Data Pkg 10 - Compound Utilizers.xlsx

XLSX spreadsheet 12 KB Posted

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DRAFT RFP TRICARE Pharmacy Services, 5th Generation (TPharm5)
Solicitation number
HT940220R0002
Issued by

About this file

This document provides details regarding a draft request for proposals for TRICARE Pharmacy Services, 5th Generation (TPharm5). The Defense Health Agency is seeking pharmacy benefit management services to support the TRICARE pharmacy program. The anticipated contract would have an 18-month base period for transition followed by seven 1-year option periods for service delivery and a potential 6-month extension. The contractor would be responsible for retail pharmacy network administration, mail order pharmacy services, specialty pharmacy services, and care coordination across all modalities. The agency is releasing the draft RFP and sections to gather industry feedback on requirements and approach by January 17, 2020. Comments received will be used to revise the RFP prior to anticipated issuance of a formal solicitation in mid-2020 for these important pharmacy support services for military service members, veterans, and their families.

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DSADHA_SSVTemplate_20170101.pdf PDF
QA CAS Applicability Specific Clauses (May 15 2020).pdf PDF
Responses to Industry on Revised Draft Section C 20200504.pdf PDF
TPharm5 - Overview of Changes to Draft Section C.DOCX DOCX document
TPharm5 Section C Draft RFP2 2020-4-6.docx DOCX document
DHA Responses to Industry on Draft RFP 20200318.pdf PDF
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Data Pkg 2 - Retail Utilization by Drug.xlsx XLSX spreadsheet
Attachment L-9.8 PA_ST_QL List.XLSX XLSX spreadsheet
Data Pkg 15 IHS_Pharmacy_Claims_Volume_2017_&_2018.xlsx XLSX spreadsheet
Data Pkg 3 TRICARE Retail Pharmacy Claim Volume.xlsx XLSX spreadsheet
Attachment L-9.4 Covered OTC List - MHS GENESIS.xlsx XLSX spreadsheet
Attachment L-10 Small Business Participation Plan.docx DOCX document
TPharm5 Draft Section J 20191127.docx DOCX document
Data Pkg 8 Mail and Retail Monthly Utilizers.xlsx XLSX spreadsheet
Attachment J-1 Definitions.DOCX DOCX document
TPharm5 Draft Section M 20191202.docx DOCX document
Attachment L-9.6 Self-Admin Injectables List.xlsx XLSX spreadsheet
Attachment L-19 Past Performance Questionnaire Template Tab F 20191120.docx DOCX document
Attachment L-3 Specialty Reimbursement for Use in Determining Incentiv....docx DOCX document
Attachment L-9 Benefit Design Document_TPharm5.xlsx XLSX spreadsheet
Data Pkg 14 Retail Claims with COB.xlsx XLSX spreadsheet
Attachment L-9.5 Non-Formulary List.xlsx XLSX spreadsheet
Data Pkg 5 MOP Utilization by Drug.xlsx XLSX spreadsheet
Data Pkg 25 - OHI Development.xlsx XLSX spreadsheet
Data Pkg 22 - Paid Claims and Rejects - Retail.xlsx XLSX spreadsheet
TPharm5 Draft Section C 20191202.docx DOCX document
Attachment L-5 Guaranty_Agreement.pdf PDF
Data Pkg 6 - MOP Utilization.xlsx XLSX spreadsheet
Attachment L-13 VA_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
Data Pkg 19 Historical_TMDS_Volume_2017-2018.xlsx XLSX spreadsheet
Attachment L-1.1 List of Data Packages.docx DOCX document
Data Pkg 13 - MTF Claims Volumes by Site.xlsx XLSX spreadsheet
TPharm5 Draft Section I 20191120.docx DOCX document
Attachment L-19.1 PPI Tool Instructions.docx DOCX document
Attachment L-9.3 Covered OTCs - Purchased Care.xlsx XLSX spreadsheet
Attachment J-5 TPharm5 Award Fee Plan 20191122.docx DOCX document
TPharm5 Draft Section D 20191120.docx DOCX document
Attachment L-12 IHS_Pharmacy_Listing_2019.xlsx XLSX spreadsheet
TPharm5 Draft Section E 20191120.docx DOCX document
Attachment L-18 CDRL Supplemental Bid Schedule.xlsx XLSX spreadsheet
Data Pkg 7 Specialty Drug Utilization, Retail and Mail.xlsx XLSX spreadsheet
Data Pkg 16 VA_VA CHDR Volume.xlsx XLSX spreadsheet
TPharm5 Draft Section H 20191121.docx DOCX document
Attachment L-7 Teaming Subcontractor Consent Ltr.docx DOCX document
Attachment L-2 Retail Network Reimbursement Table.docx DOCX document
Attachment L-4 Negotiated Specialty Retail Replenished Dispensing Fees.docx DOCX document
Tpharm5 Draft Section G 20191202.docx DOCX document
TPharm5 Draft Section F 20191202.docx DOCX document
Data Pkg 21 Enrolled Beneficiary Population.xlsx XLSX spreadsheet
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FOR OFFICIAL USE ONLY
Title: Retail and Mail Order Compound RXs and Utilizers
Date Range: 1/1/2017 - 12/31/2017
Summing up the number of utilizers could result in over stating the actual number of unique utilizers due to the possibility of overlap by Month and Service Category.
Jan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17
Service Category# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers
Mail Order536472566164714855605953
Retail10,4719,89010,5539,60110,41410,0379,64510,1519,4409,8509,7139,520
Jan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17
Service Category# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs
Mail Order567077657072855461666561
Retail13,23712,30513,49612,02813,52512,90512,23813,08912,04612,61212,33212,092
FOR OFFICIAL USE ONLY
Title: Retail and Mail Order Compound RXs and Utilizers
Date Range: 1/1/2018 - 12/31/2018
Summing up the number of utilizers could result in over stating the actual number of unique utilizers due to the possibility of overlap by Month and Service Category.
Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18
Service Category# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers# of Utilizers
Mail Order575563615569585461556040
Retail10,6959,8149,8999,7519,7149,1839,1819,5098,5769,5279,0758,671
Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18
Service Category# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs# of RXs
Mail Order596573726376725862606344
Retail13,47412,14212,62112,42612,68211,73611,92312,34610,83012,35711,49510,937

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