8/16/22
is no right of appeal or if no timely appeal has been taken, or (2) the amount finally determined
on an appeal.
(i) In arriving at the amount due the Contractor under this clause, there shall be deducted:
(1) All unliquidated advances or other payments to the Contractor under the termination
portion of the contract;
(2) Any claim which the District has against the Contractor under this contract; and
(3) The agreed price for, or the proceeds of sale of, materials, supplies, or other things
acquired by the Contractor or sold under the provisions of this clause and not recovered
by or credited to the District.
(j) If the termination is partial, the Contractor may file a proposal with the Contracting Officer
for an equitable adjustment of the price(s) of the continued portion of the contract. The
Contracting Officer shall make any equitable adjustment agreed upon. Any proposal by the
Contractor for an equitable adjustment under this clause shall be requested within ninety (90)
days from the effective date of termination unless extended in writing by the Contracting
Officer.
(k) (1) The District may, under the terms and conditions it prescribes, make partial
payments and payments against costs incurred by the Contractor for the terminated
portion of the contract, if the Contracting Officer believes the total of these payments
will not exceed the amount to which the Contractor shall be entitled.
(2) If the total payments exceed the amount finally determined to be due, the Contractor
shall repay the excess to the District upon demand together with interest computed at
the rate of 10 percent (10%) per year. Interest shall be computed for the period from the
date the excess payment is received by the Contractor to the date the excess payment is
repaid. Interest shall not be charged on any excess payment due to a reduction in the
Contractor’s termination settlement proposal because of retention or other disposition of
termination inventory until 10 days after the date of the retention or disposition, or a
later date determined by the Contracting Officer because of the circumstances.
(l) Unless otherwise provided in this contract or by statute, the Contractor shall maintain all
records and documents relating to the terminated portion of this contract for 3 years after final
settlement. This includes all books and other evidence bearing on the Contractor’s costs and
expenses under this contract. The Contractor shall make these records and documents available
to the District, at the Contractor’s office, at all reasonable times, without any direct charge. If
approved by the Contracting Officer, photographs, micrographs, or other authentic
reproductions may be maintained instead of original records and documents.
I.11 TERMINATION OF CONTRACTS FOR CERTAIN CRIMES AND VIOLATIONS
A. The District may terminate without liability any contract and may deduct from the
contract price or otherwise recover the full amount of any fee, commission, percentage,
Contract No. CFOPD-26-C-023
Medical Audit Services
58
V8/16/22
gift, or consideration paid in violation of this title if:
(1) the Contractor has been convicted of a crime arising out of or in connection with the
procurement of any work to be done or any payment made under this contract.
(2) There has been any breach or violation of:
(A) Any provision of the District of Columbia Procurement Practices Reform Act of
2010, (D.C. Law 18-371; D.C. Official Code §§ 2-351.01, et seq., or
(B) The contract provision against contingent fees.
B. If a contract is terminated pursuant to this section, the Contractor: (i) May be paid only
the actual costs of the work performed to the date of termination, plus termination costs, if
any; and (ii) shall refund all profits or fixed fees realized under the contract.
C. The rights and remedies contained in this Clause are in addition to any other rights or
remedies provided by law, and the exercise of any of them is not a waiver of any other
right or remedy provided by law.
I.12 EXAMINATION OF THE BOOKS
I.12.1 The Contractor shall establish and maintain books, records, and documents (including
electronic storage media) in accordance with generally accepted accounting principles and
practices which sufficiently and properly reflect all revenues and expenditures of funds
provided by the District under the contract that results from this solicitation. The Contractor
shall retain all records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to the contract for a period of
three (3) years after termination of the contract, or if an audit has been initiated and audit
findings have not been resolved at the end of three (3) years, the records shall be retained until
resolution of the audit findings or any litigation which may be based on the terms of the
contract. The Contractor shall assure that these records shall be subject at all reasonable times
to inspection, review, or audit by Federal, District, or other personnel duly authorized by the
Contracting Officer.
I.12.2 The Contracting Officer, the DC Inspector General, OCFO, and the District of Columbia
Auditor, and/or any of their duly authorized representatives shall, until three years after final
payment, have the right to examine any directly pertinent books, documents, papers, and
records of the Contractor involving transactions related to the contract.
I.13 NON-DISCRIMINATION CLAUSE
(a) The Contractor shall not discriminate in any manner against any employee or applicant
for employment that would constitute a violation of the District of Columbia Human
Rights Act, approved December 13, 1977, as amended (D.C. Law 2-38; D.C. Official
Code §2-1402.11) (2001 Ed.) (“Act” as used in this Section). The Contractor shall
include a similar clause in all subcontracts, except subcontracts for standard commercial
Contract No. CFOPD-26-C-023
Medical Audit Services
59
V8/16/22
supplies or raw materials. In addition, Contractor agrees and any subcontractor shall
agree to post in conspicuous places, available to employees and applicants for
employment, notice setting forth the provisions of this non-discrimination clause as
provided in Section 251 of the Act.
(b) Pursuant to rules of the Office of Human Rights, published on August 15, 1986 in the
D.C. Register, Mayor’s Order 2002-175 (10/23/02), 49 DCR 9883 and Mayor’s Order
2006-151 (11/17/06), 52 DCR 9351, the following clauses apply to this contract:
(1) The Contractor shall not discriminate against any employee or applicant for
employment because of actual or perceived: race, color, religion, national origin,
sex, age, marital status, personal appearance, sexual orientation, gender identity
or expression, familial status, family responsibilities, disability, matriculation,
political affiliation, genetic information, source of income, or place of residence
or business. Sexual harassment is a form of sex discrimination which is
prohibited by the Act. In addition, harassment based on any of the above
protected categories is prohibited by the Act.
(2) The Contractor agrees to take affirmative action to ensure that applicants are
employed, and that employees are treated during employment, without regard to
their actual or perceived: race, color, religion, national origin, sex, age, marital
status, personal appearance, sexual orientation, gender identity or expression,
familial status, family responsibilities, disability, matriculation, political
affiliation, genetic information, source of income, or place of residence or
business.
The affirmative action shall include, but not be limited to the following:
(a) employment, upgrading or transfer;
(b) recruitment or recruitment advertising;
(c) demotion, layoff, or termination;
(d) rates of pay, or other forms of compensation; and
(e) selection for training and apprenticeship.
(3) The Contractor agrees to post in conspicuous places, available to employees and
applicants for employment, notices to be provided by the Contracting Agency,
setting forth the provisions in subsections (b)(1) and (b)(2) concerning non-
discrimination and affirmative action.
(4) The Contractor shall, in all solicitations or advertisements for employees placed
by or on behalf of the Contractor, state that all qualified applicants will receive
consideration for employment pursuant to the non-discrimination requirements
set forth in subsection (b)(2).
Contract No. CFOPD-26-C-023
Medical Audit Services
60
V8/16/22
(5) The Contractor agrees to send to each labor union or representative of workers
with which he has a collective bargaining agreement or other contract or
understanding, a notice to be provided by the contracting agency, advising the
said labor union or workers’ representative of that contractor’s commitments
under this nondiscrimination clause and the Act, and shall post copies of the
notice in conspicuous places available to employees and applicants for
employment.
(6) The Contractor agrees to permit access to his books, records and accounts
pertaining to its employment practices, by the Chief Procurement Officer or
designee, or the Director of Human Rights or designee, for purposes of
investigation to ascertain compliance with this chapter, and to require under the
terms of any subcontractor agreement each subcontractor to permit access of
such subcontractor’s books, records, and accounts for such purposes.
(7) The Contractor agrees to comply with the provisions of this chapter and with all
guidelines for equal employment opportunity applicable in the District of
Columbia adopted by the Director of the Office of Human Rights, or any
authorized official.
(8) The Contractor shall include in every subcontract the equal opportunity clauses,
subsections (b)(1) through (b)(9) of this section, so that such provisions shall be
binding upon each subcontractor or vendor.
(9) The Contractor shall take such action with respect to any subcontract as the
Contracting Officer may direct as a means of enforcing these provisions,
including sanctions for noncompliance; provided, however, that in the event the
Contractor becomes involved in, or is threatened with, litigation with a
subcontractor or Contractor as a result of such direction by the Contracting
Officer, the Contractor may request the District to enter into such litigation to
protect the interest of the District.
I.14 SERVICE CONTRACT ACT OF 1965
Definitions:
“Act”, as used in this clause, means the Service Contract Act of 1965, as amended (41 U.S.C.
351- 358). “Contractor” as used in this clause, means the prime Contractor or any
subcontractor at any tier. “Service employee” as used in this clause, means any person (other
than a person employed in a bona fide executive, administrative, or professional capacity as
defined in 29 CFR 541) engaged in performing a Government contract nor exempted under 41
U.S.C. 356, the principal purpose of which is to furnish services in the United States as defined
in section 22.1001 of the Federal Acquisition Regulation. It includes all such persons
regardless of the actual or alleged contractual relationship between them and a contractor.
Contract No. CFOPD-26-C-023
Medical Audit Services
61
V8/16/22
A. Applicability. To the extent that the Act applies, this contract is subject to the
following provisions and to all other applicable provisions of the Act and regulations of
the Secretary of Labor (29CFR 4). All interpretations of the Act in Subpart C of 29
CFR 4 are incorporated in this contract by reference. This clause does not apply to
contracts or subcontracts administratively exempted by the Secretary of Labor or
exempted by 41 U.S.C. 356, as interpreted in Subpart C, 29 CFR 4.
B. Compensation: (i) The Contractor shall pay not less than the minimum wage and shall
furnish fringe benefits to each service employee under this contract in accordance with
wages and benefits determined by the Secretary of Labor or the Secretary’s authorized
representative, as specified in any attachments to this contract; (ii) If there is an
attachment, the Contractor shall classify any class of service employees not listed in it,
but to be employed under this contract. The classification shall provide a reasonable
relationship to those listed in the attachment. The Contractor shall pay that class wages
and fringe benefits determined by agreement of the interested parties: The contracting
agency, the Contractor, and the employees who will perform the contract or their
representatives. If the interested parties do not agree, the Contracting Officer shall
submit the question, with a recommendation for final determination to the Office of
Government Contract Wage Standards, Wage and Hour Division Employment
Standards Administration (ESA), and the Department of Labor. Failure to pay such
employees the compensation agreed upon by the interested parties or finally determined
by ESA is a contract violation. (iii) If the term of this contract is more than one (1)
year, the minimum wages and fringe benefits required for service employees under this
contract shall be subject to adjustment after 1 year and not less often than once every
two (2) years under wage determinations issued by ESA.
C. Minimum Wage. In the absence of a minimum wage attachment for this contract, the
Contractor shall not pay any service or other employees performing this contract less
than the minimum wage specified by section 6(a)(1) of the Fair Labor Standards Act of
1938, as amended (29 U.S.C. 206). Nothing in this clause shall relieve the Contractor
of any other legal or contractual obligations to pay a higher wage to any employee.
D. Successor Contracts. If this contract succeeds a contract subject to the Act under
which substantially the same services were furnished and service employees were paid
wages and fringe benefits provided for in a collective bargaining agreement, then, in the
absence of a minimum wage attachment to this contract, the Contractor may not pay
any service employee performing this contract less than the wages and benefits,
including those accrued and any prospective increases, provided for under that
agreement. No Contractor may be relieved of this obligation unless the limitations of
29 CFR 4.1c (b) apply or unless the Secretary of Labor or the Secretary’s authorized
representative - (i) Determines that the agreement under the predecessor was not the
result of arms-length negotiations, or (ii) Finds, after a hearing under 29 CFR 4.10, that
the wages and benefits provided for by that agreement vary substantially from those
prevailing for similar services in the locality.
E. Notification to Employees. The Contractor shall notify each service employee
commencing work on this contract of the minimum wage and any fringe benefits
Contract No. CFOPD-26-C-023
Medical Audit Services
62
V8/16/22
required to be paid or shall post a notice of these wages and benefits in a prominent and
accessible place at the work site, using such poster as may be provided by the
Department of Labor.
F. Safe and sanitary working conditions. The Contractor shall not permit services called
for by this contract to be performed in building or surroundings or under working
conditions provided by or under the control or supervision of the Contractor that are
unsanitary, hazardous, or dangerous to the health or safety of service employees. The
Contractor shall comply with the health standards applied under 29 CFR Part 1925.
G. Records. The Contractor shall maintain for three (3) years from the completion of the
work, and make available for inspection and transcription by authorized ESA
representatives, a record of the following:
(i) For each employee subject to the Act –
(a) Name and address;
(b) Work classification or classifications, rate or rates of wages and fringe
benefits provided;
(c) Rate or rates of payments in lieu of fringe benefits, and total daily and
weekly compensation;
(d) Daily and weekly hours worked; and
(e) Any deductions, rebates, or refunds from total daily and weekly
compensation.
(ii) For those classes of service employees not included in any wage determination
attached to this contract, wage rates or fringe benefits determined by the
interested parties or by ESA under the terms of paragraph (B)(iii) of this clause.
A copy of the report required by paragraph (D) of this clause will fulfill this
requirement.
H. Withholding of Payments and Termination of Contract: The Contracting Officer
shall withhold from the prime contractor under this or any other government contract
with the prime contractor any sums the Contracting Officer, or an appropriate officer of
the Labor Department, decides may be necessary to pay underpaid employees.
Additionally, any failure to comply with the requirements of this clause may be grounds
for termination for default.
I. Contractor’s Report: (i) If there is a wage determination attachment to this contract
and any classes of service employees not listed on it are to be employed under the
contract, the Contractor shall report promptly to the Contracting Officer the wages to be
paid and the fringe benefits to be provided each of these classes, when determined
under paragraph C. of this clause. (ii) If wages to be paid or fringe benefits to be
Contract No. CFOPD-26-C-023
Medical Audit Services
63
V8/16/22
furnished any service employee(s) under the contract are covered in collective
bargaining agreement effective at any time when the contract is being performed, the
prime Contractor shall provide to the Contracting Officer a copy of the agreement and
full information on the application and accrual of wages and benefits (including any
prospective increases) to service employees working on the contract. The prime
Contractor shall report when contract performance begins, in the case of agreements
then in effect, and shall report subsequently effective agreements, provisions, or
amendments promptly after they are negotiated.
J. Variations, tolerances, and exemptions involving employment: Notwithstanding any
of the provisions in this clause, the following employees may be employed in
accordance with the following variations, tolerances, and exemptions authorized by the
Secretary of Labor: (i) In accordance with regulations issued under Section 14, of the
Fair Labor Standards Act of 1938 by the Administrator of the Wage and Hour Division,
ESA(29 CFR 520, 521, 524 and 525), apprentices, student learners, and workers whose
earning capacity is impaired by age or by physical or mental deficiency or injury, may
be employed at wages lower than the minimum wages otherwise required by section
2(a)(1) or 2(b)(1) of the Service Contract Act, without diminishing any fringe benefits
or payments in lieu of these benefits required under section 2(a)(2) of the Act. (ii) The
Administrator will issue certificates under the Act for employing apprentices, and
student learners, disabled persons, or disabled clients of sheltered workshops not subject
to the Fair Labor Standards Act of 1938, or subject to different minimum rates of
minimum wages, but without changing requirements concerning fringe benefits for
supplementary cash payments in lieu of these benefits; (iii) The Administrator may
also withdraw, annul, or cancel such certificates under 29 CFR 525 and 528; and (iv)
an employee engaged in an occupation in which the employee customarily and regularly
receives more than $30 a month in tips credited by the employer against the minimum
wage required by section 2(a)(1) of the Act or section 2(b)(1) of the Act, in accordance
with regulations in 29 CFR 531. However, the amount of credit shall not exceed 40
percent of the minimum rate specified in section 6(a) (1) of the Fair Labor Standards
Act of 1938, as amended.
I.15 RECOVERY OF DEBTS OWED THE DISTRICT
The Contractor hereby agrees that the District may use all or any portion of any consideration
or refund due the Contractor under the present contract to satisfy in whole or part, any debt due
the District.
I.16 NON-DISCLOSURE AGREEMENT
A. The Contractor shall maintain as confidential, and shall not disclose to third parties without
the District’s prior written consent, any District information including, but not limited to,
the District’s business activities, practices, systems, conditions, products, services, public
information and education plans and related materials, and game and marketing plans.
B. The Contractor shall at all times obtain the prior written approval from the Contracting
Officer before it, any of its officers, agents, employees or subcontractors, either during or
Contract No. CFOPD-26-C-023
Medical Audit Services
64
V8/16/22
after expiration or termination of the contract, make any statement, or issue any material,
for publication through any medium of communication, bearing on the work performed or
data collected under this contract.
C. No information regarding the Contractor's performance of the contract shall be disclosed by
the Contractor to anyone other than District Government officials unless written approval is
obtained in advance from the Contracting Officer.
D. The District shall ensure that its personnel do not disclose to any non-District person or
organization information concerning the process the Contractor uses to provide services
under the awarded contract.
E. The Contractor, including its officers, agents, employees, and subcontractors, is expressly
prohibited from inputting, uploading, or otherwise disclosing any District information into
AI tools or any other publicly accessible artificial intelligence or machine-learning
platforms. The use of such tools constitutes public disclosure and is strictly prohibited. All
District information must be handled in a secure manner consistent with this Contract and
may only be processed using systems approved in writing by the District.
I.17 GOVERNMENT PROPERTY
Contractor use of Government property shall be governed by Chapter 41 of Title 27 of the D.C.
Municipal Regulations.
I.18 RIGHTS IN DATA
A. Definitions
1. “Products” - A deliverable under any contract that may include commodities, services
and/or technology furnished by or through Contractor, including existing and custom
Products, such as, but not limited to: a) recorded information, regardless of form or the
media on which it may be recorded; b) document research; c) experimental,
developmental, or engineering work; d) licensed software; e) components of the
hardware environment; f) printed materials (including but not limited to training
manuals, system and user documentation, reports, drawings); g) third party software; h)
modifications, customizations, custom programs, program listings, programming tools,
data, modules, components; and i) any intellectual property embodied therein, whether
in tangible or intangible form, including but not limited to utilities, interfaces,
templates, subroutines, algorithms, formulas, source code, and object code.
2. “Existing Products” - Tangible Products and intangible licensed Products that exist
prior to the commencement of work under the contract. Existing Products must be
identified on the Product prior to commencement of work or else will be presumed to be
Custom Products.
Contract No. CFOPD-26-C-023
Medical Audit Services
65
V8/16/22
3. “Custom Products” - Products, preliminary, final or otherwise, which are created or
developed by Contractor, its subcontractors, partners, employees, resellers or agents for
the District under the contract.
4. “District” – The District of Columbia and its agencies.
B. Title to Project Deliverables
The Contractor acknowledges that it is commissioned by the District to perform
services detailed in the contract. The District shall have ownership and rights for the
duration set forth in the contract to use, copy, modify, distribute, or adapt Products as
follows:
1. Existing Products: Title to all Existing Licensed Product(s), whether or not embedded
in, delivered or operating in conjunction with hardware or Custom Products, shall: (1)
remain with Contractor or third party proprietary owner, who retains all rights, title and
interest (including patent, trademark or copyrights). Effective upon payment, the
District is granted an irrevocable, non-exclusive, worldwide, paid-up license to use,
execute, reproduce, display, perform, adapt (unless Contractor advises the District as
part of Contractor’s proposal that adaptation will violate existing agreements or statutes
and Contractor demonstrates such to the District’s satisfaction) and distribute Existing
Product to District users up to the license capacity stated in the contract with all license
rights necessary to fully effect the general business purpose(s) of the project or work
plan or contract; and (2) be licensed in the name of the District. The District agrees to
reproduce the copyright notice and any other legend of ownership on any copies
authorized under this paragraph.
2. Custom Products: Effective upon Product creation, Contractor hereby conveys,
assigns, and transfers to the District the sole and exclusive rights, title and interest in
Custom Product(s), whether preliminary, final or otherwise, including all patent,
trademark and copyrights. Contractor hereby agrees to take all necessary and
appropriate steps to ensure that the Custom Products are protected against unauthorized
copying, reproduction and marketing by or through Contractor.
C. Transfers or Assignments of Existing or Custom Products by the District
The District may transfer or assign Existing or Custom Products and the licenses
thereunder to another District agency. Nothing herein shall preclude the Contractor
from otherwise using the related or underlying general knowledge, skills, ideas,
concepts, techniques and experience developed under a project or work plan in the
course of Contractor’s business.
D. Subcontractor Rights
Whenever any data, including computer software, are to be obtained from a
subcontractor under the contract, the Contractor shall use this clause, Rights in Data, in
the subcontract, without alteration, and no other clause shall be used to enlarge or
Contract No. CFOPD-26-C-023
Medical Audit Services
66
V8/16/22
diminish the District’s or the Contractor’s rights in that subcontractor data or computer
software which is required for the District.
E. Source Code Escrow
1. For all computer software furnished to the District with the rights specified in section
B.2, the Contractor shall furnish to the District, a copy of the source code with such
rights of the scope as specified in section B.2 of this clause. For all computer software
furnished to the District with the restricted rights specified in section B.1 of this clause,
the District, if the Contractor either directly or through a successor or affiliate shall
cease to provide the maintenance or warranty services provided the District under the
contract or any paid-up maintenance agreement, or if the Contractor should be declared
insolvent by a court of competent jurisdiction, shall have the right to obtain, for its own
and sole use only, a single copy of the current version of the source code supplied under
the contract, and a single copy of the documentation associated therewith, upon
payment to the person in control of the source code the reasonable cost of making each
copy.
2. If the Contractor or Product manufacturer/developer of software furnished to the
District with the rights specified in section B.1 of this clause offers the source code or
source code escrow to any other commercial customers, the Contractor shall either: (1)
provide the District with the source code for the Product; (2) place the source code in a
third party escrow arrangement with a designated escrow agent who shall be named and
identified to the District, and who shall be directed to release the deposited source code
in accordance with a standard escrow arrangement acceptable to the District; or (3) will
certify to the District that the Product manufacturer/ developer has named the District as
a named beneficiary of an established escrow arrangement with its designated escrow
agent who shall be named and identified to the District, and who shall be directed to
release the deposited source code in accordance with the terms of escrow.
3. The Contractor shall update the source code, as well as any corrections or
enhancements to the source code, for each new release of the Product in the same
manner as provided above, and certify such updating of escrow to the District in
writing.
F. Indemnification and Limitation of Liability
The Contractor shall indemnify and save and hold harmless the District, its officers,
agents and employees acting within the scope of their official duties against any
liability, including costs and expenses, (i) for violation of proprietary rights, copyrights,
or rights of privacy, arising out of the publication, translation, reproduction, delivery,
performance, use or disposition of any data furnished under this contract, or (ii) based
upon any data furnished under this contract, or based upon libelous or other unlawful
matter contained in such data.
Contract No. CFOPD-26-C-023
Medical Audit Services
67
V8/16/22
I.19 PATENTS
The Contractor shall hold and save the District, its officers, agents, servants and employees
harmless from liability of any nature or kind, including costs, expenses, for or on account of
any patented or unpatented invention, article, process, or appliance, manufactured or use in the
performance of this contract, including their use by the District, unless otherwise specifically
stipulated in this contract.
I.20 RESEVED
I.21 APPROPRIATION OF FUNDS
The District’s liability under this contract is contingent upon the future availability of
appropriated monies with which to make payment for the contract purposes. The legal liability
on the part of the District for payment of any money shall not arise unless and until such
monies shall have been provided. The District's obligation to pay under this contract is subject
to the provisions of (i) the federal Anti-Deficiency Act, 31 U.S.C. §§1341, 1342, 1349, 1351;
(ii) the District of Columbia Anti-Deficiency Act, D.C. Official Code §§ 47-355.01 – 355.08
(2001); (iii) D.C. Official Code § 47-105 (2001); and (iv) D.C. Official Code § 1-204.46
(2001), as the foregoing statutes may be amended from time to time. Any expenditures under
the contract in excess of the encumbered budget authority are subject to appropriation or
additional budget authority.
I.22 MULTIYEAR CONTRACT
If funds are not appropriated or otherwise made available for the continued performance in a
subsequent year of a multiyear contract, the contract for the subsequent year shall be
terminated, either automatically or in accordance with the termination clause of this contract.
Unless otherwise provided for in this contract, the effect of termination is to discharge both the
District and the Contractor from future performance of the Contract, but not from their existing
obligations. The Contractor shall be reimbursed for the reasonable value of any nonrecurring
costs incurred, but not amortized in the price of the supplies or services delivered under the
Contract.
I.23 RESERVED
I.24 CONTRACTS IN EXCESS OF $1 MILLION DOLLARS
Any contract in excess of one million dollars ($l,000,000) within a 12-month period shall not
be binding or give rise to any claim or demand against the District unless first approved by the
Council of the District of Columbia and signed by the Contracting Officer.
I.25 CONTRACTS THAT CROSS FISCAL YEARS
Continuation of this contract beyond the current fiscal year is contingent upon future fiscal
appropriations.
Contract No. CFOPD-26-C-023
Medical Audit Services
68
V8/16/22
I.26 RESERVED
I.27 AMERICANS WITH DISABILITIES ACT OF 1990 (“ADA”)
During the performance of the contract, the Contractor and any of its subcontractors shall
comply with the ADA. The ADA makes it unlawful to discriminate in employment against a
qualified individual with a disability. See 42 U.S.C. § 12101 et seq.
I.28 FREEDOM OF INFORMATION ACT (“FOIA”)
The District of Columbia’s Freedom of Information Act, at D.C. Official Code § 2-532 (a)(3),
requires the District to make available for inspection and copying any record produced or
collected pursuant to a District contract with a private contractor to perform a public function,
to the same extent as if the record were maintained by the agency on whose behalf the contract
is made. If the Contractor receives a request for such information, the Contractor shall
immediately send the request to the COTR designated in subsection G.1 who will provide the
request to the FOIA Officer for the agency with programmatic responsibility in accordance
with the D.C. Freedom of Information Act. If the agency with programmatic responsibility
receives a request for a record maintained by the Contractor pursuant to the contract, the COTR
will forward a copy to the Contractor. In either event, the Contractor is required by law to
provide all responsive records to the COTR within the timeframe designated by the COTR.
The FOIA Officer for the agency with programmatic responsibility will determine the
releasability of the records. The District will reimburse the Contractor for the costs of
searching and copying the records in accordance with D.C. Official Code § 2-532 and Chapter
4 of Title 1 of the D.C. Municipal Regulations.
I.29 RESERVED
I.30 INSURANCE
A. GENERAL REQUIREMENTS. The Contractor at its sole expense shall procure and maintain,
during the entire period of performance under this contract, the types of insurance specified
below. The Contractor shall have its insurance broker or insurance company submit a
Certificate of Insurance to the CO giving evidence of the required coverage prior to
commencing performance under this contract. In no event shall any work be performed until
the required Certificates of Insurance signed by an authorized representative of the insurer(s)
have been provided to, and accepted by, the CO. All insurance shall be written with financially
responsible companies authorized to do business in the District of Columbia or in the
jurisdiction where the work is to be performed and have an A.M. Best Company rating of A- /
VII or higher. The Contractor shall require all of its subcontractors to carry the same insurance
required herein.
All required policies shall contain a waiver of subrogation provision in favor of the
Government of the District of Columbia.
The Government of the District of Columbia shall be included in all policies required hereunder
to be maintained by the Contractor and its subcontractors (except for workers’ compensation,
Contract No. CFOPD-26-C-023
Medical Audit Services
69
V8/16/22
professional liability and crime) as an additional insureds for claims against The Government
of the District of Columbia relating to this contract, with the understanding that any affirmative
obligation imposed upon the insured Contractor or its subcontractors (including without
limitation the liability to pay premiums) shall be the sole obligation of the Contractor or its
subcontractors, and not the additional insured. The additional insured status under the
Contractor’s and its subcontractors’ Commercial General Liability insurance policies shall be
effected using the ISO Additional Insured Endorsement form CG 20 10 11 85 (or CG 20 10 07
04 and CG 20 37 07 04) or such other endorsement or combination of endorsements providing
coverage at least as broad and approved by the CO in writing. The Contractor and its
subcontractors’ liability policies (except for workers’ compensation, professional liability, and
crime) shall be endorsed using ISO form CG 20 01 04 13 or its equivalent so as to indicate that
such policies provide primary coverage (without any right of contribution by any other
insurance, reinsurance or self-insurance, including any deductible or retention, maintained by
an Additional Insured) for all claims against the additional insured arising out of the
performance of this Statement of Work by the Contractor or its subcontractors, or anyone for
whom the Contractor or its subcontractors may be liable. These policies shall include a
separation of insureds clause applicable to the additional insured.
If the Contractor and/or its subcontractors maintain broader coverage and/or higher limits than
the minimums shown below, the District requires and shall be entitled to the broader coverage
and/or the higher limits maintained by the Grantee and subcontractors.
1. Commercial General Liability Insurance (“CGL”) - The Contractor shall provide evidence
satisfactory to the CO with respect to the services performed that it carries a CGL policy,
written on an occurrence (not claims-made) basis, on Insurance Services Office, Inc.
(“ISO”) form CG 00 01 04 13 (or another occurrence-based form with coverage at least as
broad and approved by the CO in writing), covering liability for all ongoing and completed
operations of the Contractor, including ongoing and completed operations under all
subcontracts, and covering claims for bodily injury, including without limitation sickness,
disease or death of any persons, injury to or destruction of property, including loss of use
resulting therefrom, personal and advertising injury, and including coverage for liability
arising out of an Insured Contract (including the tort liability of another assumed in a
contract) and acts of terrorism (whether caused by a foreign or domestic source). Such
coverage shall have limits of liability of not less than $1,000,000 each occurrence, a
$2,000,000 general aggregate (including a per location or per project aggregate limit
endorsement, if applicable) limit, a $1,000,000 personal and advertising injury limit, and a
$2,000,000 products-completed operations aggregate limit.
2. Automobile Liability Insurance - The Contractor shall provide evidence satisfactory to the
CO of commercial (business) automobile liability insurance written on ISO form CA 00 01
10 13 (or another form with coverage at least as broad and approved by the CO in writing)
including coverage for all owned, hired, borrowed and non-owned vehicles and equipment
used by the Contractor, with minimum per accident limits equal to the greater of (i) the
limits set forth in the Contractor’s commercial automobile liability policy or (ii) $1,000,000
per occurrence combined single limit for bodily injury and property damage.
Contract No. CFOPD-26-C-023
Medical Audit Services
70
V8/16/22
3. i) Workers’ Compensation Insurance - The Contractor shall provide evidence satisfactory to
the CO of Workers’ Compensation insurance in accordance with the statutory mandates of
the District of Columbia or the jurisdiction in which the contract is performed.
ii) Employer’s Liability Insurance - The Contractor shall provide evidence satisfactory to
the CO of employer’s liability insurance as follows: $500,000 per accident for injury;
$500,000 per employee for disease; and $500,000 for policy disease limit.
iii) All insurance required by this paragraph 3 shall include a waiver of subrogation
endorsement for the benefit of Government of the District of Columbia.
4. Crime Insurance (3rd Party Indemnity) - The Contractor shall provide a Crime policy
including 3rd party fidelity to cover the dishonest acts of Contractor, its employees and/or
volunteers which result in a loss to the District. The policy shall provide a limit of $100,000
per occurrence.
5. Cyber Liability Insurance - The Contractor shall provide evidence satisfactory to the
Contracting Officer of Cyber Liability Insurance, with limits not less than $5,000,000 per
occurrence or claim, $5,000,000 aggregate. Coverage shall be sufficiently broad to respond
to the duties and obligations as is undertaken by Contractor in this agreement and shall
include, but not limited to, claims involving infringement of intellectual property, including
but not limited to infringement of copyright, trademark, trade dress, invasion of privacy
violations, information theft, damage to or destruction of electronic information, release of
private information, alteration of electronic information, extortion and network security.
The policy shall provide coverage for breach response costs as well as regulatory fines and
penalties as well as credit monitoring expenses with limits sufficient to respond to these
obligations. This insurance requirement will be considered met if the general liability
insurance includes an affirmative cyber endorsement for the required amounts and
coverages. Shared limits with the Professional Liability coverage will be acceptable.
6. Employment Practices Liability - The Contractor shall provide evidence satisfactory to the
Contracting Officer with respect to the operations performed to cover the defense of claims
arising from employment related wrongful acts including but not limited to: Discrimination,
Sexual Harassment, Wrongful Termination, or Workplace Torts, whether between
employees of contractor or against third parties. Employment Practices Liability coverage
must specifically state Third Party Liability coverage is included. Contractor will indemnify
and defend the District of Columbia should it be named co-defendant or be subject to or
party of any claim. Coverage shall also extend to Temporary Help Firms and Independent
Contractors hired by Contractor. The policy shall provide limits of not less than $1,000,000
for each wrongful act and $2,000,000 annual aggregate for each wrongful act.
7. Installation Floater Insurance - For projects involving District property being installed,
fabricated or erected by a contractor, the contractor shall provide an installation floater
policy with a limit equal to the full contract value. The policy shall cover property while
located at the project site, at temporary locations, or in transit; deductibles will be the sole
responsibility of the contractor.
Contract No. CFOPD-26-C-023
Medical Audit Services
71
V8/16/22
8. Professional Liability Insurance (Errors & Omissions) - The Contractor shall provide
Professional Liability Insurance (Errors and Omissions) to cover liability resulting from any
error or omission in the performance of professional services under this Contract. The
policy shall provide limits of $5,000,000 per claim or per occurrence for each wrongful act
and $5,000,000 annual aggregate. The Contractor warrants that any applicable retroactive
date precedes the date the Contractor first performed any professional services for the
Government of the District of Columbia and that continuous coverage will be maintained or
an extended reporting period will be exercised for a period of at least ten years after the
completion of the professional services. Shared limits with the Cyber Liability coverage
will be acceptable.
9. Commercial Umbrella or Excess Liability - The Contractor shall provide evidence
satisfactory to the CO of commercial umbrella or excess liability insurance with minimum
limits equal to the greater of (i) the limits set forth in the Contractor’s umbrella or excess
liability policy or (ii) $5,000,000 per occurrence and $5,000,000 in the annual aggregate,
following the form and in excess of all liability policies. All liability coverages must be
scheduled under the umbrella and/or excess policy. The insurance required under this
paragraph shall be written in a form that annually reinstates all required limits. Coverage
shall be primary to any insurance, self-insurance or reinsurance maintained by the District
and the “other insurance” provision must be amended in accordance with this requirement
and principles of vertical exhaustion.
B. PRIMARY AND NONCONTRIBUTORY INSURANCE.
The insurance required herein shall be primary to and will not seek contribution from any other
insurance, reinsurance or self-insurance including any deductible or retention, maintained by
the Government of the District of Columbia.
C. DURATION. The Contractor shall carry all required insurance until all contract work is
accepted by the District of Columbia and shall carry listed coverages for ten years for
construction projects following final acceptance of the work performed under this contract and
two years for non-construction related contracts.
D. LIABILITY. These are the required minimum insurance requirements established by the
District of Columbia. HOWEVER, THE REQUIRED MINIMUM INSURANCE
REQUIREMENTS PROVIDED ABOVE WILL NOT IN ANY WAY LIMIT THE
CONTRACTOR’S LIABILITY UNDER THIS CONTRACT.
E. CONTRACTOR’S PROPERTY. Contractor and subcontractors are solely responsible for any
loss or damage to their personal property, including but not limited to tools and equipment,
scaffolding and temporary structures, rented machinery, or owned and leased equipment. A
waiver of subrogation shall apply in favor of the District of Columbia.
F. MEASURE OF PAYMENT. The District shall not make any separate measure or payment for
the cost of insurance and bonds. The Contractor shall include all of the costs of insurance and
bonds in the contract price.
Contract No. CFOPD-26-C-023
Medical Audit Services
72
V8/16/22
G. NOTIFICATION. The Contractor shall ensure that all policies provide that the CO shall be
given thirty (30) days prior written notice in the event of coverage and / or limit changes or if
the policy is canceled prior to the expiration date shown on the certificate. The Contractor shall
provide the CO with ten (10) days prior written notice in the event of non-payment of premium.
The Contractor will also provide the CO with an updated Certificate of Insurance should its
insurance coverages renew during the contract.
H. CERTIFICATES OF INSURANCE. The Contractor shall submit certificates of insurance
giving evidence of the required coverage as specified in this section prior to commencing work.
Certificates of insurance must reference the corresponding contract number. Evidence of
insurance shall be submitted as directed in the District’s notification of award to the Contractor.
The CO may request and the Contractor shall promptly deliver updated certificates of
insurance, endorsements indicating the required coverages, and/or other evidence of the
insurance policies. If the insurance initially obtained by the Contractor expires prior to
completion of the contract, renewal certificates of insurance and additional insured and other
endorsements shall be furnished to the CO prior to the date of expiration of all such initial
insurance. For all coverage required to be maintained after completion, an additional certificate
of insurance evidencing such coverage shall be submitted to the CO on an annual basis as the
coverage is renewed (or replaced).
I. DISCLOSURE OF INFORMATION. The Contractor agrees that the District may disclose the
name and contact information of its insurers to any third party which presents a claim against
the District for any damages or claims resulting from or arising out of work performed by the
Contractor, its agents, employees, servants or subcontractors in the performance of this
contract.
J. CARRIER RATINGS. All Contractor’s and its subcontractors’ insurance required in
connection with this contract shall be written by insurance companies with an A.M. Best
Insurance Guide rating of at least A- VII (or the equivalent by any other rating agency) and
licensed in the in the District.
I.31 51% DISTRICT RESIDENTS NEW HIRES REQUIREMENTS AND FIRST SOURCE
EMPLOYMENT AGREEMENT
I.31.1 For contracts for services in the amount of $300,000 or more, the Contractor shall comply with
the First Source Employment Agreement Act of 1984, as amended, D.C. Official Code § 2-
219.01 et seq. (First Source Act).
I.31.2 The Contractor shall enter into and maintain during the term of the contract, a First Source
Employment Agreement (Employment Agreement) with the District of Columbia Department
of Employment Service’s (DOES), in which the Contractor shall agree that:
(a) The first source for finding employees to fill all jobs created in order to perform the
contract shall be the First Source Register; and
(b) The first source for finding employees to fill any vacancy occurring in all jobs covered
by the Employment Agreement shall be the First Source Register.
Contract No. CFOPD-26-C-023
Medical Audit Services
73
V8/16/22
I.31.3 The Contractor shall not begin performance of the contract until its Employment Agreement
has been accepted by DOES. Once approved, the Employment Agreement shall not be
amended except with the approval of DOES.
I.31.4 The Contractor agrees that at least 51% of the new employees hired to perform the contract
shall be District residents.
I.31.5 The Contractor’s hiring and reporting requirements under the First Source Act and any rules
promulgated thereunder shall continue for the term of the contract.
I.31.6 The CO may impose penalties, including monetary fines of 5% of the total amount of the direct
and indirect labor costs of the contract, for a willful breach of the Employment Agreement,
failure to submit the required hiring compliance reports, or deliberate submission of falsified
data.
I.31.7 If the Contractor does not receive a good faith waiver, the CO may also impose an additional
penalty equal to 1/8 of 1% of the total amount of the direct and indirect labor costs of the
contract for each percentage by which the Contractor fails to meet its hiring requirements.
I.31.8 Any contractor which violates, more than once within a 10-year timeframe, the hiring or
reporting requirements of the First Source Act shall be referred for debarment for not more
than five (5) years.
I.31.9 The contractor may appeal any decision of the CO pursuant to this clause to the D.C. Contract
Appeals Board as provided in Section I.7.
I.31.10 The provisions of the First Source Act do not apply to nonprofit organizations which employ
50 employees or less.
I.31.11The provisions of the First Source Act do not apply to nonprofit organizations which employ 50
employees or less.
I.32 COVENANT AGAINST CONTINGENT FEES
The Contractor warrants that no person or selling agency has been employed or retained to
solicit or secure the contract upon an agreement or understanding for a commission,
percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide
established commercial or selling agencies maintained by the Contractor for the purpose of
securing business. For breach or violation of this warranty, the District will have the right to
terminate the contract without liability or in its discretion to deduct from the contract price or
consideration or otherwise recover, the full amount of the commission, percentage, brokerage,
or contingent fee.
I.33 HEALTH AND SAFETY STANDARDS
Items delivered under this contract shall conform to all requirements of the Occupational Safety
and Health Act of 1970, as amended (“OSHA”), and Department of Labor Regulations under
OSHA, and all Federal requirements in effect at time of bid opening/proposal submission.
Contract No. CFOPD-26-C-023
Medical Audit Services
74
V8/16/22
I.34 FORCE MAJEURE
Neither the Contractor nor the District shall be deemed in default or otherwise liable hereunder
due to either party’s inability to perform by reason of any fire, earthquake, flood, epidemic,
accident, explosion, casualty, strike, lockout, labor controversy, riot, civil disturbance, act of
public enemy, embargo, war, act of God, or any municipal, county, state or national ordinance
or law, or any executive, administrative or judicial orders (which judicial orders are not the
result of any act or omission to act which would constitute a default hereunder), or any failure
or delay of any transportation, power or other essential thing required, or similar causes beyond
the parties control.
I.35 GOVERNING LAW
This contract shall be governed by, and construed in accordance with, the laws of the District of
Columbia, including, but not limited to, the District of Columbia Procurement Practices
Reform Act of 2010, (D.C. Law 18-371; D.C. Official Code §§ 2-351.01, et seq. and D.C.
MUN. REGS. tit. 27.
I.36 ORDER OF PRECEDENCE
A conflict in language shall be resolved by giving precedence to the document in the highest
order of priority that contains language addressing the issue in question. The following
documents are incorporated into the contract by reference and made a part of the contract in the
following order of precedence:
(1) Contract
(2) Contract Attachments
(3) Contractor Proposal dated March 9, 2026
Contract No. CFOPD-26-C-023
Medical Audit Services
75
V8/16/22
SECTION J
ATTACHMENTS
The following Attachments are hereby incorporated:
Attachment J.1 U.S. Department of Labor Wage Determination No. 2015-4281, Revision 35,
Dated December 3, 2025
Attachment J.2 Doing Business with Integrity
Attachment J.3 Government of the District of Columbia Business Associate Agreement
Section K: Representations, Certifications, and
Acknowledgements (RFP Section L.3.2.2.A)
RFP No. CFOPD-26-R-023
March 9, 2026
page 144
Section K: Representations, Certifications,
and Acknowledgements (RFP Section L.3.2.2.A)
"REGISTER OF WAGE DETERMINATIONS UNDER | U.S. DEPARTMENT OF LABOR
THE SERVICE CONTRACT ACT | EMPLOYMENT STANDARDS ADMINISTRATION
By direction of the Secretary of Labor | WAGE AND HOUR DIVISION
| WASHINGTON D.C. 20210
|
|
|
| Wage Determination No.: 2015-4281
Daniel W. Simms Division of | Revision No.: 35
Director Wage Determinations| Date Of Last Revision: 12/03/2025
_______________________________________|____________________________________________
States: District of Columbia, Maryland, Virginia
Area: District of Columbia Statewide
Maryland Counties of Charles, Prince George's
Virginia Counties of Alexandria, Arlington, Fairfax, Falls Church, Fauquier,
Loudoun, Manassas, Manassas Park, Prince William, Stafford
____________________________________________________________________________________
**Fringe Benefits Required Follow the Occupational Listing**
OCCUPATION CODE - TITLE FOOTNOTE RATE
01000 - Administrative Support And Clerical Occupations
01011 - Accounting Clerk I 21.83
01012 - Accounting Clerk II 24.50
01013 - Accounting Clerk III 27.41
01020 - Administrative Assistant 39.97
01035 - Court Reporter 29.26
01041 - Customer Service Representative I 17.59
01042 - Customer Service Representative II 19.19
01043 - Customer Service Representative III 21.54
01051 - Data Entry Operator I 19.11
01052 - Data Entry Operator II 20.85
01060 - Dispatcher, Motor Vehicle 25.71
01070 - Document Preparation Clerk 21.07
01090 - Duplicating Machine Operator 21.07
01111 - General Clerk I 20.12
01112 - General Clerk II 21.96
01113 - General Clerk III 24.65
01120 - Housing Referral Assistant 26.61
01141 - Messenger Courier 22.01
01191 - Order Clerk I 20.25
01192 - Order Clerk II 22.10
01261 - Personnel Assistant (Employment) I 22.42
01262 - Personnel Assistant (Employment) II 25.08
01263 - Personnel Assistant (Employment) III 27.95
01270 - Production Control Clerk 28.45
01290 - Rental Clerk 21.83
01300 - Scheduler, Maintenance 21.33
01311 - Secretary I 21.33
01312 - Secretary II 23.86
01313 - Secretary III 26.61
01320 - Service Order Dispatcher 22.98
01410 - Supply Technician 39.97
01420 - Survey Worker 22.94
01460 - Switchboard Operator/Receptionist 19.12
01531 - Travel Clerk I 22.65
01532 - Travel Clerk II 24.70
01533 - Travel Clerk III 26.66
01611 - Word Processor I 18.97
01612 - Word Processor II 21.29
01613 - Word Processor III 23.81
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 1/10
Ŝɨ
05000 - Automotive Service Occupations
05005 - Automobile Body Repairer, Fiberglass 29.21
05010 - Automotive Electrician 28.76
05040 - Automotive Glass Installer 27.09
05070 - Automotive Worker 27.09
05110 - Mobile Equipment Servicer 23.30
05130 - Motor Equipment Metal Mechanic 30.28
05160 - Motor Equipment Metal Worker 27.09
05190 - Motor Vehicle Mechanic 30.28
05220 - Motor Vehicle Mechanic Helper 21.32
05250 - Motor Vehicle Upholstery Worker 25.28
05280 - Motor Vehicle Wrecker 27.09
05310 - Painter, Automotive 28.76
05340 - Radiator Repair Specialist 27.09
05370 - Tire Repairer 21.12
05400 - Transmission Repair Specialist 30.28
07000 - Food Preparation And Service Occupations
07010 - Baker 17.87
07041 - Cook I 20.40
07042 - Cook II 23.72
07070 - Dishwasher 17.70
07130 - Food Service Worker 17.41
07210 - Meat Cutter 22.13
07260 - Waiter/Waitress 18.48
09000 - Furniture Maintenance And Repair Occupations
09010 - Electrostatic Spray Painter 28.23
09040 - Furniture Handler 15.47
09080 - Furniture Refinisher 24.81
09090 - Furniture Refinisher Helper 18.38
09110 - Furniture Repairer, Minor 21.80
09130 - Upholsterer 21.85
11000 - General Services And Support Occupations
11030 - Cleaner, Vehicles 17.68
11060 - Elevator Operator 17.84
11090 - Gardener 25.16
11122 - Housekeeping Aide 17.84
11150 - Janitor 17.84
11210 - Laborer, Grounds Maintenance 19.16
11240 - Maid or Houseman 17.70
11260 - Pruner 18.28
11270 - Tractor Operator 23.02
11330 - Trail Maintenance Worker 19.16
11360 - Window Cleaner 18.70
12000 - Health Occupations
12010 - Ambulance Driver 24.09
12011 - Breath Alcohol Technician 31.01
12012 - Certified Occupational Therapist Assistant 40.02
12015 - Certified Physical Therapist Assistant 36.67
12020 - Dental Assistant 23.78
12025 - Dental Hygienist 52.41
12030 - EKG Technician 45.58
12035 - Electroneurodiagnostic Technologist 45.58
12040 - Emergency Medical Technician 24.09
12071 - Licensed Practical Nurse I 27.72
12072 - Licensed Practical Nurse II 31.01
12073 - Licensed Practical Nurse III 34.57
12100 - Medical Assistant 22.48
12130 - Medical Laboratory Technician 34.27
12160 - Medical Record Clerk 25.58
12190 - Medical Record Technician 28.61
12195 - Medical Transcriptionist 20.72
12210 - Nuclear Medicine Technologist 49.45
12221 - Nursing Assistant I 15.11
12222 - Nursing Assistant II 17.01
12223 - Nursing Assistant III 18.56
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 2/10
12224 - Nursing Assistant IV 20.83
12235 - Optical Dispenser 28.14
12236 - Optical Technician 23.50
12250 - Pharmacy Technician 21.90
12280 - Phlebotomist 23.72
12305 - Radiologic Technologist 41.51
12311 - Registered Nurse I 31.84
12312 - Registered Nurse II 38.95
12313 - Registered Nurse II, Specialist 38.95
12314 - Registered Nurse III 47.12
12315 - Registered Nurse III, Anesthetist 47.12
12316 - Registered Nurse IV 56.48
12317 - Scheduler (Drug and Alcohol Testing) 38.42
12320 - Substance Abuse Treatment Counselor 30.37
13000 - Information And Arts Occupations
13011 - Exhibits Specialist I 24.30
13012 - Exhibits Specialist II 30.10
13013 - Exhibits Specialist III 36.82
13041 - Illustrator I 25.90
13042 - Illustrator II 32.08
13043 - Illustrator III 39.23
13047 - Librarian 43.76
13050 - Library Aide/Clerk 21.22
13054 - Library Information Technology Systems 39.51
Administrator
13058 - Library Technician 24.49
13061 - Media Specialist I 28.52
13062 - Media Specialist II 31.90
13063 - Media Specialist III 35.55
13071 - Photographer I 24.22
13072 - Photographer II 27.09
13073 - Photographer III 33.55
13074 - Photographer IV 41.04
13075 - Photographer V 49.65
13090 - Technical Order Library Clerk 26.65
13110 - Video Teleconference Technician 30.84
14000 - Information Technology Occupations
14041 - Computer Operator I 27.25
14042 - Computer Operator II 30.48
14043 - Computer Operator III 33.99
14044 - Computer Operator IV 37.76
14045 - Computer Operator V 41.82
14071 - Computer Programmer I (see 1)
14072 - Computer Programmer II (see 1)
14073 - Computer Programmer III (see 1)
14074 - Computer Programmer IV (see 1)
14101 - Computer Systems Analyst I (see 1)
14102 - Computer Systems Analyst II (see 1)
14103 - Computer Systems Analyst III (see 1)
14150 - Peripheral Equipment Operator 27.25
14160 - Personal Computer Support Technician 37.76
14170 - System Support Specialist 41.82
15000 - Instructional Occupations
15010 - Aircrew Training Devices Instructor (Non-Rated) 41.82
15020 - Aircrew Training Devices Instructor (Rated) 50.59
15030 - Air Crew Training Devices Instructor (Pilot) 60.66
15050 - Computer Based Training Specialist / Instructor 41.82
15060 - Educational Technologist 48.91
15070 - Flight Instructor (Pilot) 60.66
15080 - Graphic Artist 39.60
15085 - Maintenance Test Pilot, Fixed, Jet/Prop 60.66
15086 - Maintenance Test Pilot, Rotary Wing 60.66
15088 - Non-Maintenance Test/Co-Pilot 60.66
15090 - Technical Instructor 32.56
15095 - Technical Instructor/Course Developer 39.83
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 3/10
15110 - Test Proctor 26.28
15120 - Tutor 26.28
16000 - Laundry, Dry-Cleaning, Pressing And Related Occupations
16010 - Assembler 20.03
16030 - Counter Attendant 20.03
16040 - Dry Cleaner 22.90
16070 - Finisher, Flatwork, Machine 20.03
16090 - Presser, Hand 20.03
16110 - Presser, Machine, Drycleaning 20.03
16130 - Presser, Machine, Shirts 20.03
16160 - Presser, Machine, Wearing Apparel, Laundry 20.03
16190 - Sewing Machine Operator 23.86
16220 - Tailor 24.82
16250 - Washer, Machine 20.99
19000 - Machine Tool Operation And Repair Occupations
19010 - Machine-Tool Operator (Tool Room) 31.46
19040 - Tool And Die Maker 38.21
21000 - Materials Handling And Packing Occupations
21020 - Forklift Operator 24.07
21030 - Material Coordinator 28.45
21040 - Material Expediter 28.45
21050 - Material Handling Laborer 19.81
21071 - Order Filler 18.01
21080 - Production Line Worker (Food Processing) 24.07
21110 - Shipping Packer 21.99
21130 - Shipping/Receiving Clerk 21.99
21140 - Store Worker I 19.08
21150 - Stock Clerk 22.91
21210 - Tools And Parts Attendant 24.07
21410 - Warehouse Specialist 24.07
23000 - Mechanics And Maintenance And Repair Occupations
23010 - Aerospace Structural Welder 46.69
23019 - Aircraft Logs and Records Technician 37.02
23021 - Aircraft Mechanic I 44.33
23022 - Aircraft Mechanic II 46.69
23023 - Aircraft Mechanic III 48.97
23040 - Aircraft Mechanic Helper 31.21
23050 - Aircraft, Painter 42.10
23060 - Aircraft Servicer 37.02
23070 - Aircraft Survival Flight Equipment Technician 42.10
23080 - Aircraft Worker 39.66
23091 - Aircrew Life Support Equipment (ALSE) Mechanic 39.66
I
23092 - Aircrew Life Support Equipment (ALSE) Mechanic 44.33
II
23110 - Appliance Mechanic 27.81
23120 - Bicycle Repairer 20.03
23125 - Cable Splicer 43.10
23130 - Carpenter, Maintenance 28.58
23140 - Carpet Layer 24.79
23160 - Electrician, Maintenance 36.28
23181 - Electronics Technician Maintenance I 35.18
23182 - Electronics Technician Maintenance II 37.35
23183 - Electronics Technician Maintenance III 39.32
23260 - Fabric Worker 29.06
23290 - Fire Alarm System Mechanic 31.36
23310 - Fire Extinguisher Repairer 26.78
23311 - Fuel Distribution System Mechanic 37.07
23312 - Fuel Distribution System Operator 28.53
23370 - General Maintenance Worker 26.68
23380 - Ground Support Equipment Mechanic 44.33
23381 - Ground Support Equipment Servicer 37.02
23382 - Ground Support Equipment Worker 39.66
23391 - Gunsmith I 26.78
23392 - Gunsmith II 31.14
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 4/10
23393 - Gunsmith III 34.80
23410 - Heating, Ventilation And Air-Conditioning 34.66
Mechanic
23411 - Heating, Ventilation And Air Contidioning 36.51
Mechanic (Research Facility)
23430 - Heavy Equipment Mechanic 34.05
23440 - Heavy Equipment Operator 29.25
23460 - Instrument Mechanic 37.03
23465 - Laboratory/Shelter Mechanic 33.05
23470 - Laborer 19.81
23510 - Locksmith 35.47
23530 - Machinery Maintenance Mechanic 33.73
23550 - Machinist, Maintenance 34.32
23580 - Maintenance Trades Helper 20.27
23591 - Metrology Technician I 37.03
23592 - Metrology Technician II 39.00
23593 - Metrology Technician III 40.91
23640 - Millwright 29.89
23710 - Office Appliance Repairer 24.28
23760 - Painter, Maintenance 24.00
23790 - Pipefitter, Maintenance 33.08
23810 - Plumber, Maintenance 31.42
23820 - Pneudraulic Systems Mechanic 34.80
23850 - Rigger 34.16
23870 - Scale Mechanic 31.14
23890 - Sheet-Metal Worker, Maintenance 30.59
23910 - Small Engine Mechanic 24.40
23931 - Telecommunications Mechanic I 37.06
23932 - Telecommunications Mechanic II 39.03
23950 - Telephone Lineman 45.15
23960 - Welder, Combination, Maintenance 28.87
23965 - Well Driller 32.07
23970 - Woodcraft Worker 34.80
23980 - Woodworker 26.78
24000 - Personal Needs Occupations
24550 - Case Manager 23.07
24570 - Child Care Attendant 17.20
24580 - Child Care Center Clerk 21.46
24610 - Chore Aide 17.91
24620 - Family Readiness And Support Services 23.07
Coordinator
24630 - Homemaker 23.07
25000 - Plant And System Operations Occupations
25010 - Boiler Tender 42.88
25040 - Sewage Plant Operator 32.51
25070 - Stationary Engineer 42.88
25190 - Ventilation Equipment Tender 30.19
25210 - Water Treatment Plant Operator 32.51
27000 - Protective Service Occupations
27004 - Alarm Monitor 29.26
27007 - Baggage Inspector 20.31
27008 - Corrections Officer 33.19
27010 - Court Security Officer 32.91
27030 - Detection Dog Handler 22.72
27040 - Detention Officer 33.19
27070 - Firefighter 32.62
27101 - Guard I 20.31
27102 - Guard II 22.72
27131 - Police Officer I 36.09
27132 - Police Officer II 40.11
28000 - Recreation Occupations
28041 - Carnival Equipment Operator 21.74
28042 - Carnival Equipment Repairer 23.76
28043 - Carnival Worker 17.22
28210 - Gate Attendant/Gate Tender 21.78
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 5/10
28310 - Lifeguard 16.92
28350 - Park Attendant (Aide) 24.36
28510 - Recreation Aide/Health Facility Attendant 17.78
28515 - Recreation Specialist 30.17
28630 - Sports Official 19.40
28690 - Swimming Pool Operator 27.63
29000 - Stevedoring/Longshoremen Occupational Services
29010 - Blocker And Bracer 35.81
29020 - Hatch Tender 35.81
29030 - Line Handler 35.81
29041 - Stevedore I 33.42
29042 - Stevedore II 38.01
30000 - Technical Occupations
30010 - Air Traffic Control Specialist, Center (HFO) (see 2) 52.72
30011 - Air Traffic Control Specialist, Station (HFO) (see 2) 36.35
30012 - Air Traffic Control Specialist, Terminal (HFO) (see 2) 40.04
30021 - Archeological Technician I 24.14
30022 - Archeological Technician II 27.00
30023 - Archeological Technician III 33.44
30030 - Cartographic Technician 33.44
30040 - Civil Engineering Technician 41.58
30051 - Cryogenic Technician I 37.04
30052 - Cryogenic Technician II 40.90
30061 - Drafter/CAD Operator I 24.14
30062 - Drafter/CAD Operator II 27.00
30063 - Drafter/CAD Operator III 30.09
30064 - Drafter/CAD Operator IV 37.04
30081 - Engineering Technician I 22.92
30082 - Engineering Technician II 25.72
30083 - Engineering Technician III 28.79
30084 - Engineering Technician IV 35.64
30085 - Engineering Technician V 43.61
30086 - Engineering Technician VI 52.76
30090 - Environmental Technician 31.79
30095 - Evidence Control Specialist 33.44
30210 - Laboratory Technician 29.01
30221 - Latent Fingerprint Technician I 37.63
30222 - Latent Fingerprint Technician II 41.56
30240 - Mathematical Technician 42.36
30361 - Paralegal/Legal Assistant I 25.58
30362 - Paralegal/Legal Assistant II 31.69
30363 - Paralegal/Legal Assistant III 38.77
30364 - Paralegal/Legal Assistant IV 46.90
30375 - Petroleum Supply Specialist 40.90
30390 - Photo-Optics Technician 33.44
30395 - Radiation Control Technician 40.90
30461 - Technical Writer I 31.78
30462 - Technical Writer II 38.87
30463 - Technical Writer III 47.03
30491 - Unexploded Ordnance (UXO) Technician I 33.50
30492 - Unexploded Ordnance (UXO) Technician II 40.54
30493 - Unexploded Ordnance (UXO) Technician III 48.59
30494 - Unexploded (UXO) Safety Escort 33.50
30495 - Unexploded (UXO) Sweep Personnel 33.50
30501 - Weather Forecaster I 37.04
30502 - Weather Forecaster II 45.05
30620 - Weather Observer, Combined Upper Air Or (see 2) 30.09
Surface Programs
30621 - Weather Observer, Senior (see 2) 33.44
31000 - Transportation/Mobile Equipment Operation Occupations
31010 - Airplane Pilot 40.54
31020 - Bus Aide 20.16
31030 - Bus Driver 28.94
31043 - Driver Courier 21.14
31260 - Parking and Lot Attendant 17.17
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 6/10
31290 - Shuttle Bus Driver 21.06
31310 - Taxi Driver 17.71
31361 - Truckdriver, Light 23.10
31362 - Truckdriver, Medium 25.07
31363 - Truckdriver, Heavy 28.39
31364 - Truckdriver, Tractor-Trailer 28.39
99000 - Miscellaneous Occupations
99020 - Cabin Safety Specialist 19.76
99030 - Cashier 16.73
99050 - Desk Clerk 17.76
99095 - Embalmer 34.10
99130 - Flight Follower 33.50
99251 - Laboratory Animal Caretaker I 20.32
99252 - Laboratory Animal Caretaker II 22.20
99260 - Marketing Analyst 40.69
99310 - Mortician 34.10
99410 - Pest Controller 21.91
99510 - Photofinishing Worker 22.57
99710 - Recycling Laborer 23.14
99711 - Recycling Specialist 28.16
99730 - Refuse Collector 22.08
99810 - Sales Clerk 17.18
99820 - School Crossing Guard 20.44
99830 - Survey Party Chief 31.00
99831 - Surveying Aide 19.26
99832 - Surveying Technician 29.45
99840 - Vending Machine Attendant 17.68
99841 - Vending Machine Repairer 22.47
99842 - Vending Machine Repairer Helper 17.68
____________________________________________________________________________________
Note: Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal
Contractors, applies to all contracts subject to the Service Contract Act for which
the contract is awarded (and any solicitation was issued) on or after January 1,
2017. If this contract is covered by the EO, the contractor must provide employees
with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid
sick leave each year. Employees must be permitted to use paid sick leave for their
own illness, injury or other health-related needs, including preventive care; to
assist a family member (or person who is like family to the employee) who is ill,
injured, or has other health-related needs, including preventive care; or for
reasons resulting from, or to assist a family member (or person who is like family
to the employee) who is the victim of, domestic violence, sexual assault, or
stalking. Additional information on contractor requirements and worker protections
under the EO is available at www.dol.gov/whd/govcontracts.
Note: Executive Order 13658 generally applies to contracts subject to the Service
Contract Act that were awarded on or between January 1, 2015 and January 29, 2022,
and that have not been renewed or extended on or after January 30, 2022. If a
contract is subject to Executive Order 13658, the contractor must pay all covered
workers at least $13.30 per hour (or the applicable wage rate listed on this wage
determination, if it is higher) for all hours spent performing on the contract in
2025. The applicable Executive Order minimum wage rate will be adjusted annually.
Additional information on contractor requirements and worker protections under
Executive Order 13658 is available at www.dol.gov/whd/govcontracts.
ALL OCCUPATIONS LISTED ABOVE RECEIVE THE FOLLOWING BENEFITS:
HEALTH & WELFARE: $5.55 per hour, up to 40 hours per week, or $222.00 per week or
$962.00 per month
HEALTH & WELFARE EO 13706: $5.09 per hour, up to 40 hours per week, or $203.60 per
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 7/10
week, or $882.27 per month*
*This rate is to be used only when compensating employees for performance on an SCA-
covered contract also covered by EO 13706, Establishing Paid Sick Leave for Federal
Contractors. A contractor may not receive credit toward its SCA obligations for any
paid sick leave provided pursuant to EO 13706.
VACATION: 2 weeks paid vacation after 1 year of service with a contractor or
successor, 3 weeks after 5 years, and 4 weeks after 15 years. Length of service
includes the whole span of continuous service with the present contractor or
successor, wherever employed, and with the predecessor contractors in the
performance of similar work at the same Federal facility. (Reg. 29 CFR 4.173)
HOLIDAYS: A minimum of eleven paid holidays per year: New Year's Day, Martin
Luther King Jr.'s Birthday, Washington's Birthday, Memorial Day, Juneteenth
National Independence Day, Independence Day, Labor Day, Columbus Day, Veterans'
Day, Thanksgiving Day, and Christmas Day. (A contractor may substitute for any of
the named holidays another day off with pay in accordance with a plan communicated
to the employees involved.) (See 29 CFR 4.174)
THE OCCUPATIONS WHICH HAVE NUMBERED FOOTNOTES IN PARENTHESES RECEIVE THE FOLLOWING:
1) COMPUTER EMPLOYEES: This wage determination does not apply to any individual
employed in a bona fide executive, administrative, or professional capacity, as
defined in 29 C.F.R. Part 541. (See 41 C.F.R. 6701(3)). Because most Computer
Systems Analysts and Computer Programmers who are paid at least $27.63 per hour (or
at least $684 per week if paid on a salary or fee basis) likely qualify as exempt
computer professionals under 29 U.S.C. 213(a)(1) and 29 U.S.C. 213(a)(17), this wage
determination may not include wage rates for all occupations within those job
families. In such instances, a conformance will be necessary if there are nonexempt
employees in these job families working on the contract.
Job titles vary widely and change quickly in the computer industry, and are not
determinative of whether an employee is an exempt computer professional. To be
exempt, computer employees who satisfy the compensation requirements must also have
a primary duty that consists of:
(1) The application of systems analysis techniques and procedures, including
consulting with users, to determine hardware, software or system functional
specifications;
(2) The design, development, documentation, analysis, creation, testing or
modification of computer systems or programs, including prototypes, based on and
related to user or system design specifications;
(3) The design, documentation, testing, creation or modification of computer
programs related to machine operating systems; or
(4) A combination of the aforementioned duties, the performance of which
requires the same level of skills. (29 C.F.R. 541.400).
Any computer employee who meets the applicable compensation requirements and the
above duties test qualifies as an exempt computer professional under both section
13(a)(1) and section 13(a)(17) of the Fair Labor Standards Act. (Field Assistance
Bulletin No. 2006-3 (Dec. 14, 2006)). Accordingly, this wage determination will not
apply to any exempt computer employee regardless of which of these two exemptions is
utilized.
2) AIR TRAFFIC CONTROLLERS AND WEATHER OBSERVERS - NIGHT PAY & SUNDAY PAY: If you
work at night as part of a regular tour of duty, you will earn a night differential
and receive an additional 10% of basic pay for any hours worked between 6pm and 6am.
If you are a full-time employed (40 hours a week) and Sunday is part of your
regularly scheduled workweek, you are paid at your rate of basic pay plus a Sunday
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 8/10
premium of 25% of your basic rate for each hour of Sunday work which is not overtime
(i.e. occasional work on Sunday outside the normal tour of duty is considered
overtime work).
** HAZARDOUS PAY DIFFERENTIAL **
An 8 percent differential is applicable to employees employed in a position that
represents a high degree of hazard when working with or in close proximity to
ordnance, explosives, and incendiary materials. This includes work such as
screening, blending, dying, mixing, and pressing of sensitive ordnance, explosives,
and pyrotechnic compositions such as lead azide, black powder and photoflash powder.
All dry-house activities involving propellants or explosives. Demilitarization,
modification, renovation, demolition, and maintenance operations on sensitive
ordnance, explosives and incendiary materials. All operations involving re-grading
and cleaning of artillery ranges.
A 4 percent differential is applicable to employees employed in a position that
represents a low degree of hazard when working with, or in close proximity to
ordnance, (or employees possibly adjacent to) explosives and incendiary materials
which involves potential injury such as laceration of hands, face, or arms of the
employee engaged in the operation, irritation of the skin, minor burns and the like;
minimal damage to immediate or adjacent work area or equipment being used. All
operations involving, unloading, storage, and hauling of ordnance, explosive, and
incendiary ordnance material other than small arms ammunition. These differentials
are only applicable to work that has been specifically designated by the agency for
ordnance, explosives, and incendiary material differential pay.
** UNIFORM ALLOWANCE **
If employees are required to wear uniforms in the performance of this contract
(either by the terms of the Government contract, by the employer, by the state or
local law, etc.), the cost of furnishing such uniforms and maintaining (by
laundering or dry cleaning) such uniforms is an expense that may not be borne by an
employee where such cost reduces the hourly rate below that required by the wage
determination. The Department of Labor will accept payment in accordance with the
following standards as compliance:
The contractor or subcontractor is required to furnish all employees with an
adequate number of uniforms without cost or to reimburse employees for the actual
cost of the uniforms. In addition, where uniform cleaning and maintenance is made
the responsibility of the employee, all contractors and subcontractors subject to
this wage determination shall (in the absence of a bona fide collective bargaining
agreement providing for a different amount, or the furnishing of contrary
affirmative proof as to the actual cost), reimburse all employees for such cleaning
and maintenance at a rate of $3.35 per week (or $.67 cents per day). However, in
those instances where the uniforms furnished are made of ""wash and wear""
materials, may be routinely washed and dried with other personal garments, and do
not require any special treatment such as dry cleaning, daily washing, or commercial
laundering in order to meet the cleanliness or appearance standards set by the terms
of the Government contract, by the contractor, by law, or by the nature of the work,
there is no requirement that employees be reimbursed for uniform maintenance costs.
** SERVICE CONTRACT ACT DIRECTORY OF OCCUPATIONS **
The duties of employees under job titles listed are those described in the
""Service Contract Act Directory of Occupations"", Fifth Edition (Revision 1),
dated September 2015, unless otherwise indicated.
** REQUEST FOR AUTHORIZATION OF ADDITIONAL CLASSIFICATION AND WAGE RATE, Standard
Form 1444 (SF-1444) **
Conformance Process:
The contracting officer shall require that any class of service employee which is
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 9/10
not listed herein and which is to be employed under the contract (i.e., the work to
be performed is not performed by any classification listed in the wage
determination), be classified by the contractor so as to provide a reasonable
relationship (i.e., appropriate level of skill comparison) between such unlisted
classifications and the classifications listed in the wage determination (See 29 CFR
4.6(b)(2)(i)). Such conforming procedures shall be initiated by the contractor
prior to the performance of contract work by such unlisted class(es) of employees
(See 29 CFR 4.6(b)(2)(ii)). The Wage and Hour Division shall make a final
determination of conformed classification, wage rate, and/or fringe benefits which
shall be paid to all employees performing in the classification from the first day
of work on which contract work is performed by them in the classification. Failure
to pay such unlisted employees the compensation agreed upon by the interested
parties and/or fully determined by the Wage and Hour Division retroactive to the
date such class of employees commenced contract work shall be a violation of the Act
and this contract. (See 29 CFR 4.6(b)(2)(v)). When multiple wage determinations are
included in a contract, a separate SF-1444 should be prepared for each wage
determination to which a class(es) is to be conformed.
The process for preparing a conformance request is as follows:
1) When preparing the bid, the contractor identifies the need for a conformed
occupation(s) and computes a proposed rate(s).
2) After contract award, the contractor prepares a written report listing in order
the proposed classification title(s), a Federal grade equivalency (FGE) for each
proposed classification(s), job description(s), and rationale for proposed wage
rate(s), including information regarding the agreement or disagreement of the
authorized representative of the employees involved, or where there is no authorized
representative, the employees themselves. This report should be submitted to the
contracting officer no later than 30 days after such unlisted class(es) of employees
performs any contract work.
3) The contracting officer reviews the proposed action and promptly submits a report
of the action, together with the agency's recommendations and pertinent
information including the position of the contractor and the employees, to the U.S.
Department of Labor, Wage and Hour Division, for review (See 29 CFR 4.6(b)(2)(ii)).
4) Within 30 days of receipt, the Wage and Hour Division approves, modifies, or
disapproves the action via transmittal to the agency contracting officer, or
notifies the contracting officer that additional time will be required to process
the request.
5) The contracting officer transmits the Wage and Hour Division's decision to the
contractor.
6) Each affected employee shall be furnished by the contractor with a written copy
of such determination or it shall be posted as a part of the wage determination (See
29 CFR 4.6(b)(2)(iii)).
Information required by the Regulations must be submitted on SF-1444 or bond paper.
When preparing a conformance request, the ""Service Contract Act Directory of
Occupations"" should be used to compare job definitions to ensure that duties
requested are not performed by a classification already listed in the wage
determination. Remember, it is not the job title, but the required tasks that
determine whether a class is included in an established wage determination.
Conformances may not be used to artificially split, combine, or subdivide
classifications listed in the wage determination (See 29 CFR 4.152(c)(1))."
1/7/26, 12:48 PM SAM.gov
https://sam.gov/wage-determination/2015-4281/35 10/10
"55"$).&/5+
DoingBusinessWithIntegrityPage20f¢
ConfidentialityofFinancialandOtherInformation
We expectour employeestomaintainabsoluteconfidentialityconcerningallinformation
thattheyobtain,observe,orcreaterelatingtothe financialaffairsofthose we do business
with.We vigorouslyinvestigateanycompromiseofconfidentialitybyemployeesorany
attemptstoimproperlyobtainsuchinformationbyprivatepartiesorbusinesses.
BriberyandConflictofInterest
Inadditiontoourstandardsofconduct,therearecertaincriminalstatutesinthefederalcriminalcoderelatingtobriberyandconflictofinterestthatapplynotonlytoemployeesofthefederalgovernment,butalsotoemployeesoftheDistrictofColumbia.
Theofferofanythingofvalueinexpectationofspecificperformancebyagovernmentemployeeisacrime,andeventheappearanceofsuchactivityshouldbeavoided.
Employeesmaynotacceptanythingofvalue(otherthantheirgovernmsalaries)fortheperformanceoftheirduties.ThisisoutlinedbelowunderGratuitiesandOtherGiftRules.
Ouremployeesarerequiredtoreportalloffersofbribesandgratuitiestous,and
‘weensurethatthesemattersareinvestigatedandaddressed.Likewise,we
encourageanyonewhobelievestheymayhavebeensolicitedforabribeorgratuityby an OCFO employee toreportthematterimmediately,asindicatedat
theend of thisdocument.
Wealsoexpectouremployeestoavoidconflictsofinterestortheappearanceofconflictsofinterest.A particularlysensitiveissueforgovernmentemployeesistheofferofemploymentwithacompanydoingbusinesswiththeOCFO.Atanypointwhenagovernmentemployeeisconsideringemploymentwithaprivatecompanythathasabusinessrelationshipwiththegovernment,thatemployeemustdiscontinueworkonanyassignmentinvolvingthatcompanyorfacetheveryrealpossibilityofviolatingconflictofintereststatutes.Thiscouldalsojeopardizethecompany’seligibilitytobeawardedgovernmentcontracts.
Employeesarealsoexpresslyforbiddenfromperformingofficialdutiesinsituationsinvolvingfriends,relativesorpersonsorbusinesseswithwhomthey,ortheirfamilymembers,haveafinancialrelationship.Atanypointwheresucharelationshipisdiscoveredordevelops,theemployeemustdiscontinuetheirinvolvementintheofficialmatter.Fortheemployeeandthebusinessentitytocontinuetoconductofficialbusinessaftersuchaconflictisevident,wouldbeinappropriateandpossiblyillegal.
DoingBusinessWithIntegrityPage3of4
Gratuities
Itisalwaysgratifyingtohearthatourstaffhasprovidedexemplaryservicetothosewithwhomwedobusiness.Sometimes,however,theexpressionofappreciationismadeinaformthatisinappropriateforgovernmentemployeestoaccept.
OCFOemployeesareprohibitedbylawfromacceptingmoneyorotherthingsofvalueas.anappreciationforajobwelldone.Sometimeseventhemereofferofsomethingofvaluemayviolatebriberyandgratuitystatutes.A moreappropriateexpressionofgratitudefortheservicerenderedisalettertotheemployee’ssupervisor.Ifyoudon’tknowwhothatis,youmaysimplysendyourlettertotheOfficeoftheChiefFinancialOfficer,anditwillberoutedtotheproperofficial.
OtherGiftRules
Giftsoffoodand/orbeverages,evenduringholidayseasonsandothercelebratoryoccasions,arenotacceptableifthegiverhasabusinessrelationshipofanykindwiththeD.C.Government.Suchoffers,whilewell-intentioned,tendtogivetheimpressionofaspecialrelationshipbetweenthegiverandthegovernmentemployee.
Thisruledoesnotapplytotheofferandacceptanceofan insignificantitem,suchasasoftdrink,coffee,domutsandothermodestitemsoffoodandrefreshmentswhennotofferedaspartofameal.AdditionalinformationongiftrulesandexceptionsiscontainedinOCFOCodeofConduct,whichcanbeaccessedelectronicallyatwww.cfo.de.gov.GotoInformation,clickonIntegrityandOversight,thenclickonIntegrityDocumentstoreachtheCodeofConduct.
Compliance withContractingRules and Regulations
Ensuringcompliancewiththeprovisionsofcontractsisanimportantexpectationofgovernmentemployees.Evenso,wehaveseenexampleswheretheruleswerenotfollowed,usuallybasedonthe“needtogetthejobdone.”Suchbehaviorputsboththegovernmentemployeeandthecontractorinjeopardy.
Ifmodificationstoexistingcontractsarenecessary,theyshouldbeformallypursuedinaccordancewithOCFOcontractingrulesandregulations.Noworkoutsidethespecificationsofacontractshouldbeperformedwithoutanapprovedcontractmodification.Performingworkoutsideofcontractspecificationsorbeyondauthorizedfunding,couldresultinadefaultforthecontractoranddenialofpaymentforsuchwork.Inthemoreextremecases,failuretocomplywithcontractingregulationscouldbeconsideredfraudandmaybeinvestigatedasacriminalviolation.
ReportingMisconduct,Fraud, Waste and Abuse
‘TheOCFOhasazerotolerancepolicyforfraudandmisconductinvolvingitsemployeesandprograms.Similarly,wedonottolerateattemptstocorruptouremployees.
DoingBusinessWithIntegrityPage4of4
TheOfficeofIntegrityandOversightisanindependententityoftheOCFOwithresponsibilityforprotectingtheintegrityoftheOCFOandpreventingfraudandothermisconductinOCFOprograms.OIOconductsinvestigationsofallegedemployeemisconductandworkscloselywithfederalandDistrictlawenforcementagenciesininvestigatingcriminaloffensesaffectingtheintegrityoftheOCFO.
Weallwantthegovernment’sbusinesstobeconductedfairly,impartially,andwiththehighestdegreeofintegrity.Thebestwaytoensurethisistoreportanyindicationthatillegalactsoradministrativemisconductmayhaveoccurred.Hereishowyoucanreportsuchmatters,bytelephone,inperson,mail,orelectronically:
ofIni and
11004"Street,S.W.;Suite750-E
Washington,DC 20024(202)442-6433
Inadditiontoreceivingyourreport,investigatorsareavailabletodiscussanyquestionsorconcemsyoumayhaveaboutthematter.ReportingcanalsobedoneelectronicallyattheOCFOwebsite:www.cfo.de.gov.UnderInformation,clickontheIntegrityandOversightlink,andthenclickonReportingIncidentsandConcems.
OCF nfident line
Inordertoaddressanyconcernaboutreportinganonymously,theOCFOhascontractedwithanindependent,third-partyorganizationthatprovidesaconfidentialhotlineservice.ThishotlineisavailableforreportingallegationsofOCFOemployeemisconduct,andfraud,wasteandabuseinvolvingOCFOprograms.
Reportscanbemadebytelephonetothistoll-freehotline,whichisstaffed24hoursaday,at1-877-252-8805,oritcanbeaccessedatwww,ocfo,ethicspoint.com.
ictofColumbia oftheIn: orGeneral
Reportsoffraud,wasteandabusemaybereportedtotheOfficeoftheInspectorGeneralbytelephoneat1-800-521-1639,orelectronicallyatwww.oig.dc.gov.
ThisdocumentwaspreparedbytheOfficeofIntegrityandOversight,OfficeoftheChiefFinancialOfficer(RevisedMay2010)
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 1 of 19
SECTION H. HIPAA PRIVACY COMPLIANCE
This HIPAA Privacy Compliance is the standard
language that must be included in contracts which involve access to the District of Columbia
protected health information ( ) or creation of the same. This language should also be adapted and
used where 1. An agency complies with the best practices of HIPAA and its implementing regulations, 2.
Where an agency facilitates access to PHI, as defined under HIPAA, or 3. Where agencies otherwise wish
to protect similar information. Finally, where applicable, to ensure HIPAA compliance, this language must
be adapted and incorporated or attached to miscellaneous agreements or arrangements such as Memoranda
of Understanding, Memoranda of Agreement, Donation Agreements, or small purchase arrangements.
This Business Associate Agreement is between Bert W. Smith, Jr. & Company, Chartered and the District
of Columbia Office of the Chief Financial Officer, which is sharing Protected Health Information on behalf
of the District of Columbia, Department of Health Care Finance.
For the purpose of this Business Associate Agreement ( BAA ), Department of Health Care Finance
(DHCF) , a covered component within the District ( District ) Hybrid Entity will be
referred to as by the Health Insurance Portability and
.F.R.
ȚȚ160, 162 and Bert W. Smith, Jr. & Company,
Chartered by HIPAA. Bert W. Smith, Jr. & Company,
Chartered is from OCFO on behalf
of (DHCF)
Terms used, but not otherwise defined, in this BAA shall have the same meaning as those terms in the
HIPAA Regulations.
1. Definitions
a. Business Associate ǡǡ
ȋ
Ȍ
ǡ
ǡ
ǡ
ǡ
ǡ
ǡ
ǡǡ
ǡ
ǡ
ǡ
ͶʹǤ ǤȚ͵ǤʹͲǡǡ
ǡ
ǡ
Ǣǡ
ǡǡ
ǡ
ǡ
ǡ ȋ Ͷͷ Ǥ Ǥ Ț ͳͶǤͷͲͳȌǡ
ǡǡ
ǡ
ǡ
ǡ
ǡ
ǡ
Ǥ
Ǥ
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 2 of 19
ǡȋȌ
ǡǦ
ǡ
ǢȋȌ
ǢȋȌ
ǡ
ǡǡ
Ǥ
Business Associate
ǣȋȌ
ǡ
ǢȋȌǡ
ȋ
ǡ
ǡ
Ȍǡ
ͶͷǤ ǤȚͳͶǤͷͲͶȋȌǢȋȌ
ǡ
ǡǡ
ǡ
ǡ
ǢȋȌ
ǡ
Ǥ
b. Covered Entity means a health plan, a health care clearinghouse, or a health care provider
who transmits any health information in electronic form in connection with a transaction
covered by 45 C.F.R. ȚȚ 160 and 164. With respect to this BAA, Covered Entity shall also
include the designated Health Care Components of Hybrid Entity
or a District agency following HIPAA best practices.
c. Covered Functions means those functions of a Covered Entity the performance of which
makes the entity a health plan, health care provider, or health care clearinghouse.
d. Data Aggregation means, with respect to PHI created or received by a Business Associate
in its capacity as the Business Associate of a Covered Entity, the combining of such PHI
by the Business Associate with the PHI received by the Business Associate in its capacity
as a Business Associate of another Covered Entity, to permit data analyses that relate to
the health care operations of the respective Covered Entities.
e. Designated Record Set means a group of records maintained by or for a Covered Entity
that are:
i. The medical records and billing records about individuals maintained by or for a
covered health care provider;
ii. The enrollment, payment, claims adjudication, and case or medical management
record systems maintained by or for a health plan; or
iii. Records used, in whole or in part, by or for the Covered Entity to make decisions
about individuals.
f. Health Care means care, services, or supplies related to the health of an individual. Health
care includes, but is not limited to, the following:
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 3 of 19
i. Preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care,
and counseling, service, assessment, or procedure with respect to the physical or
mental condition, or functional status, of an individual or that affects the structure
or function of the body; and
ii. Sale or dispensing of a drug, device, equipment, or other item in accordance with
the prescription.
g. Health Care Components means a component or a combination of components of a Hybrid
Entity designated by a Hybrid Entity in accordance with 45 CFR § 164.105(a)(2)(iii)(D).
Health Care Components must include non-Covered Functions that provide services to the
Covered Functions for the purpose of facilitating the sharing of PHI with such functions of
the Hybrid Entity without Business Associate agreements or individual authorizations.
h. Health Care Operations shall include (1) conducting quality assessment and improvement
activities, including outcomes evaluation and development of clinical guidelines, provided
that the obtaining of generalizable knowledge is not the primary purpose of any studies
resulting from such activities; patient safety activities (as defined in 42 C.F.R § 3.20);
population-based activities relating to improving health or reducing health care costs,
protocol development, case management and care coordination, contacting of health care
providers and patients with information about treatment alternatives; and related functions
that do not include treatment; (2) reviewing the competence or qualifications of health care
professionals, evaluating practitioner and provider performance, health plan performance,
conducting training programs in which students, trainees, or practitioners in areas of health
care learn under supervision to practice or improve their skills as health care providers,
training of non-health care professionals, accreditation, certification, licensing, or
credentialing activities; (3) except as prohibited under 45 C.F.R. § 164.502(a)(5)(i),
underwriting, enrollment, premium rating, and other activities related to the creation,
renewal, or replacement of a contract of health insurance or health benefits, and ceding,
securing, or placing a contract for reinsurance of risk relating to claims for health care
(including stop-loss insurance and excess of loss insurance), provided that the requirements
of 45 C.F.R. § 164.514(g) are met, if applicable; (4) conducting or arranging for medical
review, legal services, and auditing functions, including fraud and abuse detection and
compliance programs; (5) business planning and development, such as conducting cost-
management and planning-related analyses related to managing and operating the entity,
including formulary development and administration, development or improvement of
methods of payment or coverage policies; and (6) business management and general
administrative activities of the entity, including, but not limited to: (i) management
activities relating to implementation of and compliance with the requirements of this
subchapter; (ii) customer service, including the provision of data analyses for policy
holders, plan sponsors, or other customers, provided that PHI is not disclosed to such policy
holder, plan sponsor, or customer.(iii) resolution of internal grievances;(iv) The sale,
transfer, merger, or consolidation of all or part of the Covered Entity with another Covered
Entity, or an entity that following such activity will become a Covered Entity and due
diligence related to such activity; and(v) consistent with the applicable requirements of 45
C.F.R. § 164.514, creating de-identified health information or a limited data set, and
fundraising for the benefit of the Covered Entity..
i. Hybrid Entity means a single legal entity that is a Covered Entity and whose business
activities include both covered and non-Covered Functions, and that designates Health
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 4 of 19
Care Components, in accordance with 45 C.F.R. § 164.105(a)(2)(iii)(C). A Hybrid Entity
is required to designate Health Care Components, any other components of the entity that
provide services to the Covered Functions for the purpose of facilitating the sharing of PHI
with such functions of the Hybrid Entity without Business Associate agreements or
individual authorizations. The District is a Hybrid Covered Entity. Hybrid Entities are
required to designate and include functions, services and activities within its own
organization, which would meet the definition of Business Associate and irrespective of
whether performed by employees of the Hybrid Entity, as part of its Health Care
Components for compliance with the Security Rule and privacy requirements under this
BAA.
j. Individual shall mean the person who is the subject of PHI in accordance with 45 C.F.R. §
160.103. The term individual shall also include personal representative in
accordance with 45 C.F.R. § 164.502(g).
k. Individually Identifiable Health Information shall mean information that is a subset of
health information, including demographic information collected from an individual, and;
i. Is created or received by a health care provider, health plan, employer, or health
care clearinghouse;
ii. Relates to the past, present, or future physical or mental health or condition of an
individual; or the past, present, or future payment for the provision of health care
to an individual; and
iii. That identifies the individual or with respect to which there is a reasonable basis
to believe the information can be used to identify the individual.
l. National Provider Identifier (NPI) shall mean the Standard Unique Health Identifier for
Healthcare Providers as defined at 42 C.F.R. § 162.406.
m. Organized Health Care Arrangement shall mean (1) a clinically integrated care setting in
which individuals typically receive health care from more than one health care provider;
(2) an organized system of health care in which more than one Covered Entity
participates and in which the participating Covered Entities: (i) hold themselves out to the
public as participating in a joint arrangement; and (ii) participate in joint activities that
include at least one of the following: (a) utilization review, in which health care decisions
by participating Covered Entities are reviewed by other participating Covered Entities or
by a third party on their behalf; (b) quality assessment and improvement activities, in
which treatment provided by participating Covered Entities is assessed by other
participating Covered Entities or by a third party on their behalf; or (c) payment
activities, if the financial risk for delivering health care is shared, in part or in whole, by
participating Covered Entities through the joint arrangement and if PHI created or
received by a Covered Entity is reviewed by other participating Covered Entities or by a
third party on their behalf for the purpose of administering the sharing of financial risk in
accordance with 42 C.F.R. § 160.103.
n. Personal Representative: shall mean a person authorized, under District or other
applicable law, to act on behalf of the subject of PHI in accordance with 42 C.F.R. §
164.502(g).
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 5 of 19
o. Privacy and Security Official: shall mean the person or persons designated by the
District, a Hybrid Entity, who is/are responsible for developing, maintaining,
implementing and enforcing the District-wide Privacy Policies and Procedures, and for
overseeing full compliance with HIPAA Regulations, and other applicable federal and
state privacy laws.
p. Privacy Officer shall mean the person designated by the and Security
Official or one of the District Entity, who is
responsible for overseeing compliance with a
Procedures, the HIPAA Regulations and other applicable federal and state privacy laws.
Also referred to as the agency Privacy Officer, the individual shall follow the guidance of
and Security Official, and shall be responsive to and report to the
and Security Official on matters pertaining to HIPAA compliance.
q. Privacy Rule shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 C.F.R. parts 160 and 164, subparts A and E.
r. Protected Health Information means individually identifiable health
information that is created or received by the
Business Associate from or on behalf of the Covered Entity, or agency following HIPAA
best practices, which is:
i. Transmitted by, created or maintained in electronic media; or
ii. Transmitted or maintained in any other form or medium;
iii. PHI or ePHI does not include individually identifiable health information: (i) In
education records covered by the Family Educational Rights and Privacy Act, as
amended, 20 U.S.C. § 1232g; (ii) In records described at 20 U.S.C. §
1232(g)(a)(4)(B)(iv); (iii) In employment records held by a Covered Entity in its
role as employer; and (iv) Regarding a person who has been deceased for more
than 50 years.
s. Record shall mean any item, collection, or grouping of information that includes PHI and
is maintained, collected, used, or disseminated by or for a Covered Entity.
t. Required By Law means a mandate contained in law that compels an entity to make a use
or disclosure of PHI and that is enforceable in a court of law. Required by law includes,
but is not limited to, court orders and court-ordered warrants; subpoenas or summons
issued by a court, grand jury, a governmental or tribal inspector general, or an
administrative body authorized to require the production of information; a civil or an
authorized investigative demand; Medicare conditions of participation with respect to
health care providers participating in the program; and statutes or regulations that require
the production of information, including statutes or regulations that require such
information if payment is sought under a government program providing public benefits
pursuant to 45 C.F.R. § 164.103.
u. Secretary means the person serving as Secretary of the United States Department of
Health and Human Services (HHS) or any other officer or employee of HHS to whom the
authority involved has been delegated.
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 6 of 19
v. Security Officer means the person designated by the Security Official or one of the
Health Care Components, who is responsible for
Security Rules, and other applicable federal and state privacy law(s). The Covered
well as the Associate Security Official within the Office of the Chief Technology Officer,
and shall be responsive to the same on matters pertaining to HIPAA compliance.
w. Security Rule shall mean the Standards for Security of Individually Identifiable Health
Information at 45 C.F.R. parts 160, 162 and 164, subpart C.
x. Unsecured PHI shall mean PHI that is not rendered unusable, unreadable, or
indecipherable to unauthorized persons through the use of a technology or methodology
specified by the U.S. Department of Health and Human Services Secretary in the
guidance issue under § 13402(h)(2) of the Health Information Technology Economic and
Clinical Health Act (HITECH), enacted at part of the American Recovery and
Reinvestment Act of 2009 (ARRA)(Pub.L 111-5, 123 Stat 115), approved February 17,
2009.
y. Workforce shall mean employees, volunteers, trainees, and other persons whose conduct,
in the performance of work for a Covered Entity or Business Associate, is under the
direct control of such Covered Entity, whether or not they are paid by the Covered Entity
or Business Associate.
2. Obligations and Activities of Business Associate
Business Associate agrees to comply with applicable federal and District confidentiality and
security laws, including, but not limited to the Privacy Rule and Security Rule and the following:
a. Business Associate agrees not to use or disclose PHI or ePHI (other than as permitted or
required by this BAA or as Required By Law.
Ǥ Business Associate agrees to use appropriate safeguards and comply with administrative,
physical, and technical safeguards requirements described at 45 C.F.R. §§ 164.308,
164.310, 164.312 and 164.316 as required by § 13401 of the Health Information
Technology Economic and Clinical Health Act ( HITECH ), enacted as part of the
American Recovery and Reinvestment Act of 2009 ( ARRA )(Pub.L 111-5, 123 Stat 115)
approved February 17, 2009, to maintain the security of the PHI and to prevent use or
disclosure of such PHI other than as provided for by this BAA. Business Associate
acknowledges that, pursuant § 13401, Business Associate must comply with the Security
Rule and privacy provisions detailed in this BAA.
The additional requirements of § 13401of HITECH that relate to security and apply to a
Covered Entity shall also apply to Business Associate and shall be incorporated into an
agreement between the Business Associate and the Covered Entity. Business Associate
shall be directly liable for any violations of this BAA or HIPAA Regulations. A summary
of HIPAA Security Standards for the Protection of ePHI, found at Appendix A to Subpart
C or 45 C.F.R. Part 164 is as follows:
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 7 of 19
Administrative Safeguards
Security Management Process 164.308(a)(1) Risk Analysis (R)
Risk Management (R)
Sanction Policy (R)
Information System Activity Review (R)
Assigned Security Responsibility 164.308(a)(2) (R)
Workforce Security 164.308(a)(3) Authorization and/or Supervision (A)
Workforce Clearance Procedure
Termination Procedures (A)
Information Access Management 164.308(a)(4) Isolating Health care Clearinghouse Function (R)
Access Authorization (A)
Access Establishment and Modification (A)
Security Awareness and Training 164.308(a)(5) Security Reminders (A)
Protection from Malicious Software (A)
Log-in Monitoring (A)
Password Management (A)
Security Incident Procedures 164.308(a)(6) Response and Reporting (R)
Contingency Plan 164.308(a)(7 Data Backup Plan (R)
Disaster Recovery Plan (R)
Emergency Mode Operation Plan (R)
Testing and Revision Procedure (A)
Applications and Data Criticality Analysis (A)
Evaluation 164.308(a)(8) (R)
Business Associate Contracts and Other
Arrangement
164.308(b)(1) Written Contract or Other Arrangement (R)
Physical Safeguards
Facility Access Controls 164.310(a)(1) Contingency Operations (A)
Facility Security Plan (A)
Access Control and Validation Procedures (A)
Maintenance Records (A)
Workstation Use 164.310(b) (R)
Workstation Security 164.310(c) (R)
Device and Media Controls 164.310(d)(1) Disposal (R)
Media Re-use (R)
Accountability (A)
Data Backup and Storage (A)
Technical Safeguards (see § 164.312)
Access Control 164.312(a)(1) Unique User Identification (R)
Emergency Access Procedure (R)
Automatic Logoff (A)
Encryption and Decryption (A)
Audit Controls 164.312(b) (R)
Integrity 164.312(c)(1) Mechanism to Authenticate Electronic Protected Health
Information (A)
Person or Entity Authentication 164.312(d) (R)
Transmission Security 164.312(e)(1) Integrity Controls (A)
Encryption (A)
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 8 of 19
c. The Business Associate agrees to name a Privacy and/or Security Officer who is
accountable for developing, maintaining, implementing, overseeing the compliance of and
enforcing compliance with this BAA, the Security Rule and other applicable federal and
Associate reports
violations and conditions to the District-wide Privacy and Security Official and/or the
Agency
d. The Business Associate agrees to establish procedures for mitigating, and to mitigate to the
extent practicable, any deleterious effect s that are known to the Business Associate of a
use or disclosure of PHI by the Business Associate in violation of the requirements of this
BAA.
e. The Business Associate agrees to report to Covered Entity, in writing, any use or disclosure
of the PHI not permitted or required by this BAA or other incident or condition arising out
the Security Rule, including breaches of unsecured PHI as required at 45 C.F.R § 164.410,
to the District-wide Privacy and Security Official or agency Privacy Officer within ten (10)
business days from the time the Business Associate becomes aware of such unauthorized
use or disclosure. However, if the Business Associate is an agent of the District (i.e.,
performing delegated essential governmental functions), the Business Associate must
report the incident or condition immediately. Upon the determination of an actual data
Associate will handle breach notifications to individuals, the U.S. Department of Health
and Human Services, Office for Civil Rights (OCR), and potentially the media, on behalf
of the District.
f. The Business Associate agrees to ensure that any Workforce member or any agent,
including a subcontractor, agrees to the same restrictions and conditions that apply through
this BAA with respect to PHI received from the Business Associate, PHI created by the
Business Associate, or PHI received by the Business Associate on behalf of the Covered
Entity.
Ǥ In accordance with 45 C.F.R §§ 164.502(e)(1)(ii) and 164.308(b)(2), if applicable, ensure
that any subcontractors that create, receive, maintain, or transmit PHI on behalf of the
Business Associate agree to the same restrictions, conditions, and requirements that apply
to the Business Associate with respect to such information.
h. Initially, within ten (10) business days following the commencement of this Contract, or
within ten (10) business days of a new or updated agreement with a subcontractor, the
Business Associate agrees to provide the District a list of all subcontractors who meet the
definition of a Business Associate. Additionally, Business Associate agrees to ensure its
subcontractors understanding of liability and monitor, where applicable, compliance with
the Security Rule and applicable privacy provisions in this BAA.
i. The Business Associate agrees to provide access within five (5) business days, at the
request of the Covered Entity or an Individual, at a mutually agreed upon location,
during normal business hours, and in a format as directed by the District Privacy
Official or agency Privacy Officer, or as otherwise mandated by the Privacy Rule or
applicable District laws, rules and regulations, to PHI in a Designated Record Set, to the
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 9 of 19
requirements under 45 C.F.R. §164.524.
j. The Business Associate agrees to make any amendment(s) within five (5) business days to
the PHI in a Designated Record Set that the Covered Entity directs or agrees to pursuant to
45 C.F.R § 164.526 in a format as directed by the District Privacy Official or agency
Privacy Officer
45 C.F.R. §164.526.
k. The Business Associate agrees to use the standard practices of the Covered Entity to verify
the identification and authority of an Individual who requests the PHI in a Designated
Record Set of a recipient of services from or through the Covered Entity. The Business
Associate agrees to comply with the applicable portions of the [ Insert Applicable Agency
Identity And Procedure Verification Policy], attached hereto as Exhibit A and incorporated
by reference.
l. The Business Associate agrees to record authorizations and log such disclosures of PHI
and information related to such disclosures as would be required for the Covered Entity to
respond to a request by an Individual for an accounting of disclosures of PHI in accordance
with 45 C.F.R. § 164.528 and applicable District laws, rules and regulations.
m. The Business Associate agrees to provide to the Covered Entity or an Individual, within
five (5) business days of a request at a mutually agreed upon location, during normal
business hours, and in a format designated by the District Privacy and Security Official
or agency Privacy Officer and the duly authorized Business Associate Workforce member,
information collected in accordance with Paragraph (i) of this Section above, to permit the
Covered Entity to respond to a request by an Individual for an accounting of disclosures of
PHI in accordance with 45 C.F.R. § 164.528, and applicable District laws, rules and
regulations.
n. The Business Associate agrees to make internal practices, books, and records, including
policies and procedures, and PHI, relating to the use and disclosure of PHI received from
the Business Associate, or created, or received by the Business Associate on behalf of the
Covered Entity, available to the Covered Entity, or to the Secretary, within five (5) business
days of their request and at a mutually agreed upon location, during normal business hours,
and in a format designated by the District Privacy and Security Official or agency Privacy
Officer and the duly authorized Business Associate Workforce member, or in a time and
manner designated by the Secretary, for purposes of the Secretary in determining
compliance of the Covered Entity with the Privacy Rule.
o. To the extent the Business Associate is to carry out one or more of Covered Entity's
obligation(s) under Subpart E of 45 C.F.R Part 164, the Business Associate agrees to
comply with the requirements of Subpart E that apply to the Covered Entity in the
performance of such obligation(s).
p. As deemed necessary by the District, the Business Associate agrees to the monitoring and
auditing of items listed in paragraph 2 of this BAA, as well as data systems storing or
transmitting PHI, to verify compliance.
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 10 of 19
q. The Business Associate may aggregate PHI in its possession with the PHI of other Covered
Entities that Business Associate has in its possession through its capacity as a Business
Associate to other Covered Entities provided that the purpose of the Data Aggregation is
to provide the Covered Entity with data analyses to the Health Care Operations of the
Covered Entity. Under no circumstances may the Business Associate disclose PHI of one
Covered Entity to another Covered Entity absent the explicit written authorization and
consent of the Privacy Officer or a duly authorized Workforce member of the Covered
Entity.
r. Business Associate may de-identify any and all PHI provided that the de-identification
conforms to the requirements of 45 C.F.R. § 164.514(a)-(b) and any associated HHS
guidance. Pursuant to 45 C.F.R. § 164.502(d)(2), de-identified information does not
constitute PHI and is not subject to the terms of this BAA.
s.
prior to contract award, the Business Associate shall file the Questionnaire with the Agency
Privacy Liaison or the Agency Contract Administrator within 30 days after contract
award. Business Associate shall file the Questionnaire with the Agency Privacy
Officer/Liaison or the Agency Contract Administrator on or before October 1 st of each
contract year. At the discretion of the Agency Privacy Liaison, Business Associates with
limited access to PHI may be granted a written waiver to file a letter attesting to their
HIPAA compliance on or before October 1st of each contract year.
t. All DHCF claims data and derived data products containing DHCF PHI received or created
by the Business Associate shall be maintained on servers and networks in the United States.
In the case of cloud-based applications used by the Business Associate or its subcontractors
or agents, Business Associate shall stipulate that only US-based servers and networks will
used by the cloud-based applications that host, store or analyze DHCF PHI data or derived
data products containing PHI.
3. Permitted Uses and Disclosures by the Business Associate
a. Except as otherwise limited in this BAA, the Business Associate may use or disclose PHI
to perform functions, activities, or services for, or on behalf of, the Covered Entity as
specified in the Contract, provided that such use or disclosure would not violate Subpart E
of 45 C.F.R Part 164 if the same activity were performed by the Covered Entity or would
not violate the minimum necessary policies and procedures of the Covered Entity.
b. Except as otherwise limited in this BAA, the Business Associate may use PHI for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this BAA, the Business Associate may disclose PHI for the
proper management and administration of the Business Associate, provided that the
disclosures are Required By Law, or the Business Associate obtains reasonable assurances
from the person to whom the information is disclosed that it will remain confidential and
used, or further disclosed, only as Required By Law, or for the purpose for which it was
disclosed to the person, and the person notifies the Business Associate of any instances of
which it has knowledge that the confidentiality of the information has been breached.
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 11 of 19
d. Except as otherwise limited in this BAA, the Business Associate may use PHI to provide
Data Aggregation services to the Covered Entity as permitted by 45 C.F.R. §
164.504(e)(2)(i)(B).
e. Business Associate may use PHI to report violations of this BAA or the HIPAA
Regulations to the appropriate federal and District of Columbia authorities, consistent with
45 C.F.R. § 164.502(j)(1)-(2).
4. Additional Obligations of the Business Associate
a. Business Associate shall submit a written report to the Covered Entity that identifies the
files and reports that constitute the Designated Record Set of the Covered Entity. Business
Associate shall submit said written report to the Privacy Officer no later than thirty (30)
business days after the commencement of this BAA. In the event that Business Associate
utilizes new files or reports which constitute the Designated Record Set, Business
Associate shall notify the Covered Entity of said event within thirty (30) days of the
ord Set file shall
include, but not be limited to the identity of the following:
i. Name of the Business Associate of the Covered Entity;
ii. Title of the Report/File;
iii. Confirmation that the Report/File contains PHI(Yes or No);
iv. Description of the basic content of the Report/File;
v. Format of the Report/File (Electronic or Paper);
vi. Physical location of Report/File;
vii. Name and telephone number of current member(s) of the Workforce of the
Covered Entity or other District Government agency responsible for receiving
and processing requests for PHI; and
viii. Supporting documents if the recipient/personal representative has access to the
Report/File.
b. Business Associate must provide assurances to the Covered Entity that it will continue to
employ sufficient administrative, technical and physical safeguards, as described under
the Security Rule, to protect and secure (the Covered E .
These safeguards include:
i. The Business Associate agrees to administrative, physical, and technical
safeguards that reasonably and appropriately protect the confidentiality, integrity,
and availability of the ePHI that the Business Associate creates, receives, maintains
or transmits on behalf of the Covered Entity.
ii. The Business Associate agrees to report to the Covered Entity any security incident
of which it becomes aware, including any attempts to access ePHI, whether those
attempts were successful or not.
iii. This BAA may be terminated if the Covered Entity determines that the Business
Associate has materially breached the agreement.
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 12 of 19
iv. The Business Associate agrees to make all policies and procedures, and documents
relating to security, available to the Secretary of HHS for the purposes of
determining the Covered Entity
v. This BAA continues in force for as long as the Business Associate retains any
access to ePHI.
vi. With respect to the subset of PHI known as electronic PHI (ePHI) as defined by
HIPAA Security Standards at 45 C.F.R. §§ 160 and 164, subparts A and C (the
"Security Rule"), if in performing the Services, Business Associate, its
employees, agents, subcontractors and any other individual permitted by
Business Associate will have access to any computer system, network, file, data
or software owned by or licensed to Provider that contains ePHI, or if Business
Associate otherwise creates, maintains, or transmit
Business Associate shall take reasonable security measures necessary to protect
the security of all such computer systems, networks, files, data and software.
With respect to the security of ePHI, Business Associate shall: (a) Implement
administrative, physical and technical safeguards that reasonably and
appropriately protect the confidentiality, integrity, and availability of the ePHI
that it creates, receives, maintains, or transmits on behalf of the Provider; (b)
Ensure that any agent, including a subcontractor, to whom it provides such
information agrees to implement reasonable and appropriate safeguards to protect
it; and (c) Report to the Provider any security incident of which it becomes
aware.
vii. Business Associate agrees not to electronically transmit or permit access to PHI
unless such transmission or access is authorized by this BAA and further agrees
that it shall only transmit or permit such access if such information is secured in a
manner that is consistent with applicable law, including the Security Rule. For
purposes of this BAA
readable information into unreadable, protected form so that only a recipient who
convert the information back into original readable
form. If the Covered Entity stores, uses or maintains PHI in encrypted form, or
in any other secured form acceptable under the security regulations, Covered
Entity shall promptly, at request, provide with the key or keys to decrypt such
information and will otherwise assure that such PHI is accessible by upon
reasonable request.
viii. In the event Business Associate performs functions or activities involving the use
or disclosure of PHI on behalf of Covered Entity that involve the installation or
maintenance of any software (as it functions alone or in combination with any
hardware or other software), Business Associate shall ensure that all such
software complies with all applicable standards and specifications required by the
HIPAA Regulations and shall inform of any software standards or specifications
not compliant with the HIPAA Regulations.
c. At the request of the Covered Entity, the Business Associate agrees to amend this BAA to
comply with all HIPAA mandates.
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 13 of 19
5. Sanctions
Business Associate agrees that its Workforce members, agents and subcontractors who
violate the provisions of HIPAA or other applicable federal or District privacy law will
be internal Personnel Policy
and applicable collective bargaining agreements. Business Associate agrees to impose
applicable collective bargaining agreements with respect to persons employed by it.
Members of the Business Associate Workforce who are not employed by Business
Associate are subject to the policies and applicable sanctions for violation of this BAA
In the event Business Associate imposes sanctions against any member of its Workforce,
agents and subcontractors for violation of the provisions of HIPAA or other applicable
federal or District privacy laws, the Business Associate shall inform the District Privacy
Official or the agency Privacy Officer/Liasion of the imposition of sanctions.
6. Obligations of the Covered Entity
a. The Covered Entity shall notify the Business Associate of any limitation(s) in its Notice of
Privacy Practices of the Covered Entity in accordance with 45 C.F.R. § 164.520, to the
extent that such limitation may affect the use or disclosure of PHI by the Business
Associate.
b. The Covered Entity shall notify the Business Associate of any changes in, or revocation
of, permission by the Individual to the use or disclosure of PHI, to the extent that such
changes may affect the use or disclosure of PHI by the Business Associate.
c. The Covered Entity shall notify the Business Associate of any restriction to the use or
disclosure of PHI that the Covered Entity has agreed to in accordance with 45 C.F.R. §
164.522, to the extent that such restriction may affect the use or disclosure of PHI by the
Business Associate.
7. Permissible Requests by Covered Entity
Covered Entity shall not request the Business Associate to use or disclose PHI in any manner that
would not be permissible under the Privacy Rule and Subpart E of 45 C.F.R Part 164 if done by
the Covered Entity.
8. Representations and Warranties.
The Business Associate represents and warrants to the Covered Entity:
a. That it is duly organized, validly existing, and in good standing under the laws of the
jurisdiction in which it is organized or licensed, it has the full power to execute this BAA
and it, its employees, agents, subcontractors, representatives and members of its
Workforce are licensed and in good standing with the applicable agency, board, or
governing body to perform its obligations hereunder, and that the performance by it of its
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 14 of 19
obligations under this BAA has been duly authorized by all necessary corporate or other
actions and will not violate any provision of any license, corporate charter or bylaws;
b. That it, its employees, agents, subcontractors, representatives and members of its
Workforce are in good standing with the District, that it, its employees, agents,
subcontractors, representatives and members of its Workforce will submit a letter of good
standing from the District, and that it, its employees, agents, subcontractors,
representatives and members of its Workforce have not been de-barred from being
employed as a contractor by the federal government or District;
c. That neither the execution of this BAA, nor its performance hereunder, will directly or
indirectly violate or interfere with the terms of another agreement to which it is a party,
or give any governmental entity the right to suspend, terminate, or modify any of its
governmental authorizations or assets required for its performance hereunder. The
Business Associate represents and warrants to the Covered Entity that it will not enter
into any agreement the execution or performance of which would violate or interfere with
this BAA;
d. That it is not currently the subject of a voluntary or involuntary petition in bankruptcy,
does not currently contemplate filing any such voluntary petition, and is not aware of any
claim for the filing of an involuntary petition;
e. That all of its employees, agents, subcontractors, representatives and members of its
Workforce, whose services may be used to fulfill obligations under this BAA are or shall
be appropriately informed of the terms of this BAA and are under legal obligation to the
Business Associate, by contract or otherwise, sufficient to enable the Business Associate
to fully comply with all provisions of this BAA. Modifications or limitations that the
Covered Entity has agreed to adhere to with regards to the use and disclosure of PHI of
any individual that materially affects or limits the uses and disclosures that are otherwise
permitted under the Privacy Rule will be communicated to the Business Associate, in
writing, and in a timely fashion;
f. That it will reasonably cooperate with the Covered Entity in the performance of the
mutual obligations under this Agreement;
g. That neither the Business Associate, nor its shareholders, members, directors, officers,
agents, subcontractors, employees or members of its Workforce have been excluded or
served a notice of exclusion or have been served with a notice of proposed exclusion, or
have committed any acts which are cause for exclusion, from participation in, or had any
sanctions, or civil or criminal penalties imposed under, any federal or District healthcare
program, including but not limited to Medicare or Medicaid, or have been convicted, under
federal or District law (including without limitation following a plea of nolo contendere or
no contest or participation in a first offender deferred adjudication or other arrangement
whereby a judgment of conviction has been withheld), of a criminal offense related to (a)
the neglect or abuse of a patient, (b) the delivery of an item or service, including the
performance of management or administrative services related to the delivery of an item
or service, under a federal or District healthcare program, (c) fraud, theft, embezzlement,
breach of fiduciary responsibility, or other financial misconduct in connection with the
delivery of a healthcare item or service or with respect to any act or omission in any
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 15 of 19
program operated by or financed in whole or in part by any federal, state, or local
government agency (d) the unlawful, manufacture, distribution, prescription or dispensing
of a controlled substance, or (e) interference with or obstruction of any investigation into
any criminal offense described in (a) through (d) above. The Business Associate further
agrees to notify the Covered Entity immediately after the Business Associate becomes
aware that any of the foregoing representations and warranties may be inaccurate or may
become incorrect.
9. Term and Termination
a. Term. The requirements of this BAA shall be effective as of the date of the contract award
and shall terminate when all of the PHI provided by the Covered Entity to the Business
Associate or created or received by the Business Associate on behalf of the Covered Entity,
is confidentially destroyed or returned to the Covered Entity within five (5) business days
of its request. The PHI shall be returned in a format mutually agreed upon by and between
the Privacy Official and/or Privacy Officer or their designee and the appropriate and duly
authorized Workforce member of the Business Associate. ; If it is infeasible to return or
confidentially destroy the PHI, protections shall be extended to such information, in
accordance with the termination provisions in this Section and communicated to the
Privacy Official or Privacy Officer or their designee. The requirement to return PHI to the
District at the end of the contract term or if the contract is terminated applies irrespective
of whether the Business Associate is also a Covered Entity under HIPAA. Where a
Business Associate is also a Covered Entity, PHI provided by the District, or created or
received by the Business Associate on behalf of the District, a duplicate of the record may
be acceptable if mutually agreed.
b. Termination for Cause. Upon the Covered Entity's knowledge of a material breach of this
BAA by the Business Associate, the Covered Entity shall either:
i. Provide an opportunity for the Business Associate to cure the breach within a
period of ten (10) days(or such longer period as the District may authorize in
writing) after receipt of notice from the Contracting Officer specifying such
failure or end the violation and terminate the Contract if the Business Associate
does not cure the breach or end the violation within the time specified by the
Covered Entity; or
ii. Immediately terminate the Contract if the Business Associate breaches a material
term of this BAA and a cure is not possible.
If neither termination nor cure is feasible, the Covered Entity shall report the
violation to the Secretary of HHS.
c. Effect of Termination.
i. Except as provided in paragraph (ii) of this section, upon termination of the
Contract, for any reason, the Business Associate shall return in a mutually agreed
upon format or confidentially destroy all PHI received from the Covered Entity,
or created or received by the Business Associate on behalf of the Covered Entity
within five (5) business days of termination. This provision shall apply to PHI that
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 16 of 19
is in the possession of ALL subcontractors, agents or Workforce members of the
Business Associate. The Business Associate shall retain no copies of PHI in any
form.
ii. In the event that the Business Associate determines that returning or destroying the
PHI is infeasible, the Business Associate shall provide written notification to the
Covered Entity of the conditions that make the return or confidential destruction
infeasible. Upon determination by the agency Privacy Officer/Liaison that the
return or confidential destruction of the PHI is infeasible, the Business Associate
shall extend the protections of this BAA to such PHI and limit further uses and
disclosures of such PHI for so long as the Business Associate maintains such PHI.
Additionally, the Business Associate shall:
(1) Retain only that PHI which is necessary for Business Associate to
continue its proper management and administration or to carry out its
legal responsibilities;
(2) Return to Covered Entity [or, if agreed to by Covered Entity, destroy] the
remaining PHI that the Business Associate still maintains in any form;
(3) Continue to use appropriate safeguards and comply with Subpart C of 45
C.F.R Part 164 with respect to ePHI to prevent use or disclosure of the
PHI, other than as provided for in this section, for as long as Business
Associate retains the PHI;
(4) Not use or disclose the PHI retained by Business Associate other than
for the purposes for which such PHI was retained and subject to the same
conditions set out at [Insert section number related to paragraph (ender
The
applied prior to termination; and
(5) Return to Covered Entity [or, if agreed to by Covered Entity, destroy] the
Protected Health Information retained by Business Associate when it is
no longer needed by Business Associate for its proper management and
administration or to carry out its legal responsibilities.
The obligations outlined in Section 2. Obligations and Activities of Business
Associate shall survive the termination of this Contract.
10. Miscellaneous
a. Regulatory References. A reference in this BAA to a section in the Privacy Rule means
the section as in effect or as amended.
b. Amendment. he Parties agree to take such
action as is necessary to amend this BAA from time to time as is necessary for the Covered
Entity to comply with the requirements of the Privacy Rule and HIPAA Regulations.
Except for provisions Required By Law as defined herein, no provision hereof shall be
deemed waived unless expressed in writing and signed by duly authorized representatives
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 17 of 19
of the Parties. A waiver with respect to one event shall not be construed as continuing, or
as a bar to or waiver of any other right or remedy under this BAA.
c. Survival. The respective rights and obligations of the Business Associate under Section 9.
Term and Termination of this HIPAA Compliance BAA and Sections 9 and 20 of the
Standard Contract Provisions for use with the District of Columbia Government Supply
and Services Contracts, effective March 2007, shall survive termination of the Contract.
d. Interpretation. Any ambiguity in this BAA shall be resolved to permit compliance with
applicable federal and District laws, rules and regulations, and the HIPAA Rules, and any
requirements, rulings, interpretations, procedures, or other actions related thereto that are
promulgated, issued or taken by or on behalf of the Secretary; provided that applicable
federal and District laws, rules and regulations shall supersede the Privacy Rule if, and to
the extent that they impose additional requirements, have requirements that are more
stringent than or provide greater protection of patient privacy or the security or
safeguarding of PHI than those of the HIPAA Regulations.
The terms of this BAA amend and supplement the terms of the Contract.. In the event of
a conflict between the terms of the BAA and the terms of the Contract, the terms of this
BAA shall control; provided, however, that this BAA shall not supersede any other federal
or District law or regulation governing the legal relationship of the Parties, or the
confidentiality of records or information, except to the extent that the Privacy Rule
preempts those laws or regulations. In the event of any conflict between the provisions of
the Contract (as amended by this BAA) and the Privacy Rule, the Privacy Rule shall
control.
e. No Third-Party Beneficiaries. The Covered Entity and the Business Associate are the only
parties to this BAA and are the only parties entitled to enforce its terms. Except for the
rights of Individuals, as defined herein, to have access to and amend their PHI, and to an
accounting of the uses and disclosures thereof, in accordance with paragraphs (2)(f), (g)
and (j) of this BAA, nothing in the BAA gives, is intended to give, or shall be construed to
give or provide any benefit or right, whether directly, indirectly, or otherwise, to third
persons.
f. Compliance with Applicable Law . The Business Associate shall comply with all federal
and District laws, regulations, executive orders and ordinances, as they may be amended
from time to time during the term of this BAA and the Contract; to the extent they are
applicable to this BAA and the Contract.
g. Governing Law and Forum Selection. This Contract shall be construed broadly to
implement and comply with the requirements relating to the Privacy Rule, and other
applicable laws and regulations. All other aspects of this Contract shall be governed
under the laws of the District. The Covered Entity and the Business Associate agree that
all disputes which cannot be amicably resolved by the Covered Entity and the Business
Associate regarding this BAA shall be litigated before the District of Columbia Contract
Appeals Board, the District of Columbia Court of Appeals, or the United States District
Court for the District of Columbia having jurisdiction, as the case may be. The Covered
Entity and the Business Associate expressly waive any and all rights to initiate litigation,
arbitration, mediation, negotiations and/or similar proceedings outside the physical
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 18 of 19
boundaries of the District of Columbia and expressly consent to the jurisdiction of the
above tribunals.
h. Indemnification. The Business Associate shall indemnify, hold harmless and defend the
Covered Entity from and against any and all claims, losses, liabilities, costs, and other
expenses incurred as a result or arising directly or indirectly out of or in connection with
(a) any misrepresentation, breach of warranty or non-fulfillment of any undertaking of the
Business Associate under this BAA; and (b) any claims, demands, awards, judgments,
actions and proceedings made by any person or organization, arising out of or in any way
connected with the performance of the Business Associate under this BAA.
i. Injunctive Relief. Notwithstanding any rights or remedies under this BAA or provided by
law, the Covered Entity retains all rights to seek injunctive relief to prevent or stop the
unauthorized use or disclosure of PHI by the Business Associate, its Workforce, any of its
subcontractors, agents, or any third party who has received PHI from the Business
Associate.
j. Assistance in litigation or administrative proceedings. The Business Associate shall make
itself and any agents, affiliates, subsidiaries, subcontractors or its Workforce assisting the
Business Associate in the fulfillment of its obligations under this HIPAA Compliance BAA
and the Contract, available to the Covered Entity, to testify as witnesses, or otherwise, in
the event of litigation or administrative proceedings being commenced against the Covered
Entity, its directors, officers or employees based upon claimed violation of HIPAA, the
Privacy Rule or other laws relating to security and privacy, except where the Business
Associate or its agents, affiliates, subsidiaries, subcontractors or its Workforce are a named
adverse party.
k. Notices. Any notices between the Parties or notices to be given under this BAA shall be
given in writing and delivered by personal courier delivery or overnight courier delivery,
or by certified mail with return receipt requested, to the Business Associate or to the
Covered Entity, to the addresses given for each Party below or to the address either Party
hereafter gives to the other Party. Any notice, being addressed and mailed in the foregoing
manner, shall be deemed given five (5) business days after mailing. Any notice delivered
by personal courier delivery or overnight courier delivery shall be deemed given upon
notice upon receipt.
,IWRWKH%XVLQHVV$VVRFLDWHWRWKH
QDPHDQGDGGUHVVRIWKH&RQWUDFWRU
,IWRWKH&RYHUHG(QWLW\WRWKH
2IILFHRIWKH&KLHI)LQDQFLDO
2IILFHU
2&)2
&RQWUDFWLQJ2IILFHU
7HFKQLFDO5HSUHVHQWDWLYH
&275
ATTACHMENT J.3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
BUSINESS ASSOCIATE AGREEMENT
Effective 4/1/2018 Policy Number III.10.a)
PAGE 19 of 19
l. Headings. Headings are for convenience only and form no part of this BAA and shall not
affect its interpretation.
m. Counterparts; Facsimiles. This BAA may be executed in any number of counterparts,
each of which shall be deemed an original. Facsimile copies hereof shall be deemed to be
originals.
n. Successors and Assigns. The provisions of this BAA shall be binding upon and shall inure
to the benefit of the Parties hereto and their respective successors and permitted assigns, if
any.
o. Severance. In the event that any provision of this BAA is held by a court of competent
jurisdiction to be invalid or unenforceable, the remainder of the provisions of this BAA
will remain in full force and effect. In addition, in the event a Party believes in good faith
that any provision of this BAA fails to comply with the then-current requirements of the
Privacy Rule, such party shall notify the other Party in writing, in the manner set forth in
Section 10. Miscellaneous, Paragraph k. Notices. Within ten (10) business days from
receipt of notice, the Parties shall address in good faith such concern and amend the terms
of this BAA, if necessary to bring the contested provision(s) into compliance.
p. Independent Contractor . The Business Associate will function as an independent
contractor and shall not be considered an employee of the Covered Entity for any purpose.
Nothing in this BAA shall be interpreted as authorizing the Business Associate Workforce,
its subcontractor(s) or its agent(s) or employee(s) to act as an agent or representative for or
on behalf of the Covered Entity.
q. Entire Agreement. This BAA, as may be amended from time to time pursuant to Section
10. Miscellaneous, Paragraph b. Amendment, which incorporates by reference the
Contract, and specific procedures from the District of Columbia Department of Health
Privacy Policy Operations Manual, constitutes the entire agreement and understanding
between the Parties and supersedes all prior oral and written agreements and
understandings between them with respect to applicable District and federal laws, rules and
regulations, HIPAA and the Privacy Rule, and any rules, regulations, requirements, rulings,
interpretations, procedures, or other actions related thereto that are promulgated, issued or
taken by or on behalf of the Secretary of HHS.
Attachments:
Exhibit A Identity and Procedure Verification
ExhibitA
Identityand Procedure Verification
À5¼Õ *İ2İFB İ(4oİ2İ3ÛÊUİ
¸7ēI`Ć7`İĐðİB7IĂ`øİI7İ2ýIċç7İ
o5kµsİ
)Hİ
ÑFn4İÉ*p)İ
)Hİ*pÈU@E!İ 5®±
W Ëİ)@!İ
B
ºE!İ
3HİF3@!İ
5mm Wk*(E(
E (qÒW
1> × İD
İ, İ?
İGO8-u
X O İ+-
İ İ?
İG8
â"İ
½2@Ý İ( jİ ?N
ݪSeİ1RRiİ
34FİÓ5Ø*!İ X¦İ1°dݯ©«iİ
ÜÖ4 !İ Ùİ0
İİ:
İ
İ
İİ_% İİ
İJ
İİ
8-Mİ$ İb
İ
İİ%
İİ /;
İ İ
"}
İ
^İN
İ&
İ Ča
İİ<L&İİKP\İİY/İ0
İñİİ
#
İİ
İ'İV-İ#'Vc=İ] İ&ùİĘģ
İ
İ[}İJ
åZ]İDc=İİİCyþ
,Zyİę
9ĔZ]§İ
3U)s!İ Ú
İĕ
İà İ
İ
, İ0
bĚİĖ[
İ"İİPKJ
İM¹'Aİ
qBÌÔHjİ S>İ'fV Сİįݬ² S¢>RİQ=Qă=Q1İ
(»2*Än4!İ
İİ
İİ "
İ
İ:İ
İ
İ~İ
İÁ+İ?Tİ8[İ
vİća İvīİ:İ+İTTİ
uOİ
İ
İ
%İ6<
İ<İ^İİ#lAİ+%
ĬİÍòó
£İ Î\
İ:
İ
M
ã
İ%İê
Y"İİİ_
$İ /
İ İ
İİ
-ħİDİ
$İİX
İGƤ1>
İ$ İ´bOÿ
İ
G8
eİ"İN
İİİ.ěİ
&gİİ
İ
İ#'Aİ,{İ
Ĥ
İ
ğ<İİ
LİwİKPİ İ
āPİ_
İİ
İt hİ
|İúİ
İ İĥĠĭİİİ"
İİİ+ÂÅİ
fİ
&%zdİ#¶¾İ{İ
İ$
İİN
İ%|xİİ a
İ
İ
İõİ
Īİ^¥İ
Ï)·Þ³İ r/İM6;
.İ
İ
ûĜĮ,ġđčİöĈİİCîë9è9ìİĝïé9ß9ĢĦĄİÇüáąİĀĞİ
L&İ"İ&LJ
İ
ĉ6İ ô
İ
İ
İİİ
Cí
İ
0:¨İ rİw.İİ
æİ÷Ċİ,İė/İ
İ;Y\İİC - İ
Ďİ İİİä
İDİ
İ
#Ãl¿İ
<
İĨ
İ6
İ0
0
.İ~İ
İď İĒ;
İİt$İ
/Kİ$İ hİ.İxzĩ.İ;İ+gİ #'Aİ
İ
6İ
) +/
/ %" ./*$'/#
/
*) %(,!-'/
//&
/
/
GOVERNMENT OF THE DISTRICT OF COLUMBIA
RESPONSIBILITY:
PROCEDURE:
Effective4/14/2003
Author/Reviewer:
DepartmentofHealthCareFinance
PRIVACY POLICY OPERATIONS MANUAL
documentation,statements,orrepresentations,whetheroralorwritten,fromtheunknownperson.Ifapersonisknown,DHCFstaffdonotneedtophotocopy,butmustvisuallyinspectand/orverballyaskquestionsregardingtherequestor’identityandauthoritytorequestPHIwithoutthepriorauthorizationoftheindividualasfurtherdescribedin
theaccompanyingprocedure.
TheDHCFPrivacyOfficehastheresponsibilitytoimplement
thispolicy.
1 DHCFmustrespondtoallrequestsforPHIwhentherequestorisphysicallypresent,therequestorasksinwriting(vialetter,email,facsimile,orothermedium),orverballyoverthetelephone.AllwrittenPHIrequestswillberoutedtotheDHCFPrivacyOfficeforidentityandauthorityverification.
2.WhenfieldingatelephonecallortalkingtoaPHIrequestorinperson,followtheidentityandauthorityverificationdocumentationrequirementsforeachparticularcommunicationmediatypepresentedinTable1:CommunicstionsMedia.
3. Iftherequestorisunknown theworkforcemember, obtain
4. If
evidenceofidentification.Examplesofappropriateidentificaticninclude:
. Photographicidentificationcard.
: Governmentidentificationcardorbadge.
. Appropriatedocumenton governmentletterhead
‘therequestorisnottheindividualwho isthesubjectofthe
PHIsought,obtainevidenceofauthority.Examplesofappropriateauthorityinclude,ifreasonableforthesituation:
a)Identificationasparent,guardian,orpersonactinginloco
parentiswithrespecttominors;executororadministrator
‘withrespecttoadeceasedindividualoranestate;powerof
attorneyorotherevidenceoflegalauthoritytoacton
behalfof an individualwithrespecttohealthcare;orother
evidenceofappropriaterelationshipwiththeindividual
withrespecttohealthcare.
PolicyNumberVII.25
Page2of13
Effective4/14/2003
Author/Reviewer:
GOVERNMENT OF THE DISTRICT OF COLUMBIA
Department ofHealth Care Finance
PRIVACY POLICY OPERATIONS MANUAL
b)A warrant,subpoena,orderorotherlegalprocessissuedbyagrandjury,acourt,oranadministrativetribunal.
c) A writtenstatementoflegalauthorityor,withrespecttoa
properlyidentifiedgovernmentofficial,anoralstatementofauthority,if relianceon suchoralstatementisreasonable
forthesituation.You must document theoralstatementon
FORM 9- Identityand AuthorityVerification.
Inallcases,followthe documentation requirementsforeach
particularcommunicationmediatypepresentedinTable1.
5.Iftherequestordoesnotpossesstheauthoritytorequesttheindividual’PHI,therequestormustcompleteFORM1—FamilyorNotificationDisclosureor FORM 3 — Authorization,and the
Medicaidrecipientortheirlegalpersonalrepresentativemustsign,date,andenteranexpirationdateforauthorizationtobevalid.SeeSection1.2-InformalPermissionandSection1.3-AuthorizationRequirements.DocumentonFORM |orFORM 3thetypeofidentificationtherequestorpresentssuchastheirdriver’slicense,governmentletterhead,orknowledgeofMedicaidrecipient’s
personalinformationfollowingthecriteriaforthedifferentcommunicationsmedialistedinTable1.
6.Iftherequestorhastheauthoritytorequesttheindividual’sPHI,useFORM9.CompleteFORM9 withthetypeofidentificationtherequestorpresentssuchastheirdriver’slicense,governmentletterhead,orknowledgeofMedicaidrecipient'spersonalinformationfollowingthecriteriaforthedifferentcommunicationsmedialistedinTable1.
7. Notethatifan authorizationisrequired,theauthorizationmustbe
enteredintotheDisclosureManagerModule.SelecttheRequestor
‘TypewhenrecordingtheauthorizationintotheDisclosureManager
Module.
8.Ifthepersonisanunknownperson,photocopythedocumentationpresentedtoverifytheunknownperson’sidentityandauthorityandattachthesecopiestotherelevantFORM.
9. Fax and sendvia interofficemailtheFORM and itsattachmentsto
PolicyNumberVII.25Page3of13
GOVERNMENT OF THE DISTRICT OF COLUMBIA
Department of Health Care Finance
PRIVACY POLICY OPERATIONS MANUAL
theDHCF PrivacyOfficeandanothercopytothesecuredHIPAA,
filecabinetmaintainedby theHIPAA coordinatorineachbusiness
unit.
EXHIBIT(S): ProcedureforIdentityandAuthorityVerification
Table1:CommunicationsMediaFORM 9-IdentityandAuthorityVerification
Effective4/14/2003 PolicyNumberVIL.25
Author/Reviewer: Page4 of13