2 Draft PWS Pharmacy Operations Support Contract Bridge 06NOV2024.docx

Department of Defense Defense Health Agency – Performance Work Statement – Pharmacy Operations Support Contract

Health Care Operations (HCO) Pharmacy Operations Division (POD)

Solicitation Number:

TBD

Version: 1 Date: 11/6/2024

PART 1

1.0 GENERAL INFORMATION

1.1 This is a non-personal services contract to provide program management support to the Pharmacy Operations Division. The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

1.2 Description of services/introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform program management support services as defined in this Performance Work Statement (PWS) except for those items specified as government furnished property and services. The contractor shall perform to the standards in this performance work statement.

1.3 Background: The Pharmacy Operations Division (POD) provides policy guidance and coordinates the Department of Defense (DoD) pharmacy policy with the Assistant Secretary of Defense for Health Affairs and the individual uniform Services through the Pharmacy Enterprise Support Activity. The POD is responsible for management of the TRICARE Pharmacy Benefits Program which offers pharmacy services to 9.4 million DoD eligible beneficiaries.

1.4 Objectives: The contractor shall provide quality and cost-appropriate analytical, technical, and program management services in support of all POD programs. The objectives are to:

· Provide program management support for Purchase Care and related programs required for the delivery of the pharmacy benefit

· Provide program management support for Pharmacy Informatics and enterprise pharmacy information technology programs/initiatives

· Provide customer support, technical expertise, cost and utilization analysis for DHA’s process for collecting pharmaceutical refunds related to Section 703 of the National Defense Authorization Act for Fiscal Year 2008

· Provide extensive administrative and technical support for the DoD Pharmacy and Therapeutics (P&T) Committee which manages the DoD Uniform Formulary

· Provide detailed analysis and make recommendations to determine which medications are being prescribed and the cost of the medications. Perform trend analysis of medication usage within the formularies

· Provide reports for complex analysis and monitoring for pharmacy data using various databases such as M2, pharmacy contractor databases, Commercially Available Drug Reference Databases, Medical Data Repository (MDR), and all other as needed to determine pharmacy trends, fraud waste & abuse (FWA) and pharmacy performance

· Provide support and end user training for Military Treatment Facility (MTF) related programs, including electronic prescribing program (E-Rx) and a standardized Composite Health Care System (CHCS) and Military Health Systems (MHS) GENESIS drug database

· Assist with monitoring and overseeing program integrity activities and report coordination and control with the DHA Program Integrity Office. Assistance includes planning and management of programs to minimize FWA in MHS activities.

· Provide quality assurance and recommended edits and/or updates of Pharmacy Data Transaction Service (PDTS) and related pharmacy data sources to ensure consistency, accuracy, and reliability of data and data elements used

1.5 Scope: This award provides for services to support the program management and operational requirements for the Pharmacy Operations Division. Services include technical, analytical and administrative support to assist the POD with its mission.

1.6 Period of Performance (PoP): Base period of 4 months beginning on date of award and 3 one-month option periods.

1.6.1 Transition: Phase in/phase out period

1.6.1.1 Phase in period (Deliverable # 1): The period between the award date and full performance start date constitutes the phase in period. Full pefformance start date is TBD at time of award. This Incoming Transition Plan shall include, but not limited to:

· Coordination with Government representatives

· Review, evaluation and transition of current support services

· Transition of historic data to new Contractor system

· Government-approved training and certification process, and delivery of copies of existing policies

· Transfer of hardware warranties and software licenses

· Transfer of all System/Tool documentation to include, at a minimum: user manuals, system administration manuals, training materials, disaster recovery manual, requirements traceability matrix, configuration control documents and all other documents required to operate, maintain and administer systems and tools

· Transfer of compiled and uncompiled source code, to include all versions, maintenance updates and patches

· Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes

· Distribution of Contractor purchased Government owned assets, including facilities, equipment, furniture, phone lines, computer equipment, etc.

· Transfer of GFE and Government Furnished Information (GFI), and GFE inventory management assistance

· Applicable DHA briefing and personnel in-processing procedures

· Coordinate with the Government to issue and account for government keys, ID/access cards, and security codes

During the phase-in period, the contractor shall prepare to meet all contract requirements and ensure incoming personnel are functionally trained and qualified on the full performance start date. Any remaining incoming personnel shall be trained and qualified within 30 days. The Government will make all facilities, equipment, and materials accessible to the contractor during the phase-in period.

1.6.1.2 Phase out period (Deliverable # 2): The period of time 30 days prior to the end of the award date and running concurrently with the final days of the PoP. Phase out performance is define as a plan for outgoing transition of work from an active contract to a follw-on contract/order or Government entity. This transition may be to a Government entity, another Contractor or to the incumbent Contractor under a new contract. In accordance with the Government approved plan, the Contractor shall assist the Government in planning and implementing a complete transition from this contract. This shall include formal coordination with Government staff and successor staff and management. It shall also include delivery of copies of existing policies and procedures, and delivery of required metrics and statistics. This Outgoing Transition Plan shall include, but is not limited to:

· Coordination with Government representatives

· Review, evaluation and transition of current support services

· Transition of historic data to new Contractor system

· Government-approved training and certification process

· Transfer of hardware warranties and software licenses

· Transfer of all System/Tool documentation to include, at a minimum: user manuals, system administration manuals, training materials, disaster recovery manual, requirements traceability matrix, configuration control documents and all other documents required to operate, maintain and administer systems and tools

· Transfer of compiled and uncompiled source code, to include all versions, maintenance updates and patches

· Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes,

· Distribution of Contractor purchased Government owned assets, including facilities, equipment, furniture, phone lines, computer equipment, etc.,

· Transfer of GFE and Government Furnished Information (GFI), and GFE inventory management assistance,

· Applicable DHA briefing and personnel in-processing procedures,

· Coordinate with the Government to issue and account for government keys, ID/access cards, and security codes.

1.7 Administrative specifications

1.7.1 Place of performance: The work shall be performed on-site in government space in Falls Church, Virginia and San Antonio, Texas. Telework of contractor employees may be proposed for consideration by the Government.

Uniform Formulary Beneficiary Advisory Panel meetings are held in the Washington DC / Northern Virginia area with Metro and restaurant accessibility.

1.7.2 Recognized Federal holidays: The contractor is not required to perform services on federal holidays.

1.7.3 Hours of operation The contractor is responsible for conducting business, between the hours of 0800 – 1700 Eastern Standard Time (EST) in Virginia and 0600 – 1600 Central Standard Time (CST) in Texas,, Monday thru Friday except Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings. The Contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the above reasons. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.8 Contractor travel: Contractor will be required to travel Continental United States (CONUS) and within the National Capitol Region (NCR) to attend meetings, conferences, and training. The contractor may be required to travel to off-site training locations and to ship training aids to these locations in support of this PWS. Contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation and the limitation of funds specified in this contract. All travel requires Government approval/authorization and notification to the Contracting Officer Representative (COR).

1.9 Other Direct Costs (ODC): N/A

The government will work with the contractor to identify suitable meeting locations. See section 5.11 Beneficiary Advisory Panel Support.

1.10 Quality

1.10.1 Quality Control (QC) (Deliverable # 3): The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The Quality Control Plan (QCP) shall be submitted upon award. The QCP shall document how the Contractor will meet and comply with the quality standards established in this statement of work. At a minimum, the QCP must include a self-inspection plan, an internal staffing plan, and an outline of the procedures that the Contractor will use to maintain quality, timeliness, responsiveness, customer satisfaction, and any other requirements set forth in this solicitation. After acceptance of the QCP the contractor shall receive the contracting officer’s (CO) acceptance in writing of any proposed change to his QC system.

1.10.2 Quality assurance: The government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan provides a systematic method for the Government to evaluate performance and to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

1.11 Security and Common Access Card (CAC) requirements: All security and CAC requirements are identified in the attachment found in Part 7, 7.4. Contractor personnel performing work must have and maintain the appropriate security and designation required. All work under this contract is unclassified.

1.11.1 The Automated Data Processing/Information Technology (ADP/IT) levels and position sensitivity designation for positions under this contract is: ADP/IT II: Non-critical sensitive position

1.11.2 Cybersecurity Requirements:

1.11.2.1 Contractor Employees Who Require Access to Government Information Technology. All contractor employees requiring access to government information technology shall successfully complete the current DoD approved Cyber Awareness Challenge training prior to being granted access, and annually thereafter. This training takes approximately 30 – 60 minutes to complete and requires the student to pass a test at the conclusion. The official DoD certificate of completion must be presented to the COR. DoD Cyber Awareness Challenge must be taken utilizing the Defense Health Agency (DHA) Learning Management System , Joint Knowledge Online (JKO): http://jko.jten.mil/mhs.

1.11.2.2 Contractor Employees Performing Cybersecurity / Cyberspace Functions shall comply with the requirements listed below:

1.11.2.2.1 Training: All contractor and associated subcontractor employees working Cybersecurity (Information Assurance (IA))/Cyberspace functions must comply with DoD training requirements in Department of Defense Directive (DoDD) 8140.01, and DoD 8570.01-M.

1.11.2.2.2 Certification: Per DoDD 8140.01, Defense Federal Acquisition Regulation Supplement (DFARS) 252.239-7001, contractor employees supporting Cybersecurity (Information Assurance)/Cyberspace functions shall be appropriately certified upon contract/task order award. The baseline certification as stipulated in DoD 8570.01-M must be completed prior to the beginning of their contract support services. In addition, the contractor shall comply with Computing Environment (CE) certification requirements as specified in the contract. CE certifications shall be obtained within the timelines specified in DoD 8570.01-M.

1.11.2.2.3 Privileged User Requirements: All contractor employees with privileged user status must comply with the requirements of DHA-Administrative Instruction.

1.11.2.3 Reserved

1.11.2.4 Reserved

1.11.3 Physical Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

1.11.4 Key control: The Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE: All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated. The Contractor shall develop procedures covering key control that shall be included in the QCP. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The Contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the CO.

1.11.4.1 In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon direction of the CO, re-key or replace the affected lock or locks; however, the Government, at its option, may replace the affected lock or locks or perform re-keying. When the replacement of locks or re-keying is performed by the Government, the total cost of re-keying or the replacement of the lock or locks shall be deducted from the monthly payment due the Contractor. In the event a master key is lost or duplicated, all locks and keys for that system shall be replaced by the Government and the total cost deducted from the monthly payment due the Contractor.

1.11.4.2 The Contractor shall prohibit the use of Government issued keys/key cards by any persons other than the Contractor’s employees. The Contractor shall prohibit the opening of locked areas by Contractor employees to permit entrance of persons other than Contractor employees engaged in the performance of assigned work in those areas, or personnel authorized entrance by the CO.

1.11.5 Lock combinations: The Contractor shall establish and implement methods of ensuring that all lock combinations are not revealed to unauthorized persons. The Contractor shall ensure that lock combinations are changed when personnel having access to the combinations no longer have a need to know such combinations. These procedures shall be included in the Contractor’s QCP.

1.11.6 Personally Identifiable Information (PII)/Protected Health Information (PHI), and Federal Information Requirements (refer to Clause Section for DHA Procedures, Guidance and Information 224.90 if applicable).

1.12 Key personnel (Government): The following personnel are considered key personnel by the government: Contracting Officer, Contracting Officer’s Representative

1.12.1 Key personnel (Contractor): The contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the CO. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available between 0800 and 1700 CST, Monday thru Friday except Federal holidays or when the government facility is closed for administrative reasons.

The following personnel are considered key personnel by the government:

· One Federal Ceiling Price (FCP) Support Pricing File Analyst

· One Federal Ceiling Price (FCP) Support Analyst

· Two Pharmacoeconomists

· One Cybersecurity Support Analyst

· One Database Administrator (DBA)

· One Statistical Analysis System (SAS) Business Intelligence (BI) Programmer

· One Senior Data Management Analyst

Qualifications for all key personnel are listed below:

FCP Pricing File Analyst: The contractor shall possess a Bachelor's degree and /or five years of pharmacy experience. At least two years working with pharmacy billing and/or refund processing with one of the following entities: pharmacy or chain drug store; health plan, insurer, pharmacy benefit manager, or pharmaceutical manufacturer. The contractor shall possess at least three years of experience as a Nationally Certified Pharmacy Technician (CPhT) by Pharmacy Technician Certification Board (PTCB). The contractor shall possess familiarity with processes associated with pharmacy billing for retail prescriptions, standards for development of refund calculations, submission of pharmacy refund documents, preparation of monthly utilization and cost benefit reports, National Council for Prescription Drug Programs (NCPDP) standards for refund processing, validation, and dispute resolution, Pharmaceutical pricing and developing Pharmacy Data Transaction Service reports Proficient in Microsoft Office Suite Applications (Word, Excel, Access, PowerPoint and Visio) with analytical skill to support pharmacy claim analysis, excellent written and oral communication skills.

FCP Support Analyst: The contractor shall possess a Bachelor's degree and/or five years of billing or collection experience, possess at least two years working with pharmacy billing and/or refund processing with one of the following entities: pharmacy or chain drug store; health plan, insurer, pharmacy benefit manager, or pharmaceutical manufacturer. The contractor shall possess familiarity with processes associated with, pharmacy billing for retail prescriptions, standards for refund calculations, submission of pharmacy refund documents, resolution of disputes associated with pharmacy receivables and payment detail, preparation of monthly performance reports, National Council for Prescription Drug Programs (NCPDP) standards for refund processing,validation, and dispute resolution, pharmaceutical pricing, proficient in Microsoft Office Suite Applications (Word, Excel, Access, PowerPoint and Visio) with analytical skill to support pharmacy claim analysis, excellent written and oral communication skills. Familiarity with Military Health System and TRICARE pharmacy benefit preferred, Pharmacoeconomist: The contractor shall possess a Master's degree in pharmacoeconomics (or a related discipline) with at least two years of economic modeling experience. The contractor shall possess and maintain proficiency with: SAS statistical software with at least one year of experience using SAS is required; Microsoft Office Suite Applications (Access including writing SQL queries, Excel including designing pivot tables/charts, Word, PowerPoint).. . The contactor shall possess the skills to work effectively with large administrative databases.

Cybersecurity Analyst: The contractor shall possess a Bachelor's Degree, DoD-approved cybersecurity workforce certification IAT (Information Assurance Technical) Level III per DoD 8570.01-M (e.g. CISSP, CISA, CASP CE) and five or more years cybersecurity experience. The contractor shall have experience assessing new security laws, policies, and standards in the federal government to determine impact to the program.. The contractor shall possess technical knowledge of National Institute of Standards and Technology (NIST), Risk Management Framework (RMF), Federal Risk and Authorization Management Program (FedRAMP) with a solid understanding of cloud deployment, security policy requirements and assessments, and service models as defined by the NIST. The contractor shall possess an understanding of IP networking, networking protocols and security related technologies including encryption, IPsec, PKI, VPNs, firewalls, proxy services, DNS, electronic mail and access-lists. The contractor shall possess in depth knowledge of security hardening, assessment and reporting tools (e.g. HBSS, ACAS, SCAP etc.) with the ability to assess and provide appropriate feedback for external audits and remediation plans..

Database Administrator (DBA): The contractor shall possess and maintain certification in Security+. The contractor shall possess no less than an Associate in Applied Science Degree in Database Specialist with at least five years experience in utilization and management of ODBC and SQL databases, Statistical Analysis System (SAS) Business Intelligence (BI) Programmer: The contractor shall possess and maintain certification in Security+ and SAS BI Content Development. The contractor shall possess at least three years super user experience in SAS Enterprise Guide

Senior Data Management Analyst: The contractor shall possess skills in pharmacy delivery process, delivery locations, data flow, data sources such as CHCS, MHS Genesis, TPharm4, PDTS, Business Object (BOXI) environment, SAS environment, MDR, M2, and products such as Medication Analysis and Reporting Tools (MARTs), POD scheduled reports, DHA health care data (pharmacy, inpatient, ambulatory, and ancillary care) as delivered by MTFs and civilian facilities, population data including eligibility, enrollment, address, birth/death, Military concepts such as DMIS, MEPRS, DMHRSi, deployment, Warrior Transition Unit (WTU), active duty concerns as different from other beneficiaries, health care delivery as different from civilian care and data sources (central, local, and pharmacy specific, e.g., PDTS, MDR, M2, CHCS, MEPRS, Prime Vendor, First Data Bank), tools for accessing such data (Business Objects, SQL, SAS) and guidelines for their use with attention to PHI/PII handling, DHA policy and concepts (the DHA organization, familiarity with responding to FOIAs, Congress, the White House, OMB, GAO, auditing agencies), insurance concepts (eligibility, enrollment, users, copays, PMPM, etc.) and analytic and statistical techniques.

1.13 Data rights: The Government has unlimited rights to all documents/material and data exclusively produced under this contract. All documents and materials produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the Contractor without written permission from the Contracting Officer. All contract exclusive materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.14 Government training: The Contractor shall ensure that all Contractor employees attend or successfully complete all mandatory Government training. The training typically encompasses matters of security and safety, and is provided during billable time at no cost to the Contractor.

1.15 Reporting

1.15.1 Contractor Manpower Reporting (CMR): The Office of the Secretary of Defense (OSD) Personnel and Readiness (P&R) operates and maintains a secure data collection site where the Contractor shall report Contractor manpower (including subcontractor manpower). Purchases with a total contract value of $3 million or more for services in the following service acquisition portfolio groups: logistics management services, equipment related services; knowledge-based services; and electronics and communication services shall completely fill in all the information in the format using the following web address http://www.ecmra.mil/.

1.15.1.1 As part of its submission, the Contractor shall provide the estimated total cost (if any) incurred to comply with this reporting requirement. Reporting period shall be the period of performance not to exceed 12 months ending September 30 of each government fiscal year and must be reported by 31 October of each calendar year. Contractors may use a direct Extensible Markup Language (XML) data transfer to the database server or fill in the fields on the website. The XML direct transfer is a format for transferring files from a Contractor’s system to the secure website without the need for separate data entries for each required data element at the website. The specific formats for the XML direct transfer may be downloaded from the website.

1.15.1.2 Service portfolio groups are further define in DFARS PGI 237.102-74 Taxonomy for the acquisition of service and supplies and equipment.

1.15.1.3 Contractors shall direct questions to the help desk at: http://www.ecmra.mil/.

1.15.2 Non-Disclosure Agreement (NDA) (Deliverable # 4): All DHA Government contractor personnel who will obtain access to proprietary, classified, or confidential information or any information release of which is protected or governed by law or regulation associated with DHA acquisitions shall be required to complete and sign a DHA Contractor NDA (DHA Form 49) prior to beginning work on the subject contract. The Contractor shall execute an NDA on behalf of the company and shall ensure that all staff assigned to, including all subcontractors and consultants, or other personnel performing on contract/Task order execute an NDA protecting the procurement sensitive information of the Government and the proprietary information of other contractors. The NDA shall be executed not later than first day of employment and to be renewed upon exercising a contract option period. Assignment of staff who has not executed this statement or failure to adhere to this statement shall constitute default on the part of the Contractor. The contractor shall maintain originally signed NDAs of individual employees and provide copy to the COR.

1.15.3 Contracting Officer Representative (COR): The COR will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the Contractor performs the technical requirements of the contract; perform inspections necessary in connection with contract performance; maintain written and oral communications with the Contractor concerning technical aspects of the contract; issue written interpretations of technical requirements, including Government drawings, designs, specifications; monitor Contractor's performance and notifies both the CO and Contractor of any deficiencies; coordinate availability of government furnished property; and provide site entry of Contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the Contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting contract.

1.15.4 Post award conference/periodic progress meetings: The Contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The CO, COR, and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the CO will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.16 Contingency Operations Plan (Deliverable # 5): The Contractor shall prepare and submit a Contingency Operations Plan to the Government. The Contingency Operations Plan shall be due ten (10) calendar days after the award of the order, and shall be updated on a quarterly basis. The Contingency Operations Plan shall document Contractor plans and procedures to maintain DHA support during an emergency. The Contingency Operations Plan shall include the following:

· A description of the Contractor’s emergency management procedures and policy

· A description of how the Contractor will account for their employees during an emergency

· Planned temporary work locations or alternate facilities

· How the Contractor will communicate with DHA during emergencies

· A list of primary and alternate Contractor points of contact, each with primary and alternate:

· Telephone numbers

· E-mail addresses

· Procedures for protecting Government furnished equipment (if any)

· Procedures for safeguarding sensitive and/or classified Government information (if applicable)

1.17 Operations During Emergency Situations: Individual contingency operation plans shall be activated immediately after determining that an emergency has occurred, shall be operational within twelve (12) hours of activation, and shall be sustainable until the emergency situation is resolved and normal conditions are restored or the contract is terminated, whichever comes first. In case of a life threatening emergency, the COR will immediately make contact with the Contractor Task Managers to ascertain the status of any Contractor personnel who were located in Government controlled space affected by the emergency. When any disruption of normal, daily operations occur, the Contractor Task Manager shall promptly open an effective means of communication with the COR and verify:

· Key points of contact (Government and Contractor)

· Temporary work locations (alternate office spaces, telework, virtual offices, etc.)

· Means of communication available under the circumstances (e.g. email, webmail, telephone, FAX, courier, etc.)

· Essential work products expected to continue production by priority

1.18 Monthly Progress Reports (MPR) (Deliverable # 6): The Contractor shall ensure that a MPR is submitted outlining the expenditures, billings, progress, status, and any problems/issues encountered in the performance of this taskin accordance with a mutually agreed upon format by the Government and the Contractor. The Contractor shall require all subcontractors to provide input to the MPR where there are critical or significant tasks related to the prime contract. Critical or significant tasks shall be defined by mutual agreement between the Government and Contractor.

1.19 Organizational Conflict of Interest: Contractor and subcontractor personnel performing work under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent Organizational Conflict of Interests (OCI) as defined in FAR Subpart 9.5. The Contractor shall notify the Contracting Officer immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the Contracting Officer to avoid or mitigate any such OCI. The Contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the Contracting Officer and in the event the Contracting Officer unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the Contracting Officer may effect other remedies as he or she deems necessary, including prohibiting the Contractor from participation in subsequent contracted requirements which may be affected by the OCI.

PART 2

2.0 DEFINITIONS & ACRONYMS

2.1 Definitions:

2.1.1 Category D: Information Technology and Telecommunications Services (called D-Svs)

2.1.2 Category R: Support (Professional/Administrative/Managements) Services (called R-Svs)

2.1.3 Contracting Officer (CO): A person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

2.1.4 Contracting Officer’s Representative (COR): An individual, including a contracting officer’s technical representative (COTR), designated and authorized in writing by the contracting officer to perform specific technical or administrative functions. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.5 Nonpersonal services contract: a contract under which the personnel rendering the services are not subject, either by the contract’s terms or by the manner of its administration, to the supervision and control usually prevailing in relationships between the Government and its employees.

2.1.6 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance. The Government may either prepare the quality assurance surveillance plan or require the offerors to submit a proposed quality assurance surveillance plan for the Government’s consideration in development of the Government’s plan.

2.2 Acronyms:

PART 3

3.0 GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3.1 Services: Reserved

3.2 Facilities: The Government will provide office space for all on-site Contractor personnel.

The Contractor will be provided keys or codes for access to the Government facility. These keys and codes shall be controlled, tracked, and protected. Upon termination of the contract, all keys and/or access badges to the Government facility will be turned in to the COR.

3.3 Utilities: The Government will provide all utilities in the facility for the contractor's use in performance of tasks outlined in this PWS. The Contractor shall instruct employees in utilities conservation practices. The contractor shall be responsible for operating under conditions that preclude the waste of utilities.

3.4 Equipment: The Government will provide laptops and workspace for the contractor to perform duties.

3.5 Materials: The Government will provide the following materials:

· NDAA FY95: Authorized DoD to establish contracts and managed care health providers, ie TRICARE https://www.congress.gov/bill/103rd-congress/senate-bill/2182/text

· NDAA FY00 Section 701: Pharmacy Benefits Program, Title 10 USC, Section 1074g https://www.gpo.gov/fdsys/pkg/PLAW-106publ65/html/PLAW-106publ65.htm

· NDAA FY00 Section 701: Establish Pharmacy Data Transaction System to integrate pharmacy data throughout entire enterprise https://www.gpo.gov/fdsys/pkg/PLAW-106publ65/html/PLAW-106publ65.htm

· NDAA FY00 Section 701- Established the Uniform Formulary process, tiered formulary, Pharmacy and Therapeutics Committee and Federal Advisory Committee, the Beneficiary Advisory Panel - Implementing regulation – Title 32 CFR Section 199.21 dated April 1, 2004 https://www.gpo.gov/fdsys/pkg/PLAW-106publ65/html/PLAW-106publ65.htm

· NDAA FY01 Section 711: Implementation of TRICARE Senior Pharmacy Program; Title 10 USC, Section 1073 https://www.gpo.gov/fdsys/pkg/PLAW-106publ398/pdf/PLAW-106publ398.pdf

· NDAA FY08 Section 703: Inclusion of TRICARE retail pharmacy in federal procurements of pharmaceuticals at federal ceiling prices (FCP) - Implementing regulation – Title 32 CFR Section 199.21 published March 17, 20 https://www.gpo.gov/fdsys/pkg/CRPT-110hrpt477/pdf/CRPT-110hrpt477.pdf

· NDAA FY13 Section 702, Inclusion of certain over-the-counter drugs in the TRICARE uniform formulary https://www.gpo.gov/fdsys/pkg/CRPT-112hrpt705/pdf/CRPT-112hrpt705.pdf

· 32 CFR 199 – (20 June 1995) Established purchased care mail and retail pharmacy benefit https://www.gpo.gov/fdsys/pkg/CFR-2013-title32-vol2/xml/CFR-2013-title32-vol2-sec199-21.xml

· Standard Operating Procedures (SOPs) for current processes

TRICARE Pharmacy https://tricare.mil/coveredservices/pharmacy

DoD P&T Committee Website:

https://health.mil/POD

BAP Website:

https://health.mil/bap

PART 4

4.0 CONTRACTOR FURNISHED ITEMS AND SERVICES

4.1 General: N/A

4.2 Secret Facility Clearance: N/A

4.3 Materials: N/A

4.4 Equipment: N/A

4.5 Facilities: N/A

PART 5

5.0 SPECIFIC TASKS

☒ Non-HIT: J-3 Operations

5.1 Basic Services: The contractor shall provide services to support the operational management, medication class evaluations, pharmacoeconomic analysis, utilization management, informatics support, and refund collection for the Pharmacy Operations Division (POD). The contractor shall augment the Government with management, technical, and analytical support to assist the POD with its mission to provide a world-class pharmacy benefit. The contractor shall participate in outreach activities inside and outside the Agency including public relations, publications, conferences, and presentations.

5.2 TRICARE Pharmacy (TPharm) Support: TRICARE beneficiaries have the option to obtain their prescriptions at an Military Treatment Facilities (MTF), via Mail Order Pharmacy (MOP), or at a retail pharmacy in the Retail Pharmacy Network (RPN). The TPharm contractor provides MTF, MOP and RPN services and is the aggregator of transactions from all three points of services.

5.2.1 TPharm Support Analyst

5.2.1.1 The contractor shall assist with development of Statements of Work (SOWs), Requests for Information (RPIs), Requests for Proposals (RFPs), sole source memorandum, Independent Government Cost Estimates (IGCEs), and appropriate contract modifications in support of TPharm, and any successor contract.

5.2.1.2 The contractor shall assist in preparation of information papers, briefings, and presentations for members of the Pharmacy TPharm team.

5.2.1.3 The contractor shall solicit technical information from various Government and civilian organizations and act as liaison to various DHA Program Offices and contractors on TPharm issues.

5.2.1.4 The contractor shall assist with implementation and operational activities related to TPharm IT programs to include MHS Genesis and other programs mandated by policy.

5.2.1.5 The contractor shall monitor, schedule and assist with action items as required.

5.2.1.6 The contractor shall organize work group meetings and record minutes for meetings as required. Deliverable # 7

5.2.1.7 The contractor shall attend meetings as requested and performs other related duties as assigned.

5.2.1.8 The contractor shall serve as liaison to the Federal Pricing Refund Program.

5.2.1.9 The contractor shall participate in communication activities inside and outside the DHA to include communication plans to support the implementation of new programs and benefit design changes.

5.2.1.10 The contractor shall coordinate with DHA and TPharm contractor to provide input on special programs lists (e.g. specialty drug list, mandatory mail order list, etc.)

5.2.1.11 The contractor shall assist the Government in monitoring TPharm contract deliverables and TPharm contract performance

5.2.1.12 The contractor shall assist with the Mail Order replenishment process.

5.2.1.13 The contractor shall assist with the reconciliation of purchased MOP replenishment versus claims processed.

5.2.1.14 The contractor shall assist in gathering data for audits and pharmacy claim reviews.

5.2.1.15 The contractor shall review the formulary search tool to ensure compliance with DoD P&T decisions.

5.3 Federal Ceiling Price (FCP) Suppport: The Department of Defense (DoD) receives Federal Ceiling Prices in the military treatment facilities and the TRICARE Mail Order Pharmacy program. Through authority provided in Section 703 of the FY08 National Defense Authorization Act and the final implementing regulation, DoD now obtains similar federal pricing discounts in the TRICARE retail network pharmacies.

5.3.1 FCP Pricing File Analyst

5.3.1.1 The contractor shall provide support for the implementation, operation, and maintenance of the TRICARE Retail Pharmacy Refund program, Federal pricing initiatives and other related tasks.

5.3.1.2 The contractor shall assist in the development of the quarterly pricing files for the Standard and Additional Discount programs using various databases and analysis tools (e.g. Business Objects, PDTS, First Data Bank, FDA).

5.3.1.3 The contractor shall assist with implementation and operational activities related to P&T Committee decisions that affect the refund program pricing file.

5.3.1.4 The contractor shall assist in reconciling manufacturer disputes of pricing file data.

5.3.1.5 The contractor shall track, monitor, and maintain metrics on DHA refund utilization data and pricing file data. The following reports to include but not limited to Top 25 Refund, Fiscal Year vs Calendar Year Refund Totals, and Additional Discount History these reports should be done at least quarterly. The FCP Management Plan should be done at least monthly.

5.3.1.6 The contractor shall compile and interpret cost benefit/ utilization analysis reports.

5.3.1.7 The contractor shall draft/ assist in preparation of information papers, briefings, standard operating procedures, and audits.

5.3.1.8 The contractor shall assist in development and revision documentation of policies, processes, and procedures (e.g. Standard Operating Procedures).

5.3.1.9 The contractor shall serve as the primary POC for the development of the pricing files and DHA refund utilization data.

5.3.1.10 The contractor shall coordinate with other Government and civilian organizations on the delivery of DHA refund utilization data to government organization for review and delivery to manufacturers.

5.3.1.11 The contractor shall solicit technical information from various Government and civilian organizations.

5.3.1.12 The contractor shall monitor, schedule and assist with action items as required.

5.3.1.13 The contractor shall organize work group meetings and record notes from meetings as required. Deliverable # 7

5.3.1.14 The contractor shall assist with operational activities related to the POD and Contract Resource Management yearly Defense Health Agency Contract Resource Management Basic Financial Statements Audit.

5.3.1.15 The contractor shall attend meetings as requested and perform other related duties as assigned.

5.3.2 FCP Support Analyst

5.3.2.1 The contractor shall provide support for the implementation, operation, and maintenance of the TRICARE Retail Pharmacy Refund program, Federal pricing initiatives and other related tasks.

5.3.2.2 The contractor shall assist in reconciling manufacturer quarterly refund payments and disputes of DHA refund utilization data.

5.3.2.3 The contractor shall track, monitor, and maintain metrics on dispute resolution and reconciliation of manufacturer payments.

5.3.2.4 The contractor shall draft/ assist in preparation of information papers, briefings, standard operating procedures, and audits.

5.3.2.5 The contractor shall maintain, monitor, and track the UFVARR Requests mailbox, Pharmaceutical Manufacturers website, and DoD FCP SharePoint site.

5.3.2.6 The contractor shall serve as the primary POC between the POD and Pharmaceutical Manufacturers regarding the TRICARE Retail Refund program and reconciliation of manufacturer payments.

5.3.2.7 The contractor shall serve as the primary POC between the POD and Pharmaceutical Manufacturers and Health Information Technology (HIT) regarding access and use of the TRICARE Retail Refunds Website (TRRWS).

5.3.2.8 The contractor shall serve as the refund program functional POC for TRRWS requirements, security upgrades, and future enhancements.

5.3.2.9 The contractor shall solicit technical information from various Government and civilian organizations.

5.3.2.10 The contractor shall monitor, schedule and assist with action items as required.

5.3.2.11 The contractor shall organize work group meetings and record notes from meetings as required. Deliverable # 7

5.3.2.12 The contractor shall assist in development and revision documentation of policies, processes, and procedures (e.g. Standard Operating Procedures).

5.3.2.13 The contractor shall attend meetings as requested and performs other related duties as assigned.

5.3.2.14 The contractor shall act with autonomy towards the mission and vision of the POD.

5.3.2.15 The contractor shall attend meetings as requested and performs other related duties…