Attachment L-3 Specialty Reimbursement for Use in Determining Incentiv....docx

DOCX document 20 KB Posted

Attached to
DRAFT RFP TRICARE Pharmacy Services, 5th Generation (TPharm5) Federal contract opportunity
Solicitation number
HT940220R0002
Issued by
Defense Health Agency

About this file

Written by GovTribe AI ·

This notice provides a draft request for proposals for the Defense Health Agency's TRICARE Pharmacy Services, 5th Generation contract. The potential multi-year contract would include an 18-month transition period, seven 1-year option periods for healthcare delivery, and a potential 6-month extension. The contractor would provide pharmacy benefits management services to TRICARE beneficiaries, including retail network administration, specialty pharmacy, mail order, compounding, and care coordination. The Defense Health Agency seeks industry feedback on requirements and pricing approaches by January 17, 2020, and may issue a formal solicitation in mid-2020. Interested offerors are invited to review sections of the draft RFP and provide questions or comments to help the agency provide high-quality pharmacy services within statutory and regulatory requirements.

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Other files for this federal contract opportunity

Other files attached to DRAFT RFP TRICARE Pharmacy Services, 5th Generation (TPharm5), newest first.
File Type Posted
DSADHA_SSVTemplate_20170101.pdf PDF
Responses to Industry on Revised Draft Section C 20200504.pdf PDF
TPharm5 - Overview of Changes to Draft Section C.DOCX DOCX document
DHA Responses to Industry on Draft RFP 20200318.pdf PDF
TPharm5 Draft RFP Info Session 20191211.pdf PDF
Data Pkg 13 - MTF Claims Volumes by Site.xlsx XLSX spreadsheet
Attachment L-9 Benefit Design Document_TPharm5.xlsx XLSX spreadsheet
Attachment L-2 Retail Network Reimbursement Table.docx DOCX document
TPharm5 Draft RFP READ FIRST 20191202.docx DOCX document
Tpharm5 Draft Section G 20191202.docx DOCX document
Attachment L-8 MMC Sample File.xlsx XLSX spreadsheet
Attachment L-9.8 PA_ST_QL List.XLSX XLSX spreadsheet
Attachment L-4 Negotiated Specialty Retail Replenished Dispensing Fees.docx DOCX document
Attachment L-9.9 Fluoride Products List.xlsx XLSX spreadsheet
Attachment L-12 IHS_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
Data Pkg 15 IHS_Pharmacy_Claims_Volume_2017_&_2018.xlsx XLSX spreadsheet
TPharm5 Draft Section E 20191120.docx DOCX document
TPharm5 Draft Section D 20191120.docx DOCX document
Attachment L-1.1 List of Data Packages.docx DOCX document
Attachment L-19 Past Performance Questionnaire Template Tab F 20191120.docx DOCX document
Attachment J-2 Acronym List.docx DOCX document
Attachment J-3 Website Links.docx DOCX document
Attachment L-5 Guaranty_Agreement.pdf PDF
Attachment L-7 Teaming Subcontractor Consent Ltr.docx DOCX document
Attachment L-9.3 Covered OTCs - Purchased Care.xlsx XLSX spreadsheet
Attachment L-19.1 PPI Tool Instructions.docx DOCX document
Data Pkg 3 TRICARE Retail Pharmacy Claim Volume.xlsx XLSX spreadsheet
TPharm5 Draft Section C 20191202.docx DOCX document
Data Pkg 6 - MOP Utilization.xlsx XLSX spreadsheet
Attachment L-13 VA_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
Attachment L-1.2 Non-Disclosure Agreement.docx DOCX document
Data Pkg 21 Enrolled Beneficiary Population.xlsx XLSX spreadsheet
TPharm5 Draft Section H 20191121.docx DOCX document
Data Pkg 10 - Compound Utilizers.xlsx XLSX spreadsheet
TPharm5 Draft Section I 20191120.docx DOCX document
Data Pkg 11 - Retail Utilization Detail, Guarantee Categories.xlsx XLSX spreadsheet
TPharm5 Draft Section F 20191202.docx DOCX document
Data Pkg 19 Historical_TMDS_Volume_2017-2018.xlsx XLSX spreadsheet
Attachment L-9.4 Covered OTC List - MHS GENESIS.xlsx XLSX spreadsheet
Data Pkg 7 Specialty Drug Utilization, Retail and Mail.xlsx XLSX spreadsheet
Data Pkg 14 Retail Claims with COB.xlsx XLSX spreadsheet
Attachment J-5 TPharm5 Award Fee Plan 20191122.docx DOCX document
Data Pkg 5 MOP Utilization by Drug.xlsx XLSX spreadsheet
Data Pkg 23 - Paid Claims and Rejects - MHS GENESIS.xlsx XLSX spreadsheet
Data Pkg 22 - Paid Claims and Rejects - Retail.xlsx XLSX spreadsheet
Data Pkg 24 - CHCBP Volume.xlsx XLSX spreadsheet
Attachment L-9.6 Self-Admin Injectables List.xlsx XLSX spreadsheet
Attachment L-9.7 Expanded Use of MTF and TMOP List.xlsx XLSX spreadsheet
Attachment L-18 CDRL Supplemental Bid Schedule.xlsx XLSX spreadsheet
Attachment L-1 Ordering Instructions for Data Files not on SAM.gov.docx DOCX document
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Attachment L-10 Specialty Reimbursement for Use in Determining Incentives

Option Period
Type of Rx
Pricing Basis
Guaranteed Average Price

Adjustment Percentage Guaranteed Average Dispensing Fee

1
Brand
WAC

AWP

1
Generic
WAC

AWP

2
Brand
WAC

AWP

2
Generic
WAC

AWP

3
Brand
WAC

AWP

3
Generic
WAC

AWP

4
Brand
WAC

AWP

4
Generic
WAC

AWP

5
Brand
WAC

AWP

5
Generic
WAC

AWP

6
Brand
WAC

AWP

6
Generic
WAC

AWP

7
Brand
WAC

AWP

7
Generic
WAC

AWP

Note for the Specialty Reimbursement Table Each applicable "Guaranteed Average Price Adjustment Percentage" and "Guaranteed Average Dispensing Fee" in this table will be used for the calculations described in Section H.

HT940220R0002 Page 1 of 1 Attachment L-10

File details come from the government source that posted it. Updated .