Pharmacy Refill Request and Appointment Reminder Solution_RxRefill JA_Feb2021_Redacted.pdf

2/22/2021 JA -

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FOR OFFICIAL USE ONLY - Source Selection Information – See FAR 2.101 and 3.104

Justification and Approval (J&A) for Federal Acquisition Regulation (FAR) Subpart 8.405-6

Limited Source Justification Title: Pharmacy Refill Request and Appointment Reminder Solution - RxRefill

J&A Number: JA-21-0088

1. Identification of the agency and contracting activity:

Identify the agency and the contracting activity responsible for this action.

Professional Services Contracting Division place an order

The Defense Health Agency (DHA), Contracting Office - Falls Church (CO-FC), plans to place an order, on a limited source basis, against a General Services Administration (GSA) Federal Supply Schedule (FSS) contract.

2. Nature and/or Description of Action being Approved:

State whether approval is being requested for a new contract or bridge action, and whether it is an individual or class justification.

(see DHA PGI 208.405-6) new contract modification to an existing contract

Individual

Class

The Government intends to negotiate a new Firm Fixed Price (FFP) task order with Mumps Audiofax, Inc. via General Service Administration (GSA) contract GS-35F- 0821M to provide efficient and cost effective ongoing remote support and services for the DHA Pharmacy Operations Division (POD) managed Pharmacy Refill Request and Appointment Reminder Solution (RxRefill) deployed worldwide across the Military Health System (MHS).

3. Description of Supplies/ Services:

Describe the supplies and services. Provide the period of performance for the base and all options, and the estimated value by base, option, and the total, including any extension of services, as applicable. Include type of contract (e.g., Fixed Price or Cost Reimbursement), type of funds to be used, (Department of Defense, Veterans Affairs, Joint Incentive Fund-No Year (DoD/VA JIF-NY), Operations & Maintenance (O&M), Research, Development, Test & Evaluation (RDT&E), Other Procurement (OP), or Revolving Funds-NY) and, when applicable, the estimated share and ceiling arrangements, and fee and/or profit. If the requirement is for a repair part, address whether or not it has been screened. If the repair part has been screened, provide the Acquisition Method Code (AMC) and Acquisition Method Suffix Code (AMSC). Provide the approximate date the technical data package will be available.

Description of Supplies and Services:

This task order is required to provide continued automated prescription refill requests, appointment / referral reminder notification for 9.6 million DoD beneficiaries and interoperability with the legacy and deploying Electronic Health Records (EHR), Composite Health Care System (CHCS) and MHS GENESIS respectively.

Interactive Voice Response (IVR) services for the Military Treatment Facilities (MTFs) are needed to support requirements for a standardized beneficiary centric automated telephony solution.

Interoperability requirements as part of the transition from the legacy EHR necessitates a tri-phased approach, which entails supporting, (1) prescription refill requests and appointment / referral reminder notifications for the legacy system; (2) a dual connectivity capability, sustaining the legacy operations for one year, while simultaneously supporting prescription refill requests within MHS GENESIS; and (3) a full transition to MHS GENESIS interoperability sustainment.

TOTAL Contract Value

POP: From 3/10/2021 to 3/9/2026

Estimated Value 20,667,257.97

BASE

POP: From 3/10/2021 to 3/9/2022

Estimated Value 4,941,036.69

Type of Contract (Primary):

FAR 16.202 Firm-Fixed-Price

OPTIONS - Check this box if there are options

Number of Options: 4

POP (All options): From 3/10/2022 to 3/9/2026

Estimated Value (all options): 15,726,221.30

Funding Type:

Operations & Maintenance (O&M) Extension of Services - Check this box if there is an extension clause

The Period of Performance (PoP) will be one (1) 12 month base period and four (4) 12 month option periods. The total estimated value of this effort is $20,667,257.97.

4. This acquisition is conducted under the authority of the Multiple Award Schedule Program, 41 U.S.C. 152(3) and 40 U.S.C. 501, and Regulatory Authority (see FAR 8.405-6 Limited Sources):

FAR 8.405-6(a)(1)(i)(B) -- Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly

FAR 8.405-6(a)(1)(i)(B) – Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized.

5. Rationale Justifying Use of the Statutory Authority Cited:

Provide sufficient facts and rationale justifying use of the specific regulatory authority cited under Item 4 above (see FAR 8.405-6). In all cases, supporting rationale must be included, such as, providing an explanation as to what unique qualifications or special capabilities the prospective contractor possesses, the nature of the acquisition that requires the use of the same contractor as part of a logical follow-on; or the reasons for urgency to include an explanation of how using the procedures would result in unacceptable delays. This is the most important part of the LSJ and should demonstrate that the prospective contractor has unique qualifications and/or specialized capabilities or expertise that is not prevalent elsewhere on the schedules.

In those instances where an urgent or compelling need exists, discuss the nature of the urgency. Discuss how any follow-on work will be competed (mandatory). Also, provide supporting rationale and a concise description of the extent, nature, and impact of the unacceptable delay.

If pursuing an exception per FAR 8.405-6(b) BRAND NAME (Describe in detail why a particular brand name, product, or a feature of a product, peculiar to one manufacturer must be used.)

Important note: Brand name specifications shall not be used unless the particular brand name, product, or feature is essential to the Government's requirements, AND market research indicates other companies' similar products, or products lacking the particular feature, do not meet, or cannot be modified to meet, the agency's needs.

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In accordance with FAR 8.405-6(a)(1)(i)(B), only one source is capable of providing the required supplies and services to support RxRefill capabilities dependent upon legacy EHR functionality and in direct alignment with the DHA memorandum, "Moratorium on Military Health System Legacy Systems Being Replaced by MHS GENESIS". Mumps Audiofax, Inc. presently provides the leased solution for RxRefill capabilities while meeting direction to cease future development work with the legacy system.

The Government will need to continue leasing or procure the current solution, which is not available from third-party resellers, to comply with the instruction provided within the memorandum. The IVR functionality and interoperability requires software, licenses and hardware. The hardware becomes unusable without the controlling software. There are other vendors within the marketplace capable of performing the same work, however the government would need to return the current platform and obtain a replacement solution, resulting in negative operational impacts at the MTFs.

From a deployment perspective, historical RxRefill efforts showed that equipment is built at the time of order with a construction and implementation period of approximately thirteen (13) systems per month. It is anticipated that a full replacement would take approximately nine (9) months.

During this implementation phase, the MTFs will experience a degradation of outpatient pharmaceutical services equating to reduced prescription volume throughput and decreased beneficiary satisfaction with MTF point of care services. To mitigate the injurious operational impacts and unfavorable beneficiary perception of DoD healthcare, the government estimates an additional $19,000,000 would be required to hire pharmacy technicians to perform the receipt and processing task of prescription refill requests. Additionally, this will likely decrease beneficiary satisfaction due to increased pharmacy wait times resulting from the manual processing of refill requests.

Concurrently, the Agency would need to contain the potential increase of clinic appointment no-show rates. The Government estimates that a similar effort $19,000,000 would be needed to provide staff assisted appointment and referral notifications to the beneficiaries.

6. Determination by the ordering activity contracting officer that the order represents the best value consistent with FAR 8.404(d): Describe how the contracting officer determined or will determine best value and that the anticipated cost to the Government will be fair and reasonable (see FAR 8.404(d) Pricing (DEVIATION)).

The anticipated cost to the Government for this contract action will be fair and reasonable based on historical prices, Independent Government Cost Estimate (IGCE) and current GSA Schedule pricing and similar schedules pricing. Although GSA has negotiated fair and reasonable pricing, the Government will seek additional discounts during negotiations. The award of this task order is necessary to avoid substantial duplication of cost to the Government that is not able to be recovered through competition of a new RxRefill award.

7. Description of the market research conducted among schedule holders and the results or a statement of the reason market research was not conducted: Market research requires collecting and analyzing product/service information on the technical capabilities and prices/costs from appropriate FSSs. If market research was not conducted, the reasons why it was not conducted should be stated.

If an acquisition or portion of an acquisition that uses a brand-name description or other purchase description to specify a particular brand-name, product, or feature of a product, peculiar to one manufacturer, the ordering activity must post the J&A with the solicitation (FAR 5.102(a)(6): if above the Simplified Acquisition Threshold (SAT), the justification shall cite that the acquisition is conducted under the authority of the Multiple-Award Schedule Program. The market research conducted or rationale provided in this section should support the rationale justifying the use of the Regulatory Authority cited in Section 4 above.

The HT0011-15-C-0018 contract was competed Full and Open in the summer of 2015. Two offerors responded to the solicitation. Based on the technical review of the capabilities of each offeror, it was determined that Mumps Audiofax, Inc.'s capabilities met the Government's requirements at the best value.

In April 2019, the DHA POD conducted market research through the release of a Request for Information (RFI). The Government received responses from three (3) small businesses, to include Mumps Audiofax, Inc. and one large business. It was noted that each of the vendors had the ability to provide capabilities similar to the requirements requested by the Government.

The market research was updated in January 2021 and utilized techniques that included a review of historical acquisition records, querying government-wide and commercial databases Interagency Contract Directory (ICD), General Services Administration (GSA) Electronic Library, Defense Logistics Agency (DLA) Electronic Catalog (ECAT), National Institutes of Health (NIH) Information Technology Acquisition and Assessment Center (NITAAC), and attendance of virtual trade fairs & conferences, such as Joint Federal Pharmacy Seminar held in November 2020. From a strategical position, the commercial marketplace provides an assortment of vendors presenting technical solutions with RxRefill (IVR) software and telephony hardware. The capabilities offered by the vendors to provide non-personal services customarily employ the utilization of licenses for the software, device licenses for telephony communications, various levels of preventative and repair maintenance packages with remote and on-site options, and program support (e.g. host conversions from CHCS to MHS GENESIS, network sustainment activities, transitions from Service networks to MEDCOI). As commercial products, the solutions are typically configurable, meeting DoD operational and functional requirements with minimal to no developmental customizations.

However, due to requirements associated with the moratorium the marketplace is limited to a single vendor that can provide the required licenses and software providing operational capabilities to the DoD.

8. Other Facts: Discuss any other facts supporting limiting or restricting consideration. This is where you should commend the virtues of the vendor or product.

When FAR 8.405-6(a)(1)(i)(A) is cited, provide data, estimated cost, or other rationale as to the extent and nature of the harm to the government, that would result, if schedule procedures were followed.

When FAR 8.405-6(a)(1)(i)(C) is cited for logical follow-on, include an estimate of the duplicative cost and methodology used to formulate the estimated cost.

Mumps Audiofax, Inc. possesses the operational infrastructure and knowledge required for successful performance. Mumps Audiofax, Inc. can continue to provide the licenses, software and leased hardware required to maintain and sustain the serviceable equipment deployed across the enterprise without a loss of performance, efficiency and negative impacts to the MTF pharmacies, MTF clinics and DoD beneficiaries. Mumps Audiofax, Inc. can start performance with DHA immediately, therefore, preventing any gaps in service.

9. Actions to overcome barriers: Describe the actions, if any, the agency may take, or is taking, to remove or overcome any barriers that led to the restricted consideration before any subsequent acquisition for the supplies or services is made.

(a) Efforts to Obtain Competition. (Describe efforts to ensure that offers are solicited from as many potential sources as is practicable. Also describe the extent of effective competition anticipated for this acquisition.)

(b) Actions to Increase Competition. (Include a statement of the actions taken, or to be taken, to increase competition before any subsequent acquisition of the supplies or services.)

(c) Follow-on Order. (If this is a follow-on order, state the measures initiated to eliminate or reduce competitive barriers.)

At the end of the MHS GENESIS deployment, the legacy EHR requirements will no longer be required. DHA intends to utilize competitive procedures for the continuing requirements.

Coordination & Approval

12. Technical/Functional Representative:

I certify that the information provided in this justification is accurate and complete to the best of my knowledge and belief.

Name: Title: Contracting Officer Representative (Program Manager, Functional Service Manager, etc.)

Approved:

13. Requirements Certification:

I certify that the infiormation provided in this justification is accurate and complete to the best of my knowledge and belief

Name:

J Director (or designee)

Title: Deputy Branch Chief, Informatics and Integration Branch (Responsible J Director)

J-Directorate Office:

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J-10/HCO/Pharmacy Operations Division

14. Fair and Reasonable Cost Determination: Provide the basis for this determination (e.g., describe techniques utilized, or to be utilized, to determine cost/price fair and reasonableness, such as cost analysis, price analysis, audit, should cost, independent Government estimate). As part of this basis, indicate whether certified cost or pricing data will be required or if one of the exceptions in FAR Part 15.403 will apply. Contracting Officer to include the following determination:

See block 6.

I have determined that the anticipated cost to the Government for this contract action is fair and reasonable.

Name: NELSON, Leslie; Title: Contracting Officer, Professional Services Contracting Division

Approved:

NELSON, Leslie - Monday, February 8, 2021

15. Legal Review:

I have reviewed this justification and have found it to be legally sufficient. (Note: All J&As must be reviewed by Office of General Counsel (OGC)/Legal Review.)

Name: Title: Office of General Counsel

Approved:

L

16. Contracting Officer: This certification shall be made by the contracting officer who will sign the contract resulting from this justification and approval (J&A). Include the following statement:

I certify that this justification is accurate and complete to the best of my knowledge and belief.

Name: NELSON, Leslie Title: Contracting Officer, Professional Services Contracting Division

Approved:

NELSON, Leslie - Monday, February 8, 2021

17. Competition Advocate: Based on the foregoing justification, I hereby approve the procurement of Pharmacy Refill Request and Appointment Reminder Solution - RxRefill(state supplies/services being procured) on an other than full and open competition basis pursuant to the authority of FAR 8.405-6(a)(1)(i)(B) -- Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized., subject to availability of funds, and provided that the supplies and/or services herein described have otherwise been authorized for acquisition.

Name: Title: Competition Advocate (J-4)

18. Head of Contracting Activity (or designee): Based on the foregoing justification, I hereby approve the procurement of Pharmacy Refill Request and Appointment Reminder Solution - RxRefill(state supplies/services being procured) on an other than full and open competition basis pursuant to the authority of FAR 8.405-6(a)(1)(i)(B) -- Only one source is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized., subject to availability of funds, and provided that the supplies and/or services herein described have otherwise been authorized for acquisition.

Name: B Title: Head of the Contracting Activity (HCA) (J-4)

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