EV00000600_Amendment_3.pdf

OMES FORM CP 011 – Purchasing | Rev. 05/2016

Amendment of Solicitation

Date of Issuance: 01/21/2025 Solicitation/Event No. EV00000600

Requisition No. 1310022355 Amendment No. 3

Hour and date specified for receipt of offers is changed: No Yes, to: 02/04/2025 1:00 PM CST

Pursuant to OAC 260:115-7-30(d), this document shall serve as official notice of amendment to the solicitation identified above. Such notice is being provided to all suppliers to which the original solicitation was sent.

Suppliers submitting bids or quotations shall acknowledge receipt of this solicitation amendment prior to the hour and date specified in the solicitation as follows:

(1) Sign and return a copy of this amendment with the solicitation response being submitted; or,

(2) If the supplier has already submitted a response, this acknowledgement must be signed and returned prior to the solicitation deadline. All amendment acknowledgements submitted separately shall have the solicitation number and bid opening date printed clearly in the subject line of the email.

RETURN TO: Supplier Portal (oklahoma.gov)

Benjamin Komolafe

Contracting Officer

405-522-2228

Phone Number

Benjamin.komolafe@omes.ok.gov

E-Mail Address

Description of Amendment:

a. This is to incorporate the following:

On behalf of the State of Oklahoma, the Office of Management and Enterprise Services (OMES) gives notice:

The solicitation event EV00000600 close date has been extended from 12/28/2024 to 02/04/2025

1.Could it be possible to request a copy of the current contract for Pharmacy service held by OK DOC? This would include present Fill fee and Annual Rebate information.

The current fill fee is $1.85 and estimated annual rebate is $1,700,000.00.

2.Will there be delivery to all 23 locations? Will delivery require entrance inside facilities or be set up outside at pre-determined lock boxes? Please provide addresses for each delivery if so.

Delivery will be required to inside all facilities listed in Exhibit 4.

3. Does OK DOC have licensed pharmacy locations in correctional facilities? If so, please list facility names.

ODOC has no licensed pharmacists on staff.

4. Can the state share the purpose of the RFID process? Is it to prevent theft? Where is the tracking device located?

RFID tracking is no longer required. All packaging must be barcoded per other requirements. Only RFID is removed.

5. Does the state prefer pouches or blister cards for medication orders?

A daily-multi-dose automated tablet packing system per patient in strip packaging.

6. Is approval required of all new medications prior to prescriptions being filled?

This question is vague. All orders require approval.

What reports listed are presently provided by the OK DOC EHR and Offender Management Systems? Please list.

OMS:

I pull Age breakdown for our staffing analysis. See attached.

EHR standard reports:

Allergy Report Alert Report https://oklahoma.gov/omes/services/purchasing/supplier-portal.html

RX report Problem Report VS report (MH levels, Medical Acuity etc.)

Lab reports Text order report Patient Medication report Co-pay report

We also have what is call User Defined reports where we set up the criteria we want to pull. Below are some examples.

Clinical Notes by specific staff Specific Lab results by inmate Specific vaccines administered Referrals and Consults Specific medications to include begin date and end date by inmate

7. Will the DOC provide a copy of actual invoices from the present provider for the months of October 2024 and November 2024 for pharmaceutical services?

This request is for thousands of documents and will not be fulfilled as it would create an undue hardship on ODOC.

8. To comply with the Required Bid Format beginning on page 4 of the Agency Bid Instructions, should the online bidder response include pdfs of the forms and exhibits that are already uploaded as separate files?

9. Page 6 of the Agency Bid Instructions, item 7.5., states any exceptions are to be tracked in Word format. Is this to be uploaded as a separate Word file and if so, should this also be included as a redlined pdf in the bidder response?

10.In the attachment “EV00000600_AgencyBidInstructions”, the bottom of page 8 states “7.9 Section Nine…” and top of page 9 states “7.10 Section Eleven…”. Is this supposed to read “Section 10” or is there another Section 10 that has been omitted?

11. Page 9 of the attachment “EV00000600_AgencyBidInstructions” Bidder Instructions, item 7.10 Section Eleven refers to Exhibit “3” as the Bidder Reference Worksheet, when the Bidder Reference Worksheet is actually Exhibit “2”. Please confirm.

12. Exhibit 1, Section 2 lists items 7.2a.-g. and then contains a second 7.2 and 7.2.a.-b. with different information. Following that, items 7.2.c.-g. are complete duplicates. Is there any information missing? Please advise on how this should be formatted.

13. Regarding Exhibit 2 Reference Survey, are these to be sent to clients for completion and returned to bidder for bid packet submission or is the reference required to submit the survey directly to the state? If references are to be sent directly to the state from each reference, please outline instructions to do so.

The event bid factors for the solicitation clearly state to upload completed bidder reference documents as part of bid response.

14. Exhibit 3, Item 46 requests RFID tracking technology, both on the medication packets and medication shipments. We are not sure the current technology is available from the ATP vendors for RFID on the medication packets themselves. Is this mandatory or would the State consider this as a goal to work towards?

RFID is no longer required.

15. Attachment A, page 1 under I. Purpose states, “The Contract is awarded on behalf of ODOC for canteen services.”

Should this read “pharmacy services” instead of “canteen services”?

Correct, pharmacy services.

16. On the bottom of the website upload submission page, Step 2: Enter Line Bid Responses, in addition to the Unit Bid

Price, is the “Upload Bid Response” section where you would like vendors to upload all responses to Section 7, Required bid format in the attachment “EV00000600_AgencyBidInstructions”? If not, where would vendors attach the file containing responses to this section of the RFP?

17. Please clarify what the State is referring to when stated “acquisition specifications” in Section 7.a. of the RFP.

It is unclear what this bidder is referring to as there is no Section 7.a.

18. Question #1 - Attachment B – Negotiable Terms: Regarding specification 5.1 D. – Does the DOC have any objections to this coverage being provided on a claims made form, and not per occurrence?

ODOC has no objections to this request.

19. Question #2 - Attachment B – Negotiable Terms: Regarding specification 5.2 E. – Additional coverage required in writing in connection with a particular Acquisition. Can this be clarified as to the expectation?

20. Question #3 - Attachment D – IT Terms: Security Assessment 19.1 , “The State requires any entity or third-party

Supplier Hosting Oklahoma Customer Data to submit to a State Certification and Accreditation Review process to assess initial security risk.”

21. Can details be provided to what is involved with this process?

22. Who performs this review and what is the cost associated with it? Information services – No cost

23. Question #4 - Exhibit 3 – Bidder Requirements: Given the instruction that no additional information is requested for

Yes/No questions, and responses should be limited to "yes" or "no" in the applicable column, are offerors permitted to submit a separate document providing detailed explanations or supporting information on how the requirement will be met, without impacting the evaluation process or causing the proposal to be deemed nonresponsive?

If a bidder answers yes, it may also provide additional information to support their response.

24. Question #5 - Exhibit 3: Exhibit 3 provides requirements 1 through 6, then continues with requirements 9 through the end. Were specifications 7 and 8 omitted, or was this an error on the Excel workbook?

That is due to in incorrect Excel formula, Please proceed as if there is no 7 or 8.

25. Question #6 - Exhibit 5: Exhibit 5, Column F “Quantity Filled/Billed Last 12 Months” appears to represent quantities that look too low to be for an entire year. Can it be confirmed that the quantities in Column F do reflect all dispensing quantities from the prior 12 months?

Correct.

26. Question #7 - Attachment A: Attachment A, Section II states, “ODOC has a shortage of qualified health care resources to provide necessary medical services, including pharmacy services to the inmate population within its institutions.”

Can details be provided as to how specifically pharmacy services have been impacted by a shortage of health care resources within the ODOC so respondents can address and provide solutions to the ODOC?

Bidders may not offer alternatives to provide solutions than what is required in the bidder requirements.

27. Question #8 – Participation in RFP: The Agency Solicitation Bidder document states, “Pursuant to Oklahoma Attorney

General Opinion No. 06-23, any Bidder that has assisted in preparing the Solicitation or developing the procurement terms, either directly or indirectly, is precluded from being awarded the Contract.”

Please confirm that none of the specifications for pharmacy services requested in Exhibit 3 have resulted from input or conversations or materials provided by any pharmacy provider that would likely also be a respondent to Solicitation

EV00000600.

ODOC routinely receives unsolicited requests from outside vendors requesting to have conversations with ODOC staff regarding various ways that a vendor feels it may improve a particular aspect of ODOC operations. These outside vendors also routinely provide materials regarding their own operations. ODOC can confirm that it had conversations with an outside vendor about its pharmacy operations, but none of the specifications of the solicitation were the result of any conversations nor any materials provided by any outside vendor.

28. Please confirm that if a pharmacy provider did have any input regarding specifications included in Exhibit 3, they would be excluded from participation in Solicitation EV00000600, and this would be disclosed during the responses to questions.

As no pharmacy provider had any input regarding the specifications in Exhibit 3, no provider will be excluded from participation in the solicitation.

29. Question #9 – Exhibit 1: Exhibit 1 begins with Section Two: Executive Summary and Company Information. Please confirm there is not a Section One within Exhibit 1 that needs completed by respondents.

30. Question #10 – Exhibit 3 – 340B: Exhibit 3, Specification 6 states, “The offeror shall work with the covered entity as defined in Section 340B of the Federal Public Health Services Act, 42 USC 256b, that is selected by ODOC to provide certain drugs at reduced prices for use by inmate patients of the covered entity. Offeror shall, with ODOC’s written approval, allow the selected covered entity to purchase pharmaceuticals through this contract for the use of inmate patients.”

Who is the current covered entity with access to 340B medication pricing on behalf of the ODOC?

Lindsay Municipal Hospital

31. Please provide a list of the current medications included within the existing 340B program.

32. Please confirm that no additional medications would be removed from contract or moved to a 340B program without mutual agreement of the ODOC and your selected pharmacy vendor.

Correct, only medications through 340B will be removed.

33. Question #11 Exhibit 3 – 12. B: Exhibit 3, Specification 12 states, “B. Stock fills shall only be charged one filling/dispensing fee.” However, to comply with DSCSA requirements mentioned in Exhibit 3 – Specification 4, it requires respondents to provide transaction history documentation for each piece of product dispensed as stock, there is consumable cost of packaging for each piece of stock (blister cards), there is the expense of contracting with an FDA

Registered Repackager to produce stock cards in compliant blister card packaging, and there is shipping costs for stock medications, among other expenses as well.

In consideration of the expenses required to legally provide stock medication in compliance with regulations, will ODOC consider removing this specification from Exhibit E and consider stock no differently than a patient specific order since this is a yes/no requirement yet has three subcategories of compliance (A, B, and C) within Specification 12?

No.

34. Question #12 – Exhibit 3 - Hardware/Software

Exhibit 3, Specification 23 states, “Offeror shall provide all hardware/software necessary for each ODOC facility.”

Software expenditures can get into tens of thousands of dollars (or more) if required at 23 medical service units.

As this is a yes/no designated specification and with the current use of MedUnison as your EHR, please detail specifically what other software will be required of the pharmacy and at their expense?

There is currently none.

35. Question #13 – Exhibt B – Hardware/Software: Exhibit 3, Specification 23 states, “The required amount of hardware/software at each facility will be determined by the ODOC Medical Services Manager or designee.” As with the prior question, this unilateral authority of the Medical Services Manager or designee can result in unplanned expenses placed on the pharmacy that could be tens of thousands of dollars.

As this is also a yes/no designated specification, is ODOC willing to make this an “upon mutual agreement” specification to protect the pharmacy from significant expenses unknown at the time of proposal submittal?

If not, can a dollar limit be established?

No and no.

36. Question #14 – Exhibit 3 Specification 46: Exhibit 3, Specification 46 states, “All prescription medications shall be filled by the Offeror utilizing a daily multi-dose automated tablet packaging system per patient with RFID tracking technology, both on the medication packets and medication shipments.”

A daily multi-dose automated tablet packaging system can be interpreted in multiple ways. Can you please provide as much detail as possible on what ODOC is expecting regarding your requested packaging (blister cards, strip packaging, baggies, etc.)?

To clear up all ambiguity, can an image of the desired packaging being sought by ODOC in specification 46 please be provided for clarity.

Strip packaging. Conducing a search on the internet for “multi-dose strip packaging prescription” will provide various examples of this. An example below:

37. With the specific mention of RFID tracking technologies:

What RFID technologies or companies have been consulted by ODOC regarding this solution?

Does ODOC have a specific RFID technology that is favored?

Does ODOC have the existing infrastructure at all 23 medical service units to accommodate RFID technology (rabbit-ears, signal boosters, wiring and conduit in place, etc.)?

If not, will all required infrastructure be provided by ODOC since this will result in possibly significant and very costly changes to actual facility infrastructure?

RFID requirements have been removed and only a barcode is required.

38. Question #15 – Exhibit 3, Specification 49: Exhibit 3, Specification 49 states, “All prescription medication packets with multiple prescriptions shall have barcodes for each prescription”

Would a 2D barcode consumable by MedUnision be acceptable that documents all medications within a packet in place of separate linear barcodes for each medication?

Yes, as long as the barcode scanner that is supplied by the bidder interfaces with the 2D barcode.

39. Question #16 -Exhibit 3, Specification 70: Exhibit 3, Specification 70 states that Medication Administration Records are to be provided. Are all 23 medical service units requiring paper MARS each month? No.

40. Question #17 – Respondent Qualifications

A 23 facility/20,000 inmate statewide Department of Correction is a much larger undertaking compared to a pharmacy program implemented at a small local jail or small state Department of Correction and requires significant experience and expertise working with large Departments of Corrections systems to meet ODOC scope of work requirements safely and effectively.

To be considered responsible, qualified, and eligible for an award, will ODOC consider adding language that an Offeror is to have current or prior contracts within the past five years for medication dispensing and pharmacy program management services to at least three state Department of Corrections clients with a census of 20,000 or more lives and where the Offeror is responsible for all medication purchases?

If not, is there any minimum standard of experience regarding medication dispensing and pharmacy program management services to state Department of Corrections that will be required by the ODOC to establish qualifications?

Yes, the offeror shall have a minimum of 10 years documented experience service private, federal, state and/or local jail systems of similar size.

41. Question #18 – Purchasing Volume

ODOC is a very large financial undertaking (approximately $25 million annually) compared to a pharmacy program implemented at a small local jail or small state Department of Correction. Awarding to a new vendor will require significant financial resources to fund initial and ongoing drug purchases along with many high-cost limited distribution medications not often used at local and small DOCs, high-cost biologicals, oncology medications, hemophilia factor products, and Hepatitis C medications not often used at local jails or small DOCs.

To be considered financially capable, qualified, and eligible for an award, will ODOC consider adding language that Offeror’s have at least $250 million in aggregate purchase volume for each of the past three calendar years verifiable via an Offeror’s audited financial statements at the time of the proposal response so this one single contract does not exceed 10% of an Offeror’s total aggregate sales?

If not, is there a minimum annual aggregate purchasing volume for each of the past three years that ODOC will require for an Offeror to be considered financially qualified at the time of the bid to meet the significant medication purchase requirements (~ $25 million) of the ODOC?

Financial viability will be determined by the evaluation team after solicitation has closed.

42. Question #19 – Quantities: How many days’ worth of medication (7, 14, 30 days) is typically dispensed for routine medication orders and do you wish to keep it the same?

This contract will require a daily multi-dose packaging system.

43. Question #20 - MAT Program

Is there a current MAT program in place at ODOC:

If so, can any details be provided regarding the current number of inmate patients that are receiving MAT medications on average per month?

There is a pilot project currently in place at one ODOC facility. This is through a grant and our current pharmacy provider is not involved with the process.

If Sublocade and Brixadi are used, how many inmate patients on average per month are currently receiving these injections?

N/A.

44. Question #21 – Inspections: Exhibit 3 does not require facility inspections. Please confirm this is not a requirement.

No, it is not.

45. Question #22 - Electronic Reconciliation

Many correctional institutions within the industry are using electronic check-in and return programs for inventory management. Manual daily order check-in and return processing time can be decreased by up to 75%, medication diversion potential is virtually eliminated, and ODOC will have full accountability of all medications received by, and returned from, your facility for accounting purposes.

What is the name of your current barcode electronic order reconciliation (check-in), and medication return management system that is provided by your current pharmacy vendor at no additional cost? ODOC’s current contract is with Pharmacorr.

46. Would you find value in adding this requirement to your current solicitation for bidders to provide a free solution for electronic inventory management if a solution in not currently in place so all medications shipped to, and returned from

ODOC are accounted for? There would be value in this, but it would not be scored higher in the evaluation.

47. If not, what reservations does ODOC have regarding a no cost web-based software solution for medication check-in, inventory management, and electronic returns? N/A

48. Question #23 - Online Reporting Access

Many correctional institutions within the industry have fingertip access to meaningful and actionable electronic reporting available to County administrative personnel monitoring contract expenses. Analyzing prescriber ordering trends and expenditures to better manage facility operations is critical to your County administrative team and dependent upon reliable and accurate pharmacy reporting.

What is the name of the current online reporting dashboard used by facility and county administrative staff to access meaningful and accurate reporting? We are not aware of the reporting that is used by the County Jail administrators.

49. Would you find value in adding this requirement to your current solicitation for bidders to provide a no cost solution for online reporting so your facility-level staff and administrators can access online reports 24/7/365 if a solution is not currently in place? If not, what reservations does ODOC have regarding a no cost web-based software solutions that provides actionable and meaningful reporting to help your clinical and financial teams?

Currently, we provide medications to inmates that are housed in county jails awaiting intake into an ODOC facility. This is through our current pharmacy vendor and would continue with the awarded pharmacy vendor.

50. Question #24 - EHR/EMR

Regarding the version of MedUnison deployed at ODOC:

Is the system also used for eMAR purposes? Yes.

51. Is the system Electronic Prescribing of Controlled Substances (EPCS) compliant?

A large portion of the Controlled Substances prescribed for ODOC are ordered as stock medications. Those that are ordered patient specific require additional steps and are not ordered electronically.

52. Can you please provide the name and email of your EHR/EMR contact so that bidders can contact them for system specifications, interface requirements, and capabilities?

Medunison. wes@medunison.com

53. Question #25 - Evaluation Committee: To best understand the perspective of everyone on the evaluation committee, can you please share the name and title of each person that will be involved in the selection process?

No.

54. Will a final decision be made by the evaluation committee, or will the committee provide a recommendation to a final decision maker? The evaluation committee will provide a recommendation for award.

55. If so, who is the final decision maker regarding an award? This information will not be shared.

56. Question #26 - Intent to Award Notification

57. Companies submitting a proposal are not typically alerted to the scoring and evaluator notes until after a contract is approved and signed. This leaves no option for respondents to clarify items that may have been misinterpreted or overlooked during the evaluation process.

Will ODOC provide an email response (or other notice) of your intent to award along with evaluator scoring and evaluator notes ahead of awarding a contract for bidders to review with the evaluation committee?

58. Question #27 - Additional Questions: Will there be an opportunity to ask more questions for clarification purposes, in the event responses to submitted questions are unclear?

Yes.

59. Question #28 - Debriefing Request: Understanding that a debriefing is not an opportunity to challenge the decision, nor will it include a comparison of a respondent’s unsuccessful proposal with any other respondent’s proposals. What is the protocol at ODOC for respondents who submitted an unsuccessful proposal to obtain a meeting for debriefing and discussion of their proposals to learn from the RFP process?

60. General Question – The release date of the solicitation is listed as 11/26/2024 on the Supplier Portal. Electronic notifications were delayed and not distributed by the OMES purchasing department of the solicitation until 12/3/2024.

Will the state consider extending the due date of the solicitation to allow pharmacies to prepare a more competitive bid?

Yes.

61. General Question – What is the intended start date of the contract? As soon as possible.

62. Document Bidder’s Instructions, Page 4, Sections 6.1 and 7. – The instructions state “The Bid is required to be structured into labelled and easily identifiable sections using the Bid Packet format provided below.” The Supplier Portal provides for the different sections and documents to be uploaded separately and individually. Uploading the individual documents in the Supplier Portal doesn’t seem to match what is described in Section 7. Should the individual documents be uploaded in the Supplier Portal or should one document be submitted as described in Section 7? For example, the

Supplier Portal provides a place to upload Form 004, however, Section Three is to contain more information that what is included on Form 004. Should Form 004 be included in Section 3 and uploaded in the Supplier Portal?

63. Document Bidder’s Instructions, Page 7, Sections 7.7.d and 7.7.e – Is an information technology VPAT required? Is an information technology Security Certification and Accreditation Assessment required?

64. Attachment A – Solicitation No. EV00000600 Section I. Purpose – Please clarify “The Contract is awarded on behalf of

ODOC for canteen services.” Does this solicitation only include prescription and OTC medications ordered by the medical staff or does it include medications for the canteen as well?

Medical staff only.

65. Attachment A – 2. Solicitation Criterion – The bid will be evaluated using a best value criterion, based on price and ability to meet specifications. How is the ODOC going to determine the “best value”? Will it be determined off of points and if so, what is the weight between Price and ability to meet specifications?

Ability to meet specifications will be determined as pass/fail. The lowest price among all bidders that have the ability to meet specifications will be what’s scored.

66. Attachment B Section 3.1 and Exhibit 3 Invoicing Requirement #64.F – The Solicitation states that shipping is included in the price of the product. Should the shipping be added to the drug cost, the dispensing fee, or will the ODOC pay for shipping under a separate line item on the invoice?

A separate line on the invoice.

67. Exhibit 3 Company Information Requirement #6 – Is there another line item for the dispensing fee for being the contracted pharmacy for the 340B covered entity. The dispensing fee is typically increased due to the additional compliance requirements for the contracted pharmacy.

This bid does not include the medications that are ordered through 340B process. ODOC’s 340B medications are ordered via an outside entity.

68. Exhibit 3 – Contract Requirements Requirement #12 and Packaging #46 – Is the dispensing fee in Section #12 to be charged per prescription or per daily multimed package dispensed required in Section #46?

It is expected that each bidder will disclose their dispensing fee model, with the appropriate fees included.

69. Exhibit 3 – Contract Requirements Requirement #12 and Packaging #46 – Would the ODOC consider different fill fees for different package types? For example, one fill fee for the daily multimed packets and another dispensing fee for an inhaler, blister card or a clinic stock package?

No, ODOC would not. It would not have the capability to audit the orders to ensure correct fill fees are being charged.

70. Exhibit 3 Contract Requirement #12A and Reporting #71 – Where a pharmacy owns a wholesaler will the DOC require invoice cost be verified against an alternate source? Pharmacies who own a Wholesale business can manipulate Actual

Acquisition Cost by artificially decreasing cost estimates for contract bid then inflating them after contract award.

No, ODOC does not have the capability to do this.

71. Exhibit 3 Contract Requirement #12B – Will stock fills only be charged one dispensing fee per order requested? For example, will there only be one dispensing fee that is to be charged if ODOC orders a stock quantity that has multiple pieces (ie 5 inhalers as a single dispensing order or 5 inhalers as 5 separate orders and 5 dispensing fees)?

It is expected that each bidder will disclose their dispensing fee model, with the appropriate fees included.

72. Exhibit 3 Contract Requirements #13 – The requirement references supplies listed in Exhibit 3. Exhibit 3 does not include a list of supplies. Please provide a supplies list that was meant to be in Exhibit 3.

Per Exhibit 3 Contract Requirements #13 - These items will be limited to standard pharmacy expense items (i.e., expense items that you would not normally charge a patient for separately), such as controlled substance logbooks, clear plastic bag/light protective bags, vials/lids, spoons/oral syringes for liquid administration, etc. These items will not include things that would normally charge a patient/insurer for separately, such as syringes/needles for injection, test strips, lancets, etc.

73. Exhibit 3 – Contract Requirements Requirement #15 – This requirement states that “specialty orders for refilled medications” with a cost that is greater than $5,000.00 will be verified with the CMO or designee. Is this all medication over $5,000.00 in cost or just medications designated as specialty medication? If requirement is solely for specialty medication, how does ODOC define specialty medication? Will Offeror be supplied with a list of those medications at contract award?

All medications over $5,000 will be verified with the CMO or designee.

74. Exhibit 3 Contract Requirement #16 – There is no requirement for day supply in this proposal. What constitutes an early refill? The example provided is if 21 or more days have not passed since the last fill. Is the offeror to assume that a

30day supply of medication is required?

Prescription orders will be written for 30 days supply or the appropriate days supply for the medication (i.e. antibiotics may be written for a 7 or 10 day supply). The prescriptions will be filled and sent daily, or up to 3 days in the case of holidays and/or weekends.

75. Exhibit 3 Contract Requirement #16 – What is the day supply or quantity that the offeror is to dispense for a PRN medication? A 30-day supply will be dispensed, unless otherwise requested by the provider’s order.

76. Exhibit 3 Contract Requirement #16 – Requires orders requested for early refill 21 or more days ahead of when it is due to be verified. How does ODOC define early refills when a patient’s medications are packaged in a daily multi-dose packet and one of the medications the patient takes daily has a dose adjustment? Will the other medications in that pouch be required to be refilled early so that all medications in the daily packet are correct? Who is responsible for pulling the packets that are no longer correct once medications in the packets are adjusted (change in dose, discontinued, etc) or patient’s therapy changes (add medication to therapy regimen)? The medications will be delivered daily, or up to 3 days in the case of holiday and/or weekends. This would eliminate the need to pull packets that are not correct.

77. Exhibit 3 Contract Requirement #23 – Is the RFID hardware/software (Readers, Software to process the information received, interfaces, etc.) at each facility the responsibility of the ODOC?

RFID requirement is no longer applicable.

78. Exhibit 3 Ordering Requirement #25 – Who is responsible for the shipping charges associated with the mailing of any mandated forms to the pharmacy vendor?

From ODOC to the vendor? ODOC will be.

79. Exhibit 3 Ordering Requirement #26 – Request states to discuss ordering cut-off times and hours of operations for contacting the pharmacy. ODOC does not define any specific times. Should the current ODOC cut-off times continue to be 4pm Central Time, Monday through Friday, for new, refill, and stock orders?

This is listed for the bidder to offer their own ordering cut-off times and hours of operations for contacting the pharmacy.

80. Exhibit 3 Ordering Requirement #27 – Requests explanation of procedures for maintaining a controlled substance. Does this pertain to the storage of controlled substances at the site or is this specific to fulfillment of the pharmacy legally processing the order? Will MedUnison be updated for compliance with DEA regulations, including multifactor authentication, to submit CDS prescriptions electronically?

MedUnison will be updated for any compliance that are required by law.

81. Exhibit 3 Ordering Requirement #28 – Request explanation on how refills are managed. For medications packaged in daily-dose multi packet where there is a change in only one of the packaged medications from the multi packet would the

ODOC prefer a complete package replacement? Will the DOC accept this will result in an additional dispensing fee and a decrease in the quantity of tablets available from the prescriptions of the unaffected medications?

The medications will be delivered daily, or up to 3 days in the case of holiday and/or weekends. If a prescribed medication is ordered for 30 days and 3 refills, the medication would be delivered daily for the length of the prescription, or the prescription is discontinued.

82. Exhibit 3 Ordering Requirement #28 – Requests explanation on how refills are managed. Managing refills depends on what day supply of medications is sent. What is the day supply desired to be dispensed by the ODOC? What is the allowed refill window before the refill request is considered too soon?

Deliveries would be to be given the next calendar day..

83. Exhibit 3 Ordering Requirement #28 – Requests explanation on how refills are managed. A cycle fill process historically results in excess of waste, but a short day supply dispensing would require more frequent. Does the ODOC want an automatic cycle fill process implemented?

If a prescribed medication is ordered for 30 days and 3 refills, the medication would be delivered daily for the length of the prescription, or the prescription is discontinued.

84. Exhibit 3 Ordering Requirement #28 – Requests explanation on how refills are managed. Does the DOC place any limits on number of dispensing fees per prescription allowed per 30 days? Per year?

It is expected that each bidder will disclose their dispensing fee model, with the appropriate fees included.

85. Exhibit 3 Ordering Requirement #29 – Please clarify the statement “How are orders transmitted after-hours?” Is this meant for medications to be filled by the Offeror during the next business hours or is this meant for orders to be filled at the local pharmacy?

Please explain the process of ordering medications through a local pharmacy after-hours.

86. Exhibit 3 Ordering Requirement #33 – The requirement states “Local pharmacies will act as subcontractors and will be held to the same terms and conditions of this contract.” Will the local pharmacies be required to package medication in the daily multidose packaging? Most retail pharmacies do not offer this service, and the medications would not be added to the patient’s current dose packs.

No, this will not be required.

87. Exhibit 3 Packaging Requirement #46 – The Solicitation states “All prescription medications shall be filled by the Offeror utilizing a daily multi-dose automated tablet packaging system. Some medications are not appropriate for this type of packaging. Will the ODOC allow other packaging when multi-dose packaging is not appropriate? Some examples would include: Controlled substances, Hazardous drugs, Non-solid oral dosage forms, KOP and Pill Line Only medications cannot be packaged together, therapeutically incompatible medications, there is a list of medications that are not recommended to be dispensed in pouches due to applicable USP compendial requirements or guidelines, there is a list of medications that should not be ran, through the packaging machine according to the manufacturers of the machine, medications from other sources, such as from stock or an outside pharmacy (local, specialty, or 340b), medications that are to be dosed on an “as needed” or prn basis, and lastly OK law states that if two medications have physical characteristics that make them indistinguishable from each other, then the medication shall not be packaged together in the same customized adherence medication packaging (CAMP), a potential issue for over-the-counter medications. If so, what packaging would be allowed?

For tablets/capsules that are not appropriate for the daily packaging, blister cards would be acceptable.

88. Exhibit 3 Packaging Requirement #46 – The requirement states that RFID tracking technology must be included on the medication packets and medication shipments. To better understand the information that is required, what data elements are required to be programmed into the RFID tags? RFID requirement is no longer applicable.

89. Exhibit 3 Packaging Requirement #46 – What system will you use to read the RFID information?

RFID requirement is no longer applicable.

90. Exhibit 3 Packaging Requirement #46 – How will you integrate the information on the RFID tag into your database?

RFID requirement is no longer applicable.

91. Exhibit 3 Packaging Requirement #46 – Does the ODOC currently have the technology (hardware and software) in place to use the RFID tracking for medications? Will the ODOC be responsible for implementing the hardware and software requirements for RFID at the sites and/or maintenance and repair of existing system?

RFID requirement is no longer applicable.

92. Exhibit 3 Packaging Requirement #46 – Will a separate interface need to be established with the offeror and ODOC to transmit the RFID data? Who is responsible for this cost?

RFID requirement is no longer applicable.

93. Exhibit 3 Packaging Requirement #46 – Where are the RFID readers to be located? For example, at the mail room door, within the medication room(s) or within a specific med cart(s)?

RFID requirement is no longer applicable.

94. Exhibit 3 Packaging Requirement #46 – Will check-in of all medications at the facility be required or will this be accomplished by RFID technology?

RFID requirement is no longer applicable.

95. Exhibit 3 Packaging Requirement #46 – What happens when there are errors reading the RFID tag at the facility? For instance, if there is interference caused by too many RFID tags in close proximity to each other resulting in failure to capture data?

RFID requirement is no longer applicable.

96. Exhibit 3 Packaging Requirement #46 – The requirements do not state the day supply for the vendor to supply with each dispensing. The variability in day supply will greatly affect many facets of the solicitation responses, including the cost and the operations at the sites. A 30-day supply will require a significant amount of storage and will increase wasted medication due to medication changes, but will have less dispensing fees than a lower day supply. A smaller day supply will potentially decrease storage requirements and waste but will significantly increase the spend on dispensing fees.

What day supply does the ODOC want proposed for this solicitation so that all responses (especially dispensing fees) can be evaluated equally?

Our prescriptions will be written for a 30-day supply. They will be packaged in the daily multi-dose automated tablet packaging system and delivered daily, or up to 3 days in the case of holiday and/or weekends. It is expected that each bidder will disclose their dispensing fee model, with the appropriate fees included.

97. Exhibit 3 Packaging Requirement #46 – KOP and Pill Line Only medications will have to be packaged separately in the daily multidose packaging. How will the ODOC notify the pharmacy of the status of each medication order for each patient?

For tablets/capsules that are not appropriate for the daily packaging, those that are KOP, and narcotics blister cards would be acceptable in a 30 days supply packaging.

98. Exhibit 3 Packaging Requirement #47 – Can you elaborate on the requirement for a minimum of 3 prescriptions to the same patient?

The multi-dose packaging system must have the ability to provide multiple scripts to the same patient. in the same packaging system.

99. Exhibit 3 Packaging Requirement #52 – The requirement that all medication shipments be sorted and labeled on the outside of the packaging by housing unit/date and time requires clarification. Was the intention that a shipping box for morning administration medications be separated from the shipping box of afternoon administration medications etc.?

Or was the intention that each administration time be clearly labeled on the patient package within the shipping box?

Clarification is required to estimate shipping costs if those are to be included in the fill fee.

Multiple units can be shipped together. It will be expected that inside the shipping box the individual units will be boxed in smaller containers/boxes.

100. Exhibit 3 Delivery Requirement #57 – Refills and stock medications shall be delivered no later than three business days based on Offeror's daily ordering cutoff time. Allowing three business days can significantly extend the amount of time to receive the medications when holidays and weekends are involved. Would ODOC accept a next day delivery requirement in cases where patient could potentially go without all medications during the extended window of three business days allowed in the solicitation.

New prescriptions will need to be shipped overnight/next day shipping. Refills and stock items will need to arrive no later than 3 days.

101. Exhibit 3 Delivery Requirement #57 – Refills and stock medications shall be delivered no later than three business days based on Offeror's daily ordering cutoff time. Does this include refrigerated items?

Refrigerated items will need to be shipped in a manner that will protect the integrity of the medication being shipped.

102. Exhibit 3 Delivery Requirement #57 – Refills and stock medications shall be delivered no later than three business days based on Offeror's daily ordering cutoff time. Does this include control substances?

Yes.

103. Exhibit 3 Delivery Requirement #57 – Refills and stock medications shall be delivered no later than three business days based on Offeror's daily ordering cutoff time. Does this include emergency stock or refill medications? Who pays the additional shipping costs in these situations?

Emergency medications can be picked up from a backup pharmacy. If/when a refill or stock medication is requested as an emergency order, the cost of shipping would be paid for by ODOC. It would be requested that these medications be shipped with the daily order.

104. Exhibit 3 Returns Requirement #59 – Due to the increased amount of medication waste associated with multidose packaging, who is responsible for the destruction of the unusable medications?

The medications will be delivered daily, or up to 3 days in the case of holiday and/or weekends. This will minimize the waste. The facility will waste non-controlled medications via an appropriate waste container.

105. Exhibit 3 Returns Requirement #59 – Who is responsible for the shipping of the unused medications that are ineligible for return and must be destroyed?

The facility will waste non-controlled medications via an appropriate waste container.

106. Exhibit 3 Contract Implementation Requirement #59 – Who is responsible for costs for any additional training at the facilities throughout this contract period, not just during implementation?

The vendor, but training may be made available through telecommunications.

107. Exhibit 3 Invoicing Requirement #62 – The requirement mentions email addresses listed in Exhibit 3. Will the email addresses be provided to the successful vendor upon award? Yes.

108. Exhibit 3 Invoicing Requirement #65 – The requirement says any and all rebates and/or credits received for drugs shall be itemized as a separate line item in the invoice. Does this mandate that all rebates are to be passed along to the

ODOC? No.

109. Exhibit 3 Ordering Requirements – Oklahoma Board of Pharmacy does not allow remote order entry other than for hospitals. Will the ODOC require that medication order entry, drug utilization review, pharmacist verification #1 and pharmacist verification #2, etc. is done in the facility that dispenses the medication to comply with the law?

ODOC will not dispense medications. ODOC nursing staff will administer medications. ODOC will ensure compliance with the Oklahoma Board of Pharmacy.

110. Exhibit 3 Reporting Requirement #72 – The requirement states the “Offeror shall submit a written report of their quality assurance review…” Is this referring to quarterly audits performed by a pharmacist at the facility? Are the cost of these audits included in the dispensing fee?

These audits are to be completely by the vendor. All vendor costs are to be included in the dispensing fee.

111. Exhibit 3 Reporting Requirement #72 – Who is responsible for the cost for any additional audits/training requested by

ODOC to be done in addition to the quarterly audits? The vendor.

112. Exhibit 5 ODOC Historical Medications – Supplier's Proposed Pricing - To be able to price a fill fee accurately, how many fill fees is ODOC anticipating by changing to pouch packaging?

Estimated 500,000 per year.

113. Exhibit 5 ODOC Historical Medications – Supplier's Proposed Pricing – How many fill fees will the ODOC expect for a patient that is prescribed a 30 day supply?

It is expected that each bidder will disclose their dispensing fee model, with the appropriate fees included.

114. Exhibit 5 ODOC Historical Medications – Supplier's Proposed Pricing – How many fill fees will the ODOC expect if there are multiple medications prescribed for a 30 day supply? For example, if a patient is prescribed 4 medications and it is being dispensed every 7 days, for a 28 day supply, is that considered to be 4 dispensing fees or will it be 16 dispensing fees (4 medications x 1 fill per week x 4 weeks per month)?

It is expected that each bidder will disclose their dispensing fee model, with the appropriate fees included.

115. Exhibit 5 ODOC Historical Medications – Supplier's Proposed Pricing – There is a line for Estimated Annual Rebates, however, there is nothing stated in the RFP if rebates are going to be shared, kept by the pharmacy or 100% passed back to the ODOC. What is the ODOC’s expectation of rebate distribution?

ODOC has no expectation. It is the vendor’s responsibility to list an estimate, which can be $0, but will be scored accordingly in the evaluation as it would be an increased cost to ODOC.

116. Exhibit 5 ODOC Historical Medications – Supplier's Proposed Pricing – 340B programs will significantly affect the purchasing volume rebates and manufacturer rebates that will affect the rebates available to the ODOC. To estimate the rebates available, which medications should be excluded in the rebate calculations, in other words, which medications will be included in the 340B program?

Currently the medications that are being ordered through the 340B are; Eliquis, Xarelto, Epzicom, Abacavir, Biktarvy, Darunavir, Descovy, Dovato, Edurant, Sustiva, Truvada, Emtriva, Baraclude, Epclusa, Intelence, Evotaz, Genvoya, Isentress, Epivir, Maraviroc, Pifeltro, Prezcobix, Norvir, Stribild, Symtuza, Viread, Tivicay, Triumeq, Zepatier, Mavyret, Vosevi, Ribavirin, and Vemlidy. This list is subject to change as we consider additional medications for the 340B program.

117. Exhibit 5 ODOC Historical Medications – Will drugs being obtained from 340b be included in the pricing comparison? As an example, if Triumeq is to be obtained through 340b pricing, comparing offeror’s pricing of Triumeq would be irrelevant. Further, Triumeq can be administered with a split regimen that is typically less expensive and contains the exact same pharmacotherapy.

No, 340B medications will not be included.

118. Exhibit 5 ODOC Historical Medications – Will a new pricing exhibit 5 be available that excludes all medications that are to be obtained from 340b to allow for true comparison of drug pricing from offerors?

No, as no 340B medications that OODC obtains are listed.

b. All other terms and conditions remain unchanged.

Supplier Company Name (PRINT) Date

Authorized Representative Name (PRINT) Title Authorized Representative Signature