S000000161 - Drug Pricing Product Exclusions.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- Pharmacy Benefit Manager
- Solicitation number
- S000000161
- Issued by
- Pulaski County, Arkansas
About this file
This document is related to a state and local contract opportunity for a Pharmacy Benefit Manager (PBM) issued by the state of Arkansas. The contract opportunity requires prospective contractors to complete two separate tabs - one for "Specialty" drugs and the other for "Non-Specialty" drugs. For each claim, the prospective contractor must indicate whether they would exclude the claim from their pricing guarantees for discounts, dispensing fees, and rebates, and provide the reason for the exclusion (e.g., 340B, Vaccine, Paper Claim, etc.). The contract opportunity ID is 66aa825a1c6ad762160889b6.
The pricing terms, set asides, incumbents, current environment, funding requirements and sources, and other salient information are not provided in the document. The document primarily focuses on the specific requirements for prospective contractors to identify which drug claims they would exclude from their pricing guarantees and the associated reasons for the exclusions.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment D - Formulary Disruption Reporting~1.xlsx | XLSX spreadsheet | |
| S000000161 Q and A.pdf | ||
| Attachment C - Retail Network Disruption Report~1.xlsx | XLSX spreadsheet | |
| Attachment G Arkansas Independents Network.xlsx | XLSX spreadsheet | |
| Contract and Grant Disclosure~17.pdf | ||
| Attachment B - List of Exclusions~1.xlsx | XLSX spreadsheet | |
| S000000161 Cost Workbook.xlsx | XLSX spreadsheet | |
| S000000161 Pharmacy Benefits Manager.pdf | ||
| S000000161 Technical Proposal Packet.docx | DOCX document | |
| Attachment A - Non-Disclosure Agreement~1.docx | DOCX document | |
| Attachment E - Financial and Formulary Scoring Examples~1.xlsx | XLSX spreadsheet | |
| Attachment F - Specialty Pharmacy Listing- Revised.xlsx | XLSX spreadsheet | |
| S000000161 Bidders Conference PPT.pdf |
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Text version
Instructions
OFFICIAL SOLICITATION EXCLUDED DRUG LIST
S000000107 Medicare Advantage Prescription Drug Services S000000161 Pharmacy Benefits Manager
Prospective Contractor Name:
| ∙ Prospective Contractors shall complete both tabs. |
| ∙ The first tab "Specialty" should contain all claims from the provided data file that the Prospective Contractor considers as Specialty drugs. |
| ∙ The second tab "Non-Specialty" should contain all claims from the provided data file that the Prospective Contractor does not consider as Specialty drugs. |
| ∙ Prospective Contractor should fill in Column A of each sheet for every claim that Prospective Contractor would exclude from pricing guarantees. The "SegalID" within the claims data will be the unique identifier for each claim. |
| ∙ Within each tab, Prospective Contractor should indicate whether the claim would be excluded from their financial guarantees. This should be indicated separately for discounts, dispensing fees, and rebates. |
| ∙ For each excluded claim, Prospective Contractor should indicate the reason for which the claim was excluded from pricing guarantees (i.e. 340B, Vaccine, Paper Claim, etc.) |
Specialty
SPECIALTY DRUG EXCLUSIONS
SegalID NDC AWP Discount Guarantee Exclusion Dispensing Fee Guarantee Exclusion Rebate Minimum Guarantee Exclusion
Non-Specialty
NON-SPECIALTY DRUG EXCLUSIONS
SegalID NDC AWP Discount Guarantee Exclusion Dispensing Fee Guarantee Exclusion Rebate Minimum Guarantee Exclusion
File details come from the government source that posted it. Updated .