Q A_First_Set_Answers.pdf

SOLICITATION HT9402-13-R-0001

TRICARE PHARMACY PROGRAM, FOURTH GENERATION (TPHARM4)

QUESTION AND ANSWER (Q&A) SET #1

HT9402-13-R-0001

Question: Answer:

"To the extent that you can disclose this – when would the fourth generation of this contract go into effect? Apologies if I missed that in the solicitation materials, but I couldn’t find the effective date. From recollection and my notes around the prior contract, I believe that it might run through November 2014, but just wanted to double-check."

See Section L.3.3. of the RFP.

"We request the 4 documents cited in subjected solicitation under section C.5.2" http://manuals.tricare.osd.mil/ is the link that will connect you to the documents requested.

The link is also located on the solicitation notice instruction on the Federal Business Opportunities web page.

L.6.4 states “The Table of Contents and tabs separating sections of the volumes will not be counted as long as they do not contain proposal content.” L.8.1.2. says “The GOV will count the pages upon receipt of proposals beginning with the first piece of paper of the technical proposal (Volume II), which shall be regarded as page one. Pages in excess of 70 (starting at page 71) will not be evaluated.”

QUESTION: Can The GOV confirm that the Table of Contents and tabs separating sections of the volume does not count against the 70-page limit in Volume II Technical Proposal?

See forthcoming amendment.

Please confirm the Network Pharmacy File described in L.8.2.1.3.2 is outside of the 70-page limit of Volume II Technical Proposal.

In accordance with Section M.3.6.1 and L.9.2, if one of the top five largest commercial clients is not relevant based on the services the offeror provides to that client, can the offeror provide the next largest, relevant client as an alternate reference?

No. As specified in Section L.9.2., “offerors shall submit a description for each of its five (5) largest commercial clients, measured by total prescriptions processed, for itself and / or its critical subcontractors.”

In accordance with C.8.1.4., we have observed there is not a CLIN for vaccines. Is it the GOV’s intent to have the contractor build this fee into its proposed admin fee?

The contractor is paid for each retail claim processed under CLINs x001 through x004, which includes vaccines. See G.11.1.4.2 for the pass-through payments by the Government to the retail pharmacy for vaccines.

In support of C.16.1.4, will the offerors be required to have approved and auditable business systems including a purchasing system, a CAS compliant cost-accounting system, an estimating system, and a time-charging system in place prior to the start date of services under the TPharm4

A Government audit and determination of adequacy of an offeror’s business systems is not a prerequisite. For C.16.1.4, the successful offeror simply must provide the specified data http://manuals.tricare.osd.mil/ contract, and if so will there be a pre-award audit?

in the specified data fields at the specified times.

Section C.10.1.13 states “The contractor shall provide an EOB to the beneficiary detailing the beneficiary’s retail, mail order, specialty, and MTF prescription activity. The contractor shall provide EOBs primarily by electronic means, but will also offer to deliver by mail at the beneficiary’s request.”

QUESTION: If the email address provided by the beneficiary is invalid, inaccurate, or the contractor does not have an email address, is the contractor required to mail EOBs to the beneficiary on a quarterly basis if the beneficiary does not specifically request an EOB?

Is the contractor required to make a pharmacist or a designated point of contact available 24 hours a day to communicate with MTFs?

The contractor’s pharmacy help desk support for MTF pharmacies will need to meet the outcomes described under C.10.2.2 during the hours of operation described in C.10.2.3. The RFP does not prescribe how the contractor is to achieve.

The MTF Data Integrity Reviews described in Section C.11.3 includes reporting that appears similar to the activities described in the Program Integrity sections of C.11.5.

QUESTION: Please confirm the requirements noted in C.11.5.1 are not applicable to MTF claims.

C.11.5.1 does not exclude MTF claims.

C.11.5.1.1. specifies “100% of all new claims daily”.

Section C.7.7.2 states that “100% of all transfers shall be completed within 21 days from beneficiary authorization.”

QUESTION: There may be instances where a beneficiary mistakenly provides an inaccurate phone number for his/her provider, and this request should not be considered complete since it requires development. Once the accurate information is obtained to complete the transfer, the 21 day clock begins. Please confirm that the 21-day period begins once the contractor receives a complete request from the beneficiary with all of the information necessary to complete the conversion.

100% of all transfers shall be completed within 21 days from beneficiary authorization irrespective of the completeness of the beneficiary request.

In order to help all offerors accurately price their bid, please provide the average failure rate of TED accuracy for all TMA contractors during the first year of the contract by month, and the average length of time it takes to correct a single

The Government will not provide performance information for other contracts. All contractors must meet the standards per their contract.

The quality and quantity of TED submittals and

TED error during the first year of performance.

correction work is directly proportional to the effort put in by the contractor during the set-up testing phase as well as during ongoing maintenance.

Section C.11.5.1.1 requires the Contractor to perform an automated review of 100% of all new claims daily, and to identify problem areas at the pharmacy and pharmacist level.

QUESTION: Since electronic pharmacy claims in the current NCPDP D.0 format do not include pharmacist-level identification, how does the GOV propose the Contractors fulfill this requirement?"

Section C.10.1.1. notes that “through its beneficiary services operation, the Contractor shall provide accurate, complete, and timely responses in a courteous manner to questions from beneficiaries about any aspect of the services provided under this contract.” In C. 10.1.14., the GOV outlines its performance standards for the beneficiary call center.

QUESTION: Please confirm that these standards apply to all inbound call centers regardless of what telephone number is used by the beneficiary?

Yes, standards apply regardless of the telephone number used by the beneficiary. There are no exceptions to the standard.

Section C.7.11.9. requires the TPharm4 contractor to coordinate with the NPV and the DLA as necessary in order to accomplish the replenishment of TMOP pharmaceutical agents. The operational processes for this coordination are between the Contractor and the NPV, but shall not be inconsistent with NPV requirements established in the DLA- TS/NPV contract SPM2DX-13-D-1000, or successor contracts.

QUESTION: Please clarify that the GOV will sponsor a MOU between the TPharm4 contractor and the NPV that is consistent with the terms, conditions, and service levels of the NPV and TPharm4 contract.

The RFP does not require a MOU, but the contractor is free to enter into an MOU.

Section A We noticed SF33 box 5 shows a Date Issued as 6/27/2015.

QUESTION: Will the GOV change this date through Amendment?