36C24724Q0650.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

679-24-4-031-0342

36C24724Q0650

Alecia Mitchell Alecia.mitchell@va.gov 05-24-2024

13:00 EDT

Department of Veterans Affairs VISN 7 Network Contracting Office LaVista Business Park - Bldg A 2008 Weems Road Tucker GA 30084

X 100

X

524292

Net 30

N/A

X

Tuscaloosa VA Medical Center

3701 Loop Road Tuscaloosa AL 35404

VISN 7 Network Contracting Office LaVista Business Park - Bldg A 2008 Weems Road Tucker GA 30084

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

Contractor shall furnish all labor, travel, equipment, and material necessary to provide emergency pharmacy and financial management services for reimbursement of non-VA pharmacy first fill and/or urgent prescriptions for beneficiaries seen at the Tuscaloosa VAMC, Mobile Clinic locations, Selma Community Based Outpatient Clinic Tuscaloosa Home Based Primary Care and the Selma Home Based Primary Care. Urgent prescriptions filled are for medications that a VA beneficiary cannot wait to receive through the mail. See the attached Statement of Work.

See CONTINUATION Page

X X

X 1

Earnest Ellison Contracting Officer

Table of Contents

SECTION A .................................................................................... Error! Bookmark not defined.

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES ..................................... Error! Bookmark not defined.

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 DELIVERY SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 FSS RFQ INTRODUCTORY LANGUAGE

C.2 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ...36

C.3 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

C.4 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.5 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.6 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.7 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS

AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.3 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.4 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C247

VISN 7 Network Contracting Office

LaVista Business Park - Bldg A

2008 Weems Road

Tucker GA 30084

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Upon Completion of Service

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVI

CES

QUANTI

TY

UNI

T UNIT PRICE AMOUNT

600.00 EA _______________

600 prescriptions Contract Period: Base POP Begin: 08-01-2024 POP End: 07-31-2025

600 prescriptions Contract Period: Option 1 POP Begin: 08-01-2025 POP End: 07-31-2026

600 prescriptions Contract Period: Option 2 POP Begin: 08-01-2026 POP End: 07-31-2027

600 prescriptions Contract Period: Option 3 POP Begin: 08-01-2027 POP End: 07-31-2028

600 prescriptions Contract Period: Option 4 POP Begin: 08-01-2028 POP End: 07-31-2029

GRAND TOTAL _______________

B.3 DELIVERY SCHEDULE

ITEM

NUMBER SHIPPING INFORMATION QUANTITY

DELIVERY

DATE

600.00

Statement of Work for Urgent and/or First Prescription Fills March 2024

Statement of Work

Emergent Prescription Contract for VA Beneficiaries seen at Tuscaloosa Veteran’s Administration Medical Center (TVAMC)

Facility, Mobile Clinic locations, Home Based Primary Care, CBOCs or Non-VA Clinics

Introduction/Background: Providing pharmaceuticals to our growing patient population is essential to patient centered care and necessary to ensure that Veterans are provided similar services as the Tuscaloosa Veterans Affairs Medical Center (TVAMC) may provide. The TVAMC identified the need to continue the service of a non-VA pharmacy first fill and/or urgent prescriptions contract for beneficiaries seen at TVAMC facility, Mobile Clinic locations, Selma Community Based Outpatient Clinic (CBOC) Tuscaloosa Home Based Primary Care (HBPC) 50-mile catchment area, and the Selma HBPC 50-mile catchment area. Urgent prescriptions filled under this contract are for medications that a VA beneficiary cannot wait to receive through the mail. This contract is to provide financial management services to ensure reimbursement of emergent fill pharmacy benefits for qualified VA beneficiaries. The contract is between VHA, as a health plan, and the contractor for the purpose of reimbursing the contractor a set price for prescriptions filled at the Veteran’s request for which the Veteran was not charged.

Location of Services: The vendor will have a minimum of two (2) authorized pharmacies within twenty (20) miles of the TVAMC locations listed below. However, it is preferred that the vendor have more than two (2) in all areas to provide patients with multiple choices.

Description: This contract is to provide financial management services to ensure reimbursement of emergent fill pharmacy benefits for prescriptions filled from a pre-approved “emergent medication list” including pharmaceutical products and services to qualified VA beneficiaries who have presented a valid VA prior authorization prescription voucher written within 72 hours from the TVAMC areas as defined above. The contract is between TVAMC (hereafter referred to as TMAC or the Agency), as a health plan, and the contractor for the purpose of reimbursing the contractor a set price for prescriptions filled by utilized pharmacies at the Veteran’s request for which the Veteran was not charged.

Valid VA prior authorization prescription vouchers are for “ONE-TIME USE ONLY”. Contractor will provide financial services for emergent drugs, initial and intermittent skilled new provider

VA Facility Point of Contact/ Contracting Officer’s Representative (COR)

Location Address

Tuscaloosa VA Medical Center and Home Based Primary Care

Tuscaloosa VAMC/Tuscaloosa

HBPC

3701 Loop Road E Tuscaloosa, AL 35404

Selma CBOC and Selma HBPC

206 Vaughn Memorial Drive Selma, AL 36701

Tuscaloosa VAMC Mobile Clinic locations

Livingston Mobile Clinic

101 Country Club Road Livingston, AL 35470

Demopolis Mobile Clinic

105 Highway 80 East Demopolis, AL 36732

Fayette Mobile Clinic

530 North Temple Avenue Fayette, AL 35555

Hamilton Mobile Clinic

317 7th Avenue Southwest Hamilton, AL 35570

March 2024 training, initial patient assessment and monitoring, incidentals, education and training for patient and caregiver as referred by the Agency. Contractor shall provide oversight of pharmaceutical services to include, monitoring of medication dispense history and reporting of repeat incidents of urgent/emergent medication refill requests/dispensing within a ninety (90)-day period for eligible veterans as requested by the Agency. Contractor will assure all utilized pharmacies provide patient/caregiver education in the drugs, initial patient assessment, monitoring, and incidentals. This will include all necessary teaching tools and materials that are appropriate for this patient population. Referrals generated from the CBOCs will be coordinated through the Agency and the contractor. Required response time shall be at the discretion of the Agency, CBOC provider and pharmacy service for contracted services. This service is to be provided to Veterans on a daily basis continuing timely quality patient care. For billing and auditing purposes, the Valid VA prior authorization prescription vouchers and VA prescription must be attached and filed.

Dispensing of reoccurring emergent pharmaceuticals and/or prescriptions in excess of 14-day supply is prohibitive, as determined by clinic staff of the Agency. Dispensing of emergent pharmaceuticals and/or prescriptions 72 hours after the prescription was written is prohibitive, as determined by clinic staff of the Agency. The Agency will provide the contractor an authorized restricted “emergent drug list” to be used. Only approved drugs on the Agency’s “emergent drug list” will be approved. All drugs not listed on the “emergent drug list” will require review by the Agency pharmacy designee for alternatives, disapproval or approval. Only new prescriptions will be reimbursed with a limit to a maximum of a fourteen (14)-day supply.

The contractor is prohibited from transferring Protected Health Information (PHI) by fax or email to and/or from a VA Medical facility unless they have been issued a VA PKI “partner” certificate to allow encrypted email exchange. Invoices, authorizations, and reports can then be sent via PKI encrypted email. If prior authorization for the payment of an emergent pharmaceutical is necessary and the contractor does not have a VA issued PKI “partner” certificate, verbal contact is sufficient to obtain the pharmaceutical payment authorization. The contractor is encouraged not to store any VA patient information on a mobile device. The contractor shall perform to the standards in this contract.

Contractor must assure all utilized pharmacies are registered with the Drug Enforcement Agency (DEA) and be able to dispense controlled substances Scheduled II, III, IV and V, meet DEA acceptable guidelines and be in good standing in the state of Alabama. Contractor will provide claims and invoices monthly, timely and electronically. Invoices shall be submitted in arrears, monthly and clearly state specific date of filling, quantity provided, days’ supply, prescription number and name or initials of the dispensing pharmacist, drug name, supplies, services, and patient identifiers, as agreed upon by Agency and contractor. Service shall be provided without disruption to patient care during the 12 month period of performance. The contractor shall perform to the standards in this contract. The COR shall be responsible for verifying contract compliance. This ensures the Agency pays for only appropriate charges. It is the responsibility of the Contractor to ensure billing is accurate, follows established guidelines and is appropriate.

Objectives:

This requirement will include, but is not limited to:

March 2024

1. The vendor’s pharmacies will fill and dispense prescriptions that are written by a VA provider assigned to one of the locations as defined above. The pharmacies will also fill prescriptions written by providers contracted by the VA to provide patient care services.

2. The operating hours of most VA facilities and CBOCs are 8:00 a.m. to 4:30 p.m., Monday-

Friday, excluding federal holidays. There are clinics with expanded operating hours including Saturdays. The vendor’s pharmacies will be available to fill prescriptions Monday through Friday during operating hours. A minimum of one pharmacy shall be available to fill prescriptions on Monday -Saturday from 9:00 a.m. until a minimum of 9 p.m.

3. Prescriptions will be written on a VA prescription form (or electronic equivalent). At the discretion of the VA facility or CBOC, prescriptions may also be faxed or sent electronically.

VA beneficiaries will be identified as being approved for prescription services via this contract by a specific card, voucher, or other system mutually agreed upon by the VA and the vendor.

Prescriptions written under this contract are only good for 72 hours. For billing and auditing purposes, the Valid VA prior authorization prescription vouchers and VA prescription must be attached and filed.

4. Only approved drugs on the Agency’s “emergent drug list” communicated by the Contracting

Officer Representative (COR) or their designee can be dispensed to VA beneficiaries. The Agency’s “emergent drug list” must not be confused with the VA National Formulary. The Agency’s Medical Executive Committee reserves the rights to make modifications to the Agency’s “emergent drug list” at their discretion. When changes are made to the “emergent drug list”, the COR, or designee will send the updates to the Contractor’s Point of Contact.

The Agency may update the emergent drug list as needed without contract modification.

5. Agency providers who write prescriptions for a patient as a convenience that do not meet the emergency guidelines are not covered for reimbursement by the Agency and will be the responsibility of the patient to make payment. These prescriptions are not to be submitted to the Agency for payment. The VA is not responsible for payment of any prescription for products not on the “emergent drug list” even if ordered by VA authorized practitioners. If a VA authorized practitioner prescribes a product not on the approved list the pharmacist shall notify the patient that the prescription is not covered and that the patient will be responsible for the cost, payable at that time. Prescriptions that fall into this category will have the following terminology (or equivalent) noted on the reverse side of the prescription:

“This prescription will not be paid for by the Department of Veterans Affairs.”

6. Prescriptions will be filled and dispensed only for medications written by providers authorized by the TVAMC. TVAMC will be responsible for the creation and maintenance of their provider list. A process will be established with the vendor to add, remove, and/or change provider information, as needed, without modification of the contract. The vendor will have a method to immediately notify its contracted pharmacies of the updated provider information.

7. The vendor’s pharmacies will fill new prescriptions only. No refills will be authorized. A new prescription is defined as a written, verbal, or electronically transmitted, prescription for a drug product and strength that has not been previously dispensed to the beneficiary in the past 90 days. A repeat order for the same drug product within 90 days, even if transmitted as a new prescription order is not considered a new prescription.

8. Most prescriptions will be limited to a maximum of ten (10) days. An antibiotic may be filled for up to a fourteen (14) day supply. The TVAMC may set a different day supply for a specific

March 2024 patient and/or medication. Exceptions may be made for second courses of antibiotic therapy and urgent doses of maintenance medications as deemed necessary by the provider, and require pre-authorization by designated TVAMC pharmacy staff

9. All prescriptions reimbursed under this contract will be, to the extent permitted by law, the least expensive drug product the pharmacy has in stock. Generic drugs will be dispensed as a standard, whenever possible. All generic medications used must comply with Federal and State requirements. The VA will only reimburse for the brand name drug if no generic form of the drug exists in the marketplace. A product is not considered a generic equivalent unless the strength, quantity and dosage are the same as the brand name drug. The generic name must be displayed on all labels for all medication. If a generic medication is commercially available, but not in stock at an authorized pharmacy, that pharmacy must contact the Agency directly for approval prior to dispensing a name brand medication. The pharmacy may request alternative therapy from the prescribing provider. The alternative therapy must be from the Agency’s approved “emergent drug list

10. VA beneficiaries will pick up prescriptions at the dispensing pharmacy. No prescriptions are to be mailed or delivered.

11. The Agency may randomly audit prescription fills. Access will be allowed during regular business hours, upon reasonable notice, to any written or electronic information deemed necessary to verify claim information, prescription volume, and the usual and customary charges to the general public for covered prescriptions. The vendor and/or the contracted pharmacy will make all TVAMC prescription records and invoices available at the time of the audit. Representatives of the TVAMC are authorized to visit the vendor’s site and/or the premises of any pharmacy filling TVAMC prescriptions during regular business hours for the purposes of auditing and evaluation, which may include the inspection of clinical records.

Inspection shall be limited to TVAMC records.

12. The vendor’s pharmacy will have a means of documenting that the VA beneficiary picked up the prescription. This documentation must include pick-up date, prescription number, and signature. A copy of the documentation must be maintained with the vendor and/or at the contract pharmacy and be readily accessible for random TVAMC audit for at least 2 years.

13. Auxiliary labels will be affixed to the prescription as needed. The vendor’s contracted pharmacy will provide appropriate counseling and drug interaction sheets, including FDA Medication Guides when appropriate. The VA does not consider signing for a prescription to be appropriate counseling.

14. The reimbursement amount will not exceed the price charged to the general public or the vendor’s lowest third-party reimbursement plan (e.g., Average Wholesale Price (AWP) discounted by the applicable percentage plus the applicable dispensing fee). All pricing information is to remain confidential.

15. Average Wholesale Price (AWP) will be based on the current Pharmacy Fundamental

Reference REDBOOK and REDBOOK updates published by the Medical Economics Data, Inc. The vendor will provide access to the REDBOOK throughout the contract term. If a vendor offers to use any other means of pricing, they will provide appropriate documentation similar to that of the REDBOOK and its updates. Award of a contract will not be made to any offeror who does not provide sufficient evidence to substantiate the fairness/reasonableness of their pricing.

March 2024

16. The vendor shall submit monthly electronic invoices through the VA’s Invoice Processing Payment System (IPPS), utilizing Tungsten OB10 access.

17. The vendor shall provide monthly electronic reports of prescriptions filled via email to the facility Point of Contact or COR, Pharmacy Associate Chief(s) and Pharmacy Chief. The data should be provided in Excel or other similar format that allows the facility to sort and analyze the data. Vendor must have mechanism in place to catch duplicate or reveal erroneous claims. The data must be sent via a secure method that adheres to VA privacy and security regulations. There should be one report broken down by facility and/or clinic.

At a minimum, the report must include the following columns.

a. Contract number

b. Patient name

c. Patient unique identification number

d. Prescription number

e. Medication name and strength

f. NDC

g. Dispensed Quantity

h. Prescriber

i. Fill Date

j. Days Supply

k. AWP

l. Product Cost (Charge to the VA)

m. Dispensing Fee

n. VA facility/CBOC

18. The vendor shall reimburse their contracted pharmacies within 30 days of receiving an invoice.

19. The vendor’s contracted pharmacies will keep all information concerning VA beneficiaries confidential and shall not release or disclose information to any person, except as authorized in writing and according to all applicable laws. The Privacy Act of 1974, Public Law 93-579, December 31, 1974 (5 USC 552a) applies to this procurement.

20. Pharmacies authorized to fill prescriptions under the vendor’s plan must be provided periodic provider education on Contractor processes required for prescription reimbursement and must agree to the following conditions:

a. Register with the Drug Enforcement Agency (DEA) and be able to dispense controlled substances Scheduled II, III, IV and V, meet DEA acceptable guidelines and be in good standing in the state of Alabama.

b. Provide initial patient assessment and monitoring, incidentals, education and training for patient and caregiver.

c. Pharmacists must log into the PDMP database for every controlled substance prescription to ensure physicians have documented completion.

d. Pharmacists will review allergy history with patients prior to filling prescriptions.

e. Report to the vendor all adverse drug events reported by VA beneficiaries for vendor reporting to designated VA pharmacy staff and the prescribing provider. This notification will be made via telephone followed by written notification. Adverse drug events include, but shall not be limited to dispensing errors, drug allergies, and adverse drug reactions.

f. Report to vendor all medication errors regarding VA beneficiaries for vendor reporting to designated VA pharmacy staff and the prescribing provider. This notification will be made via telephone followed by written notification. The Contractor shall notify the VA

March 2024 in writing whenever a malpractice claim involving a VA patient has been filed against the contract within three (3) working days.

21. Pharmaceutical services provided to VA beneficiaries under this contract will meet all standards applicable to Medicaid recipients in the State where services are provided.

22. The vendor will continuously meet or exceed The Joint Commission medication management standards related to procurement, preparation, storage, dispensing, security, recall, and patient education. Additional information related to these standards is available at the Joint Commission website at www.jointcommission.org.

23. When new CBOCs are opened and services are needed, they will be added to this contract.

The Contracting Officer will notify the vendor. The vendor will submit a listing of proposed pharmacies for that area to the facility point of contact or Contracting Officer Representative (COR). The Contracting Officer will approve additional pharmacies via a supplemental agreement to the contract.

24. The vendor will develop a method for monitoring and reporting any prescriptions filled that involve medications affected in any recall. This process must include notification to the affected patients, replacement of medication at no charge (if deemed required) and reporting actions to designated VA pharmacy staff.

25. Contractor must be able to:

a. Register verified VA providers for prescription authority.

b. Complete On demand patient enrollment

c. Complete real time claims adjudication

d. Provide direct customer service support and telephone call-in number

e. Demonstrate a streamlined preauthorization process

f. Maintain on-going process of “emergent drug list” changes, pharmacy coverage and provider updates

g. Establish an extensive reporting package that provides customers with multiple monthly reports

h. Provide accessibility to the Agency staff for daily support. Daily support shall include in person, telephone and online support as determined by the Agency and contractor.

26. The vendor must require credentialing, certification and continuing education of employees and/or utilized pharmacies providing services under this contract in accordance with Alabama State Board of Pharmacy, DEA or their appropriate professional accreditation agency and state rules and regulations.

27. Contractor will assure provision of pharmaceutical products as described in the contract agreement in accordance with all HCPCS Codes, Centers for Medicare and Medicaid Services (CMS) rules, guidelines and Industry standards.

28. Contractor will assure that where Medicare Part D (Prescription Drug Plan) covers eligible pharmaceuticals services, payment will be coordinated with Medicare for Veterans who are referred for services that have Medicare Part D coverage.

http://www.jointcommission.org/

March 2024

29. Utilized pharmacies by the Contractor must be within a 20 mile radius of the VA facility/CBOC providing care.

30. The service area shall include but not limited to the State of Alabama: Fayette, Hamilton, Marengo, Sumter and Tuscaloosa Counties.

31. Authorized Pharmacy Notification: The Contractor shall establish a system of signed certification for each individual dispensing pharmacist working under authorized subcontractors. This ensures Pharmacists are aware of contract span of coverage and Agency and Contractor expectations.

SCOPE and GENERAL REQUIREMENTS:

The contractor shall provide pharmacy benefit management services to VA beneficiaries in the Tuscaloosa VA Medical Center Mobile Clinic as deployed to the locations stated above, the Selma Outreach Clinic, the Tuscaloosa Home Based Primary Care (HBPC) 50 mile catchment area and the Selma HBPC 50 mile catchment area.

Only new prescriptions shall be filled with no refills authorized. A new prescription is defined as a written, verbal, or electronically transmitted, prescription for a drug product and strength that has not been previously dispensed to the beneficiary in the past 90 days. A repeat order for the same drug product within 90 days, even if transmitted as a new prescription order is not considered a new prescription.

1. The filling of prescriptions shall be inclusive of patient medical profile review and proper filling and labeling in accordance with proper pharmacy practices and state requirements.

Procedures shall include necessary patient education and counseling consistent with the Omnibus Budget Reconciliation Act (OBRA)1990 requirement to ensure appropriate use and optimal outcomes from drug therapy. Counseling includes the following information at a minimum:

• Name, description and use of the medication

• Dose, dosage form and route

• Special directions and precautions

• Common side effects and action requires if they occur

• Techniques for self-monitoring drug therapy

• Action to be taken if a dose is missed

• Proper storage

• Possible side effects to the medication

• Appropriate auxiliary labels attached to the containers.

• All prescriptions MUST have Consideration must be given to a patient’s ability to open “childproof” containers.

• Generic name must be indicated on drug label for all medications.

• Beyond use dating should be present on all dispensed containers.

2. The contractor must have a minimum of two pharmacies within a 20-mile radius of each location established for the Mobile Clinic setup, the Selma Outreach Clinic, the Tuscaloosa Home Based Primary Care (HBPC) 50 mile catchment area and the Selma HBPC 50 mile catchment area. The facility must be handicapped accessible, have handicapped parking spaces available and have seating available for patients waiting for prescriptions.

March 2024

3. Additional areas may be added to this contract by mutual agreement as services are needed for new setup locations in service area. Contract requirement and rates will be as stated in the proposal and subsequent contract.

a. Pricing: If the contract is ordered from one of the GSA FSS schedules for Financial and

Business Solutions, the order must include the GSA contract price list Per Claim Fee and the discount arrangement. The GSA contract price for the prescriptions and any discount should also be stated in the contract such as: Drug prices are based off a discount from the Drug Topics MediSpan Average Wholesale Price (AWP). Ex. AWP minus 55% for Generic and AWP minus 15% for Brand name. If the contract is not ordered through GSA, the contract must contain specific details on all pricing. The total cost charges to the VA shall be the same or lower than that charged to their best customer and in no case, more than charged to the general public.

b. The contractor must provide a price list to the Contracting Officer showing pricing of the pharmaceuticals. As price list changes the contractor must submit the revised price list to the Contracting Officer.

4. The contractor shall invoice for reimbursement at the prices stated in the Schedule of

Supplies of this contract. The Contractor shall bill the appropriate TVAMC Billing Contact monthly for services rendered. More frequent billing cycles are negotiable. The VA will randomly audit all billings. Pharmacies under contract shall make records available to the VA auditor in a timely manner at the location where dispensed.

5. All invoices shall reference the following information:

• Name and Address of Contractor

• Name, title and phone number of person to be notified in event of questions

• Name and address of official to whom payment is to be sent

• Contract Number and Obligation Number (PO#)

• Date of Invoice

• P.O. Number

• Due Date

• Item billed as a line item

• Dispense Fee as a line item

Invoices must be submitted via the Invoice Processing Payment System utilizing Tungsten OB10 access. In addition, each invoice should be emailed to the COR on a monthly basis.

6. REPORTS. The contractor shall provide monthly reports. These reports shall also include any medication errors or medication related incidents. These reports shall be provided to the COR at the TVAMC main campus. Cumulative monthly, quarterly and annual reports shall also be provided to the COR. A copy of the cumulative quarterly and annual reports shall be provided to the Contracting Officer. The reports will contain the following information.

a. Billing Pharmacy

• Prescription Number

• Date of Fill

• Drug Generic Name

• Drug Strength

• Quantity Dispensed

• NDC number of Product Dispensed

March 2024

• Cost of Drug Dispensing Fee

• Prescriber Last Name

• Cost Type Code (ex. AWP)

• Day’s Supply

• Total Ingredient Cost Paid

• Total Normalized Cost

• If the prescription was an approved exception to the VA formulary drug list, the name of the TVAMC approving official must be included on the invoice.

b. The Contracting Officer also requires a quarterly report comparing the dollar amount of drugs dispensed under the contract price compared to Average Wholesale Price.

7. Staffing Thresholds: At all times, at a minimum, any pharmacy that the Contractor utilizes must have on duty, a registered pharmacist in good standing and must meet all state and federal qualifications and standards to dispense drugs within the 12-month contractual support during each year of the period of performance. All staff dispensing drugs must be Alabama State registered, certified and or licensed.

8. Staffing Compensation: At all times, at a minimum the contractor must meet the federal standard for minimum wage pay compensation for all employees associated with providing service to this contract.

9. Period of performance: The period of performance shall be for one (1) base year of 12 months and four (4) 12-month option years. The period of performance reads as follows:

• Base year - August 1, 2024 thru July 31, 2025

• Option year one - August 1, 2025 thru July 31, 2026

• Option year two - August 1, 2026 thru July 31, 2027

• Option year three - August 1, 2027 thru July 31, 2028

• Option year four - August 1, 2028 thru July 31, 2029

The government reserves the right to extend the term of this contract at the prices set forth in Section B in accordance with the terms and conditions contained in clause 52.217-9 entitled, "Option to Extend the Term of the Contact."

10. Quality control (QC): The contractor shall develop and maintain an effective QC program to ensure services are performed in accordance with this SOW. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services.

The contractor's QC program is the means by which he assures himself his work complies with the requirement of the contract. As a minimum, the contractor shall develop QC procedures addressing the areas identified in the SOW. After acceptance of the QC plan, the contractor shall receive the contracting officer's (CO's) acceptance in writing of any proposed change to his QC system.

11. Quality assurance: The government shall evaluate the contractor's performance under this contract in accordance with the quality assurance surveillance plan (QASP). This plan is primarily focused on what the government must do to ensure the contractor has performed in

March 2024 accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rates.

12. Government remedies: The CO (contracting officer) shall follow Federal Acquisition Requirement (FAR) 52.212-4, "Contract Terms and Conditions-Commercial Items" or 52.246-4, "Inspection of Services-Fixed Price" for a contractor's failure to perform satisfactory services or failure to correct non-conforming services.

13. Recognized holidays: The following terms have the following meanings:

(1) Work hours: Monday through Friday, 8:00 a.m. - 4:30 p.m. Some entities Saturdays 8:00 a.m. – 12 noon

(2) National Holidays: The 10 holidays observed by the Federal Government are:

• New Year’s Day

• Martin Luther King’s Birthday

• Presidents Day

• Memorial Day

• Juneteenth National Independence Day

• Independence Day

• Labor Day

• Columbus Day

• Veterans Day

• Thanksgiving

• Christmas

• Any other day specifically declared by the President of the United States to be a national holiday.

14. Hours of operation or place of performance: The contractor is responsible for assuring pharmacies are available for prescription processing and monitoring between the hours of 8:00 a.m. - 4:30 p.m., Monday through Friday and Saturdays 8:00 a.m. – 12noon, except federal holidays or when the government facility is closed due to local or national emergencies, administrative closings, or similar government-directed facility closings. Deviations from these hours should be provided and justified in the proposal. The contractor must at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this statement of work (SOW) 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 work force are essential.

15. Security requirements: Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal laws, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security.

16. Physical security. The contractor shall be responsible for safeguarding all government property provided for contractor use if applicable.

17. The Parties agree that the Contractor’s personnel will not be considered VA employees for any purpose and shall be considered employees of the Contractor.

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18. Contractor employees are not covered by the Federal Tort Claim Act. When Contractor employee has been identified as a provider in a tort claim, the Contractor employee is responsible for notifying the Contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor employee’s action or non-action is the responsibility of the Contractor and/or insurance carrier. The Contractor shall notify the VA of the action or non-action.

19. A comprehensive record keeping system shall be approved by the Contracting Officer and be in place prior to initiation of the contract. The Contractor shall submit with their proposal a sample of their proposed record keeping system. A computerized system is preferred.

20. A pharmacist will be available to answer any drug related questions that a patient may have after the prescription is filled. This may be in the form of written and/or verbal information.

21. The contractor and contractor employees shall maintain the confidentiality of all patient information and shall be held liable in the event of a breach of confidentiality as outlined in Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, 45 Code of Federal Regulations (CFR) Parts 160 and 164, VHA Handbook 1605.1 and VHA Handbook

1605.2. Breach of confidentiality is grounds for termination of this contract. The contractor and its employees are subject to all federal and state statutes, rules, and regulations regarding patient privacy, including, but not limited to the above listed regulations. All shall maintain compliance in regards to healthcare activity for purposes of the following statutes and the VA regulations implementing these statutes: the Privacy Act, 5 U.S.C sections 552a, and 38 U.S.C., sections 5701, 5705, and 7332.

The contractor cannot store patient information on a mobile device and verbal contact is sufficient to obtain prior authorization when needed. The contactor is prohibited from transferring Personnel Health Information (PHI) by fax or email to and/or from a VA Medical facility. Invoices and reports must be sent desensitized when sent via encrypted email or certified postal mail with a return receipt.

22. Special qualifications: The contractor is responsible for ensuring all employees possess all required licenses for operating. Contractor shall provide a copy of the Agencies Professional Accreditation and assure licensure and competency of all employees according to Alabama State Board of Pharmacy and/or other regulatory/accrediting agency standards and provide proof of it to the TVAMC upon request. These should include an annual update of the following:

1) Job/position description

2) Annual performance evaluation

3) Initial assessment of competence of pharmaceutical services to include monitoring of medication dispensing

4) On-going (at least annually) assessment of pharmaceutical management

5) Copy of license, certification or registration

23. The contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide the following for these personnel:

• General liability

• Workers compensation

• Professional liability insurance

• Health examinations

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• Income tax withholding

• Social security payments, and

• At a minimum the federal standard of minimum wage

24. Post-award conference or periodic progress meetings: The contractor agrees to attend any post-award conference convened by the contracting activity or contract administration office in accordance with FAR 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.

25. COR and Designee:

The COR monitors all technical aspects of the contract and assists in contract administration.

The COR is authorized to perform the following functions: assure 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 and specifications; monitor contractor's performance and notify 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 order.

26. Contract manager: 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.

27. Identification of contractor employees: All contract personnel attending meetings, answering government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are government officials. They must also ensure all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed. Contractor personnel will be required to obtain and wear badges in the performance of pharmaceutical services.

Definitions and acronyms:

This section includes all special terms and phrases used in the SOW. Each definition provided should be carefully considered; that definition becomes binding for all requirements in the

March 2024 contract. This section should also contain a complete listing of all acronyms used; giving both the acronym and the term the acronym represents.

SOW: Statement of Work

Contracting officer's representative (COR): A representative from the requiring activity appointed in writing by the CO to perform surveillance and to act as liaison to the contractor.

Defective service: A service output that does not meet the standard of performance associated with it in the SOW.

Quality assurance surveillance plan (QASP): A written document specifying the surveillance method used for surveillance of contractor performance.

Quality control (QC): Actions taken by a contractor to control the performance of contracted services to meet PWS requirements.

Quality assurance: Actions taken by the government to assure contracted services meet PWS requirements.

Tuscaloosa Veterans Affairs Medical Center: TVAMC or The Agency

Billing and Payment: The quantities of supplies or services specified as estimates only and are not purchased by this contract. Delivery of performance shall be made only as authorized by the Agency. The Contractor is to provide services through authorized pharmacies in accordance with the pricing schedule below:

Item # Description Cost

1 Dispensing Fee Per Prescription

2 Discount from Average Wholesale Pricing (AWP) per Prescription

3 Administrative Fee per Prescription

For billing and auditing purposes, the Valid VA prior authorization prescription vouchers and VA prescription must be attached and filed.

A completed invoice shall be submitted for payment by the Contractor. Sums due to the Contractor will be paid monthly upon receipt and after review of a properly executed invoice submitted by the Contractor after review of the COR. The COR shall be responsible for verifying contract compliance. This ensures the Agency pays for only appropriate charges. It is the responsibility of the Contractor to ensure billing is accurate, follows established guidelines and is appropriate.

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Failure to follow guidelines submitted by the Agency or submission of inappropriate or inaccurate charges will result in a monetary loss at the Contractor’s expense. The Agency will not be responsible for payment of justified charges that fall into this category.

The COR shall submit signed documentation of charges that will not be paid to the Contractor within sixty (60) calendar days of receipt of the invoice for payment. This documentation shall include a line-item reference and rejection justification.

Applicable publications:

6.1 Publications applicable to this SOW are listed below:

Technical exhibit 1: performance requirements summary of mandatory requirement;

Quality Assurance Surveillance Plan for TVAMC Location Areas Pharmaceutical Services

(QASP)

Performance Requirements (PR)

Indicator Standard Performance Threshold

Method of Surveillance

Incentive

PR #1

Contractor will assure provision of emergent drugs, to the patient in a timely manner.

All prescriptions shall be provided timely, within 24 hours of initial contact.

All prescriptions shall be provided timely, within 24 hours of initial contact.

100% during quarterly review period.

Quarterly reviews of Patients’ medical record and observation.

Monitoring customer comments.

Exercise of Option

PR # 2

Skilled training and education of new providers authorized to write prescriptions.

Training and education of provider shall be completed within 24 hours of registration.

Training and education of the provider shall be completed within 24 hours. An acknowledgement of completion must be submitted to COR and kept on file.

95% during quarterly rating period

Quarterly reviews and observation.

Monitoring customer comments.

Exercise of Option

PR # 3

Monitoring of medication dispensing and reporting of repeat incidents of

Monitoring of medication dispensing and reporting of repeat incidents of

Contractor shall monitor and notify providers and subcontractors of urgent/emergent

95% during quarterly rating period.

Quarterly invoice reviews and observation.

Monitoring

Exercise of Option

March 2024 urgent/emergent medication refill requests/dispensing within a ninety (90)-day period.

urgent/emergent medication refill requests/dispensing within a ninety (90)-day period.

standard and report repeat incidents to the Agency.

customer comments.

PR # 4

Only new prescriptions will be approved with a limit to a maximum of a fourteen (14)-day supply with a valid VA prior authorization prescription voucher written within 72 hours.

Only new prescriptions will be filled with a limit to a maximum of a fourteen (14)-day supply with a valid VA prior authorization prescription voucher written within 72 hours.

Contractor shall monitor and notify providers and subcontractors of urgent/emergent standard and report repeat incidents to the Agency.

98% during quarterly rating period

Quarterly invoice reviews and observation.

Monitoring customer comments.

Exercise of Option

PR # 5

Contractor and utilized pharmacies must comply with DEA and Alabama State Board of Pharmacy standards.

Vendor shall maintain compliance with all DEA and Alabama State Board of Pharmacy standards related to pharmaceutical management and notify VA of non-compliance.

Contractor will provide appropriate verification of Alabama State Board of Pharmacy accreditation.

Contractor will notify VA of any conditions of non-compliance with recommendations within 7 days of their notification.

100% during annual review

Verification will be provided annually.

Verification will be required prior to award of contract and prior to utilization of contract option years.

Exercise of Option

PR # 6

Contractor will provide a copy of a prescription and voucher when requested upon audit. For billing and auditing purposes, the Valid VA prior authorization prescription vouchers and VA prescription must be attached and filed.

Copy of prescription and voucher shall be provided timely, within 3 business days of initial request.

Copy of prescription and/or voucher shall be provided timely, within 3 business days of initial request.

98% during quarterly rating period.

Monthly audit of prescriptions submitted to Agency for reimbursement.

Exercise of Option

Types of surveillance:

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