The file's text, extracted by GovTribe without its formatting.
Deliverables Schedule
TECHNICAL EXHIBIT 2
Deliverables Schedule
| Deliverable Number |
| PWS Section |
| Standard/Deliverable |
| Performance Threshold (This is the maximum error rate. It could be “zero deviation from standard.”) |
| Medium/ Format |
| Submit To |
| 1 |
| 1.6.1 General Information |
| Quality control plan (QCP) -Develop and implement internal quality control procedures that produce timely, accurate, complete, and relevant data, which meet the full requirements of this performance work statement |
| Draft due within 30 days of contract start date, with final version due within 120 days of contract start date |
Updates to final plan as necessary
| Electronically with updates as needed |
| COR and Project Management Office (PMO) for approval |
| 2 |
| 1.6.5.2 General Information |
| Notice of Delay – performance delays |
| Due within 24 hours of occurrence |
| Verbally and electronically |
| COR and Project Management Office (PMO) |
| 3 |
| 1.6.5.3 General Information |
| Continuity of Operations Planning (COOP) |
| Due within 30 days of contract start date |
| Electronically with updates as needed |
| COR and Project Management Office (PMO) for approval |
| 4 |
| 1.6.8.2 Security Requirements |
| Memorandum of Understanding (MOU) and Interconnection Security Agreement (MOU/ISA) |
| Due within 30 days of contract start date |
| Electronically in Government- provided format with most recent updates as needed |
| COR, Project Management Office (PMO) and ISO for approval |
| 5 |
| 1.6.8.3 Security Requirements |
| System Security Plan (SPP), Contingency/Disaster Recovery Plan, and an Incident Response Plan |
| Draft document due within 60 days of contract start date and final document due no less than 30 days prior to the implementation date |
| Electronically in Government- provided format with updates as needed |
| COR and Government Information Security Officer (ISO) for approval |
| 6 |
| 1.6.8.5 Security Requirements |
| Security Incident Report |
| Due within one hour of becoming aware of the incident, whether suspected or confirmed, and updated as additional information becomes available |
| Electronically using Government provided Incident Reporting form |
| COR and ZZOWCPSECURITY@DOL.GOV |
| 7 |
| 1.6.8.5 Security Requirements |
| Privacy Disclosure Plan |
| Due with the solicitation proposal |
| Included in proposal |
| Contracting Officer (CO) and COR |
| 8 |
| 1.6.8.6 System Security |
| DOL Third-Party Security Monitoring Checklist |
| Due no less than 30 days prior to the implementation date and annually thereafter |
| Electronically in Government- provided format with updates as needed |
| COR and Government Information Security Officer (ISO) for approval |
| 9 |
| 1.6.8.6 System Security |
| Monthly audit log reviews, user account reviews, vulnerability scans and additional security documentation as required |
| Due quarterly after implementation |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 10 |
| 1.6.8.6 System Security |
| Establish Secure SFTP connection between DOL and Contractor. |
| Due within 150 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 11 |
| 1.6.8.7 Background Investigations |
| Security Documentation Review Certification and signed non-disclosure agreement (NDA) |
| Due prior to entry on duty (EOD) |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 12 |
| 1.6.10 Post Award Conference / Periodic Progress Meetings |
| Provide secure web directory or SharePoint site, which hosts meeting minutes and recordings, and other contract documents, including, but not limited to requirements, test results, and standard operating procedures. |
| Due within 60 days of contract start date. |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 13 |
| 1.6.12 Personnel |
| Staffing Plan- Chart/matrix showing ALL proposed personnel (including outside consultants or Subject Matter Experts) by task and by hours. The contractor should clearly specify the role and responsibilities of each proposed staff and discuss the qualifications of the individuals proposed for specific tasks. Personnel includes Pharmacists, FWA Experts, call support, information technology support, data analytic support, Pharmacy and Therapeutics Committee, Medical Director, and other staff. |
| Due within 30 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 14 |
| 1.6.12 Personnel |
| Appoint and electronically notify the COR of the names and contact information of its authorized Contractor Program Manager (PM), who shall be the primary interface with the DOL COR on current PBM contract performance, and an alternate PM to serve in the primary PM role when the primary is unavailable. Appoint and electronically notify the COR of the names and contact information of clinical staff supporting the contract, including a Lead Clinical Pharmacist (Pharm.D.), a Lead FWA Expert, and a Technical Manager. |
| Due within 5 business days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 15 |
| 1.6.13 Key Personnel |
| Must notify the Government of vacancies in key positions. Resumes must be provided for all candidates for key positions. The Government may request a “meet and greet” with any potential candidate for clarification of the candidate's qualifications. |
| Due within 3 business days of occurrence |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 16 |
| 1.6.14.1Other Personnel |
| The contractor must provide a minimum of 10 full-time equivalent (FTE) pharmacists in addition to the Lead Clinical Pharmacist and Alternate Lead Clinical Pharmacist. Should have an Oncology Pharmacy ty Certification (BCOP) from the Board of Pharmacy Specialties. |
| Due no less than 90 days prior to the implementation date |
| Electronic confirmation |
| COR and Project Management Office (PMO) for approval |
| 17 |
| 1.6.16 Organizational Conflict of Interest |
| Notice of any actual or potential Organizational Conflict of Interest and plan to avoid or mitigate any such OCI. |
| Due within 24 hours of awareness of occurrence |
| Electronically |
| CO, COR, and Project Management Office (PMO) for approval |
| 18 |
| 1.6.17 Transition-In/Transition-Out Period |
| Transition In Project Plan to include project schedule, risk assessment, and communication plan |
| Draft document due within 30 days of contract start date and final document within 45 days of contract start date |
| Electronically in MS Word with schedule in MS Project and MS Excel, with updates as needed |
| COR and Project Management Office (PMO) |
| 19 |
| 1.6.17 Transition-In/Transition-Out Period |
| Transition Out plan to include project schedule and risk assessment |
| Due within 15 business days of request by the COR |
| Electronically with updates as needed |
| COR and Project Management Office (PMO) for approval |
| 20 |
| 3.2 Government-furnished Information/Documents |
| Return all Government-furnished property, equipment, data, and information |
| Due upon expiration or termination of the contract, within Government provided timeframes |
| Electronically |
| CO, COR, and Project Management Office (PMO) for approval |
| 21 |
| 4.4 List of Pharmaceutical Networks for the Areas to be Served |
| Provide a list of network pharmacies that includes each pharmacy’s National Council for Prescription Durg programs (NCPDP) identification number, name, address, and ZIP code. Pharmacies added to the network in the past month and the date they were added and pharmacies removed from the network in the past month and the date they were removed. |
| Due monthly and upon Government request |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 22 |
| 5.2.3 Pharmacy Networks |
| Notice of removal of a pharmacy from the contractor’s network to include the rationale |
| Due within three business days of occurrence |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 23 |
| 5.2.4 Pharmacy Networks |
| Pharmacy search tool for claimants affected by network changes |
| Due on the implementation date |
| Electronically via website/portal |
| COR and Project Management Office (PMO) for approval |
| 24 |
| 5.2.12 Provider Enrollment Data |
| Provider enrollment system and database accessible by OWCP |
| Due within 90 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) |
| 25 |
| 5.3.1 Welcome Packet |
| Welcome packet including a welcome letter, MBIC, information about the contractor’s pharmacy, DME, diagnostic services, and frequently asked questions (FAQs). for DEEOIC and DCMWC |
| Draft document due within 30 days of contract start date and final document within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 26 |
| 5.3.1 Welcome Packet |
| Welcome packet including a welcome letter, benefit card, information about the pharmacy and DME programs for DFELHWC |
| Draft document due no less than 180 days prior to the implementation date, and final document no less than 30 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 27 |
| 5.3.2 Customer Support |
| Application programming interface with the ECOMP |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 28 |
| 5.3.3 Customer Support |
| Call center with dedicated toll-free phone numbers for DEEOIC and DCMWC |
| Due within 150 days of contract start date |
| Phone number and implementation |
| COR and Project Management Office (PMO) for approval |
| 29 |
| 5.3.3 Customer Support |
| Call center with dedicated toll-free phone numbers for DFELHWC |
| Due on the implementation date |
| Phone number and implementation |
| COR and Project Management Office (PMO) for approval |
| 30 |
| 5.3.3 Customer Support |
| Call center audio recordings |
| Due within 5 days upon request |
| Electronically |
| COR and Project Management Office (PMO) |
| 31 |
| 5.3.3 Customer Support |
| Call center written notes of all customer support calls |
| Due within 5 days upon request |
| Electronically |
| COR and Project Management Office (PMO) |
| 32 |
| 5.3.3 Customer Support |
| Call center call scripts for DEEOIC and DCMWC |
| Due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 33 |
| 5.3.3 Customer Support |
| Call center call scripts for DFELHWC |
| Due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 34 |
| 5.3.3 Customer Support |
| Train and implement a threat protocol with the call center staff. OWCP will provide the outline for this protocol. |
| Due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 35 |
| 5.3.5 Customer Support |
| Call center performance standards document |
| Due with proposal with final revisions due 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 36 |
| 5.3.7 Customer Support |
| Provide an agenda to scheduled meetings |
| Due one business day before a scheduled meeting |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 37 |
| 5.3.8 Customer Support |
| System training sessions |
| Due no less than 30 days prior to the implementation date, and no less than 5 days prior to implementing any significant system changes thereafter, and when requested by the COR |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 38 |
| 5.4.2 Assisting with Business Rules |
| Emergency fill process |
| Due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 39 |
| 5.5.9 Processing Claims for Payment |
| Fully functional mail room |
| Due on the implementation date |
| Implementation |
| COR and Project Management Office (PMO) for validation |
| 40 |
| 5.5.15 Processing Claims for Payment |
| Historical pharmacy transactions data incorporated in all contractor’s systems utilized to fulfill the requirements under this contract |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 41 |
| 5.5.21 Processing Claims for Payment |
| Provide specification document for generating and transmitting programs required data files, such as bill history file, pharmacy data file, and treasury payment file, to include specific file formats and transmission timeframes |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 42 |
| 5.5.21 Processing Claims for Payment |
| Generate and transmit various data files in the format and with the content requested by OWCP, including but not limited to Bill History File, Pharmacy Data File, Payment File |
| Due weekly, or as specified by the Government |
| Electronically |
| COR and Project Management Office (PMO) |
| 43 |
| 5.5.22 Processing Claims for Payment |
| Provide system interfaces to receive and ingest eligibility files from the DEEOIC and DCMWC Programs and apply updates timely to ensure that eligibility and coverage determinations are accurate. |
| Due within 90 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 44 |
| 5.5.22 Processing Claims for Payment |
| Provide system interfaces to receive and ingest eligibility files from the DFELHWC Program and apply updates timely to ensure that eligibility and coverage determinations are accurate. |
| Due no less than 155 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 45 |
| 5.5.22 Processing Claims for Payment. Eligibility |
| Perform a one-time load of the claimant eligibility file extract from the OWCP for DEEOIC and DCMWC programs and begin processing claims for eligible claimants as a third-party provider through OWCP’s current pharmacy system. |
| Due within 150 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 46 |
| 5.5.22 Processing Claims for Payment. Eligibility |
| Perform a one-time load of the claimant eligibility file extract from the OWCP for DFELHWC program |
| Due no less than 100 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 47 |
| 5.5.24 Processing Claims for Payment. Eligibility |
| Provide a business rules specification document for eligibility for each program. |
Due within 120 days of contract start date
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 48 |
| 5.5.25 Processing Claims for Payment. Eligibility |
| Perform a one-time load of the existing claimant authorizations |
| Due no less than 30 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 49 |
| 5.6.2 Fee Schedule |
| Provide Maximum Allowable Cost (MAC) List for generic drug products to be used as the basis for payment of multi-source products from all distribution channels, including, but not limited to retail, mail-order, and specialty pharmacies. |
Due within 90 days of contract start date
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 50 |
| 5.6.2 Fee Schedule |
| Quarterly updates to Maximum Allowable Cost (MAC) List for generic drug products to be used as the basis for payment of multi-source products from all distribution channels, including, but not limited to retail, mail-order, and specialty pharmacies. |
Due every quarter after initial submission
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 51 |
| 5.6.3 Fee Schedule |
| Compile and compare the lowest published U&C rates from major retail pharmacies, link these prices to the relevant GPI as part of the U&C rate, and provide this file to the OWCP for approval |
Due within 90 days of contract start date and an updated deliverable due annually (every 12 months) Comment by Proudfoot, Robert S - SOL: @Wood, Michelle G - OWCP
| Michelle: Elliott does not have access to the shared documents. Please decide if he should have access or not so he can review and edit | Comment by Cook, Elliott - OWCP: looks good. thank you. |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 52 |
| 5.6.5 Fee Schedule |
| Provide a specification document articulating the contractor’s method for determining the full pass-through price |
Due within 90 days of contract start date
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 53 |
| 5.6.6.3 Classification of Drugs as Generic or Brand Name |
| Document detailing the contractor’s procedures and the system of classification of drugs as “name brand” or “generic” |
| Draft due within 60 days of contract start date, final due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) and COR for government approval |
| 54 |
| 5.6.6.4 Classification of Drugs as Generic or Brand Name |
| Request to classify a drug when the classification methodology at 5.6.6 is unclear. |
| Due within 10 days of the day that the contractor knew or should have known the methodology was unclear. |
| Electronically |
| COR and Project Management Office (PMO) |
| 55 |
| 5.6.9 Classification of Drugs as Generic or Brand Name |
| Provide an OWCP approved definition or a list of specialty drugs |
| Due within 120 days of contract start date and quarterly after implementation |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 56 |
| 5.6.10 Classification of Drugs as Generic or Brand Name |
| Document for specific dispense as written (DAW) processing logic that incorporates Medi-Span's MS code and conforms to NCPDP guidelines. |
| Draft due within 60 days of contract start date and Final within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 57 |
| 5.7 Fraud, Waste and Abuse Monitoring |
| Document detailing FWA detection and reporting program |
| Due within 120 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 58 |
| 5.8.1 Key Performance Reports |
| Key Performance Reports |
| Due within 5 business days after the end-of-month reporting period |
| Electronically |
| COR and Project Management Office (PMO) |
| 59 |
| 5.8.2 Internet Based Reporting Tool |
| Implement a secure, internet- based reporting tool for use by authorized OWCP program staff to generate management reports on an ad hoc basis. |
| Due no less than 30 days prior to the implementation date. |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 60 |
| 5.9.2 Information Management |
| Completed process, including completed testing, for automated image transfer into claimant case files |
| Due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government acceptance testing and approval |
| 61 |
| 5.10.1 Clamant Web Portal |
| Provide a specification document detailing the functionality of the Claimant Web Portal for each program |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 62 |
| 5.10.1 Clamant Web Portal |
| Provide fully functional Clamant Web Portal for each program |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 63 |
| 5.10.2 Prescriber Web Portal |
| Provide a specification document detailing the functionality of the Prescriber Web Portal for each program. |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 64 |
| 5.10.2 Prescriber Web Portal |
| Provide fully functional Prescriber Web Portal for each program |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 65 |
| 5.10.3 Staff Portal |
| Provide a specification document detailing the functionality of the Staff Portal for each program. |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 66 |
| 5.10.3 Staff Portal |
| Provide a fully functional Staff Portal for each program. |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 67 |
| 5.11.1 Formulary Management |
| Provide names, and degrees, practice specialties/board certifications of members of the Pharmacy and Therapeutics Committee. Notify OWCP within 30 days of membership changes. Disclose any financial interests in drug manufacturing companies and employment relationship to PBM. |
| Due within 30 days of contract start date and updated as needed. |
| Electronically |
| COR and Project Management Office (PMO) for approval |
| 68 |
| 5.11.1 Formulary Management |
| Provide draft P&T progress report template and clinical recommendations and pharmacoeconomic analysis template. Provide quarterly P&T progress reports at least 4 times a year. |
| Draft due within 30 days of contract start date. Final due on the first business day after January 1. April 1, July 1, and October 1 of each year. |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 69 |
| 5.11.2.1 Drug Formulary System. |
| Specification documents detailing formulary and DUR Point of Sale (POS) edits (e.g. drug-drug interactions and contraindications, therapeutic duplications, refill too soon edits, minimum/maximum dosage, DAW edits, quantity limits, step therapy edits) along with all drug information compendia utilized in formulating their POS edits for each program |
| Draft due within 120 days of contract start date; Final due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 70 |
| 5.11.2 Drug Formulary System. |
| Complete an impact analysis identifying all claimants that have been recently dispensed non-formulary medications, medications outside of formulary limits, or medications for non-accepted conditions for each program and provide DOL with this analysis in the format DOL requests. |
| Final due no less than 130 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 71 |
| 5.11.2 Drug Formulary System. |
| Complete an initial major communication campaign notifying claimants and prescribers of non-formulary medications and transitioning them to formulary alternatives through a clinical letter campaign. |
| Due no less than 45 days prior to implementation date |
| Hard Copy |
| COR and Adversely impacted claimants, designated representatives, representative payees, prescribing physicians, and participating pharmacies |
| 72 |
| 5.11.2 Drug Formulary System. |
| Complete 4 impact analysis identifying all claimants that have been recently dispensed non-formulary medications, medications outside of formulary limits, or medications for non-accepted conditions for each program and provide DOL with this analysis in the format DOL requests. |
First analysis due 60 days from the Option year 1 start date. Second analysis due 150 days from the Option year 1 start date. Third analysis due 240 days from the Option year 1 start date. Forth analysis due 320 days from the Option year 1 start date.
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 73 |
| 5.11.2 Drug Formulary System. |
| Complete 3 major communication campaigns notifying claimants and prescribers of non-formulary medications and transitioning them to formulary alternatives through a clinical letter campaign. |
| First outreach campaign due by day 90 of the Option year 1. The second outreach campaign due by day 180 of the Option year 1. |
The third outreach campaign due by day 270 of the Option year 1.
| Hard Copy |
| COR and adversely impacted claimants, designated representatives, representative payees, prescribing physicians, and participating pharmacies |
| 74 |
| 5.11.2.2 Drug Formulary System. |
| Provide drug formularies for DCMWC and the drug compendia used to build the formulary and the methods involved. |
| Draft due within 90 days of contract start date; Final due no less than 160 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 75 |
| 5.11.2.2 Drug Formulary System. |
| Fully implement POS edits for DCMWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 76 |
| 5.11.2.2 Formulary Management |
| Fully implement the drug formulary for bill processing for DCMWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 77 |
| 5.11.2.3 Drug Formulary System. |
| Provide drug formularies for DEEOIC and the drug compendia used to build the formulary and the methods involved. |
| Draft due within 90 days of contract start date; Final due within 210 days of contract start date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 78 |
| 5.11.2.3 Drug Formulary System. |
| Fully implement POS edits for DEEOIC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 79 |
| 5.11.2.3 Formulary Management |
| Fully implement the drug formulary for bill processing for DEEOIC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 80 |
| 5.11.2. Drug Formulary System. |
| Provide drug formularies for DFELHWC and the drug compendia used to build the formulary and the methods involved |
| Draft due within 90 days of contract start date; Final due no less than 160 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 81 |
| 5.11.2. Drug Formulary System. |
| Fully implement POS edits for DFELHWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 82 |
| 5.11.2. Formulary Management |
| Fully implement the drug formulary for bill processing for DFELHWC |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 83 |
| 5.11.5 Formulary Management |
| Written notice for approval by OWCP at least 90 days prior to implementation of any formulary change. |
| Due 90 days prior to implementation of any formulary change |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 84 |
| 5.11.5.1 Formulary Management |
| Provide formulary recommendation for previously approved drug products upon release of new FDA recommendations. |
| Due within 180 days of FDA releasing new recommendations. |
| Electronically |
| COR and Project Management Office (PMO) |
| 85 |
| 5.11.5.2 Formulary Management |
| Provide formulary recommendations for new drug products upon FDA approval of new products. |
| Due within 180 days of market availability of new drug products. |
| Electronically |
| COR and Project Management Office (PMO) |
| 86 |
| 5.11.5.3 Formulary Management |
| Written notice to adversely impacted claimants, designated representatives, prescribing physicians, and participating pharmacies at least 45 days prior to implementation of any formulary change. |
| Due 45 days prior to implementation of any formulary change |
| Hard Copy |
| COR and adversely impacted claimants, designated representatives, representative payees, prescribing physicians, and participating pharmacies |
| 87 |
| 5.11.5.4 Formulary Management |
| Provide notice of important changes in the pharmaceutical industry, including but not limited to issuance of new black box warnings and withdrawal of drugs from the market. |
| Due within 24 hours of confirming changes |
| Electronically |
| COR and Project Management Office (PMO) |
| 88 |
| 5.12.2 Formulary Management |
| Provide the hierarchy of claims processing edits. |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) |
| 89 |
| 5.12.1, 5.12.19, 5.12.20 PBM Drug Utilization Review |
| Provide a specification document detailing the processes of concurrent, retrospective and clinical drug utilization review. |
| Within 120 days of contract start date; Final no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) |
| 90 |
| 5.12.18 PBM Drug Utilization Review |
| Provide a document detailing appeals process and pathway (such as elevation to OWCP) when claims cannot be resolved at the PBM level |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 91 |
| 5.12.20.1 PBM Drug Utilization Review |
| Provide SOP for Prior authorization request forms (PARF) and prior authorization request template (PART) reviews |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 92 |
| 5.12.20.2 PBM Drug Utilization Review |
| Provide SOP for 90 MED Program |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 93 |
| 5.12.20.3 PBM Drug Utilization Review |
| Provide SOP for Medication Use Evaluation (MUE) |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 94 |
| 5.12.20.4 PBM Drug Utilization Review |
| Provide SOP for Targeted Medication Use Evaluation (MUE) |
| Due no less than 245 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 95 |
| 5.12.20.5 PBM Drug Utilization Review |
| Provide Claimant Adherence Program |
| Due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 96 |
| 5.13 Durable Medical Equipment |
| The contractor shall ensure all bills/invoices for payment are proper, accurate, complete, and timely to facilitate the timely processing and prompt payment of medical bills. The contractor shall also be registered in OWCP’s Medical Bill Processing System and Electronic Funds Transfer (EFT) System to expedite bill processing per OWCP’s Medical Bill Processing Procedures. All bills/invoices must be submitted timely and contain proper, accurate and complete information to be deemed proper for payment in accordance with OWCP’s Fee Schedule, Medical Bill Processing Procedures, and the Prompt Payment Act. |
| Due no less than 215 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |
| 97 |
| 5.13.2 Durable Medical Equipment |
| Maintain a list of in-network DME suppliers to include the number of suppliers by state and territory |
| Due monthly and upon Government request |
| Electronically |
| COR and Project Management Office (PMO) |
| 98 |
| 5.16.1 Testing |
| Provide Test plan (including RTM, test schedules, test scenarios, test cases, and test scripts for all requirements and historical data) that addresses all aspects of the Contractor’s comprehensive testing program |
| Due no less than 180 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 99 |
| 5.16.2 Testing |
| Provide a Requirements Traceability Matrix, testing plan and testing cases associated with all available systems |
| Due no less than 180 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 100 |
| 5.16.3 Testing |
| Provide a schedule for all testing activities as part of the test plan, to identify timeframes for the System Integration Testing (SIT), volume and performance testing, parallel testing, and Government Acceptance Testing (GAT). The schedule must include timelines for correction and re-test of any identified defects or missed requirements that were discovered during GAT. The contractor must provide a GAT period of no less than ten weeks. |
| Due no less than 180 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 101 |
| 5.16.5 Testing |
| Release the system to the Government for Acceptance Testing (GAT) |
| Due no less than 100 days prior to the implementation date |
| Electronically |
| COR and Project Management Office (PMO) for government approval |
| 102 |
| 5.17.2 System Audits |
| SOC, I Type II audit performed by independent auditor |
| Due annually during the timeframe of February - September |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 103 |
| 5.17.5 System Audits |
| Letter of Representation addressing contractor responsibility to identify control objectives and related policies and procedures, |
Auditor’s Letter of Representation as to independence and objectivity from the contractor and DOL, Auditor’s current resumes, Auditor’s most recent Peer Review, Auditor’s detailed scope document, Auditor’s letter documenting representations made by the contractor during the audit, Electronic version of the complete audit report, and Plan of action and milestones (POA&M), according to OWCP specifications, for weaknesses identified in audits.
| Due annually by the dates specified by the COR |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 104 |
| 508 Testing (In accordance with Section I.10 DOL-2019-01 SECTION 508 REQUIREMENTS (January 2019)) |
| Accessibility test results based on the required test methods with an explanation for any false positives. Documentation of features provided to help achieve accessibility and usability for people with disabilities. Documentation of core functions that cannot be accessed by persons with disabilities. Documentation on how to configure and install the ICT item to support accessibility. |
| Draft testing results due no less than 100 days prior to the implementation date; Final test results due no less than 40 days prior to the implementation date |
| Electronically |
| COR and Government Information Security Officer (ISO) for approval |
| 105 |
| Implementation |
| Complete implementation of all elements of the PWS. |
| Due on the implementation date |
| Electronically |
| COR and Project Management Office (PMO) and other stakeholders |