DRAFT-Statement_of_Work_OPC .docx

Pharmacy Prescription Services

STATEMENT OF WORK

1. Scope of Work The contractor shall provide Pharmacy Services to eligible veterans seen by authorized prescribers at any of the Northern California Health Care System (NCHCS) Station 612, CA VA outpatient clinics (hereafter referred to as VAOPC). This statement of work is limited to the provision of outpatient prescriptions for urgently needed medications. The intent of this work is to make pharmacy services available to patients seen at the VAOPC after normal clinic hours when a VA pharmacy is not available in our CBOCS, or when the VA pharmacy is closed: in the evenings during select weekdays and on Saturday mornings; or in the event of a natural disaster emergency where the contractor can offer services to Veterans who are not able to get their emergent medications from the VA and have to go to a community pharmacy.

All prescriptions filled under this contract shall be reimbursed as set forth in the Fee Schedule.

2. Specific Contractor Tasks include:

Contractor shall provide prescription Pharmacy Services, which shall include, but are not limited to the following:

a. Contractor shall fill and dispense original prescriptions written by VA physicians, or VA-credentialed mid-level, non-physician providers, when acting within their VA-approved scope of practice, which may include prescribing specific medications.

b. Prescriptions accepted by the contractor must be written by authorized VAOPC providers. List of authorized providers are attached at the bottom of the document.

c. Prescriptions will be written in the printed work copy of the medication order from the VA’s CPRS electronic record, with such order hand signed by the VA’s contracted provider. Such prescriptions presented by a veteran under this contract will be considered authorization for contractor to fill such prescription. Schedule 2 narcotics will only be covered when the Disaster Response Plan has been implemented, otherwise, they are not covered. Schedule 3-5 prescriptions may be phoned in by the VA provider to the contract pharmacy as VA providers do not have the proper prescription security forms to prescribe them in writing. Non-controlled medication prescriptions that are phoned in will not be reimbursed. However, if the Disaster Response Plan is in place, then the phone orders will be reimbursed. Services provided by contractor without prior written authorization, with the exception of emergency-controlled substances, will not be reimbursed under this contract.

d. The Pharmacist working for the contractor will evaluate each prescription for drug interactions, contraindications given recorded drug allergies, appropriate doses, and accurate directions. Incomplete, erroneous or questionable prescriptions will be clarified with the prescriber prior to dispensing.

e. Prescriptions will be filled and dispensed only for prescription (legend) drugs listed in the VANCHCS formulary. Contractor will verify that the drugs are on VA Formulary by accessing http://www.pbm.va.gov/apps/VANationalFormulary/ . This link allows the Contractor to check for formulary status by generic or brand name, and is accessible to all. Over the counter (OTC) drugs, parenteral drugs, prosthetic items and expendable supplies (even if listed on the formulary) will not be provided by the contractor, with the exception of insulin or insulin syringes if they are prescribed for the patient on printed work copy of the medication order from the VA’s CPRS electronic record.

f. Prescriptions filled under this contract are limited to quantities enough for a fourteen (14) day supply.

g. Prescriptions filled by contractor must include necessary auxiliary warning labels and other printed medication information customarily provide to other contractor clients. In accordance with California pharmacy regulations, patients must be offered medication counseling.

h. Contractor shall provide “new” prescription fills only. No refills of prescriptions are authorized under this contract.

i. Prescriptions filled under this contract are for pick up by the VA patient or representative at the contractor pharmacy. There is no authorization for delivery or mailing of these prescriptions.

j. When patient or his/her representative picks up prescriptions, contractor shall release such prescriptions by first verifying the identity of the veteran with the veteran’s VA identification card.

3. Generics

Prescriptions processed under this contract shall be filled with generic drugs to the extent permitted by law. Contractor pharmacist will select the least expensive generic drug product in stock. Contractor shall follow the same standards as the VA pharmacy when substituting generic products: same chemical ingredient, same strength, same dosage form as the branded product and an FDA therapeutic equivalency rating of “AB” for oral products or “AT” for topical products.

4. Documentation

a. Contractor shall maintain a written log of VA prescriptions filled under this contract. The log shall indicate the date the prescription was filled and contractor’s prescription number. The VA patient or his representative shall sign next to the prescription number at the time of prescription pick up to signify receipt of each prescription.

b. VANCHCS reserves the right to conduct random audits of the patient logs against invoices. Contractor will make the logs promptly available to the VA auditor as requested and at the location of where the prescription(s) was (were) filled.

5. Pharmacy Location

Contractor will specify one physical pharmacy location for the filling and dispensing of all prescriptions covered under this contract. This location must be within 5 miles of the VAOPC.

6. Contractor Qualification Requirements

a. Contractor must provide all required personnel to perform the pharmacy services covered under this contract. This includes qualified California licensed technicians, licensed pharmacists and other personnel as needed.

b. Contractor must have a minimum of 2 years-experience operating a licensed outpatient pharmacy.

c. The pharmacy designated to provide services under this contract must have a current and valid DEA and a California license granted by the State Board of Pharmacy.

d. Pharmacists who fill and/or check prescriptions covered under this contract must also be licensed by the California State Board of Pharmacy.

e. Pharmacy technicians who participate in prescription filling activities covered under this contract must also be registered with the California State Board of Pharmacy.

7. Equipment and Facilities

a. Contractor shall provide all equipment, facilities and supplies necessary for performing the prescription pharmacy services required herein.

b. Contractor’s place of business where prescription services will be provided must have adequate parking and patient waiting areas.

c. The location from which prescriptions will be dispensed must have handicapped access in accordance with the American with Disabilities Act.

d. Prior to contract award, and thereafter as necessary, VANCHCS staff will conduct a physical inspection of the contractor’s place of business to ensure the facility meets requirements contained herein. Inspections may also be conducted if the contractor performs significant physical renovations affecting patient access or pharmacy operations.

8. Hours of Operation

a. Contractor will provide prescription services to VA beneficiaries Monday through Saturday, excluding Federal Holidays, from 8AM until 7:30PM (or the pharmacies regular business hours).

b. The VAOPC is closed during Federal Holidays: New Year’s Day, Martin Luther King Jr., President’s Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving, and Christmas.

9. HIPAA Compliance

Under HIPAA Privacy and Security Rules, the Contractor providing services under this contract is considered to be a “covered entity,” and thus is not required to enter into a Business Associate Agreement with VA. However, the Contractor must observe Public Law 104-191 and all respective regulations implementing this law while providing services under this contract.

10. Estimated Quantities

a. The quantities of prescriptions to be filled according to this agreement are estimates, based upon the projected need for urgent prescriptions in a typical VA outpatient clinic of an approximate equal size and scope of services as the VAOPC. Typically, this would include about 5 prescriptions per business day for antimicrobials, pain medications, cardiovascular and psychotropic medications. The volume of prescriptions may fluctuate depending of patient needs.

b. VANCHCS does not imply or guarantee that any fixed number of prescriptions will be required during the contract period. VANCHCS will not be obligated to reimburse the contractor for any specified amount of services, but will be obligated to make payment for any services received in the quality and quantity as requested.

11. Invoicing and Payment

a. Payment made during all periods of performance of this agreement shall constitute the total cost for services rendered by the contractor.

b. Invoices rendered by the contractor to VANCHCS for services furnished under this agreement, will be invoiced in full for each month in which services were performed. All payments made under this contract will be made monthly in arrears in accordance with FAR Clause 52.212-4. No advance payments will be authorized. Invoices shall be e-mailed to the COR Wendi Purcell, Pharmacy Procurement Supervisor; VANCHCS (Wendi.Purcell@va.gov). Physical mailing address is VANCHCS, Pharmacy Service (119), 5342 Dudley Blvd. McClellan Park, CA 95652.

c. Invoices submitted will show the total prescription filled accompanied by a detailed report listing prescription number, patient name, drug, quantity and amount charged. All invoices applicable to this agreement must be submitted no later than thirty (30) days after the end of the contract period. Any problems regarding unpaid invoices should be directed to the Contracting Officer.

d. All invoices must include the name, title and phone number of person to be notified in the event of defective invoicing.

12. Quality Assurance and Contract Performance Monitoring:

a. In accordance with VA regulations, a record-keeping system will be established and maintained by the COR to ensure contract compliance.

b. The services specified herein may be changed by mutual written agreement of the parties, in accordance with the terms and conditions set forth herein.

13. Terms of the Agreement

a. This agreement is effective for the period identified in the “Schedule of Supplies and Service” and is subject to the availability of VA funds. Services will not be performed by the contractor beyond the expiration date, unless specifically authorized to do so (in writing) by the Contracting Officer.

b. Contractor personnel performing services under this agreement will not be considered VANCHCS employees for any purpose, and shall be considered employees of the contractor. VA will not make payment for any of their employee’s compensation including holidays or leave including sick leave. In addition, the contractor shall be required to provide their own worker’s compensation, liability insurance, health examinations, income tax withholdings and social security payments.

14. VANCHCS Responsibilities

a. After award, the Contracting Officer will designate a VA employee as the Contracting Officer’s Representative (COR). The COR will be responsible for overseeing and directing the services to be performed by under this agreement.

15. Contractor Business Integrity (CBI):

a. Compliance and Business Integrity Training & Education-Contract (Revenue Cycle) Employees.

(1) Awareness Training: Contractor employees shall complete initial compliance awareness training within 30 days of commencing work under this contract as well as complete annual compliance awareness refresher training. At a minimum, CBI, awareness training will include the following topics: (a) the revenue cycle, (b) seven elements of an effective compliance program, (c) definition of high risk areas, and (d) definition of any compliance concerns and how to address a compliance concern. This requirement can be fulfilled by completing the training module available via the following Internet site: http://www.visn21.va.gov/CBI.asp

(2) Remedial Training: When notified, contract employees must complete remedial training and education to address any detected compliance exceptions.

(3) Proof of Training: When notified, contract employees must complete remedial training and education to address any detected compliance exceptions.

16. RECORDS MANAGEMENT:

The following standard items relate to records generated in executing the contract and should be included in a typical Electronic Information Systems (EIS) procurement contract:

a. Citations to pertinent laws, codes and regulations such as 44 U.S.C chapters 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.

b. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

c. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government IT equipment and/or Government records.

d. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

e. Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract.

f. The Government Agency owns the rights to all data/records produced as part of this contract.

g. The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver sufficient technical documentation with all data deliverables to permit the agency to use the data.

h. Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

i. No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

j. Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information.