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B-193858 1 (1979-10-25)

handle is hein.gao/gaobadukc0001 and id is 1 raw text is: 
                  I                 --L-IGEST- f
                           THE COMPTROLLER GENERAL
DECISION                   OF THE UNITED STATES
                           WASHINGTON, 0.C. 20548
                                                         675


FILE:    B-193858                DATE: October 25, 1979

MATTER OF: Indian Health Management, Inc. - Purchase
              Order for Medical Services

DIGEBT:    Due to extreme shortage of medical personnel,
           Rosebud Public Health Service Indian Hospital
           entered into agreement with and issued purchase
           order to Indian Health Management, Inc. for
           services needed. Although the physician
           assistant services secured under the agreement
           were improperly provided under circumstances
           that created an employer-empoyee relationship,
           payment for services received may be made in
           view of the extenuating circumstances involved.

    This decision is in response to a request of December 28,
1978, .by William E. Wasem, Chief Area Financial Management
,Branch, Public Health Service, Department of Health, Educa-
tion and Welfare (HEW), Aberdeen, South Dakota, for a decision
as to the allowability of a payment to Indian Health Management,
Inc. (IHM) for the services of a physician assistant who worked
in the hospital at various times from September 28 through
November 6, 1978. This employment was the result of a mem-
orandum of agreement between IHM and the hospital in which
IHM agreed to provide the hospital with the services of its
physician assistant and nursing staff. This memorandum,
covering a 12-month period, also provided that these services
would be scheduled by the Service Unit Director of the hospital
and that the hospital would be billed monthly.. The hospital
entered into this agreement because of an extreme shortage
of medical personnel at the time and because sufficient staff
could not be hired by the Indian Health Service.

    The Chief, Administrative Services Branch, Aberdeen Area
Indian Health Services, after reviewing the above memorandum,
made a determination that it involved an improper personal
service procurement in violation of HEW Procurement Regula-
tion 3-22. 101-2, which states in part:

    Services should not be obtained by contract in
    such manner that the contractor or his employees
    are in effect employees of the Government.
    * * * Generally speaking, contracts which in their






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