CSP902222_A2.pdf

Index No.: DOH046 Contract No.: CSP902222 Eff. Date: 7/01/24

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

AMENDMENT FOR CHANGE

AMENDMENT NO. 2

TO: LIMITED DISTRIBUTION - OHIO DEPARTMENT OF HEALTH

FROM: KATHLEEN C. MADDEN, DIRECTOR, DEPARTMENT OF ADMINISTRATIVE SERVICES

SUBJECT: CONTRACT FOR CHILDREN WITH MEDICAL HANDICAPS (CMH) PHARMACY CLAIMS PROCESSING

SERVICES

Attached are pages 1, 3 and 5 to this contract. Remove these pages from the existing contract and replace with the attached pages on the effective date.

As a result of mutual agreement between the State of Ohio and the Contractor, this amendment is issued to renew the subject contract an additional 24 months, effective 07/01/24 through 06/30/26.

Additionally, this amendment is issued a price change for Item Number 39876 in the Price Schedule, effective with all orders on or after 07/01/24.

All other prices, terms and conditions remain unchanged.

This Amendment, the Contract and any additional Amendments thereto are available from the DAS Web site at the following address:

http://www.ohio.gov/procure

Affected Contractor(s):

0000246630 Conduent State Healthcare, LLC 100 Campus Dr., 2nd Floor Florham Park, NJ 07932 Tom.Peoples@Conduent.com

Eff. Date: 07/01/24

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

MANDATORY USE CONTRACT FOR: CHILDREN WITH MEDICAL HANDICAPS (CMH) PHARMACY CLAIMS

PROCESSING SERVICES

CONTRACT NUMBER: CSP902222 EFFECTIVE DATES: 01/01/22 TO 06/30/24

* Renewal through 07/01/26

The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.

CSP902222 that opened on 06/02/21. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.

This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.

This Requirements Contract is available to the OHIO DEPARTMENT OF HEALTH as applicable.

The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.

This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:

www.ohio.gov/procure

* Indicates mutual renewal for 24 months effective 07/01/24, per amendment 2.

PRICE SCHEDULE

TITLE: CHILDREN WITH MEDICAL HANDICAPS (CMH) PHARMACY CLAIMS PROCESSING SERVICES

RFP NUMBER: CSP902222

UNSPSC CATEGORY CODES: 85100000, 84131600

OAKS

ITEM

NO.

DESCRIPTION

COST

01/01/22 – 06/30/24

07/01/24 – 06/30/25

07/01/25 – 06/30/26

* 39876 Provide claims service and processing in a pharmacy point of sale electronic transaction system.

$75,214 / PER

MONTH

$86,496.25 / PER

$99,470.69 / PER

One-time cost to update the Contractor’s secure FTP server and file processing, as well as make alterations to Contractor’s Drug Reference file and Provider Reference file import and load into the OS+ pharmacy claims adjudication system.

$100,050*

*Indicates the cost for Item No. 39876 to $86,496.25/month for the time period of 07/01/24-06/30/25 and increase to 99,470,69/month for the time period of 07/01/25-06/30/26, effective with all orders on or after 07/01/24.

Index No. DOH046

SUMMARY OF AMENDMENTS

Amendment Number

Revision Date Description

2 7/01/24

This amendment is issued to notify that as a result of mutual agreement between the State of Ohio and the Contractor, this contract is renewed for an additional 24 months, effective 07/01/24 through 06/30/26.

Additionally, this amendment is issued to increase the cost for Item No. 39876 to $86,496.25/month for the time period of 07/01/24-06/30/25 and increase to 99,470,69/month for the time period of 07/01/25-06/30/26, effective with all orders on or after 07/01/24.

All other prices, terms and conditions remain unchanged.

1 3/25/22

This amendment is issued to add a mutually agreed upon modification and one-time cost to update the Contractor’s secure FTP server and file processing, as well as make alterations to the Contractor’s Drug Reference file and Provider Reference file import and load into the OS+ pharmacy claims adjudication system, in accordance with the agreed upon Ohio CMH CR 1 Reference File Changes Final 03172022.docx, which is incorporated herein by reference.