STATE OF HAWAII

DEPARTMENT OF HEATLH

KA ‘OIHANA OLAKINO

ADULT MENTAL HEALTH DIVISION

HAWAII STATE HOSPITAL

45-710 KEA'AHALA ROAD

KANEOHE, HI 96744

December 8, 2025

INVITATION FOR BIDS

No. IFB-HSH-26-02

SEALED OFFERS

FOR

AUDIT SERVICES OF PHARMACY BILLINGS

Will be received through the State of Hawaii eProcurement System (HIePRO) at https://hiepro.ehawaii.gov/welcome.html until 2:00 p.m. Hawaii Standard Time (HST) on December 31, 2025

Offerors interested in responding to this electronic solicitation must be registered on the HIePRO in order to participate in this procurement.

Questions relating to this solicitation may be directed to Utey Uch, Business Manager, via email at utey.uch@doh.hawaii.gov

TABLE OF CONTENTS

NOTICE TO BIDDERS I

SECTION 1 - SPECIFICATIONS

SECTION 2 – BID SUBMITTAL AND CONTENT

SECTION 3 – CONTRACT AWARD AND TERMS

SECTION 4 – SPECIAL PROVISIONS

ATTACHMENTS AND EXHIBIT

Attachment 1 - Offeror’s Qualification Form Attachment 2 - Wage Certificate Attachment 3 – IRS Form W-9 Exhibit A – Sample Invoice in Excel Exhibit B – Sample Invoices in dpf formate (pages 2-3 & page 122)

NOTICE TO BIDDERS

The Hawaii State Department of Health, Adult Mental Health Division, Hawaii State Hospital, (“HSH”) issues IFB No. HSH-26-02 via the Hawaii Electronic Procurement System (HIePRO) seeking an independent contractor to provide auditing services of pharmacy billings for medication services and drugs for HSH’s patients. Bids must be submitted via HIePRO no later than the bid due date below. Bids received after the bid due date and time or not submitted via HIePRO will not be considered.

Bidders are advised to allow ample time for submitting their bid to ensure the submission process is completed and timely. Bidders are solely responsible for ensuring their bid submission is completed prior to the bid due date and time.

TENTATIVE TIMELINE

SECTION 1 – SPECIFICATIONS

1.1. Overview

The Hawaii State Hospital (“HSH”) is operated under the jurisdiction of the Department of Health (DOH). HSH is accredited by The Joint Commission (TJC) to provides adult inpatient psychiatric services.

HSH serves adults with mental illness and/or dual diagnoses (e.g., medical conditions, substance abuse, developmental disabilities, etc.). Majority of the patients are committed by the judicial system. Almost all patients are committed by either Civil or Penal Code commitment. Average daily census at HSH in December 2024 was 371.

HSH seeks an independ contractor to provide auditing services of pharmacy billings for medication services and drugs for HSH’s patients. The auditor shall audit monthly invoices for medication services and drugs for the period from April 1, 2018, to present and auditing for future monthly invoices in accordance with Scope of Services, of this Invitation for Bids (“IFB”).

1.2. Scope of Services

The CONTRACTOR shall provide auditing services for pharmacy billings for medication services and drugs for patients of the Hawaii State Hospital (“HSH”) from April 1, 2018, to the present, as well as auditing future monthly invoices as follow:

1. Audit of invoices to ensure the rates and fees are correctly billed by the Pharmacy in accordance with the contracted rates between HSH and Pharmacy.

· Invoices:

· An invoice is submitted by the Pharmacy for the drug/medication and services provided for one month. The Pharmacy submits one invoice every month to HSH.

· The invoice is for medication and pharmacy services provided to HSH’s patients. The invoice is available in pdf format (about 450 to 480 pages) and excel format.

· NDC per month: about 450 to 550 (see Exhibit A, Invoice Sample: 495 NDC)

· Transactions per month: about 3,400 to 4,300 (see Exhibit A, Invoice Sample: 3,880 transactions)

· The Contractor shall audit the invoices to ensure the rates and fees are correctly billed by the Pharmacy in accordance with the contracted rates between HSH and Pharmacy.

2. Perform an audit of all monthly pharmacy invoices which have been submitted by the Pharmacy for period from April 2018 to present.

3. Audit planning and schedule.

· The Contractor is required to complete the audit of the pharmacy invoices by June 30, 2026, covering the monthly pharmacy invoices for the period from April 2018 through May 2026.

· The audit of monthly pharmacy invoices for the period after May 2026 shall be completed within two weeks of receiving the pharmacy invoices.

4. Provide reports: Contractor shall submit written reports to the HSH Administrator, Associate Administrator of Support Services, and Business Manager:

· Progress Reports: Monthly progress reports shall include detailed descriptions in the following areas: (1) Audited Billing Period, (2) Tasks Accomplished; (3) Problems/Issues; (4) Remaining Tasks; (5) Preliminary Findings; (6) Adherence to Schedule; and (7) Any other areas as requested by HSH.

· Preliminary Draft Reports: Preliminary draft of the Independent Auditors’ Reports on the pharmacy billings. Upon request, the Contractor shall meet with the HSH Administrator, Associate Administrator of Support Services, and/or Business Manager to discuss the preliminary drafts.

· Final Independent Auditors’ Reports. The Contractor shall deliver copies of the final Independent Auditors’ Reports on the pharmacy billings. HSH may distribute the final independent audit’s report to other State of Hawaii officials and/or may post the final Independent Auditors’ Reports to its public website. The Contractor shall be considered to have completed all of the work required under this Contract only upon delivery to and, subject to applicable professional standards, final acceptance by HSH of the final reports.

· Form and Content of Independent Auditors’ report. The reports shall be prepared conforming to the templated provided by the Contractor during the submittal as specified in SECTION 2.

1.3. Experience and Qualifications

CONTRACTOR must meet the following minimum experience and qualifications as follows:

1. Three (3) years of experience in auditing pharmacy billings and charges.

2. Knowledge of various drug prices including, but not limited to Average Whole Price (AWP) and Wholesale Acquisition Cost (WAC).

3. Knowledge of Medicare, Medicaid, and private insurance process relating to the medication and drug for patients at State Hospitals.

4. Must has subscription to use the drug price database that are needed to conduct the audit required by this procurement.

SPECIFICATIONS 1-1 IFB-HSH-26-02

SECTION 2 – BID SUBMITTAL AND CONTENT

2.1. Submission of Offers

Submission of the bid via HIePRO confirms a bidder has carefully examined this Invitation for Bids (“IFB”), provide the services in accordance with Section 1.2, Scope of Services of this IFB.

Offeror shall use the legal name as registered with the Department of Commerce and Consumer Affairs (DCCA) and Hawaii Compliance Express (HCE), if applicable. Failure to do so may delay proper execution of the contract.

2.2. Tax Liability

Both out-of-state and Hawaii bidders are advised that the amount bid on this solicitation is subject to the general excise tax imposed by Chapter 237, Hawaii Revised Statutes (HRS) and, if tangible property is being imported into the State of Hawaii for resale, the use tax imposed by Chapter 238, HRS. (Refer to Taxes in the General Provisions.) Bidders are therefore cautioned to consider such taxes in formulating their bids since no adjustments to the prices bid shall be allowed.

2.3. Bid Price

The total bid price and unit price offered and submitted by the Contractor shall be inclusive of wages, fringe benefits, subscription fees for the drug price database, all applicable taxes, and any incidental costs.

2.4. Submittal

All submittals shall be made via HIePRO. The following documents shall be completed and submitted by the vendor.

· Attachment 1 - Offeror’s Qualification Form.

· Section A: Provide vendor’s information and if any, subcontractor’s information

· Section B: Provide a statement of experience and qualifications that meet the requirements set forth in Section 1.3, Experience and Qualifications.

· Section C: Provide at least three references for whom the offeror has provided the pharmacy billing audit services.

· Attachment 2 - Wage Certificate

· Attachment 3 – IRS Form W-9 BID SUBMITAL AND CONTENT 2-ii IFB-HSH-26-02

SECTION 3 – CONTACT AWARD AND TERMS

3.1. Award Of Contract

Method of Award.

· Contractor must meet the minimum experience and qualifications speicified in Section 1.3, Experience and Qualifications.

· Selection and award shall be contingent on the lowest and most responsible and responsive offer. Award(s), if made, shall be to the responsive, responsible offeror(s) submitting the lowest Estimated Total Sum Bid. All Unit Bid Prices and Estimated Total Bid Prices will be rounded to the nearest cents (two (2) decimal places).

Tied Bids. Should the low bids from responsive, responsible Bidders be identical in price, award, if any, will be made to the Bidder who received the previous award. The same bidder will continue to receive the award for the same item for succeeding contracts so long as all low bids are identical. When this method or any other permissible method is not feasible, award will be determined by drawing lots.

3.2. Protest

Pursuant to HRS §103D-701 and HAR §3-126-3, an actual or prospective bidder who is aggrieved in connection with the solicitation or award of a contract may submit a protest.

A protest shall be submitted in writing within five (5) working days after the aggrieved person knows or should have known of the facts giving rise thereto; provided that a protest based upon the content of the solicitation shall be submitted in writing prior to the date set for receipt of bids. Further provided that a protest of an award or proposed award shall be submitted within five (5) working days after the posting of award or if requested, within five (5) working days after the Procurement Officer’s debriefing was completed.

3.3. Approvals

Any agreement arising out of this bid may be subject to the approval of the Department of the Attorney General, and if applicable, to all further approvals, including the approval of the Governor, as required by statute, regulation, rule, order, or other directive.

3.4. Term of Contract

The Contractor shall provide the services set forth in Section 1.2, Scope of Services, of this IFB for the period stated in the NOTICE TO BIDDERS, unless the contract is terminated earlier..

Agencies may contact Contractor prior to the commencement date to arrange for services starting on or after the commencement date.

Unless terminated, the contract may be extended without re-bidding, upon mutual agreement in writing between the State and the Contractor, prior to the expiration date, for not more than five (5) additional twelve (12) month periods, or parts thereof. Provided, however, the contract price for the extended period shall remain the same or lower than the initial contract price, subject to any price increase allowed by the contract.

The Contract price may be adjusted prior to the beginning of the extension period and shall be subject to allotment and the availability of state funds.

The contract may be suspended and/or terminated in accordance with the General Conditions attached herein to this HIePRO solicitation.

3.5. Subcontractors

The Contractor shall not delegate any duties listed in this IFB to any subcontractor unless the Procurement Officer has given written approval. The State reserves the right to approve all subcontractors and shall require the primary contractor to replace any subcontractors found to be unacceptable. The primary contractor will be the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from the contract, and shall be responsible for all services whether or not the primary contractor performs them.

CONTACT AWARD AND TERMS 3-ii IFB-HSH-26-02

SECTION 4 – SPECIAL CONDITIONS

4.1. Responsibility of Bidders

Bidders are advised that in order to be awarded a contract under this solicitation, Bidders will be required to be compliant with all laws governing entities doing business in the State including the following chapters and pursuant to HRS §103D-310(c):

· Chapter 237, General Excise Tax Law;

· Chapter 383, Hawaii Employment Security Law;

· Chapter 386, Worker’s Compensation Law;

· Chapter 392, Temporary Disability Insurance;

· Chapter 393, Prepaid Health Care Act; and

· §103D-310(c), Certificate of Good Standing for entities doing business in the State.

4.2. Vendor Compliance

1. Vendor shall provide proof of compliance obtained through Hawaii Compliance Express (HCE). The vendor’s name on the Certificate of Vendor Compliance (CVC) must exactly match the vendor’s name under which the quote for this solicitation is submitted. A copy of CVC must be submitted with quote. The vendor is responsible for maintaining compliance. Non-compliance may result in a vendor not receiving an award, delay of payment, or cancellation of award.

2. The interested offeror must be a registered company to do business in the State of Hawaii.

4.3. Campaign Contributions

Contractors are hereby notified of the applicability of Section 11-355, HRS, which states that campaign contributions are prohibited from specified State or county government contractors during the term of the contract if the contractors are paid with funds appropriated by a legislative body.

4.4. Insurance

1. Prior to the contract start date, the Contractor shall procure at its sole expense and maintain insurance coverage acceptable to the State in full force and effect throughout the term of the Contract. The Bidder shall provide proof of insurance for the following minimum insurance coverage(s) and limit(s). The type of insurance coverage is listed as follows:

a. General Liability Insurance General liability insurance issued by an insurance company in the amount of at least ONE MILLION AND NO/100 DOLLARS ($1,000,000.00) for bodily injury and property damage liability arising out of each occurrence or each claims-made claim and TWO MILLION AND NO/100 DOLLARS ($2,000,000.00) aggregate.

b. Automobile Liability Insurance Automobile liability insurance covering owned, non-owned, leased, and hired vehicles with a minimum of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury per accident, and $1,000,000 for property damage per accident.

2. The insurance shall be obtained from a company authorized by law to issue such insurance in the State of Hawaii (or meet Section 431: 8-301, Hawaii Revised Statutes, if utilizing an insurance company not licensed by the State of Hawaii).

For both the general liability and automobile liability insurance, the insurance coverage shall be primary and shall cover the insured for all work to be performed under the Contract, including changes, and all work performed incidental thereto or directly or indirectly connected therewith. The CONTRACTOR shall maintain in effect this liability insurance until the STATE has certified that the CONTRACTOR's work under the Contract has been completed satisfactorily.

Prior to or upon execution of this Contract, the CONTRACTOR shall obtain a certificate of insurance verifying the existence of the necessary insurance coverage in the amounts stated above.

Each insurance policy required by this Contract shall contain the following clause:

It is agreed that any insurance maintained by the State of Hawaii will apply in excess of, and not contribute with, insurance provided by this policy.

The general liability and automobile liability insurance policies required by this Contract shall contain the following clause:

The State of Hawaii and its officers and employees are additional insured with respect to operations performed for the State of Hawaii.

The certificate of insurance shall indicate these provisions are included in the policy.

SPECIAL PROVISIONS 4-ii IFB-HSH-26-02

ATTACHMENTS AND EXHIBIT

Attachment 1 - Offeror’s Qualification Form Attachment 2 - Wage Certificate Attachment 3 – IRS Form W-9 Exhibit A – Sample Invoice in Excel Exhibit B – Sample Invoices in dpf formate (pages 2-3 & page 122)

ATTACHMENTS A-1 IFB- HSH-26-02

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