Data Pkg 25 - OHI Development.xlsx

XLSX spreadsheet 12 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

This document contains a draft request for proposals for pharmacy services under the TRICARE program. The Defense Health Agency is seeking a follow-on stand-alone contract to provide pharmacy benefits to TRICARE beneficiaries for an estimated period of up to nine years, including an 18-month transition period, seven 1-year option periods, and a potential 6-month extension. Services will cover retail network administration, mail order, specialty pharmacy, and coordination of clinical services. The draft RFP includes sections on contract structure, requirements for the pharmacy benefit provider network, quality management, and patient safety reporting. Interested vendors are invited to submit questions on the draft RFP by January 17, 2020 relating to the use of statements of objectives, specialty pharmacy services, retail network access, compounded medications, care coordination, and patient safety notifications. The agency intends to issue a formal solicitation in mid-2020 and hold an informational session on the draft RFP on December 11, 2019 to provide an overview and take questions from potential offerors in advance.

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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
QA CAS Applicability Specific Clauses (May 15 2020).pdf PDF
TPharm5 Section C Draft RFP2 2020-4-6.docx DOCX document
TPharm5 Draft RFP Info Session 20191211.pdf PDF
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
TPharm5 Draft Section L 20191202.docx DOCX document
Attachment L-9.5 Non-Formulary List.xlsx XLSX spreadsheet
Data Pkg 9 Customer_Service_Volume.xlsx XLSX spreadsheet
Data Pkg 16 VA_VA CHDR Volume.xlsx XLSX spreadsheet
Data Pkg 17 - TRICARE Beneficiaries by Zip Code.xlsx XLSX spreadsheet
Attachment L-1.3 Business Associate Agreement.docx DOCX document
Attachment L-9.2 Retail Vaccine List.docx DOCX document
Attachment L-9.1 Non-FCP Compliant List.xlsx XLSX spreadsheet
Data Pkg 1 Retail Utilization by Pharmacy.xlsx XLSX spreadsheet
Data Pkg 4 - Clinical Review Volume.xlsx XLSX spreadsheet
Attachment L-6 Client Authorization.docx DOCX document
TPharm5 Draft Section K 20191120.docx DOCX document
HT940220R0002 SF33 and Section B 20191202.pdf PDF
Attachment J-4 MTF Sites.xlsx XLSX spreadsheet
Data Pkg 8 Mail and Retail Monthly Utilizers.xlsx XLSX spreadsheet
TPharm5 Draft Section J 20191127.docx DOCX document
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Text version

Sheet1

OHI Development
Potential OHIJan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18
Total OHI Identified94,67177,297144,793441,618149,494117,912182,272162,00183,83093,46683,22481,717105,19187,02888,77786,36679,58581,93981,16796,50978,306106,97092,03585,169
Total Number of Letters Sent48,28049,01749,98841,24731,34933,38137,91431,64127,93125,42824,56521,09028,80625,77222,08119,56218,31315,67618,11217,62811,53017,75814,08416,248
OHI FormsJan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18
Total number of Forms Returned9,6095,3195,9074,4084,1743,6463,2813,7732,4942,9912,5062,3512,0152,2813,6912,0621,4191,4431,8861,8471,5261,2461,040844
Percentage of Forms Returned19.90%10.85%11.82%10.69%13.31%10.92%8.65%11.92%8.93%11.76%10.20%11.15%7.00%8.85%16.72%10.54%7.75%9.21%10.41%10.48%13.24%7.02%7.38%5.19%
Total number of Confirmations7,0104,6194,9133,6373,4432,9182,6053,0011,9972,4081,9951,7701,5561,7922,8261,6371,1111,1181,4701,1401,171951794621
Percentage of Confirmations14.52%9.42%9.83%8.82%10.98%8.74%6.87%9.48%7.15%9.47%8.12%8.39%5.40%6.95%12.80%8.37%6.07%7.13%8.12%6.47%10.16%5.36%5.64%3.82%
Total number of Denials1,000569869646668652619691450539468517406439797402294301391327341286236215
Percentage of Denials2.07%1.16%1.74%1.57%2.13%1.95%1.63%2.18%1.61%2.12%1.91%2.45%1.41%1.70%3.61%2.06%1.61%1.92%2.16%1.86%2.96%1.61%1.68%1.32%
Beneficiary OHIJan-17Feb-17Mar-17Apr-17May-17Jun-17Jul-17Aug-17Sep-17Oct-17Nov-17Dec-17Jan-18Feb-18Mar-18Apr-18May-18Jun-18Jul-18Aug-18Sep-18Oct-18Nov-18Dec-18
Placeholders Created47,61444,08065,337232,96758,44754,63859,86440,01127,70028,81823,52821,86031,05824,85223,65722,99620,66718,24518,06119,16616,54619,83016,44415,281
Full Records Built Out47,05133,21779,453205,05491,04263,271122,398121,98756,12764,64859,69659,85474,13362,17665,12063,36158,91563,69163,10677,34361,76087,13775,59169,888

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