STATE 0000000551SL-01 Pharmacy Services Specialty Meds QVL.docx

State of Missouri Office of Administration, Division of Purchasing

Request for Proposal (RFP) for Pharmacy Services – Specialty Medications Qualified Vendor List

PROPOSAL DUE NO LATER THAN: 9/17/2026 AT 2:00 PM CENTRAL TIME

Proposal response must be submitted electronically through MissouriBUYS, powered by MOVERS, at https://missouribuys.mo.gov.

E-mailed, mailed, courier, or hand-delivered proposal responses will not be accepted.

RFP CONTACT INFORMATION:

BUYER: Nicolle Backes

PHONE NO.: (573) 751-5341

EMAIL: nicolle.backes@oa.mo.gov See “RFP Questions” in Section 1 for appropriate communications during the procurement process.

DELIVER SUPPLIES/SERVICES FREE ON BOARD (FOB) DESTINATION TO THE FOLLOWING ADDRESS:

Various Veterans Homes Locations throughout the State of Missouri

ATTENTION:

1. After reviewing the Request for Proposal (RFP), the vendor must complete and return Exhibit A, Proposal Signature Page and all other necessary exhibits.

2. Due to lead times for obtaining the information needed to complete the various Business Compliance Exhibits herein as explained in the RFP’s Vendor Response Exhibits, vendors are encouraged to IMMEDIATELY begin securing these verifications.

3. The vendor must be registered in MissouriBUYS, powered by MOVERS in a “Prospective” or “Spend Authorized” registration status to submit a proposal. The vendor must achieve “Approved” registration status in MissouriBUYS (WebProcure/Proactis) and “Spend Authorized” registration status in MissouriBUYS, powered by MOVERS to be considered for a contract award. Reference Section 5.

AMENDMENT #01 to STATE 0000000551SL

TITLE: Pharmacy Services – Specialty Medications Qualified Vendor List

CONTRACT PERIOD: Effective Date of Contract through One Year

PLEASE BE ADVISED OF THE FOLLOWING CHANGES AND CLARIFICATIONS:

1. Contract period has been REVISED.

2. Preproposal conference list has been ADDED.

Vendors may review the revision(s) to the MissouriBUYS, powered by MOVERS electronic solicitation and the amendment document(s) at https://MissouriBUYS.mo.gov. You may be required to acknowledge the electronic amendment.

ATTENTION: IF YOU HAVE ALREADY SUBMITTED A RESPONSE TO THE SOLICITATION, ACCEPTANCE OF THE AMENDMENT AND RESUBMISSION YOUR SOLICITATION RESPONSE IS NECESSARY TO ENSURE THE STATE OF MISSOURI SUCCESSFULLY RECEIVES YOUR SOLICITATION RESPONSE.

Follow the instructions in the Reference Guide for How to Submit Response Online (https://missouribuys.mo.gov/media/pdf/movers-bid-response-instructions ) and outlined below if previously responded to the solicitation prior to the amendment issuance.

1) Log into MissouriBUYS, powered by MOVERS (https://missouribuys.mo.gov/).

2) Under Tasks click View Negotiations below Solicitations.

3) The Active Solicitations page will appear. Utilize the search filters and click on the Solicitation Number to open.

4) The Overview page will display. Click Create Response.

5) A Warning pop-up box will open. The supplier must click Yes to continue to view and acknowledge amendments.

6) The supplier should highlight the Amendment(s) and view the changes made via the amendment(s). Once the review is complete, select the Acknowledgement checkbox for each amendment and click Submit at the top right-hand corner of the page. NOTE: A Warning pop-up box will open if all amendments have not been acknowledged. Click Yes to continue.

7) A Confirmation pop-up box will open confirming amendments have been acknowledged. It will also warn that resubmission of the previously submitted response is necessary prior to response to the amendment. Click OK.

8) Supplier will need to click Create Response again and respond to the amended solicitation. NOTE: The Create Response step includes attaching the supplier’s response again.

State of Missouri Office of Administration, Division of Purchasing

Request for Proposal (RFP) for Pharmacy Services – Specialty Medications Qualified Vendor List

REVISED PER AMENDMENT 01

PROPOSAL DUE NO LATER THAN: 9/17/2026 AT 2:00 PM CENTRAL TIME

Proposal response must be submitted electronically through MissouriBUYS, powered by MOVERS, at https://missouribuys.mo.gov.

E-mailed, mailed, courier, or hand-delivered proposal responses will not be accepted.

RFP CONTACT INFORMATION:

BUYER: Nicolle Backes

PHONE NO.: (573) 751-5341

EMAIL: nicolle.backes@oa.mo.gov See “RFP Questions” in Section 1 for appropriate communications during the procurement process.

DELIVER SUPPLIES/SERVICES FREE ON BOARD (FOB) DESTINATION TO THE FOLLOWING ADDRESS:

Various Veterans Homes Locations throughout the State of Missouri

ATTENTION:

1. After reviewing the Request for Proposal (RFP), the vendor must complete and return Exhibit A, Proposal Signature Page and all other necessary exhibits.

2. Due to lead times for obtaining the information needed to complete the various Business Compliance Exhibits herein as explained in the RFP’s Vendor Response Exhibits, vendors are encouraged to IMMEDIATELY begin securing these verifications.

3. The vendor must be registered in MissouriBUYS, powered by MOVERS in a “Prospective” or “Spend Authorized” registration status to submit a proposal. The vendor must achieve “Approved” registration status in MissouriBUYS (WebProcure/Proactis) and “Spend Authorized” registration status in MissouriBUYS, powered by MOVERS to be considered for a contract award. Reference Section 5.

RFP Organization:

RFP Vendor Response Exhibits (Return these exhibits with the proposal)

BUSINESS COMPLIANCE EXHIBITS

Attachments (Separate Documents) (Do not return these documents with response)

Separate Documents: The vendor is advised that the separate documents to this document referenced above provide additional requirements, information, and/or instruction. The separate documents must be downloaded from the Division of Purchasing’s MissouriBUYS, powered by MOVERS, website at: https://missouribuys.mo.gov/. The separate documents are downloadable from the same web page where the solicitation document is downloadable. It shall be the sole responsibility of the vendor to obtain each of the separate documents. The vendor shall not be relieved of any responsibility for performance under the subsequent contract due to the failure of the vendor to obtain a copy of the separate documents.

STATE 0000000551SL Page 68

INTRODUCTION AND BACKGROUND INFORMATION SECTION

Introduction:

Purpose: This document constitutes a request for competitive, sealed proposals for the development of a Qualified Vendor List (QVL) for the provision of pharmacy services for specialty medicine as set forth herein for the Department of Public Safety, Missouri Veterans Commission (hereinafter referred to as “state agency”).

The state reserves a right to conduct a refresh procurement should there be a need to allow additional vendors to be considered to provide services.

Minimum Experience Qualifications: There are minimum experience qualifications in the RFP (See Section 2.2, Minimum Experience Requirements in Section 2: Scope of Work).

Titles: Titles of paragraphs used herein are for the purpose of facilitating reference only and shall not be construed to infer a contractual construction of language.

Background and Historical Usage Information:

The Missouri Veterans Commission is a state agency within the Department of Public Safety that has been serving Veterans for over 75 years. The Missouri Veterans Commission Headquarters is located in Jefferson City, Missouri and operates the Veterans Services Program, five (5) State Veterans Cemeteries, and seven (7) State Veterans Homes. The Missouri Veterans Commission is committed to honoring and serving Missouri Veterans whose dedication and sacrifices have preserved our nation and its freedom.

Missouri Veterans Homes have a combined total of 1,238 beds and it is anticipated to maintain a 65% occupancy rate or higher, as there is currently a waiting list for all seven State of Missouri Veterans Homes.

The resident occupancy rate is based on the current Department of Veterans Affairs (VA) requirements for per diem and the available capacity within the State of Missouri Veterans Homes.

The following table includes the name, address, number of beds, and number of specialty medications ordered per month for the seven State of Missouri Veterans Homes that will require specialty pharmacy services. The number of specialty medications per month number is as of September 2025 monthly orders.

Missouri Veterans Home-Cameron 1111 Euclid Cameron, Missouri 64429

Missouri Veterans Home-Cape Girardeau 2400 Veterans Memorial Drive Cape Girardeau, Missouri 63701

Missouri Veterans Home-Mexico #1 Veterans Drive Mexico, Missouri 65265

Missouri Veterans Home-Mt. Vernon 1600 S. Hickory Mt. Vernon, Missouri 63136

Missouri Veterans Home-St. James 620 N. Jefferson St. James, Missouri 65559

Missouri Veterans Home-St. Louis 10600 Lewis and Clark Blvd.

St. Louis, Missouri 63136

Missouri Veterans Home-Warrensburg 1300 Veterans Road Warrensburg, MO 64093

Currently, all medications are given orally but are subject to change based on need and physician’s order.

The following medication is currently being given in homes but are subject to changes based on need and physician’s order: Levodopa/Imbrija Inhaler, Entyvio, and Cabozantinib (Cabometyx).

Current and/or Previous Contract Information:

No current contract exists for the products and/or services being obtained via this RFP.

RFP Questions:

Buyer is Single Point of Contact for Solicitation: Vendors and their agents (including subcontractors, employees, consultants, or anyone else acting on their behalf) must direct all of their questions or comments regarding the RFP, the evaluation, etc., to the buyer indicated on the first page of this RFP. It is preferred that questions be emailed to the buyer.

Except as noted herein, vendors and their agents are instructed not to contact any other state employee regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and/or exclusion from specific procurements. Vendors can be sanctioned for unauthorized contact with any evaluator under 1 Code of State Regulation (CSR) 40-1.060(8)(G) and (H) available at http://www.sos.mo.gov/adrules/csr/csr.asp.

Minority Business Enterprise/Women Business Enterprise (MBE/WBE) and Service-Disabled Veteran Enterprise certification or subcontract questions should be directed to the Office of Equal Opportunity (OEO) at http://oeo.mo.gov.

Vendor is Responsible for Asking Questions About the RFP: It is the vendor’s responsibility to ask questions, request changes or clarifications, or otherwise advise the Division of Purchasing if the vendor believes that any language, specifications, or requirements are: (1) ambiguous, (2) contradictory or arbitrary, (3) violate any state or federal law or regulation, (4) restrict or limit the requirements to a single source, or (5) restrict or limit the vendor’s ability to submit a proposal.

Vendor Question Deadline: Every attempt shall be made to ensure that the vendor receives an adequate and prompt response. However, in order to maintain a fair and equitable procurement process, all vendors will be advised, via the issuance of an amendment to the RFP, of any relevant or pertinent information related to the procurement. All questions and issues should be submitted no later than ten (10) calendar days prior to the proposal closing date and time of the proposals. If not received prior to ten (10) calendar days before the proposal closing date and time, the Division of Purchasing may not be able to fully research and consider the respective questions or issues.

State’s Response to Vendor Questions: Upon the Division of Purchasing’s consideration of questions and issues, if the Division of Purchasing determines that changes are necessary, the resulting changes will be included in a subsequently issued RFP amendment(s); absence of such response indicates that the questions and issues were considered but deemed unnecessary for an RFP amendment. All vendors will be advised of any change to the RFP’s language, specifications, or requirements by a formal amendment to the RFP. There will be no posted written records of the questions/communications (i.e., formal question/answer document).

RFP is State’s Only Official Position: The only official position of the State of Missouri shall be that which is contained in the RFP and any amendments thereto.

Amendments:

If the Division of Purchasing determines that changes to the RFP are necessary, the resulting changes will be included in a subsequently issued RFP amendment(s) prior to the proposal closing date and time.

Pre-Proposal Teleconference:

Pre-proposal Teleconference Date and Time: A pre-proposal teleconference regarding this RFP will be held on Wednesday, September 2, 2026 at 10:30 a.m., Central Time. Vendors are encouraged to participate in the pre-proposal teleconference as it will be used as the forum for questions, communications, and discussions regarding the RFP. The vendor should become familiar with the RFP and develop all questions prior to the pre-proposal teleconference in order to ask questions and otherwise participate in the public communications regarding the RFP.

Pre-Proposal Teleconference Agenda: The vendor should have a copy of the RFP for the pre-proposal teleconference since it will be used as the agenda for the pre-proposal teleconference.

Communication Prior to the Teleconference: The vendor is encouraged to review the RFP prior to the pre-proposal teleconference and may submit written communications and/or questions regarding the RFP, which reference the RFP paragraph numbers, to the buyer identified on page one. Such prior communication will provide the State of Missouri with insight into areas of the RFP which may be brought up for discussion during the conference and which may require clarification.

Communication During the Teleconference: During the pre-proposal teleconference, it shall be the sole responsibility of the vendor to orally address all issues previously presented to the buyer by the vendor, including any questions regarding the RFP or areas of the RFP requiring clarification.

Amendment to the RFP: Any modifications needed to the RFP as a result of discussions from the pre-proposal teleconference will be accomplished as an amendment to the RFP. Neither formal minutes of the pre-proposal teleconference nor written records of the questions/communications will be maintained.

Pre-Proposal Teleconference Special Accommodations: Vendors are strongly encouraged to advise the Division of Purchasing within five (5) state business days of the scheduled pre-proposal teleconference of any special accommodations needed for people with health conditions or impairments who will be participating in the pre-proposal teleconference so that these accommodations can be made.

Pre-Proposal Teleconference Dial-In Information: The vendor should contact the buyer from the Division of Purchasing as indicated on the first page of this RFP to obtain dial-in instructions. The vendor will be provided with a telephone number to dial and/or webinar information to access, in order to listen and participate in the pre-proposal teleconference. The vendor shall refrain from contacting anyone other than the buyer to obtain the dial-in information.

Glossary of Terms and Acronyms:

Whenever the following terms and acronyms appear in the RFP document or any amendment thereto, the definitions or meanings described below shall apply.

Agency Specific Glossary:

Biologicals – Term typically used in reference to vaccines, immunizations, tuberculosis testing, etc.

Brand-name drug – A medication sold under a specific, trademarked name.

Co-insurance – A type of insurance in which the insured pays a share of the payment made against a claim.

Complex Chronic Condition – A long-term medical condition that involves multiple body systems or a severe impact on one system, requiring ongoing specialized care.

Compound Medication – Custom-made drugs prepared by licensed pharmacists to meet the specific needs of individual patients.

Controlled Substance – A drug or chemical substance whose possession or use are regulated under the Controlled Substances Act.

Drug Tiers – A system used by health insurance plans to categorize prescription medications based on cost and clinical value.

Medications – Industry term sometimes used interchangeably with pharmaceuticals.

Formulary – A list of prescription medications that are covered by a health insurance plan.

Licensed Nurse – A nurse holding a valid license, typically a registered nurse (RN) or a licensed practical nurse (LPN).

Non-Formulary – A prescription drug that is not included in the list of covered drugs (formulary) provided by a health insurance plan.

Patient Medication Liaison – A specialty clinic employee that has direct access to doctors, nurses, pharmacists and other health providers. They are a friendly, knowledgeable resource with expertise on how to save time and money on specialty medications.

Pharmaceuticals – Medicinal drugs.

Prescription – A physician authorized order for the dispensing and administration of medication.

Prior Authorization – A restriction placed on certain drugs that require your doctor to get approval from your benefit plan before your plan will cover the medication. The doctor must provide information on why you are taking the prescribed medication. Frequently noted as “PA” on the formulary.

Specialty Medication – Drugs taken for complex chronic conditions. These drugs are often injected, given through an IV, or taken by mouth. These drugs can cost more and require additional clinical monitoring. They may not be available at retail pharmacies.

Specialty Pharmacy – A type of pharmacy that dispenses specialty medications. Specialty pharmacies offer in-depth patient support such as clinical patient management and patient co-pay assistance programs to offset expensive co-pays of specialty medications.

STAT Delivery – Medications delivered to the state agency within twenty-four (24) hours from the time of the order being placed by the state agency.

State Agency Administrator – Penultimate manager of a Veterans Home and holder of a state nursing home administrator license.

General Glossary, Acronyms, and Abbreviations:

Agency and/or State Agency means the statutory unit of state government in the State of Missouri for which the equipment, supplies, and/or services are being purchased by the Division of Purchasing (Purchasing). The agency is also responsible for payment, unless otherwise specified herein.

Amendment means a written, official modification to a solicitation or contract.

Attachment applies to all documents which are included with an RFP to incorporate any informational data or requirements related to the performance requirements and/or specifications.

Buyer means the procurement staff member of Purchasing.

Code of State Regulation (CSR) contains the current administrative rules of executive agencies of Missouri government. The regulations are arranged by agency rather than by subject.

Contract means a legal and binding agreement between two or more competent parties, for a consideration for the procurement of equipment, supplies, and/or services.

Contractor means a supplier, offeror, person, or organization who is a successful vendor as a result of an RFP and who enters into a contract.

Exhibit applies to forms which are included with an RFP for the vendor to complete and submit with their proposal prior to the specified closing date and time.

May means that a certain feature, component, or action is permissible, but not required.

Must means that a certain feature, component, or action is a mandatory condition.

Party refers to either the State of Missouri or the contractor as an entity that may enter into a contract pursuant to the terms herein.

Pricing Page(s) applies to the form(s) on which the vendor must state the price(s) applicable for the equipment, supplies, and/or services required in the RFP. The pricing pages must be completed and submitted by the vendor with the proposal prior to the specified proposal closing date and time.

Proposal Closing Date and Time and similar expressions mean the exact deadline required by the RFP for the receipt of sealed proposals.

Purchase Order means the authorized document issued by the state agency to the contractor indicating descriptions, quantities, and agreed prices for products and/or services.

Reasonable, Necessary or Proper as used herein shall be interpreted solely by the State of Missouri.

Request for Proposal (RFP) means the solicitation document issued by Purchasing to potential vendors for the purchase of equipment, supplies, and/or services as described in the document. The definition includes the following sections: Introduction and Background Information; Scope of Work; Terms and Conditions (“terms and conditions” and “Terms and Conditions” are used interchangeably throughout the RFP); General Contractual Requirements; and Vendor Submission, Evaluation, and Award Information; and the RFP Vendor Response Exhibits, Attachments, and Amendments of the RFP.

RSMo (Revised Statutes of Missouri) refers to the body of laws enacted by the Legislature which govern the operations of all agencies of the State of Missouri. Chapter 34 of the statutes is the primary chapter governing the operations of Purchasing.

Shall has the same meaning as the word must.

Should means that a certain feature, component and/or action is desirable but not mandatory.

State collectively referring to the state government and/or the agencies thereof.

Supplier has the same meaning as the word, vendor.

Vendor means the supplier, offeror, person, or organization that responds to an RFP by submitting a proposal with prices to provide the equipment, supplies, and/or services as required in the RFP document.

Accuracy of Background Information:

Although an attempt has been made to provide accurate and up-to-date information, the State of Missouri does not warrant or represent that the background information provided herein reflects all relationships or existing conditions related to this RFP.

****END OF INTRODUCTION AND BACKGROUND INFORMATION SECTION****

SCOPE OF WORK SECTION

General Requirements:

The contractor shall provide modern, specialty medications and services (hereinafter referred to as specialty pharmacy services) for Veterans at the following Missouri Veterans Homes (hereinafter collectively referred to as the state agency), in accordance with the provisions and requirements stated herein and to the sole satisfaction of the state agency.

Missouri Veterans Home St. Louis 10600 Lewis and Clark Blvd.

St. Louis, Missouri 63136

Missouri Veterans Home Mt. Vernon 1600 S. Hickory Mt. Vernon, Missouri 63136

Missouri Veterans Home Cameron 1111 Euclid Cameron, Missouri 64429

Missouri Veterans Home Warrensburg 1300 Veterans Road Warrensburg, Missouri 64093

Missouri Veterans Home Mexico #1 Veterans Drive Mexico, Missouri 65265

Missouri Veterans Home St. James 620 N. Jefferson St, James, Missouri 65559

Missouri Veterans Home Cape Girardeau 2400 Veterans Memorial Drive Cape Girardeau, Missouri 63701

The contractor must comply with all rules and regulations established by State of Missouri statute, federal regulations, and Department of Veterans Affairs standards applicable to specialty pharmacy services. The contractor must provide specialty pharmacy services, which shall not prevent the state agency from remaining in compliance with all applicable laws and standards including, at a minimum, Chapter 42 and 338, RSMo.

The contractor’s services must meet all standards for quality of services required by the Department of Veterans Affairs, 38 CFR Parts 51 & 58, “Per Diem for Nursing Home Care of Veterans in State Homes”. Information regarding the Department of Veterans Affairs 38 CFR Parts 51 & 58 can be found on the following website: https://www.benefits.va.gov/warms/booki.asp

The contractor shall have a quality assurance plan and must share such plan with the state agency upon request.

The contractor shall ensure adequate, on-hand quantities of specialty medications and shall maintain an uninterrupted supply of medications for all Veterans 24 hours per day, 7 days per week.

Contractor’s Obligation: Unless otherwise specified herein, the contractor shall furnish all material, labor, facilities, equipment, and supplies necessary to perform the services required herein.

Minimum Experience Requirements:

The contractor must meet or exceed the following minimum experience requirements at the time of proposal submission:

The contractor must possess a current, valid registration with the Missouri State Board of Pharmacy, a Specialty Pharmacy Accreditation through a major accrediting body (such as URAC, ACHC or the Joint Commission) and must maintain a certificate of general and professional liability insurance. Upon request by the state agency, the contractor must provide a copy of the current, valid Pharmacy registration, proof of accreditation and liability insurance to the state agency.

The contractor must have a Drug Enforcement Agency (DEA) license.

The contractor should have one (1) year of experience providing pharmacy services at the same scope as required herein.

Personnel Qualifications:

The contractor shall include the following personnel to administer and perform the contract requirements:

Pharmacy Director – The contractor shall designate one (1) individual as a Pharmacy Director, or position of comparable title. The Pharmacy Director must be a licensed and registered Pharmacist in the State of Missouri.

The contractor should have one (1) year of experience providing pharmacy services with for a governmental agency.

Pharmacy Technician – The contractor shall employ an individual(s) as a Pharmacy Technician, or position of comparable title. The contractor’s Pharmacy Technician must be certified in the State of Missouri.

The contractor should have one (1) year of experience providing pharmacy services with for a governmental agency.

Pharmacists– The contractor shall employ Pharmacist(s). The contractor’s Pharmacist must be a licensed and registered Pharmacist in the State of Missouri.

The contractor should have one (1) year of experience providing pharmacy services with for a governmental agency.

The contractor shall understand and agree that the state agency reserves the right to request any of the contractor’s personnel assigned to provide the services be removed without just cause. The contractor shall understand and agree that the state agency will allow the contractor a reasonable time to find a replacement. The state agency shall approve all replacement personnel. The state agency reserves the right to require background checks and non-disclosure agreements (NDA) of selected contractor personnel, at the contractor’s expense.

Upon and as requested by the state agency, the contractor shall provide references, resumes, licenses, and any other information requested for any of the contractor’s personnel providing services under the contract.

The state agency reserves the right to conduct interviews with the contractor’s personnel after review of such information.

The state agency also reserves the right to reject any or all of the personnel after review of information submitted by the contractor and/or interviews. The state agency will provide the contractor with justification for each rejection. Upon any rejection by the state agency, the contractor shall continue to provide candidates for the position in question until the state agency approves a candidate.

Contact Person: The contractor shall designate a contact person who shall serve as the contractor’s contact and shall be the liaison between the contractor and the state agency by no later than five (5) business days after authorization to proceed.

Background Checks: Prior to providing services under the contract, the contractor must ensure personnel (including any third-party personnel) pass standard background checks equal to those required by the State of Missouri for employees, and if required by the state to address an audit, the contractor must attest whether all applicable employees passed background checks performed in accordance with the contractor’s standard background check process. The contractor shall be responsible for all costs associated with background checks. The state agency reserves the right to require the contractor to provide evidence of employees and all sub-contractors and their employees passing a background check. Link to MSHP Criminal Record Check website: http://www.mshp.dps.missouri.gov/MSHPWeb/PatrolDivisions/CRID/crimRecChk.html. The standard background check shall be a nationwide fingerprint check through Missouri State Highway Patrol completed at a frequency determined by the state.

Qualified Vendor List Utilization and Requirements:

The state shall establish a Qualified Vendor List for specialty pharmacy services stated herein. Once established, the list will identify the contractors that provided their product catalog for the specialty pharmacy services stated herein.

The state agency shall review all contractor’s product catalogs at the time a new prescription is received for a client. All terms and conditions of the contract shall apply. Determination of prescription specifications for each client shall be made by the state agency in accordance with the prescription.

Because the state agency needs multiple contractors throughout the state to effectively meet the state agencies’ demand for specialty pharmacy services, the Division of Purchasing reserves the right to add more contractors subsequent to the initial award of contract(s) by conducting a separate procurement process(es) to supplement the list of qualified vendors. Qualifying vendors may be added as additional contractors subject to the same considerations identified herein regarding award of a contract.

Product Catalog Evaluation:

In order to fulfill the State of Missouri’s procurement obligation to make awards to the lowest and best contractor, the state agency will review the product catalogs from all awarded contractors for the specific specialty pharmacy item needed by the state agency.

Review of the New Prescription: The state agency will identify the following items on the new prescription request for the client received from the client or doctor.

Name of client;

Name of medication;

Frequency of medication; and

Number of refills.

Evaluation and Award of Product Catalogs: The state agency will review all product catalogs from all awarded contractors for the medication identified on the prescription. The state agency will identify the prices for prescribed medication from each contractor. The state agency shall consider (1) price and (2) any preference considerations identified in the contract award for the individual QVL contractors by the Division of Purchasing in determining the “lowest and best” option.

More specifically, the evaluation shall be based upon (1) price and (2) any bonus points from the original RFP evaluation for Organizations for the Blind and Sheltered Workshop Participation and Missouri Service-Disabled Veteran Business Enterprise Participation. The contractor with the lowest cost that meets the state agency’s needs shall be considered the “lowest and best” option and awarded the specific prescription, unless a vendor qualifies for SDVE or Organization for the Blind/Sheltered Workshop bonus points in which case, cost and bonus points will determine the “lowest and best” option. The state agency shall have the right to reject all options and not make an award.

Upon determination of each contractor’s total cost for product in the catalog, cost points shall be computed from the results of the calculation stated below using a scale of 200 possible points and the following formula:

Lowest Responsive Contractor’s Price Compared Contractor’s Price

For those contractors awarded bonus preference points during the evaluation of STATE 0000000551SL number, such bonus preference points shall be added to the contractor’s cost evaluation points. The contractor that meets the state agency’s minimum with the most points after totaling the cost evaluation points with the bonus preference points will be considered the lowest and best contractor, including consideration of preferences.

The state agency will document their determination of the “lowest and best” option at the time the prescription is awarded. The contractor shall be awarded the prescription for that client through the life of the prescription, including any refills.

The state agency will notify the lowest and best contractor with a request for the medication via online portal, phone or fax. The request will contain the following information:

Name of client;

Location of delivery of medication;

Name of medication;

Frequency of medication; and

Number of refills.

In the event, the contractor is unable to provide the specific medication as specified on the state agency request to fill the prescription, the contractor shall contact the state agency within seventy-two (72) hours. The state agency will then proceed to move onto the next lowest and best contractor that can provide the prescribed medication.

In situation identified as an emergency by the state agency, the contractor shall respond within twenty-four (24) hours.

In the event a cancellation on prescription for a client is required, the state agency will reach out via online portal, phone or fax to the contractor as soon as possible.

In the event a medication is not listed in the product catalog, the state agency will reach out to all contractors for a price quote on the specific medications required. The state agency will then follow the steps listed above with the pricing quoted by the contractors.

Contractor and Personnel Requirements:

The contractor shall provide sufficient quantities of competent and qualified pharmacists, pharmacy technicians, and other personnel as needed to provide the required services in a responsive and timely manner. All contractor pharmacy personnel providing services must be licensed or registered in the State of Missouri, in accordance with chapter 338, RSMo.

Upon request by the state agency, the contractor must provide a copy of each applicable license to the state agency.

The contractor must provide the state agency with a copy of the contractor’s Drug Enforcement Agency (DEA) license prior to providing services, upon renewal of the contract, and upon request by the state agency.

Pharmacy Director –Within five (5) business days from the date the state agency authorizes the contractor to proceed with services, the contractor must provide the state agency with the contact information for the contractor’s Pharmacy Director. The duties of the contractor’s Pharmacy Director shall include, at a minimum, the following:

Oversight of all specialty pharmacy services;

Providing consulting and/or advisory services to the state agency staff including written reports detailing findings, supportive evidence, if necessary;

Interacting with state agency staff;

Informing the state agency immediately to any changes to rules and regulations to State of Missouri Statute, federal regulation, and Department of Veterans Affair standards applicable to pharmacy services or affecting the state agency; and

Being available for the Department of Veterans Affairs annual regulatory inspection, if requested by the state agency.

Pharmacy Technician – The contractor’s Pharmacy Technician may perform services to individual, multiple or all Missouri Veterans homes. These duties may be conducted in conjunction with other assigned clients. The duties of the contractor’s Pharmacy Technician shall include, at a minimum, the following:

Oversight of all technical duties of pharmacy services;

Entering requested physician orders for medications into the pharmacy computer system for filling orders;

Obtaining and entering Veteran insurance or billing designation information into the pharmacy system for appropriate billing of medications;

Locating, dispensing, packing and labeling prescribed medication for a Veteran; and

Ensuring all medications are reviewed by the pharmacist for accuracy prior to being dispensed.

Implementation Requirements:

The contractor must be fully operational and begin providing services by no later than thirty (30) calendar days after the state agency’s notification to proceed with services. During the thirty (30) calendar day implementation period, the contractor shall complete all activities identified below:

By no later than ten (10) business days after the state agency’s notification to proceed with services, the state agency will identify a state agency contact person for each Veteran’s home and will provide the contact information for the state agency contact person to the contractor. The contractor shall identify the personnel that shall serve as the contractor’s contact person, and a contact person(s) for regular business hours, after hours, and emergencies. The contractor must coordinate services with the state agency contact person at each state agency Veteran’s home herein.

The state agency will provide the contractor with each Veteran’s diagnosis and current specialty medication regimen. The contractor must input each Veteran’s current diagnosis and current specialty medication regime into the contractor’s pharmacy system during implementation. For new admissions thereafter, the contractor shall enter each Veteran’s diagnosis and current medication regimen within 24 hours after admission.

A copy of the state agency’s current policies and procedures will be provided to the contractor within ten (10) business days after the state agency authorizes the contractor to proceed with contract services, if requested by the contractor.

The contractor shall operate in accordance with the contractor’s own specialty pharmacy operational procedure manual, which shall be made available to the state agency upon request.

Specific Pharmacy Requirements:

1.1.1 The contractor shall provide specialty pharmacy services 24 hours per day, 7 days per week.

1.1.2 The contractor shall provide specialty pharmacy services that shall include, at a minimum, the following:

a. Pharmaceuticals.

b. Biologicals.

c. Unit dose controlled/packaged medications.

d. Liquid medications.

e. IV Therapy and infusion support/education.

f. Adherence Monitoring for tracking usage and refill reminders.

g. Benefits Investigation, to include Prior Authorizations if required.

h. Delivery services.

i. STAT services. and

j. Care coordination services with MVH-staff

1.1.3 The contractor shall maintain individual Veteran records for all medications and medications dispensed, including quantities and frequency of refills for a minimum of seven (7) years per state agency regulation. All medications must be ordered by a physician.

a. The state agency will have the right to audit medications purchased against medications dispensed.

b. The state agency, or their designee, will have the right to seek manufacturer rebates for specialty drugs.

The contractor shall utilize the state agency’s Medication Administration Records, Treatment Administration Records, and Physician Order Sheets as needed to provide the pharmacy services, unless alternate Medication Administration Records, Treatment Administration Records, and Physician Order Sheets are approved by the state agency

The contractor shall provide the state agency their product catalog within fifteen (15) days of notice to proceed with services from the state agency. The contractor shall provide the state agency their updated product catalog in January on an annual basis, unless mutually agreed upon by the state agency and contractor when the product catalog will be submitted each year and the frequency of the update.

Pharmaceutical Requirements:

1.1.4 Should the state agency have an active sharing agreement with the Veterans Administration for potential reimbursement of qualifying medications, the contractor must provide specialty pharmaceuticals to include biologicals, immunotherapy, and other medications used to treat complex conditions using the most recent version of the Veterans Administration National Formulary. The Veterans Administration National Formulary can be viewed at the following website: http://www.pbm.va.gov/nationalformulary.asp.

a. In the event a physician orders a medication not on the Veterans Administration National Formulary, the contractor shall review options with the state agency on alternatives of the ordered medication that are on the Veterans Administration National Formulary or if no alternatives are available.

b. If the state agency and the contractor mutually agree that the non-formulary medication should be provided to the Veteran, the contractor shall then obtain the state agency home administrator’s approval prior to providing the medication.

1.1.5 The contractor shall fill prescriptions for liquid medications in plastic, disposable containers in sizes required by the dosage ordered by the state agency and/or contracted physician, unless otherwise required by the manufacturer. The contractor may fill prescriptions for liquid medications in unit dose containers.

a. The label must state the number of cubic centimeters (cc) equal to the specific dosage ordered.

b. The contractor must provide dropper/oral syringes for use with liquid medications to accurately administer the physician’s designated dose.

1) The dropper/oral syringes must be clearly calibrated to the exact dosage ordered by the physician.

1.1.6 The contractor must provide medication for all Veterans with orders for specialty medications including new admissions, re-admissions, medication order changes, and STAT medication requests.

1.1.7 The contractor shall notify the state agency’s Director of Nursing upon discovery of any prescription, dispensing, or packaging errors on the part of the contractor. Within 72 hours of such notification, the contractor shall provide a written follow-up notification to the state agency’s Director of Nursing of any prescription, dispensing, or packaging errors and shall further provide a written description of the corrective action taken pertinent to the incident and documentation regarding the action that will be taken to prevent such errors in the future.

1.1.8 The contractor shall provide therapeutic equivalence of all medications dispensed at all times.

a. The contractor must dispense of all medications in conformance to the standards set by the latest supplements to or editions of the United States Pharmacopeia, Veterans Administration National Formulary of New and Non-Official Drugs, and the Approved Drug Products Listing (Orange Book) published by the Food and Drug Administration.

b. Medications must have the maximum expiration date. The expiration date for all medications shall not be reached before the prescription’s anticipated consumption date.

c. Medications must be pharmaceutically elegant in color, taste, and odor, and general appearance must be consistent.

d. Medication labels must be clearly marked if the medication is different (color, shape, size, etc.) due to a change by the manufacturer.

1.1.9 The contractor shall provide all medications prescribed for Veterans, to the specifications identified herein and in accordance with state, federal, and local laws and regulations.

a. Medications shall be packaged to include the following information:

1) Prescription number;

2) Name of medication;

3) Description of medication;

4) Strength of medication;

5) Expiration date for medication; and

6) Lot number for medication.

b. Medications shall be labeled in accordance with the Federal Food, Drug, and Cosmetic Act to contain, at a minimum, the following information:

1) Pharmacist name or initials;

2) Physician name;

3) Instructions for medication administration;

4) Date prescription was filled;

5) Prescription/medication order date;

6) Name and strength of generic or trade name of medication;

7) Name of Veteran for whom the medication was prescribed; and

8) Controlled medications marked with an identifying symbol.

1.1.10 The contractor shall provide tablets via a “bubble card” packaged system or a similar functional equivalent, which shall be no greater than the “32-day Exchange Time Pass” system. Each dose in the “bubble card” or similar functional equivalent must be numbered (i.e. one (1) through thirty-two (32)), unless otherwise specified by the state agency. Such “bubble card” or similar functional equivalent must comply with the following:

a. Be clay coated news-backed carton board with foil applied to the back inside of the card; or

b. Be some other packaging material(s) pre-approved by the state agency.

c. The state agency reserves the right to request a change to the packaging requirements. Any changes to the packaging requirements will be mutually agreed upon between the contractor and the state agency.

1.1.11 Leave of Absence Medications – With at least forty-eight (48) hours of notice by the state agency physician, the contractor must dispense, package, label, and deliver medications for self-administration for the period the Veteran is not at the state agency Veterans home. The labeling for leave of absence medications shall be in compliance with applicable federal, state, and local laws and regulations including, at a minimum, the following:

a. Veteran’s name;

b. Instructions for self-administration;

c. Name and strength of medication;

d. Number of units dispensed;

e. Physician’s name; and

f. Prescription number.

1.1.12 The contractor shall perform recall of medications when a manufacturer indicates recall is necessary.

a. The contractor shall notify the state agency of the expiration date, lot number, and any other identifying information of medication recalled. The notification process shall be mutually agreed upon by the contractor and state agency.

b. The state agency will return the recalled medication to the contractor by utilizing the delivery services provided by the contractor.

Intravenous (IV) Therapy Requirements:

1.1.13 The contractor shall prepare, label, and deliver all IV Therapy at appropriate intervals. The contractor must prepare all IV Therapy in a laminar flow clean air hood using aseptic techniques. The labeling for the IV Therapy must including the following:

a. Veteran’s name;

b. Room number;

c. Name of IV solution and volume;

d. Name of IV medication and dose;

e. IV expiration date and time;

f. Area(s) for nurse to write time and date hung;

g. IV flow rate; and

h. Nurse’s name.

Delivery Requirements:

1.1.14 Change-Over Deliveries – The contractor shall provide delivery services for change-over medication orders at least once per month. The specific delivery time and day shall be mutually agreed upon between the contractor and state agency and must be consistent month-to-month. The contractor may make change-over deliveries on a more frequent basis, if coordinated with and approved by the state agency.

a. In the event of a dispute concerning times of delivery for change-over deliveries, the decision of the state agency shall be final and without recourse.

b. The contractor shall not be required to make change-over deliveries on New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, or Christmas Day.

c. The contractor may utilize Federal Express, UPS, or similar shipping or courier services as a substitute for the monthly change-over deliveries and associated contractual requirements if appropriate tracking numbers and timely receipt can be guaranteed for each shipment.

1.1.15 Non-Change Over Deliveries – The contractor must provide a system that enables the state agency to contact the contractor to place non-change over orders (including new orders, new admissions, emergency orders, etc.) on a 24-hours a day, seven days a week basis, including New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day, if necessary. The contractor’s contact system for non-change over deliveries must be approved by the state agency.

a. The contractor may utilize Federal Express, UPS, or similar shipping or courier services as a substitute for the non- change-over deliveries and associated contractual requirements if appropriate tracking numbers and timely receipt can be guaranteed for each shipment. Non-change over deliveries should arrive to the facility no later than 48 hours after the order has been received.