36C25520Q0040-000.docx

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* = Required Field FedBizOpps Sources Sought Notice Rev. March 2010 Q Pharmacy Services, Columbia, MO VAMC 66048 36C25520Q0040 N 446110 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 Jeanine Wallace jeanine.wallace@va.gov Columbia VAMC 800 Hospital Drive Columbia, MO 65201-5272 jeanine.wallace@va.gov This is a sources sought request for potential vendors to respond to this requirement to determine the market for Urgent Pharmacy Benefit Management Services for the Columbia VAMC and seven (7) Community-Based Outpatient Clinics (CBOCS) and its Home Based Primary Care (HBPC) program. located at

See the Performance Work Statement on the following pages which include CBOC location addresses and HBPC zip codes.

Contractor shall provide socioeconomic status and classification (SDVOSB, SB, VOSB, etc.) The NAICS Code is 446110 Pharmacies and Drug Stores and the small business standard is 30 Million.

All interested vendors should provide a response to Jeanine Wallace at jeanine.wallace@va.gov before 11:00 AM on 11/7/2019.

*** This is not a Request for Quote (RFQ). This is a Pre-Solicitation Notice only. A Solicitation is not available at this time. ***

PERFORMANCE WORK STATEMENT

FOR URGENT PHARMACY BENEFIT MANAGEMENT SERVICES

1. GENERAL

1.1 SERVICES REQUIRED: The Contractor will provide urgent pharmacy benefit management services to eligible veteran beneficiaries assigned to the Harry S. Truman Memorial Veterans’ Hospital’s (HSTMVH) seven community-based outpatient clinics (CBOCs) and its Home Based Primary Care (HBPC) program. Services will also be required for patients at any and all new future CBOC locations and for new HBPC patients within the HSTMVH primary service area. Services required include filling prescriptions, dispensing prescriptions, and counseling patients on all controlled and non-controlled prescriptions written by VA providers.

1.2 PLACES OF PERFORMANCE:

1.2.1 The seven CBOC locations are as follows:

Ft. Leonard Wood

Mexico

Jefferson City

700 GW Lane Street

3460 South Clark Street

3430 W Edgewood Dr

Waynesville, MO 65583

Mexico, MO 65265

Jefferson City, MO 65109

Phone: (573) 774-2285

Phone: (573) 581-9630

Phone: (573) 635-0233

Lake of the Ozarks

St. James

Marshfield

940 Executive Drive

207 Matlock Drive

1240 Banning Street

Osage Beach, MO 65065

St. James, MO 65559-1999

Marshfield, MO 65706

Phone: (573) 302-7890

Phone: (573) 265-0448

Phone: (417) 468-1963

Sedalia

Kirksville

3320 West 10th Street

1510 North Crown Drive

Sedalia, MO 65301

Kirksville, MO 63501

Phone: (660) 826-3800

Phone: (660) 627-8387

1.2.2 Our HBPC patients are located in the following zip code areas:

1.3 AUTHORITY/POLICY/HANDBOOKS (WITH LINKS): Joint Commission Medication use standards (www.jointcommission.org).

1.4 DEFINITIONS/ACRONYMS: The use of the term “contract” within this Performance Work Statement is used to denote a binding legal contract for the procurement of services. “Contractor” refers to the awarded holder of this contract. “Contractor employee” is defined as an employee or personnel of the prime contractor or of any subcontractor, affiliate, partner, joint venture or team members with whom the Contractor is associated. It also includes consultants engaged by any of those entities.

2. QUALIFICATIONS: Pharmaceutical care provided to beneficiaries under this contract shall meet all standards applicable to Medicaid recipients in the State where the services are provided. Personnel assigned by the Contractor to perform the services covered by this contract shall be licensed in good standing without restrictions in a State, Territory, or Commonwealth of the United States or District of Columbia. Offerors are required to verify all Federal, State, and/or local licenses and certification(s) applicable to the provision of Pharmacy Services at the time a pharmacy is added to the network. The qualifications of contractor personnel shall also be subject to review by the HSTMVH Chief of Pharmacy and the HSTMVH Chief of Staff. The Contractor, its employees, agents, and subcontractors shall not be VA employees for any purpose. Contractor employees shall read, understand, speak, and write English fluently.

3. HOURS OF OPERATION:

3.1 Business Hours: The majority of CBOC and HBPC operating hours are 8:00 a.m. to 4:30 p.m. central standard time, Monday through Friday. The services covered by this contract shall be furnished by the Contractor’s pharmacies during both day and evening hours, Monday through Saturday, excluding the following federal holidays:

When the holiday is on a Saturday, the preceding Friday shall be the federal holiday. When the holiday is on a Sunday, the following Monday shall be the federal holiday. The services specified herein may be changed by written modification to this contract. The modification will be prepared by the VA Contracting Officer.

4. CONTRACTOR RESPONSIBILITIES:

4.1 SERVICES REQUIRED: The contractor’s pharmacies shall fill and dispense urgent medications from original prescriptions written by VA providers assigned to HSTMVA, the VA CBOCs, and the VA HBPC program within 30 minutes from presentation of the prescription by the patient. The services covered by this contract shall be furnished by the contractor’s pharmacies located more than 25 miles from HSTMVA.

Services shall be provided in accordance with all terms, conditions, and provisions of the resulting contract for one year from date of award with four additional one-year option periods to be exercised at the discretion of the government. The contractor must have a minimum of two licensed pharmacies accepting its plan in each of the seven CBOC locations and within the designated zip code areas. The intent of the Government is that the contractor have at least two licensed pharmacies in all service areas to provide patients with more choices and additional access to pharmacies.

4.2 It is impossible to determine the exact quantities that will be required during the contract delivery order period. The contractor shall be required to fill all prescription orders written during the contract delivery order period. The fact that the estimated dollar value is not obtained shall not constitute a price adjustment under the contract delivery order.

4.3 Prescriptions filled will be in written form provided by an HSTMVA provider, a CBOC provider, or an HBPC VA provider. Dispensing pharmacies must be able to accept the written prescription.

4.4 The Contractor will accept a phone call or an electronic e-mail from the Contracting Officer Representative advising him/her of any new VA providers by providing the National Provider Identifier (NPI)number.

4.5 Urgent prescriptions will be filled and dispensed only for medications listed in the Urgently Needed Medication Formulary List as authorized by the HSTMVA. The HSTMVA Urgently Needed Medication Formulary List will be e-mailed to the contractor at time of contract award and after each update by the Chief of Pharmacy or his/her designee. There shall be a mechanism in place, provided by the contractor, to provide real-time messaging and hard edits to the pharmacies in order to limit dispensed medications to the specified Urgently Needed Medication Formulary List to prevent non-formulary or prior authorization medications from being dispensed without specific prior approval by the Chief of Pharmacy or his/her designee. In addition, there must be a mechanism in place to update the Urgently Needed Medication Formulary List as needed.

4.6 Prescriptions shall be filled and limited to a maximum of a seven (7) day supply except for antibiotics and antibacterials which shall be limited to a maximum of a ten (10) day supply. No prescription refills will be authorized. The contractor shall only fill new prescriptions with no refills. All prescriptions must have proper auxiliary labels attached and appropriate counseling and drug interaction sheets provided.

4.7 Prescriptions shall be filled with generic drugs to the extent permitted by law, and the least expensive drug product the pharmacy has in stock will be dispensed. Generic drugs shall be dispensed if, in the professional judgement of the pharmacist, the substitute product is available, safe, and effective, and to the greatest extent possible, contains the same chemical ingredients of the same strength, quantity, and dosage of the brand name. All generic products used must be AB rated per the Orange Book. All generic products used must be in compliance with Federal and State requirements.

4.8 VA beneficiaries or their designees will pick up their prescriptions at the dispensing pharmacy. No prescriptions will be mailed or delivered to patients.

4.9 Contract pharmacies shall maintain an electronic record of VA prescriptions filled and require the patient to sign next to each prescription number for each prescription received.

4.10 The contractor and his/her contract pharmacies shall 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 U.S.C. 552a) applies to this procurement. Special consideration shall be given to provide privacy of all patient individually identifiable health information. The contractor employee shall provide patients with the utmost care and attention. All patients shall be assured of their privacy and personal dignity. The contractor and its employees shall ensure strict compliance to the release of Protected Health Information in accordance with the Code of Federal Regulation, Title 45, Public Welfare, Subtitle A, Department of Health and Human Services, Part 164, Security and Privacy (45 CFR 164), paragraph 2.2.3, “Health Insurance Portability and Accountability Act (HIPAA)" and paragraph 2.3, "General Guidelines on Releasing Medical Information".

4.11 The contractor shall report in writing all adverse drug events and medication errors to the Chief, Pharmacy Service, HSTMVA, Columbia, Missouri, and to the prescribing CBOC or HBPC physician. The report should describe the date and nature of the adverse event or medication error and corrective actions taken.

4.12 The contractor shall provide the COR with copies of pharmacist state licenses on an annual basis.

4.13 The contractor and its pharmacies 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:

4.14 Contractor will provide electronic monthly, quarterly and annual reports to the COR. The reports will show the total number of prescriptions filled and the total dollar amount per location. Reports will be due by the 15th day following the end of the month, quarter, or year. Monthly reports will also reflect expenditures to the COR including but not limited to:

4.15 As services are needed for new CBOCs in the HSTMVA primary service area, additional pharmacies will be added to this contract delivery order. If a new CBOC is to be opened, the Contracting Officer (CO) will notify the contractor in advance of the opening. At that time, the contractor shall submit a listing of proposed pharmacies for that area to the CO. The COR shall approve additional pharmacies for that area to the CO. Additional pharmacies shall be added to the contract via an amendment to the contract delivery order.

4.16 The Contractor shall designate a program manager (contractor representative) under this contract delivery order and shall provide his/her name, title, address, phone number, fax number, and e-mail address to the CO & COR. The program manager (contractor representative) shall work closely with the COR in regards to all services covered by the contract delivery order and/or any issues arising under the contract delivery order.

4.17 The Contractor shall provide a list of pharmacies within its network that are geographically-accessible to HSTMVA and each CBOC, handicapped-accessible, and which have the most accessible weekday and weekend and day and evening operating hours. The contractor shall provide this list for HSTMVA and each CBOC to the CO and the COR within five (5) days after receipt of this purchase order and provide updates to this list. The list shall include the following information:

4.18 Contractor will offer counseling by a pharmacist to ensure appropriate and optimal outcomes from drug therapy. Counseling should include the following:

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

4.19 The contractor shall ensure contractor employees maintain open and professional communication with members of the VHA. Complaints relating to any contractor personnel’s failure to maintain such open and professional communication shall be validated by the COR and shall be reported in writing within 24 hours to the Contracting Officer (CO) and the Contractor for action.

4.20 The contractor shall have sufficient qualified employees to support all services in the event an employee scheduled to work becomes ill, resigns, is terminated by the contractor, or is otherwise unavailable to work. Contract requirements are not altered or mitigated by inclement weather.

4.21 The contractor shall accept a call from the COR advising him/her of all existing and/or new VA provider's state license numbers and his/her federal and/or state drug license numbers. The contractor shall immediately notify its contract pharmacies of the provider information so as to avoid delay in patient services. Notification of provider information may occur on either the day the VA provider fills in at the CBOC or prior to CBOC duty as time allows.

4.22 The contractor shall develop and maintain a quality control program to ensure services are performed in accordance with commonly accepted commercial practices, The Joint Commission, this contract, VA handbooks and directives and all federal, state, and local laws and regulations. At a minimum, the contractor shall develop quality control procedures addressing the areas identified in the Service Delivery Summary. The contractor shall develop and implement procedures to identify, prevent, correct, and ensure no recurrence of defective services. The contractor shall provide a copy of the quality control plan to the contracting officer no later than the orientation date, and updated copies as changes occur. Records of all inspections conducted by the contractor and corrective action taken shall be made available to the government upon request.

4.23 The contractor employees shall participate and comply with all VISN 15 Performance Measures.

4.24 Performance shall be according to the requirements contained in this agreement and Veteran’s Healthcare Administration (VHA) rules, regulations, handbooks policies, and standard operating procedures (SOP’s).

4.25 The contractor employees, upon request, shall provide quality data and information related to services provided and participate in the VA’s performance improvement programs when requested to do so.

4.26 Reimbursements shall be determined by the Average Wholesale Price (AWP) discounted by the applicable percentage plus the applicable dispensing fee. The total price charged to the VA shall not exceed that charged to the general public and shall not exceed the price charged by the Contractor’s lowest third party reimbursement plan.

4.27 Average Wholesale Price (AWP) will be based on the current Pharmacy Fundamental Reference Redbook and Redbook Updates published by Medical Economics Data, Inc. Contractor shall be required to provide HSTMVA with a current copy of the REDBOOK and updates throughout the contract term. If a contractor offers to use any other means of providing pricing, they shall 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 pricing.

5. GOVERNMENT RESPONSIBILITIES:

5.1 The Chief, Pharmacy Service, HSTMVH, will recommend the assignment of a COR to the CO. The COR will be delegated in writing by the CO, and a copy of the delegation letter will be provided to the Contractor. The COR will monitor the day-to-day performance of the Contractor to verify compliance with the contract. Any incident of contractor non-compliance as evidenced by his/her monitoring shall be forwarded immediately to the CO by the COR.

5.2 HSTMVH staff shall establish and maintain a record keeping system that will record the services provided under this contract delivery order and ensure correct reimbursement of prescriptions/services provided are paid.

5.3 The VA shall randomly audit all prescription fills. The Department of Veterans Affairs shall have free access during regular business hours and upon reasonable notice to such books, records, invoices, and prescription files as deemed necessary to verify claim information, prescription volume, and the usual and customary charges to the general public for covered prescriptions. The contractor shall make all prescription records and invoices available at the time of the audit.

6. SPECIAL CONTRACT REQUIREMENTS:

6.1 The contractor shall continuously meet or exceed Joint Commission Medication use standards related to procurement, preparation, dispensation, control, security, recall, and patient education. Additional information related to these standards can be accessed through the Joint Commission website at www.jointcommission.org. The Contractor shall develop and maintain written policies and procedures for credentialing, certification, and continuing education of employees and/or subcontractors providing services under this contract in accordance with their appropriate professional accreditation agency and state rules and regulations.

6.2 As VA routinely reviews and updates policies and procedures covering contractor computer access, this contract may be modified to reflect new policies and procedures during the term of this agreement. This includes any new training requirements from regulatory sources.

6.3 The Government reserves the right to fill any prescription covered under this contract delivery order through the use of its own resources and/or staff.

6.4 The services specified in the Description/Specifications/Statement of Work can only be changed by written amendment issued by the contracting officer.

6.5 When unacceptable performance occurs, the COR shall inform the Contracting Officer and the contractor. This shall normally be in writing unless circumstances necessitate verbal communication. In any case the COR shall document the discussion and place it in the COR file. When the COR determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to the contractor's Program Manager and the Contracting Officer. The contractor shall acknowledge receipt of the CDR in writing. The CDR shall specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR shall also state how long after receipt the contractor has to present this corrective action plan to the COR. The Government shall review the contractor’s corrective action plan to determine acceptability. Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the Contracting Officer.

6.6 Quality assurance monitoring documentation shall become an official Government record of the contractor’s performance.

6.7 The Government may evaluate the quality of professional and administrative services provided by the contractor, but retains no control over the professional aspects of services rendered (e.g., professional judgments, diagnosis for specific medical treatment), in accordance with Federal Acquisition Regulation (FAR) 37.401(b).

6.8 The contractor and all contractor personnel provided under this agreement shall be subject to quality assurance monitoring by VA for contract administration purposes.