Change Order Notice Form Procare Amendment 2~1.pdf
PDF 2 MB Posted
- Solicitation number
- 21-482DPH-HLTHP-B-23198
- Issued by
- Illinois
About this file
This document is a Change Order Notice for an amendment to the Illinois Department of Public Health's (IDPH) Ryan White Part B AIDS Drug Assistance Program (ADAP) contract with Procare Pharmacy. The change order extends the current contract by 6 months, from June 30, 2021 to December 31, 2021, and increases the contract value by $13 million. The contract provides for the dispensing of brand and bio-equivalent multi-source pharmaceuticals to eligible individuals diagnosed with HIV/AIDS through the ADAP program. The change order is necessary to ensure over 14,000 HIV positive individuals throughout the state can continue to obtain life-prolonging drugs and therapies in a cost-effective manner.
The $13 million in additional funding includes $10 million for pharmaceutical deductibles and co-payments and $3 million for dispensing fees. The ADAP program utilizes 340B pricing for the wholesale purchase of pharmaceuticals and bills Medicare Part D and Medicaid when applicable to conserve limited program resources. If this contract amendment is not approved, the ADAP program would have no means to provide these critical HIV-related drugs and therapies to eligible individuals.
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Change Order Notice Chief Procurement Office General Services v.20.1
44 Ill. Adm. Code 1.1525(h) requires notice of renegotiated contracts and change orders that increase the cost of a contract by more than $10,000 or the time of completion by a total of 30 days or more to be posted on the Bulletin/BidBuy for 14 days.
This Change Order Notice provides detail as to why the change order is needed and, pursuant to Section 33E-9 of the Criminal Code, that the circumstances said to necessitate the change in performance were not reasonably foreseeable at the time the contract was signed or the change is germane to the original contract as signed. Change orders are defined by Section 1-15.12 of the Procurement Code and Section 1.2067 of the CPO-GS' Administrative Rules.
Detailed explanation for this change order:
11.0.0.20130303.1.892433.887364
| BBREFNO.: 21-482DPH-HLTHP-B-23198 |
| ProcurementTitle: ADAP Dispensing Contract Amendment #2 - CVS |
| DropDownList1: DPH - Public Health |
| thedetails: Overall, the Illinois Department of Public Health’s Ryan White Part B AIDS Drug Assistance Program (ADAP) is charged to provide prescribed brand and bio-equivalent multi-source pharmaceuticals to eligible individuals who are diagnosis with HIV/AIDS. The pharmacy benefit manger (PBM) that is a Medicaid-licensed pharmacy that must have the ability and experience of dispensing and tracking AIDS Drug Assistance inventory contained in the Department’s approved formulary with within a virtual-integrated system. The PBM will initiate pharmaceutical drugs and products for eligible clients with HIV/AIDS through the State of Illinois’ Contract Wholesale Provider and will not have an opportunity to subcontract ancillary services. The vendor will also broker all pharmaceutical deductible and co payments associated with approved formulary medication following Department Protocol and Procedures. In addition, with the signing of the Health Care Reform Act allows ADAPs to provide support for Medicare Part D clients in order to count towards the clients True-Out-Of-Pocket (TrOOP) costs (Section 3314 of the Affordable Care Act amended 1860D-2(b)(4)(C) of the Social Security Act; The Affordable Care Act, Public Law is 111-148). The PBM will also run electronic coordination of benefit claims automatically during standard prescription processing and adjudicate the claims on ADAP’s behalf. The vendor will also provide monthly reports indicating how much ADAP paid on behalf of the patient. These reports will be provided to the TrOOP facilitator to ensure these payments are counted for the client. |
This contract amendment is necessary to provide the dispensing of the HIV-related drugs and therapies to eligible individuals in the most cost-effective means. This contract includes, when applicable, billing to Medicare Part-D, back-billing to Medicaid as individuals become eligible, after which ADAP is credited and drug inventory is restocked to conserve limited ADAP resources. When applicable, client’s insurance is billed for that portion of the insurance benefit and ADAP is billed the deductible and co-payment. This contract is necessary for the dispensing of brand and bio-equivalent multi-source pharmaceuticals purchased by the Department and shipped to the Contractor, for ADAP clients throughout the state. Along with the state contract for the wholesale purchase of pharmaceuticals (based on 340-B pricing), this contract provides a system to provide HIV-related drugs and therapies to eligible individuals. If this contract is not approved, over 14,000 HIV positive individuals throughout the state would have no means of obtaining these life-prolonging drugs and therapies. According to Health Resources Services Administration, this system is the most cost-effective means of providing HIV-related drugs and therapies to eligible individuals. When HIV positive clients are in regular medical care, and take medications, their viral loads are lowered, decreasing the infection of the virus and helping to protect the health and safety of the citizens of Illinois.
The current contract end date is 6/30/2021 and this change order will add 6 months of time and an additional $13M for 6 month. The cost of pharmaceutical deductibles and co-payments is beyond the cost of the dispensing fees and estimated at $10M semi-annually. The annual estimate for dispensing fees is $3M. The entire contract is estimated at $13M for the additional 6 months. The new contract end date will be 12/31/2021
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