Pharmacy_Benefits_Management_DOL_10-29-17.docx

United States Department of Agriculture (USDA) Safety and Health Management Division USDA Pharmacy Benefits Management Program

STATEMENT OF OBJECTIVES (SOO)

PURPOSE

The United States Department of Agriculture (USDA) intends to issue a contract for a national department-wide Pharmacy Benefits Management Program for Workers' Compensation. This contract will implement a contract vehicle for the USDA, Pharmacy Benefits Management Services for its Workers' Compensation Program.

The USDA will solicit an expert and experienced Contractor, specializing in federal Workers' Compensation (WC) to support the first National Pharmacy Benefits Management Program for Workers' Compensation.

BACKGROUND

The medical costs associated with the Pharmacy Benefits Management Program will be paid for by Employee Compensation Fund. This fund is reimbursed annually through a "chargeback" process by the USDA. The Contractor's revenue is generated through negotiated pricing arrangements with providers. The Contractor pays the provider directly and then invoices OWCP at a rate that incorporates revenue for the Contractor, but is less than the Federal Employee Compensation Act (FECA) Fee Schedule. The Contractor selected shall negotiate its own contract with pharmacies and providers for services that shall generate a discount for generic and brand named drugs, DME, and ancillary services at a rate that is below the FECA fee schedule that is acceptable to USDA. The Contractor shall be responsible for assisting USDA staff with achieving the goal of increasing program penetration, defined as the number of service items paid through the Pharmacy Benefits Management Program versus the total items paid The Pharmacy Benefits Management Program will allow any USDA employee injured on-the-job to receive services at no direct cost to the USDA. Participation in the Pharmacy Benefits Management Program is voluntary and does not affect the employee's right to initial choice of treating physician s stipulated by the FECA.

The Office of Workers’ Compensation Programs, U.S. Department of Labor (OWCP) will review the final contract and any related marketing material to ensure that implementation is carried out in accordance with the statutory and regulatory rights of injured workers and in keeping with the Federal Employees’ Compensation Act (FECA) statute, regulations, and procedures. All entitlement and eligibility decisions are made by OWCP, who has the sole authority to make such decisions. Additionally, all records, including medical reports about employees and other factual information and documentation, created or accessed under any Pharmacy Benefit Program are subject to the Privacy Act of 1974 and the DOL/GOVT-1 System of Records.

OBJECTIVE

USDA is seeking a national Pharmacy Benefits Management (PBM) program contractor for Federal workers' compensation to administer the program. This will be a national program for USDA employees who are injured on the job and require prescription medication and durable medical equipment paid from the OWCP Employee Compensation Fund which is then reimbursed by USDA through the OWCP annual Chargeback process.

The use of a PBM system will be a voluntary program where employees will have the option of using the approved PBM providers or choosing their own pharmacy provider.

The USDA will provide the Contractor with an orientation and briefing, as well as a range of documentation and material that will provide an overview of USDA's organizational structure, mission, and goal, the assigned WC program staff, their locations, and their current duties and responsibilities.

SCOPE OF WORK

The contractor shall provide all personnel, labor, and material to execute the scope of work and all objectives with-in this subject contract.

Eligibility

Two groups of USDA employees will be eligible for coverage under this program.

1. Group 1 is comprised of those who have an existing claim under the Federal Employees Compensation Act (FECA). These employees have fully adjudicated workers' compensation claims and have coverage for all prescriptions that meet the OWCP requirements for their accepted injury.

2. Group 2 is comprised of new FECA claimants. These employees are newly injured on the job and have filed FECA claims pending the assignment of the claims by OWCP.

USDA requests that the PBM provide a system for first fill prescription coverage for employees who sustain a traumatic injury at work. The PBM will provide a pharmacy card system to these employees as part of the USDA injury packet. Prescription coverage as authorized by OWCP, will be provided to all injured employees upon filing a FECA claim for traumatic injury and approved occupational illness claims. A claim number is assigned by OWCP at the point of case creation, which on average takes approximately three (3) days.

Pharmacy Benefits Management Program Requirements Objectives The Contractor, at minimum, shall demonstrate the following objectives to operate the PBM Program, to include, but not limited to:

1. Pharmacy Benefits Management Services will be at zero cost to USDA. Vendor revenue is generated by negotiating pricing arrangements with pharmacy providers.

2. Contractor must have a minimum of 5 years’ experience in providing Pharmacy Benefits Management services in conjunction with the Federal Office of Workers' Compensation Programs (OWCP).

3. National access to large pharmacy chains and a majority of other pharmacies with a minimum of 68,000 network pharmacies during contract term.

4. Ability to securely electronically transfer, at point of sale, all prescription information between participating network pharmacy, PBM and OWCP.

5. Claims processing conforming to the National Council for Prescription Drug Programs (NCPDP) standards.

6. Prescriptions must be billed using the 11 digit NDC Number. For example, CPT code 99070 is not an acceptable method.

7. Must provide a pharmacy identification method to eligible employee. OWCP requires a method of limiting this program to USDA employees.

8. Mail order program option for employees requesting this service and to include the use of USPS for the delivery.

9. Program to include reports to identify generic substitution in available allowable cases.

10. Ability to administer an ICD-10 code based invoice in accordance with and as determined by OWCP.

11. Dedicated and Security-cleared customer service representatives for USDA job-injured employees to access 24/7 to provide information regarding claims, drug information, payments, etc.

12. Has the ability to phase in PBM services to support for employees receiving prescriptions, durable medical equipment services as a benefit of the FECA program.

13. Provide discount pricing and savings (Average Wholesale Price (AWP) - discount of x %) for generic and brand drugs.

14. Reporting must include:

a. Prescription transactions by provider;

b. Therapeutic overlap analysis if requested.

15. Must have a single program manager assigned full-time to support the USDA account with a minimum of 5 years Federal PBM workers' compensation program experience.

16. Institute performance metrics to measure the contract effectiveness.

17. Must pass USDA required Security Clearance for the following groups:

a. Account management

b. Customer service representatives

c. Clinical Staff

d. Reporting and data analytics

e. Information Technology staff (Database administrator, programmers etc.)

f. Billing and Accounting staff

18. Has the ability to implement a Report Information System that includes: cost savings, utilization review, classes of drugs provided unusual prescription practices by treating providers and actual cost savings.

19. Can provide efficient, accurate, and timely processing of DME requests for compensable medical conditions by implementing well-defined and documented internal quality assurance procedures to ensure the correct and most efficient processing of requests, referrals, and integrity of data.

20. Assure accurate and timely reports and response to inquiries from treating physician, claimant, and Health and Resource Management staff within a timeframe acceptable to USDA.

21. Can bill for all DME items using definable and/or acceptable coding.

22. Can ensure contracted discount rate below FECA fee schedule is used for DME items.

23. Has access to medical imaging and testing networks, chains or suppliers sufficiently to affect a minimum penetration rate, based on dollars, as mutually agreed to during contract term.

24. Has the ability to bill for medical imaging and testing services using definable and/or acceptable coding.

25. Provide dedicated and security-cleared customer service representatives for USDA job injured employees to access 24/7 to enroll in the PBM, provide information regarding network pharmacies, claim denials, claim, drug information, payments, and request authorizations for services via the ACS portal, etc.

26. Will institute performance metrics every 30 days, to measure the effectiveness of the contract.

27. Comply with The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191 The Privacy Act of 1974 (Pub.L. 93-579, 88 Stat. 1896, enacted December 31, 1974, 5 U.S.C. § 552a), AGENCY RESPONSIBILITIES

Post Award Kick-Off Meeting

In order to better understand USDA's organizational and cultural environment within five working days from the date of contract award, the USDA will host a Post Award Kick-Off Meeting. The intent of the Post Award Kick-Off Meeting is not only to discuss the PWS, tasks and deliverables; accountability and responsibility to include the Quality Assurance Surveillance Plan (QASP) for each task and deliverable; risk identification and mitigation controls, but discuss how the Contractor will easily accomplish the objectives outlined in the Statement of Objectives (SOO). The USDA will provide the Contractor with an orientation and briefing, as well as a range of documentation and material that will provide an overview of USDA's organizational structure, mission, and goal, the assigned WC program staff, their locations, and their current duties and responsibilities. This documentation will include:

a. Organization charts, including the current roles and responsibilities of all of the organizations within the Department, and

b. Identification of the Contracting Officer Representative (COR) for technical program direction under the scope of work executed by contract.

Upon award of the contract, the agency will be responsible for the following:

a. Notifying DOL OWCP within five days after contract award of the selected Contractor. The Contractor shall not perform Inherently Governmental Functions as prescribed in Federal Acquisition Regulation (FAR) 7.503. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract.

b. With the exception of the contract/discount price, such pharmacy services must be provided in accordance with OWCP rules for such services. No formularies or other restrictions can be imposed by USDA or their contractor. USDA bears responsibility to assist in the development of the claim; to assist the employee with the FECA claims process; and fully bears the ultimate responsibility for the entire financial costs of the FECA claim through the FECA chargeback process. The PBM program will be entirely voluntary for USDA employees; USDA will allow OWCP to review the program materials provided to employees and their claimants, and USDA agrees to undertake the responsibility to provide claimants with information relative to the provision of the voluntary PBM program.

PERFORMANCE BASED OBJECTIVES BY TASK AND DELIVERABLES

The Contractor shall provide a Performance Work Statement (PWS) providing the details for each Objective outlined in the SOO. The USDA expects the Contractor to meet the following objectives for implementing the requirements in support of the Pharmacy Benefit Management Program contract:

Objective 1: Post-Award Orientation and Kick-Off Meeting Task

Coordinate and facilitate the kickoff meeting, provide meeting agenda and Work Plan that identifies all tasks, resources utilized (i.e., number, labor category, and description), deliverables to be completed, and the corresponding timetable/delivery dates.

Date: Within 10 business days after the contract award

Location: United States Department of Agriculture, 355 E Street, SW, 10th Floor, Washington, D.C. 20024

Tentative Attendees: Contracting Officer (CO), Contracting Officer’s Representative (COR), Program Manager (PM) and/or USDA's senior executives.

I a. Deliverable: Coordinate and facilitate the meeting, and provide meeting agenda within five business days after the contract has been awarded.

l b. Deliverable: Within five business days after the kick-off meeting, the Contractor shall submit the Work Plan in both hard-copy and electronic forms to the COR. Format requirements include letter size paper (8 1/2" x 11"), Arial 12 font, created in a program compatible with Microsoft Office 2007 programs.

Objective 2: Establishing a Contractor Account Manager Task

Appoint and electronically notify the COR of the name and contact information of its authorized Contractor Program Manager (PM) who shall be the primary interface with USDA's COR on current PBM contract performance.

2a. Deliverable: Establish a Contractor Account Manager within 5 business days after contract award.

Objective 3: Meetings with the USDA COR and PM Task

Discuss the progress of the USDA PBM with the USDA COR, PM and USDA management officials no less than quarterly and as needed per request by USDA COR. These meetings may be scheduled by either the COR or the assigned USDA Program Manager. Scheduled meeting may takes place in person, during on-site visits or via conference calls.

3a. Deliverable: Establish a meeting schedule within five business days after contract award.

Objective 4: Quality Control Task

Develop and implement internal quality control procedures that produce timely, accurate, complete and relevant data that meets the full requirements of this contract. An evaluation of the PBM system will be conducted to make sure that efficient and effective management processes remain in place and that data are handled in a secure manner and protected to meet all of the FECA and Privacy Act requirements as well as USDA information security requirements.

Contractor shall ensure data is handled in a manner that is compliant with security measures that HIPPA rules require where applicable.

4a. Deliverable: The Contractor shall develop and implement internal quality control procedures immediately upon award of contract. The Government will approve an agreed upon Quality Assurance Surveillance Plan (QASP) after award.

Objective 5: Progress Reports Tasks

Develop and provide monthly progress reports to the USDA COR or USDA PM. The specific format and content of these reports shall be developed by the Contractor and approved by the USDA PM. In general, the PBM reports should include summary information that enables USDA management to make key decisions about the direction of the WC PBM. The scope, content, and format of these reports will be agreed upon between the USDA PM and the PBM Manager.

5a. Deliverable: The Contractor shall submit the management information reports in hard-copy and electronic final form to the COR on a monthly basis by the third Wednesday of the month. In the event of a holiday or closure due to an Executive Order, reports shall be due the next business day

Objective 6: Management Information Reports Tasks

Develop and provide monthly progress reports to USDA and COR submitted by the third Wednesday of the month. In the event of a holiday or closure due to an Executive Order, reports shall be due the next business day. The specific format and content of these reports shall be worked out by the COR and the Contractor's Program Manager.

In general, the Contractor shall include summary information that enables USDA management to make key decisions about the direction of the PBM Program. The Contractor shall submit a draft progress report template for review and approval by the USDA. In addition to the monthly progress reports outlined above, the Contractor shall provide management information reports to the USDA COR.

6a. Deliverable: Aggregate transaction report on USDA cases reflecting the number of cases, type of prescription medication(s) provided, etc.

6b. Deliverable: Penetration rate showing use of PMB at agency level to support identification of areas needing retraining for continuous improvement in penetration.

6c. Deliverable: Periodic information on any cost savings achieved through the Contractor management of the PBM, including actual and cost avoidance savings on costs.

6d. Deliverable: Maintain, retain, and make available complete and accurate bill payment and financial reporting history.

6e. Deliverable: Provide timely and accurate reports including the tracking penetration, cost savings, and performance metrics against program goals.

6f, Deliverable: Report cost savings and utilization at USDA designated levels of the USDA organization.

6g. Deliverable: Provide reporting support that will allow USDA to develop repeatable and ad hoc program reports based upon USDA need.

6h. Deliverable: Provide assigned staff to support the design, development, implementation, and enhancement of reports.

a. Cost savings.

b. Report or identification of transactions processed.

c. Proposed fee schedule revisions and actual cost savings.

d. Comparative analysis of billed amount to paid amount.

e. Produce hard copy and/or electronic format.

f. Electronic transmission of reports to USDA.

g. Prepare non-standard reports if requested.

Objective 7: Contractor Case Files

The Contractor shall also make available to the USDA COR, upon request, a copy of individual transactions or a summary of the data from the PBM system, so that the COR can review the system data on specific cases. Alternatively, the USDA COR and USDA PM may visit the Contractor headquarters or facility as needed.

7a. Deliverable: These transaction, fulfillment or scripts will be made available to the USDA COR and USDA Program Manager upon request.

7b. Deliverable: Upon termination of the contract, all computer and records will be turned over to USDA or destroyed at the direction of the USDA COR.

Objective 8: Help Desk Task

The Contractor shall provide dedicated and security-cleared customer service representatives for USDA job-injured employees to access 24/7 to enroll in the PBM, provide information regarding network pharmacies, claim, drug information, payments, and request authorizations for services via the ACS portal, etc.

INFORMATION SECURITY

The Contractor and its personnel shall be subject to the same Federal laws, regulations, standards, and USDA policies as USDA personnel regarding information and information system security. These include, but are not limited to, Federal Information Security Management Act (FISMA), Appendix III of the Office of Management and Budget Circular A-130, and guidance and standards available from the Department of Commerce's National Institute of Standards & Technology (NIST). This also includes the use of common security configurations available from NIST's web site at http://checklists.nist.gov. To ensure that appropriate security controls are in place, All information and material concerning Federal WC claims or data that the Contractor may acquire as a result of providing PBM services to USDA whether such claims or data are electronic, verbal or written, are covered by the Privacy Act and remain the property of DOL.

The Contractor must follow the procedures set forth in USDA personally Identifiable Information requirements at the following web site: http://www.ocio.usda.u.ov/

APPLICABLE DOCUMENTATION, DEFINITIONS

All Contractor personnel shall follow and adhere to all of the policies and procedures established by OWCP DOL Office of WC Programs for the Federal WC Program and Office of Occupational Safety and Health for the Federal OSH Program, contained in their regulations, in FECA, OSHA and in the Privacy Act. All technical terms used in this contract arc as defined by DOL in its regulations or in the FECA and OSHA legislation. http://www.do1.gov/owcp/dfec/index.htm

KEY PERSONNEL

The Contractor shall assign sufficient experienced personnel who are qualified in the conduct of similar skills and who have a proven background and level of experience for the work required. Key project personnel include only those persons who will be assigned to this project and who will be the actual personnel responsible for management and/or performance in the event the proposal results in award. The Contractor shall provide a minimum of two resumes for Key Project Personnel which the Contractor deems essential to contract performance, including the proposed Project/PM. The resumes shall include the employee's education (including names of school and degree/certificate), and specific experiences that arc directly related to the requirements of this procurement. Resumes shall include periods of employment, title and job descriptions, and level of responsibility.

AGAR 452.237-74 Key Personnel

(a) The Contractor shall assign to this contract the following key personnel: Project Manager

(b) During the first ninety (90) days of performance, the Contractor shall make no substitutions of key personnel unless the substitution is necessitated by illness, death, or termination of employment. The Contractor shall notify the Contracting Officer within 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (c) below. After the initial 90-day period, the Contractor shall submit the

Information required by paragraph (c) to the Contracting Officer at least 15 days prior to making any permanent substitutions.

(c) The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the Contracting Officer. Proposed substitutes should have comparable qualifications to those of the persons being replaced. The Contracting Officer will notify the Contractor within 15 calendar days after receipt of all required information of the decision on substitutions. The contract will be modified to reflect any approved changes of key personnel. (End of Clause)

Travel The Contractor shall not charge local travel costs in the Washington, DC metropolitan area to the Government. All travel, when required, will be billed in accordance with Federal regulations. The Contractor shall submit travel requests to the Contracting Officer's Representative (COR) for approval of travel at least 1 week in advance of travel.

Organizational Conflict of Interest N/A

Contracting Officer's Representative (COR) The COR is designated by the Contracting Officer to perform technical liaison between the contractor's management and the Contracting Officer in routine technical matters constituting general program direction within the scope of the contract/task order. Under NO circumstances is the COR authorized to effect any changes in the work required under this contract/task order whatsoever, or enter into any agreement that has the effect of changing the terms and conditions of this Task Order, or that causes the Contractor to incur any costs.

In addition, the COR will NOT supervise, direct, or control contractor employees. Notwithstanding this provision, to the extent that contractor accepts any direction that constitutes a change to his contract/task order without prior written authorization of the Contracting Officer, costs incurred in connection therewith are incurred at the sole risk of the contract, and if involved under this Task Order will be disallowed.

On all matters that pertain to the contract terms, the contractor must communicate with the Contracting Officer. Whenever, in the opinion of the contractor, the COR requests efforts beyond the terms of the contract, the contractor shall so advise the Contracting Officer. If the COR persists and there still exists a disagreement as to the proper contractual coverage, the Contracting Officer will be notified immediately, preferably in writing.

Proceeding with work without proper contractual coverage may result in nonpayment or necessitate submittal of a contract claim. The prime contractor's management should clearly communicate this position to its employees working on this contract and to any subcontractors also providing support.

Section 508 Requirements All electronic and information technology (EIT) procured through this contract must meet the applicable accessibility standards at 36 CFR 1194, unless an agency exception to this requirement exists. 36 CFR 1194 implements Section 508 of the Rehabilitation Act of 1973, as amended, and is viewable at http://www/acessboard.gov/sec508/508standards.htm.

The Contractor shall indicate whether each product or service is compliant or non-compliant with the accessibility standards at 36 CFR 1194. Further, the proposal must indicate where full details of compliance can be found (e.g., vendor's Web site or other exact location).

Deliverables of Performance 1 a. Deliverable: Coordinate and facilitate the meeting, and provide meeting agenda within five business days after the contract has been awarded.

1b. Deliverable: Within five business days after the kick-off meeting, the Contractor shall submit the Work Plan in both hard-copy and electronic forms to the COR. Format requirements include letter size paper (8 1/2" x 11"), Arial 12 font, created in a program compatible with Microsoft Office 2007 programs.

2a. Deliverable: Establish a Contractor Account Manager within 5 business days after contract award.

3a. Deliverable: Establish a meeting schedule within five business days after contract award.

4a. Deliverable: The Contractor shall develop and implement internal quality control procedures immediately upon award of contract. The Government will approve an agreed upon Quality Assurance Surveillance Plan (QASP) after award.

5a. Deliverable: The Contractor shall submit the management information reports in hard-copy and electronic final form to the COR on a monthly basis by the third Wednesday of the month. In the event of a holiday or closure due to an Executive Order, reports shall be due the next business day

6a. Deliverable: Aggregate data and information on USDA cases reflecting the number of cases, the nature of injuries or illnesses, the age of claimants, number of years of claimant on compensation roll, type of prescription medication(s) provided, etc.

6 b. Deliverable: Detailed breakdowns of the foregoing information/data by USDA organizational structure to show the nature of injury and illness and to enhance internal USDA case management.

6c. Deliverable: Periodic information on any cost savings achieved through the Contractor management of the PBM, including actual and cost avoidance savings on medical costs.

6d. Deliverable: Maintain, retain, and make available complete and accurate bill payment and financial reporting history.

6e. Deliverable: Provide timely and accurate reports including the tracking/monitoring of program utilization, cost savings, and performance metrics against program goals.

6f. Deliverable: Provide reports and statistics for quality reviews including utilization review and fraud and abuse detection.

6g, Deliverables: Report cost savings and utilization at all levels (national, district, state area, county, and field) of the USDA organization.

6h. Deliverable: Provide a database that will allow USDA to develop other repeatable and ad hoc program reports based upon USDA need.

6i. Deliverable: Provide assigned staff to support the design, development, implementation, and enhancement of reports. Provide an Information System that includes at a minimum:

a. Cost savings.

b. Report or identification of unusual practices by treating providers.

c. Proposed fee schedule revisions and actual cost savings.

d. Comparative analysis of billed amount to paid amount.

e. Produce hard copy and/or electronic format.

7a. Deliverable: These files will be maintained and made available to the USDA COR and USDA Program Manager upon request.

7b. Deliverable: Upon termination of the contract, all computer and paper files and records will be turned over to USDA or destroyed at the direction of the USDA COR.

SCHEDULE OF DELIVERABLES

Provide the meeting agenda

5 business days after the contract has been awarded.

Progress Reports

Once a month (3'd Wednesday of each month}

Management Information Reports

Once a month (3'd Wednesday of each month}

Contractor Case Files

Immediately upon award of contract and/or upon request by USDA COR.

Information Security/Personnel Security{ Provide a list of all personnel assigned to the contract for USDA HSPD-12 Screening)

Immediately upon award of contract.

PERIOD OF PERFORMANCE

ACCEPTANCE AND INSPECTION

1. FAR 52.212-4(a)

a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or re-performance of nonconforming services at no increase in contract price. If repair/replacement or re-performance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights-

1) Within a reasonable time after the defect was discovered or should have been discovered; and

2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

2. In accordance with approved contractor Quality Assurance Surveillance Plan (QASP).

Pharmacy Pricing:

RETAIL PRESCRIPTIONS

Brand Medications After Warehouse Pricing -15% + $0.00 (no dispensing fee)

Generic Medications After Warehouse Pricing -50% + $0.00 (no dispensing fee)

MAIL ORDER PRESCRIPTIONS

Brand Medications After Warehouse Pricing -20% + $0.00 (no dispensing fee)

Generic Medications After Warehouse Pricing -50% + $0.00 (no dispensing fee)

Dispensing Fees:

There shall be no dispensing fees. The contractor will absorb all costs related to dispensing fees to increase the bottom line savings for the USDA.

Penetration Rates:

The contractor shall offer penetration metric performance measurement and financial guarantee to the USDA as follows:

1. Within 12 months from the signing of the contract with the USDA, the contractor guarantees a 90% penetration of total paid Rx dollars* Excluding Compounds

2. Calculation for Penetration Guarantee: (Total monthly Rx In-Network* Dollars x 0.17%) x (90% minus current monthly penetration %)

3. Estimated yearly payment to the USDA at a maximum 5 point penalty is $28,000 at our current run rate if we don't reach our guaranteed penetration performance of 90%.

4. Estimated yearly payment to the USDA could be higher or lower if the USDA paid Rx dollars to Contractor is higher or lower than current year run rate.

5. If a payout is issued, the contractor shall provide the Office of Workers' Compensation (OWCP) a check that can be processed against the USDA's annual chargeback cost.

Durable Medical Equipment (DME) and Medical Imaging/Testing Pricing:

The contractor shall provide USDA with tiered pricing which is based on the dollar volume of DME and Medical Imaging service items that are processed through the contractor.

Durable Medical Equipment (DME)

$0 < $500K

>$500K < $1 Million

< $1 Million

Additional Information

1. Applicable GSA Contract _____________ for the rates noted above.

2. Business Size and Socioeconomic Category (i.e. Small Business; Small Disadvantaged Business; 8a Program; 8a STARS; HubZone; Service-Disabled Veteran Owned Small Business; Veteran Owned; Woman Owned)

3. Contractor’s Duns # _________________.

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