Statement of Work.doc

STATEMENT OF WORK (SOW)

1. Background This contract is between the VA Salt Lake City Medical Health Care System Pharmacy (VASLCHCS) and (third party Pharmacy) for the dispensing of pharmaceutical medications for eligible Veterans at the Utah State Veterans home. The VHASLC HCS will provide all medications to eligible Veterans except when VHASLC HCS can’t provide timely service within 5 days to 7 days for the Utah State Veteran Home. VASLCHCS will contract with the third-party Pharmacy to ensure that emergent, repackaged and 30-day supply-controlled medications are provided to the Utah State Veterans’ homes within the designated time-period. The third-party Pharmacy will not break the chain of custody by using a subcontracted Pharmacies. All pharmacies supplying medications for the Utah State Veterans Homes on behalf of the VASLC HCS-Pharmacy must be part of the Third-party Pharmacy and not a subcontractor. Must be able to pick up necessary medications from the SLC Outpatient Pharmacy and distributed to the State Veterans Homes within 4 Hours for emergency and controlled medications and 24 hours for repackaging..

Pursuant to VA Directive 1108.07, 38 C.F.R. §§ 51.43, 51.41 (c)(2) and 17.96, VA may furnish a drug or medicine for certain eligible Veterans who are not otherwise eligible for higher per diem under 38 U.S.C. § 1745(3 & a-c) 1712(d) and the Cleland Dole Act. The drug must be packaged in a form that is mutually acceptable to the SVH and to VA as set forth in a written agreement. NOTE: In accordance with 38 C.F.R. § 51.43(c), VA may furnish a drug or medicine if the drug or medicine is included on VA’s National Formulary, unless VA determines a non-Formulary drug or medicine is medically necessary. Third-Party Pharmacy and VAMC hereby certify that they will not violate the Anti-Kickback Statute (42 U.S.C. §1320a-7b(b)) with respect to their performance under this Agreement. The parties acknowledge and agree that each party to an arrangement or transaction relating to Third Party Pharmacy business line of institutional pharmacy services operations that is between 3rd Party Pharmacy and any actual source of health care business or referrals to 3rd Party Pharmacy and involves, directly or indirectly, the offer, payment, solicitation, or receipt of anything of value and who meets the definition of a Covered Person under Third Party’s Integrity Agreement shall complete at least one (1) hour of training regarding the Anti-Kickback Statute and examples of arrangements that potentially implicate the Anti-Kickback Statute. 3rd Party Code of Conduct and Anti-Kickback Statute Policies and Procedures are available to Community by Physical and/or website available.

2. Scope

This is an agreement between the Utah Department of Veterans Affairs and the 3rd party Pharmacy to ensure qualified Veterans at the Utah State Veterans Homes will be provided with prescribed medications in a timely manner per VA Directive 1108.07 and according to the VA Formulary.

3. Specific Tasks

1.

Ensure all records/documents (including non-VA pharmacy records) such as prescription records, signature logs, billing statements, patient eligibility records and invoices) are available to the VA upon request.

2.

Notify the VA Chief of Pharmacy or designee in writing whenever a malpractice claim involving a patient has been filed against the contracted pharmacy within 3 working days.

3.

Notify the Chief of the VA Pharmacy or designee in writing within 3 days of any significant Drug interaction, Adverse Reaction/effect and/or significant effect due to delays in medication delivery on any VA patient receiving medication from the vendor.

4.

Provide monthly invoices for review prior to VHALSLC HCS Point of Contact (POC) and the State of Utah Vet Home representee to review appropriate billing to meet this standard of work, this includes but not limited to emergent supply standard of 5-days supply to all qualified Veterans except the St. George SVH which is 7-day supply-controlled medications and repackaging fees. Exceptions are unit of use greater than 5 to 7 days for example inhalers which would be limited to smallest increment for first emergent fill. The VA POC will submit review to be shared with third party Pharmacy to address any discrepancy. Discrepancies will be addressed and adjusted prior to submitting to IPPS / Tungston per task #5.

5.

Provide a monthly bill per patient from each Nursing home with Date of supply, Patient's name with last four of the SS#, Name of Medication, Rx cost, quantity (units packaged), packaging cost, and total for each patient, cost per repacking, and total for all patients at the identified home. This includes embedding the SLC VA Pharmacy POC review indicated within step 5. This information will be submitted through the IPPS/ CBO located in Austin, Texas. Any disputed charges will be billed back to the State Veterans Home if ordered by the facility and not approved under the formulary criteria, are not a qualified veteran or request is a refill and not an emergent fill.

6.

The contractor shall be responsible for maintaining all prescription and drug wholesale transaction electronic records pursuant to the Drug Supply Chain Security Act (DSCSA) for 6 years from the current date.

a.

The contractor must continue to maintain 6 years of all prescription and drug wholesale transaction electronic records pursuant to the Drug Supply Chain Security Act (DSCSA) even if they are no longer the current contractor of record.

b.

The data records kept pursuant to Drug Supply Chain Security (DSCSA) shall be provided in an organized manner using DVD, CDR, or retrievable by electronic means without any aid of software that would cause additional cost to VHASLCHCS.

7.

In the event that 3rd party Pharmacy determines during the term of the parties’ agreement that the rates and pricing terms for Facility-Pay products and services are less than The 3rd parties actual cost of providing such products and services and/or the fair market value of such products and services, 3rd party may adjust the rates and pricing terms as specified in a written notice from 3rd Party Pharmacy to the VA’s designated Contracting Officer’s Representative (COR). This action is subject to audited by the VA at any time.

8.

Must fill medications according to the VA Formulary and provide the VA Pharmacy with a copy of new, emergency prescriptions.

4. Requirements:

RESPONSIBILITIES OF THE VA:

1.

Fill prescription medications from a written, telephone, fax or other electronic prescription format that are submitted to the VA outpatient pharmacy by the NH or third-party Pharmacy.

2.

VA will ensure that all orders will have the prescriber's name assigned to the prescription.

3.

VA will provide pharmacy services from 8 a.m. to 4:30 p.m. Monday through Friday.

4.

The VA will reimburse third-party Pharmacy for the cost of re-packaging of medications in cards, strip packing or bubble packs for eligible patients upon confirmation from the State Veterans Home and the VA Pharmacy.

5.

VA Pharmacy will provide "use by" dates on the prescription label.

6.

VA Pharmacy will maintain information of medications sent to 3rd Party Pharmacy for repackaging.

7.

VA Pharmacy will reimburse 3rd Party Pharmacy for medications that cannot be dispensed by the VA Pharmacy in a timely manner or are emergent fills. These emergent fills will be for no more than a 5-day supply (exceptions St. George 7 day) and in smallest quantity required for 5- or 7-day supply. Unless the smallest unit of use is a multidose unit with an example being an inhaler. Any residual supply needed to complete the prescription will be provided by the VA Pharmacy.

8.

The VA Contracting Officer Representative (COR) or designee will certify the Third-party Pharmacy invoice and verify with the State Veterans Home receipt of invoiced items and Veterans eligibility .

9.

The VA shall have the right to audit prescription scripts and invoices from 3rd Party Pharmacy.

a.

Price/Cost Schedule will be based on the Average Wholesaler Price (AWP) for generic medication and Wholesaler Average Cost (WAC) for brand name medication.

10.

The VA will secure all medications in totes and make sure refrigerated products are Packed in appropriate cooled containers when repackaging medications are picked up by the Third-party Pharmacy.

11.

The VA pharmacy will be available to assist Third-party Pharmacy regarding VA policy on medication dispensing, Formulary issues or other VA procedures as needed.

Responsibility of the 3rd Party Pharmacy:

1.

To provide all prescription orders received by the contractor from the SVH to the VHASLCHCS Pharmacy by in-person delivery, telephone, fax or electronic submission during the VA Pharmacy hours of operation from 8 a.m. to 4:30 p.m. Monday through Friday.

2.

To assess that courier did not breach secured container and all appropriate medication containers are accounted for upon receiving.

3.

To contact VA Pharmacy POC if any delivery issues occur.

4.

To ensure the patient's prescriber is indicated and legible on all prescriptions.

5.

To ensure that all telephone orders for non-controlled medications will have the signature of the RN transcribing the order. If the prescriber has not signed the order, the prescription will be assigned to the NH prescriber indicated by the RN on the prescription.

6.

To ensure that controlled substances (C-II and C-III) have a prescriber signature, quantity, and indication if used pm on the prescription prior to VA dispense. All C-IV substances will be assigned a 30-day fill equivalent and 5 refills unless otherwise indicated.

7.

To adhere to VA National Formulary unless permitted by the VA Non-Formulary (NF) requests will require adequate prescriber information to meet VA NF criteria. The NF request is to be submitted to the VA prior to dispense of a non-Formulary product.

8.

To adhere to VA National Formulary unless permitted by the VA Non-Formulary (NF) requests will require adequate prescriber information to meet VA NF criteria. The NF request is to be submitted to the VA prior to dispense of a Non-Formulary products.

9.

To verify with the VH all Veterans meet requirements of Aid and Attendance, percentage of service connection, catastrophically disabled etc. Along with keeping records and communicating any new Veteran additions or deletions from the NH with the VA POC.

10.

To ensure that emergent prescriptions filled do not to exceed a 5- day supply, exception, St. George, 7-day supply. Using the smallest quantity of unit of use for first time fills, example inhalers. To ensure emergency prescriptions are authorized and delivered within 4 hours after notification without the use of a subcontractor.

11.

To ensure that the third-party Pharmacy utilizes low-cost generic equivalent medications. If the third-party Pharmacy interchanges brand or generic products that potentially may lead to varying serum drug concentrations affecting clinical outcomes. (e.g. Warfarin as Coumadin®, carbamazepine as Tegretol®, phenytoin as Dilantin® etc.) The third-party Pharmacy will confirm with the VA pharmacy, so they dispense the same generic by the third-party Pharmacy if the VA generic is not available and the alternate bio-equivalent product is urgently needed; the third-party Pharmacy will contact the prescriber to discuss what will be appropriate to provide.

12.

To maintain records of medications received and sent for repackaging.

13.

Third-party Pharmacy will prepare invoices for repackaging of medications and emergency prescriptions filled by the third-party Pharmacy then submit these invoices monthly to the VA pharmacy.

14.

The Third-party Pharmacy will participate in unscheduled quarterly compliance reviews conducted by VAMC Salt Lake City pharmacy representatives.

a.

The Third-party Pharmacy shall provide the quarterly AWP generic and WAC brand name medication information to the COR for any scripts dispensed in the previous quarter. 16. Third party pharmacy biller will submit monthly invoices to SLC VA Pharmacy POC prior to submitting into the Tungsten system for payment to verify all charges are correct and no charges have been included that are the responsibility of the Utah State Veterans Home Facility.

15. Will submit all charges through the Tungsten system which the Third-Party Pharmacy is responsible for setting up their account at the initiation of the Contract.

5. Performance Monitoring The COR will work with the Utah State Veterans home to monitor the 3rd Party Pharmacy, to ensure medications arrive at the UT State Veterans homes facilities and the proper billing is being charged to the VA Medical center Pharmacy . Failures to provide the needed medications within 4 Hours for emergency medication and 24 hours for same day for repackaging., more than 3 miss billings and patient harm can result in a poor review.

6. Security Requirements

All patient information will be transmitted using approved systems with validated security protocols by VASLCHCS security. All parties will follow all HIPPA and patient security requirements. The C&A requirements do not apply, and a Security Accreditation Package is not required.

The C&A requirements do not apply, and a Security Accreditation Package is not required.

7. Other Pertinent Information or Special Considerations.

All third-party Pharmacy sites will be licensed and in good standing with the Utah State Division of Professional Licensing for Pharmacy and Controlled substance pharmacy. All employees handling medications need to be a licensed Pharmacist or Pharmacy Technician in good standing with the Utah State Department of Occupational Licensing (DOPL).

Medications must be transported, handled and processed ensuring the chain of custody always remains intact. Patient information will not be shared outside of the State Veterans Home, The 3rd Party Pharmacy and the SLC VA Pharmacy.

8. Risk Control Third Party Pharmacy shall provide staff with proper education and PPE for handling medications according to State Pharmacy guidlines.

9. Place of Performance Salt Lake City VA Medical Center Pharmacy.

500 South Foothill Blvd

Salt Lake City, UT 84148

Nursing Homes Served by this contract:

George E. Wahlen Veterans Home

1102 North 1200 West

Ogden, UT 84404

Central Utah Veterans Home – Payson

1551 North Maine Street

Payson, UT 84651

William E. Christofferson Salt Lake Veterans Home

700 S Foothill Blvd

Salt Lake City UT, 84113

Southern Utah Veterans Home - Ivins

160 North 200 East

Ivins, UT 84738

10. Period of Performance Base year: April 2, 2026, to April 1st, 2027 Option year 1 : April 2, 2027, to April 1st, 2028 Option year 2: April 2, 2028, to April 1st, 2029 Option year 3 : April 2, 2029, to April 1st, 2030 Option year 4 : April 2, 2030, to April 1st, 2031