DRAFT Statement of Work for Emergent and Interim Medications 01-27-2021.pdf

DRAFT Statement of Work for Emergent and Interim Medications

The Michael E. DeBakey VA Medical Center (MEDVAMC), 2002 Holcombe Blvd., Houston, TX 77030, have a requirement for emergency and interim patient medications for the below listed Community Based Outpatient

Clinics (CBOCs) and new CBOC as they are established. Seeking vendor who can set up agreements with pharmacies located close to the clinics. This program allows emergent prescriptions written by VA providers at

Community Based Outpatient Clinics to be filled at local pharmacies.

Locations: The site of the pharmacy must be in a reasonable proximity (within 5 miles) of the CBOCs. The following is a list of the clinics, and their location:

MEDVAMC CBOCs:

• Conroe VA Outpatient Clinic

▪ 800 Riverwood Court, Suite 100

▪ Conroe, Texas 77304

▪ County: Montgomery

• Galveston VA Outpatient Clinic

▪ 3828 Avenue N

▪ Galveston, Texas 77550

▪ County: Galveston

• Texas City VA Outpatient Clinic

▪ 9300 Emmett F. Lowry Expressway, Suite 206

▪ Texas City, Texas 77591

▪ County: Galveston

• Lake Jackson VA Outpatient Clinic

▪ 208 S. Oak Drive, Suite 700

▪ Lake Jackson, Texas 77566

▪ County: Brazoria

• Richmond VA Outpatient Clinic

▪ 22001 SW Freeway, Suite 200

▪ Richmond, Texas 77469

▪ County: Fort Bend

• Katy VA Outpatient Clinic

▪ 750 Westgreen

▪ Katy, Texas 77450

▪ County: Harris

• Tomball VA Outpatient Clinic

▪ 1200 Main Street

▪ Tomball, Texas 77375

▪ County: Harris

• Beaumont VA Outpatient Clinic

▪ 3420 Veteran Circle

▪ Beaumont, Texas 77707

▪ County: Jefferson

A. General Requirements for MEDVAMC CBOCs

1. Hours of Service: The contractor at a minimum will provide pharmaceutical services from 8:00 a.m. to

5:00 p.m. Monday through Saturday. The CBOCs usual hours of operation are from 8 – 4:30 p.m., Monday through Saturday.

2. Prescriptions filled will be in written form provided by an approved CBOC VA physician(s). The VA will provide the vendor with a list of VA-approved providers and their signatures. Dispensing pharmacies must be able to accept the written prescriptions on VA Form 10-2577F, Security Prescription Form.

Should the state in which the dispensing pharmacy operate require other than the VA Form 10-2577F, Security Prescription Form, it will be the contractor’s responsibility to provide the VA Medical Center, Chief of Pharmacy, with the regulation/requirement ordering addresses, and ordering information needed to provide the CBOC with the proper security form.

3. The intent of this contract is for emergency medications only. As much as possible, it is expected that the drugs will be generic medications. Generic drugs shall be dispensed, if in the professional judgment of the pharmacist the substitute product is available, safe, 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 in compliance with Federal and State requirements. Brand name drugs ONLY if no generic form of the drug exists in the marketplace.

4. Medications which typically should be started immediately or should not have an interruption in therapy are antibiotics, acute care pain medications, insulin (especially in the Type 1 patient with diabetes mellitus), medications that require monitoring levels (e.g., valproic acid), and medications that may have a

‘rebound’ detrimental effect (e.g., paroxetine, clonidine, or beta-blockers [metoprolol & atenolol]). These are primarily the medications that will be considered ‘emergency’ and days supply will be limited to a maximum of 10 days (or up to a 14-day antibiotic course). A Formulary will be developed by the Vendor and approved by the Medical Center. This Formulary will be shared with each CBOC once approved.

Each Medical Center’s formulary list may be different, and each list shall be approved by the requisite

Medical Center.

5. This contractual arrangement is not meant to be utilized for routine (refill) medications or new (non-emergent) medications.

6. All Controlled II Class Drugs (e.g., methadone, oxycodone, morphine) will be processed by the Medical

Center pharmacy.

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

8. The contractor is responsible for assuring that all persons, whether they be employees, agents, sub-contractors, or anyone acting for or on behalf of the contractor, are properly licensed at all times under applicable state law and/or regulations and may be subject to privileging and or background checks by the VA.

9. The contractor shall provide Pharmacy Management Services to include traditional prescription screening, dispensing and counseling services (by a registered and licensed pharmacist) to eligible veterans presenting authorized prescriptions from providers at the applicable CBOC.

10. Printed drug information will be provided to each patient to supplement verbal instructions. These services will require a medication history and check for allergies, interactions and duplications.

11. Pharmacies authorized to fill prescriptions under the contractor’s plan must agree to the following conditions:

a. The contractor and its 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 applies to this contract.

b. Representatives of the VA are authorized to visit the premises of any pharmacy filling VA prescriptions under the contractor’s plan during business hours for the purpose of auditing and evaluation, which may include the inspection of clinical records. VA representative shall given 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.

c. Contract pharmacies shall maintain a log of VA prescriptions filled and have the patient sign next to each prescription number for each prescription received. A copy of the log shall be maintained at the contract pharmacy and be readily accessible for random VA inspection.

d. All adverse drug events reported to the contractor’s pharmacies by beneficiaries of the VA will be reported to COR. Adverse drug events include dispensing errors, drug allergies, and adverse drug reactions.

e. Pharmaceutical care provided to beneficiaries under this contract shall meet all standards applicable to the current Joint Commission accreditation manual for Ambulatory

Care/Pharmaceutical Services.

12. The VA Contracting Officer Representative (COR) will provide contractor, via phone, all existing and/or new VA physicians’ state license number, federal and/or State drug license number, and NPI.

The contractor shall immediately notify its contract pharmacies of the physician information so as to avoid delay in patient services. Notification of physician information may occur on either the day the

VA physician fills-in at the CBOC or prior to CBOC duty as time allows.

13. Medical supplies, injectable and prosthetic items are not included in this contract except for emergency supply of insulin vials and syringes.

14. Schedule of Insurance: The contractor shall procure and maintain for the entire contract period:

Workmen's Compensation and employer's general liability Insurance. Prior to contract award, the contractor shall certify to the Contracting Officer in writing and provided documentation that the required insurance has been obtained. The parties agree that such personnel shall not be considered a

VA employee for any purpose and shall be considered employees of the contractor.

15. Price Schedule: The contract rate is an all-inclusive rate. No separate fees will be allowed for such incidental costs of malpractice insurance coverage, supplies, equipment, etc. The price for the medications will be based on a negotiated percentage of the Average Wholesale Price (AWP) and a dispensing fee. The total price charge 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.

16. Contractor shall provide dispensing fee prescription and discounts offered, as well as indicate the AWP source (Blue Book, Medispan, or Red Book) it is using to base their discount on after award to the COR.

17. Environment of Care: The contractor shall maintain a clean and safe environment at all times.

18. Contracting with Parties Listed on the OIG List of Excluded Individuals/Entities: In accordance with

HIPAA and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal payments due to fraud and/or abuse of the Medicare and Medicaid programs. The list of excluded individuals/entities can be found on the OIG web site at www.hhs.gov/oig. At the signing of the contract, the contractor is affirming that OIG site has been reviewed and that none of the contractor’s employees are on this list.

19. Payments shall be processed monthly, in arrears, upon submission of a properly prepared invoice.

20. Invoices: The monthly summary invoice shall include a subtotal of each clinic with the number of scripts written at that clinic and the overall costs. There shall also be an attached spreadsheet that reflects: Patient’s name, last 4 of social security number, medication, days fill, total medication dispensed and cost for each of the clinics.

Please e-mail the same information, encrypted to designated COR.

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

22. No personal information, social security number, etc., concerning the Veteran patient is conveyed by the VA to the contracted pharmacies.