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Deliverables Schedule
TECHNICAL EXHIBIT 2
Deliverables Schedule
If the implementation plan includes a phased schedule such that the programs are implemented individually, on separate dates, then any deadlines based on implementation date will have separate deadlines for each program. For example, if DFELHWC implementation is May 15th, DCMWC is July 15th and DEEOIC is September 15th then a deliverable due 100 days prior to implementation would be due on February 5th, April 6th, and June 7th, respectively.
| Deliverable Number |
| PWS Section |
| Standard/Deliverable |
| Performance Threshold (This is the maximum error rate. It could be “zero deviation from standard.”) |
| Medium/ Format |
| Submit To |
| 1 |
| 1.6.1 |
| Quality control plan (QCP) -Develop and implement internal quality control procedures that produce timely, accurate, complete, and relevant data, which meet the full requirements of this performance work statement |
| Draft due within 30 days of contract start date, with final version due within 120 days of contract start date |
Updates to final plan as necessary
| Electronically with updates as needed |
| COR and Project Management Office (PMO) for approval |
| 2 |
| 1.6.5.2 |
| Notice of Delay – performance delays |
| Due within 24 hours of occurrence |
| Verbally and electronically |
| COR and Project Management Office (PMO) |
| 3 |
| 1.6.5.3 |
| Continuity of Operations Planning (COOP) |
| Due within 30 days of contract start date |
| Electronically with updates as needed |
| COR and Project Management Office (PMO) for approval |
| 4 |
| 1.6.8.2 |
| Memorandum of Understanding (MOU) and Interconnection Security Agreement (MOU/ISA) |
| Due within 30 days of contract start date |
| Electronically in Government- provided format with most recent updates as needed |
| COR, Project Management Office (PMO) and ISO for approval |
| 5 |
| 1.6.8.3 Personal Information and Privacy |
| System Security Plan (SPP), Contingency/Disaster Recovery Plan, and an Incident Response Plan |
| Draft document due within 60 days of contract start date and final document due no less than 30 days prior to the implementation date |
| Electronically in Government- provided format with updates as needed |
| COR and Government Information Security Officer (ISO) for approval |
| 6 |
| 1.6.8.3.1.1 |
| Security Incident Report |
| Due within one hour of becoming aware of the incident, whether suspected or confirmed, and updated as additional information becomes available |
| Electronically using Government provided Incident Reporting form |
| COR and ZZOWCPSECURITY@DOL.GOV |
| 7 |
| 1.6.8.3.1.1 |
| Privacy Disclosure Plan |
| Due with the solicitation proposal |
| Included in proposal |
| Contracting Officer (CO) and COR |
| 8 |
| 1.6.8.4 SYSTEM SECURITY |
| DOL Third-Party Security Monitoring Checklist |
| Due no less than 30 days prior to the implementation date and annually thereafter |
| Electronically in Government- provided format with updates as needed |
| COR and Government Information Security Officer (ISO) for approval |
| 9 |
| 1.6.8.4 SYSTEM SECURITY |
| Monthly audit log reviews, user account reviews, vulnerability scans and additional security documentation as required |
| Due quarterly after implementation |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 10 |
| 1.6.8.4 SYSTEM SECURITY |
| Establish Secure SFTP connection between DOL and Contractor. |
| Due within 150 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 11 |
| 1.6.8.5 |
| Security Documentation Review Certification and signed non-disclosure agreement (NDA) |
| Due prior to entry on duty (EOD) |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 12 |
| 1.6.9.1 Special Qualifications/Requirements |
| Manufacturer-Derived Revenue file for each OWCP program |
| Due quarterly, starting 180 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 13 |
| 1.6.12 Personnel |
| Staffing Plan- Chart/matrix showing ALL proposed personnel (including outside consultants or Subject Matter Experts) by task and by hours. The contractor should clearly specify the role and responsibilities of each proposed staff and discuss the qualifications of the individuals proposed for specific tasks. Personnel includes Pharmacists, FWA Experts, call support, information technology support, data analytic support, Pharmacy and Therapeutics Committee, Medical Director, and other staff. |
| Due within 30 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 14 |
| 1.6.12 Onboarding Key Personnel |
| Appoint and electronically notify the COR of the names and contact information of its authorized Contractor Program Manager (PM), who shall be the primary interface with the DOL COR on current PBM contract performance, and an alternate PM to serve in the primary PM role when the primary is unavailable. Appoint and electronically notify the COR of the names and contact information of clinical staff supporting the contract, including a Lead Clinical Pharmacist (Pharm.D.), a Lead FWA Expert, and a Technical Manager. |
| Due within 5 business days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 15 |
| 1.6.13 |
| Must notify the Government of vacancies in key positions. Resumes must be provided for all candidates for key positions. The Government may request a “meet and greet” with any potential candidate for clarification of the candidate's qualifications. |
| Due within 3 business days of occurrence |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 16 |
| 1.6.14.1 |
| The contractor must provide a minimum of 10 full-time equivalent (FTE) pharmacists in addition to the Lead Clinical Pharmacist and Alternate Lead Clinical Pharmacist. Should have an Oncology Pharmacy ty Certification (BCOP) from the Board of Pharmacy Specialties. |
| Due no less than 90 days prior to the implementation date |
| Electronic confirmation |
| COR and Project Management Office (PMO) for approval |
| 17 |
| 1.6.16 |
| Notice of any actual or potential Organizational Conflict of Interest and plan to avoid or mitigate any such OCI. |
| Due within 24 hours of awareness of occurrence |
| Electronically |
| CO, COR, and Project Management Office (PMO) for approval |
| 18 |
| 1.6.17 |
| Transition In Project Plan to include project schedule, risk assessment, and communication plan |
| Draft document due within 30 days of contract start date and final document within 45 days of contract start date |
| Electronically in MS Word with schedule in MS Project and MS Excel, with updates as needed |
| COR and Project Management Office (PMO) |
| 19 |
| 1.6.17 |
| Transition Out plan to include project schedule and risk assessment |
| Due within 15 business days of request by the COR |
| Electronically with updates as needed |
| COR and Project Management Office (PMO) for approval |
| 20 |
| 1.6.17 |
| Formulary transition letters - Written notice to adversely impacted claimants, designated representatives, representative payees, prescribing physicians, and participating pharmacies of formulary changes. |
| Due no less than 40 days prior to implementation date |
| Hard Copy |
| COR and Adversely impacted claimants, designated representatives, representative payees, prescribing physicians, and participating pharmacies |
| 21 |
| 3.1 |
| Return all Government-furnished property, equipment, data, and information |
| Due upon expiration or termination of the contract, within Government provided timeframes |
| Electronically |
| CO, COR, and Project Management Office (PMO) for approval |
| 22 |
| 4.4 |
| Provide a list of network pharmacies that includes each pharmacy’s National Council for Prescription Durg programs (NCPDP) identification number, name, address, and ZIP code. Pharmacies added to the network in the past month and the date they were added and pharmacies removed from the network in the past month and the date they were removed. |
| Due monthly and upon Government request |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 23 |
| 5.2.3 |
| Notice of removal of a pharmacy from the contractor’s network to include the rationale |
| Due within three business days of occurrence |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 24 |
| 5.2.4 |
| Pharmacy search tool for claimants affected by network changes |
| Due on the implementation date |
| Electronically via website/portal |
| COR and Project Management Office (PMO) for approval |
| 25 |
| 5.2.13 Provider Enrollment Data |
| Provider enrollment system and database accessible by OWCP |
| Due within 90 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) |
| 26 |
| 5.3.1 Welcome Packet |
| Welcome packet including a welcome letter, benefit card, information about the pharmacy and DME programs, diagnostic services and Frequently Asked Questions (FAQs) for DEEOIC and DCMWC |
| Draft document due within 30 days of contract start date and final document within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 27 |
| 5.3.1 Welcome Packet |
| Welcome packet including a welcome letter, benefit card, information about the pharmacy and DME programs for DFELHWC |
| Draft document due no less than 180 days prior to the implementation date, and final document no less than 30 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 28 |
| 5.3.2 |
| Application programming interface with the ECOMP |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 29 |
| 5.3.3 Customer Support (Task two) |
| Call center with dedicated toll-free phone numbers for DEEOIC and DCMWC |
| Due within 150 days of contract start date |
| Phone number and implementation |
| COR and Project Management Office (PMO) for approval |
| 30 |
| 5.3.3 Customer Support (Task two) |
| Call center with dedicated toll-free phone numbers for DFELHWC |
| Due on the implementation date |
| Phone number and implementation |
| COR and Project Management Office (PMO) for approval |
| 31 |
| 5.3.3 Customer Support (Task two) |
| Call center audio recordings |
| Due within 5 days upon request |
| Electronically |
| COR and Project Management Office (PMO) |
| 32 |
| 5.3.3 Customer Support (Task two) |
| Call center written notes of all customer support calls |
| Due within 5 days upon request |
| Electronically |
| COR and Project Management Office (PMO) |
| 33 |
| 5.3.3 Customer Support (Task two) |
| Call center call scripts for DEEOIC and DCMWC |
| Due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 34 |
| 5.3.3 Customer Support (Task two) |
| Call center call scripts for DFELHWC |
| Due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 35 |
| 5.3.5 Customer Support (Task two) |
| Call center performance standards document |
| Due with proposal with final revisions due 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 36 |
| 5.3.7 |
| Provide an agenda to scheduled meetings |
| Due one business day before a scheduled meeting |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 37 |
| 5.3.8 Customer Support (Task two) |
| System training sessions |
| Due no less than 30 days prior to the implementation date, and no less than 5 days prior to implementing any significant system changes thereafter, and when requested by the COR |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 38 |
| 5.5.9 Processing Claims for Payment (Task Four) |
| Fully functional mail room |
| Due on the implementation date |
| Implementation |
| COR and Project Management Office (PMO) for validation |
| 39 |
| 5.5.15 Processing Claims for Payment (Task Four) |
| Historical pharmacy transactions data incorporated in all contractor’s systems utilized to fulfill the requirements under this contract |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 40 |
| 5.5.21 Processing Claims for Payment (Task Four) |
| Provide specification document for generating and transmitting programs required data files, such as bill history file, pharmacy data file, and treasury payment file, to include specific file formats and transmission timeframes |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 41 |
| 5.5.21 |
| Generate and transmit various data files in the format and with the content requested by OWCP, including but not limited to Bill History File, Pharmacy Data File, Payment File |
| Due weekly, or as specified by the Government |
| Electronically |
| COR and Project Management Office (PMO) |
| 42 |
| 5.5.22 Processing Claims for Payment (Task Four) |
| Provide system interfaces to receive and ingest eligibility files from the DEEOIC and DCMWC Programs and apply updates timely to ensure that eligibility and coverage determinations are accurate. |
| Due within 90 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 43 |
| 5.5.22 Processing Claims for Payment (Task Four) |
| Provide system interfaces to receive and ingest eligibility files from the DFELHWC Program and apply updates timely to ensure that eligibility and coverage determinations are accurate. |
| Due no less than 155 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 44 |
| 5.5.22 Processing Claims for Payment (Task Four). Eligibility |
| Perform a one-time load of the claimant eligibility file extract from the OWCP for DEEOIC and DCMWC programs and begin processing claims for eligible claimants as a third-party provider through OWCP’s current pharmacy system. |
| Due within 150 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 45 |
| 5.5.22 Processing Claims for Payment (Task Four). Eligibility |
| Perform a one-time load of the claimant eligibility file extract from the OWCP for DFELHWC program |
| Due no less than 100 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 46 |
| 5.5.24 |
| Provide a business rules specification document for eligibility for each program. |
Due within 120 days of contract start date
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 47 |
| 5.5.25 Processing Claims for Payment (Task Four). |
| Perform a one-time load of the existing claimant authorizations |
| Due no less than 30 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 48 |
| 5.6.1.3 |
| Document detailing the contractor’s procedures and the system of classification of drugs as “name brand” or “generic” |
| Draft due within 60 days of contract start date, final due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) and COR for government approval |
| 49 |
| 5.6.1.4 |
| Request to classify a drug when the classification methodology at 5.6.1 is unclear. |
| Due within 10 days of the day that the contractor knew or should have known the methodology was unclear. |
| Electronically |
| COR and Project Management Office (PMO) |
| 50 |
| 5.6.3 Fee Schedule (Task Five) |
| Develop and provide documents that contain pricing for generic and brand name drugs for both point of sale and mail order pharmacy, and compounded drugs. The specific format and content of these reports shall be developed by the contractor and approved by OWCP. Develop and provide documents that identify the pricing methodology for drugs, and DME. The specific format and content of these reports shall be developed by the contractor and approved by OWCP. |
| Draft due within 90 days of contract start date; Final within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 51 |
| 5.6.4 Classification of Drugs as Generic or Brand Name |
| Provide an OWCP approved definition or a list of specialty drugs |
| Due within 120 days of contract start date and quarterly after implementation |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 52 |
| 5.6.5 Classification of Drugs as Generic or Brand Name |
| Document for specific dispense as written (DAW) processing logic that incorporates Medi-Span's MS code and conforms to NCPDP guidelines. |
| Draft due within 60 days of contract start date and Final within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 53 |
| 5.7 Fraud, Waste and Abuse Monitoring (Task Six) |
| Document detailing FWA detection and reporting program |
| Due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 54 |
| 5.8.2 Internet Based Reporting Tool |
| Implement a secure, internet- based reporting tool for use by authorized OWCP program staff to generate management reports on an ad hoc basis. |
| Due no less than 30 days prior to the implementation date. |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 56 |
| 5.8.3 Classification of Drugs as Generic or Brand Name |
| Manufacturer-Derived Revenue report |
| Due on quarterly basis, within 30 calendar days of the end of each quarter of a calendar year |
| Electronically |
| COR and Project Management Office (PMO) |
| 57 |
| 5.8.3 Progress Reports and Management Information Reports |
| Develop and provide monthly progress reports. Reports shall include key performance metrics associated with the requirements in the PWS. In general, the contractor shall include summary information that includes operational aspects of all PBM services provided, grouped by program. The contractor shall submit a draft progress report template for review and approval by OWCP. The OWCP COR and the PBM Manager shall agree on the scope, content, and format of these reports. Reports shall be submitted to the OWCP COR by the third Wednesday of the month for the previous calendar month. In the event of a holiday or closure due to inclement weather or executive order, reports shall be due the next business day. |
| Draft progress report templates due within 30 days after contract start date. Monthly reports no less than 12 times per year on the third Wednesday of the month for the previous month |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 58 |
| 5.9.2 Customer Support (Task two) |
| Completed process, including completed testing, for automated image transfer into claimant case files |
| Due no less than40 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 59 |
| 5.10.1 Clamant Web Portal |
| Provide a specification document detailing the functionality of the Claimant Web Portal for each program |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 60 |
| 5.10.1 Clamant Web Portal |
| Provide fully functional Clamant Web Portal for each program |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 61 |
| 5.10.2 Prescriber Web Portal |
| Provide a specification document detailing the functionality of the Prescriber Web Portal for each program. |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 62 |
| 5.10.2 Prescriber Web Portal |
| Provide fully functional Prescriber Web Portal for each program |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 63 |
| 5.10.2.1 Authorization and Stakeholder Portals (Task Nine) |
| Provide a specification document detailing the functionality of the Prior Authorization Portal for each program. |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 64 |
| 5.10.2.1 Authorization and Stakeholder Portals (Task Nine) |
| Provide a fully functional Prior Authorization Portal for each program. |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 65 |
| 5.10.3.1 Reporting and Data (Task Seven) |
| Provide data warehouse or equivalent available for OWCP to access paid, denied, and reversed claims at any time. |
| Due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 66 |
| 5.11.1 Formulary Management |
| Provide names, and degrees, practice specialties/board certifications of members of the Pharmacy and Therapeutics Committee. Notify OWCP within 30 days of membership changes. Disclose any financial interests in drug manufacturing companies and employment relationship to PBM. |
| Due within 30 days of contract start date and updated as needed. |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 67 |
| 5.11.1 Formulary Management |
| Provide draft P&T progress report template and clinical recommendations and pharmacoeconomic analysis template. Provide quarterly P&T progress reports at least 4 times a year. |
| Draft due within 30 days of contract start date. Final due on the first business day after January 1. April 1, July 1, and October 1 of each year. |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 68 |
| 5.11.2.1 Drug Formulary System. |
| Specification documents detailing formulary and DUR Point of Sale (POS) edits (e.g. drug-drug interactions and contraindications, therapeutic duplications, refill too soon edits, minimum/maximum dosage, DAW edits, quantity limits, step therapy edits) along with all drug information compendia utilized in formulating their POS edits for each program |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 69 |
| 5.11.2.2 Drug Formulary System. |
| Provide drug formularies for DCMWC and the drug compendia used to build the formulary and the methods involved. |
| Draft due within 90 days of contract start date; Final due no less than 160 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 70 |
| 5.11.2.2 Drug Formulary System. |
| Fully implement POS edits for DCMWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 71 |
| 5.11.2.2 Formulary Management |
| Fully implement the drug formulary for bill processing for DCMWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 72 |
| 5.11.2.3 Drug Formulary System. |
| Provide drug formularies for DEEOIC and the drug compendia used to build the formulary and the methods involved. |
| Draft due within 90 days of contract start date; Final due within 210 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 73 |
| 5.11.2.3 Drug Formulary System. |
| Fully implement POS edits for DEEOIC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 74 |
| 5.11.2.3 Formulary Management |
| Fully implement the drug formulary for bill processing for DEEOIC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 75 |
| 5.11.2.4 Drug Formulary System. |
| Provide drug formularies for DFELHWC and the drug compendia used to build the formulary and the methods involved |
| Draft due within 90 days of contract start date; Final due no less than 160 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 76 |
| 5.11.2.4 Drug Formulary System. |
| Fully implement POS edits for DFELHWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 77 |
| 5.11.2.4 Formulary Management |
| Fully implement the drug formulary for bill processing for DFELHWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 78 |
| 5.11.5 Formulary Management |
| Written notice for approval by OWCP at least 90 days prior to implementation of any formulary change. |
| Due 90 days prior to implementation of any formulary change |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 79 |
| 5.11.5.1 |
| Provide formulary recommendation for previously approved drug products upon release of new FDA recommendations. |
| Due within 180 days of FDA releasing new recommendations. |
| Electronically |
| COR and Project Management Office (PMO) |
| 80 |
| 5.11.5.2 |
| Provide formulary recommendations for new drug products upon FDA approval of new products. |
| Due within 180 days of market availability of new drug products. |
| Electronically |
| COR and Project Management Office (PMO) |
| 81 |
| 5.11.5.3 Formulary Management |
| Written notice to adversely impacted claimants, designated representatives, prescribing physicians, and participating pharmacies at least 45 days prior to implementation of any formulary change. |
| Due 45 days prior to implementation of any formulary change |
| Hard Copy |
| COR and Adversely impacted claimants, designated representatives, representative payees, prescribing physicians, and participating pharmacies |
| 82 |
| 5.11.5.4 |
| Provide notice of important changes in the pharmaceutical industry, including but not limited to issuance of new black box warnings and withdrawal of drugs from the market. |
| Due within 24 hours of confirming changes |
| Electronically |
| COR and Project Management Office (PMO) |
| 83 |
| 5.12.2 |
| Provide the hierarchy of claims processing edits. |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) |
| 84 |
| 5.12.18 PBM Drug Utilization Review (Task Eleven) |
| Provide a document detailing appeals process and pathway (such as elevation to OWCP) when claims cannot be resolved at the PBM level |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 85 |
| 5.12.20.1 PBM Drug Utilization Review (Task Eleven) |
| Provide SOP for Prior authorization request forms (PARF) and prior authorization request template (PART) reviews |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 86 |
| 5.12.20.2 PBM Drug Utilization Review (Task Eleven) |
| Provide SOP for 90 MED Program |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 87 |
| 5.12.20.3 PBM Drug Utilization Review (Task Eleven) |
| Provide SOP for Medication Use Evaluation (MUE) |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 88 |
| 5.12.20.4 PBM Drug Utilization Review (Task Eleven) |
| Provide SOP for Targeted Medication Use Evaluation (MUE) |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 89 |
| 5.12.20.5 PBM Drug Utilization Review (Task Eleven) |
| Provide Claimant Adherence Program |
| Due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 90 |
| 5.13 Durable Medical Equipment |
| The contractor shall ensure all bills/invoices for payment are proper, accurate, complete, and timely to facilitate the timely processing and prompt payment of medical bills. The contractor shall also be registered in OWCP’s Medical Bill Processing System and Electronic Funds Transfer (EFT) System to expedite bill processing per OWCP’s Medical Bill Processing Procedures. All bills/invoices must be submitted timely and contain proper, accurate and complete information to be deemed proper for payment in accordance with OWCP’s Fee Schedule, Medical Bill Processing Procedures, and the Prompt Payment Act. |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 91 |
| 5.13.2 |
| Maintain a list of in-network DME suppliers to include the number of suppliers by state and territory |
| Due monthly and upon Government request |
| Electronically |
| COR and Project Management Office (PMO) |
| 92 |
| 5.16.1 System Testing (Task Fourteen) |
| Provide Test plan (including RTM, test schedules, test scenarios, test cases, and test scripts for all requirements and historical data) that addresses all aspects of the Contractor’s comprehensive testing program |
| Due no less than 180 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 93 |
| 5.16.2 System Testing (Task Fourteen) |
| Provide a Requirements Traceability Matrix, testing plan and testing cases associated with all available systems |
| Due no less than 180 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 94 |
| 5.16.3 |
| Provide a schedule for all testing activities as part of the test plan, to identify timeframes for the System Integration Testing (SIT), volume and performance testing, parallel testing, and Government Acceptance Testing (GAT). The schedule must include timelines for correction and re-test of any identified defects or missed requirements that were discovered during GAT. The contractor must provide a GAT period of no less than ten weeks. |
| Due no less than 180 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 95 |
| 5.16.5 System Testing (Task Fourteen) |
| Release the system to the Government for Acceptance Testing (GAT) |
| Due no less than 100 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 96 |
| 5.17.2 System Audits |
| SOC, I Type II audit performed by independent auditor |
| Due annually during the timeframe of February - September |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 97 |
| 5.17.5 System Audits |
| Letter of Representation addressing WCMBP Contractor responsibility to identify control objectives and related policies and procedures. Auditor’s Letter of Representation as to independence and objectivity from the WCMBP Contractor and DOL Auditor’s current resumes Auditor’s most recent Peer Review Auditor’s detailed scope document Auditor’s letter documenting representations made by the WCMBP Contractor management during the audit electronic version of the complete audit report Plan of action and milestones (POA&M), according to OWCP Specifications, for weaknesses identified in audits. |
| Due annually |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 98 |
| 508 Testing (In accordance with Section I.10 DOL-2019-01 SECTION 508 REQUIREMENTS (January 2019)) |
| Accessibility test results based on the required test methods with an explanation for any false positives. Documentation of features provided to help achieve accessibility and usability for people with disabilities. Documentation of core functions that cannot be accessed by persons with disabilities. Documentation on how to configure and install the ICT item to support accessibility. |
| Draft testing results due no less than 100 days prior to the implementation date; Final test results due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 99 |
| Implementation |
| Complete implementation of all elements of the PWS. |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
