Statement of Work (Draft).pdf

STATEMENT OF WORK

FIRST FILL (EMERGENT) PHARMACY SERVICES FOR

COMMUNITY BASED OUTPATIENT CLINICS (CBOC)

Central Arkansas Veterans Healthcare System (CAVHS) (October 5, 2021)

1. SCOPE

The contractor shall provide all labor, tools, materials, equipment, and supervision necessary to provide pharmacy benefit management first-fill services in complete and strict accordance with the contract and all attachments thereto. The contractor shall fill first time prescriptions for CAVHS patients seen at the associated Community Based Outpatient Clinics (CBOCs) and provide medication counseling per Omnibus Budget Reconciliation Act of 1990 requirements (OBRA-90). Prices shall be offered with respect to Average Wholesale Price (AWP).

2. LOCATIONS COVERED

The contractor shall provide pharmaceutical benefits management, products, and services to VA beneficiaries for eight (8) CAVHS CBOC’s. The contractor must provide pickup locations no than 5 miles from each location listed below. The location for these sites is as follows:

2.1. El Dorado CBOC - 1702 North West Avenue, El Dorado, AR 71730

2.2. Hot Springs CBOC - 177 Sawtooth Oak Street, Hot Springs, AR 71901

2.3. Mena CBOC - 300 Morrow Street, South, Mena, AR 71953

2.4. Mountain Home CBOC - 759 Highway 62 E, Twin Lakes Plaza

Suite 331, Mountain Home, AR 72653

2.5. Pine Bluff CBOC - 2906 Market Street, Pine Bluff, AR 71601

2.6. Russellville CBOC - 3106 West 2nd Court, Russellville, AR 72801

2.7. Searcy CBOC – 1120 South Main Street, Searcy, AR 72143

2.8. Conway CBOC - 1520 East Dave Ward Drive, Conway, AR 72032

3. PRICES AND TERMS

Under the authority of Public Law 104-262 and 38 USC 8153, the contractor shall be licensed in the State of Arkansas to provide emergent pharmacy health care resources in accordance with the terms and conditions stated in this Statement of Work, to the CAVHS CBOCs listed in Section 2. Pricing will be in accordance with the Discounts from AWP for Brand Name and Generic Prescriptions as well as the Dispensing Fee per prescription per the Schedule of Supplies/Services, Section B.1 of the contract.

4. PRESCRIPTION REQUIREMENTS

For the contractor to receive payment for eligible veteran prescriptions, the following conditions shall be met:

4.1. All prescriptions submitted in accordance with the following requirements shall constitute a written order by the government under this contract.

4.2. The contractor shall fill only new authorized prescriptions. No refills shall be processed by contractor except in situations where obtaining a refill by mail from the VA Pharmacy in CAVHS will lead to adverse consequences for the patient by virtue of being out of medication. This shall be preauthorized by the CAVHS Clinical Pharmacy Section and so noted on the invoice.

4.3. All prescriptions shall be filled for legend drugs listed in the Department of Veterans Affairs Formulary of Drugs and Expendable Supplies. Upon award, a copy will be provided to the contractor. The contractor shall be responsible for supplying each pharmacy under this contract with a current and/or updated copy of the Veterans Affairs Formulary of Drugs and Expendable Supplies. This formulary may be periodically updated; therefore, contractor is required to ensure prescriptions are filled based on most current list. Prescriptions shall be filled within 1 hour of submitting prescription order to pharmacy.

4.4. Prescriptions filled under this contract shall be, to the extent permitted by law, the least expensive drug product the pharmacy has in stock. Generic drugs shall be dispensed whenever possible.

4.5. Generic drugs shall be dispensed if, in the professional judgment of the pharmacist, the substitute product is available, safe, effective and to the greatest extent possible, contains the same chemical ingredients of the same strength , quantity, dosage of the brand name and must be therapeutically equivalent. All generic products used shall be in compliance with Federal and Arkansas State according to the orange book. Those products that must be dispensed by brand name only are Dilantin and Pacerone. The generic name must be indicated on drug label for all medications. The pharmacy shall dispense generic Coumadin following VA guidelines for dispensing.

4.6. Generic Substitutions - The Arkansas State Board of Pharmacy recognizes the Federal Food and Drug Administration's Approved Drug Products with Therapeutic Equivalence Evaluations (The Orange Book) as the basis for the determination of generic equivalency within the limitations stipulated in that publication. If the Federal Food and Drug Administration approves a drug product as bioequivalent and publishes that product with "A"(AA, AB, AN , AO, AP, and AT) rating in the Approved Drug Products with Therapeutic Equivalence Evaluations (The Orange Book), an Arkansas pharmacist, or any pharmacist dispensing drugs to patients in Arkansas, may substitute that product consistent with law. Conversely, if the drug product is "B" rated, is changed from an "A" rating to a "B" rating, or is not rated, the pharmacist shall not substitute without the consent of the prescribing practitioner. When a pharmacist substitutes a bioequivalent drug product for the drug prescribed, the patient shall be notified of the substitution by a pharmacist involved in the dispensing process.

4.7. The contractor shall fill all prescriptions at the discounted rate proposed within the contract of the Drug Topics Red Book Average Wholesale Price (AWP) or MediSpan.

4.8. The contractor shall provide traditional prescription screening, dispensing and counseling services (by a registered and licensed pharmacist) in accordance with all federal and state requirements. Printed drug information shall be provided to each patient to supplement verbal instructions. These services shall require a medication history and check for allergies, interactions and duplicates.

4.9. A signature card for each authorized prescribing physician shall be on file at the contracted pharmacy.

5. AUTHORIZED QUANTITIES

5.1. Non-Controlled Substances:

5.1.1. Ten (10) Days, no refills.

5.1.2. Exception: Antibiotics, ten (10) days or course of therapy.

5.2. Controlled Substances:

5.2.1. Class II Controlled: Three (3) day supply, no refills.

5.2.2. Class III Controlled: Ten (10) day supply, no refills.

5.2.3. Class IV & V: Ten (10) day supply, no refills.

6. OTHER RESTRICTIONS

6.1. Prescription shall NOT be mailed to patients under any circumstances.

6.2. Prescriptions filled and not picked up within 7 calendar days shall be returned to stock and noted on the invoice as a credit.

7. HOURS OF OPERATION

7.1. The minimum hour of operation under this contract shall be 9:00am - 6:00pm, Monday thru Friday and 9:00am - 4:00pm, Saturdays except on Federal Holidays. Federal holidays are as follows:

7.1.1. New Year's Day January 1

7.1.2. Martin Luther King's Birthday Third Monday in January

7.1.3. President's Birthday Third Monday in February

7.1.4. Memorial Day Last Monday in May

7.1.5. Independence Day July 4

7.1.6. Labor Day First Monday in September

7.1.7. Columbus Day Second Monday in October

7.1.8. Veterans Day November 11

7.1.9. Thanksgiving Day Fourth Thursday in November

7.1.10. Christmas December 25

7.2. In addition to the days designated as holidays, the Government observes the following days:

7.2.1. Any other day designated by Federal Statute

7.2.2. Any other day designated by Executive Order

7.2.3. Any other day designated by the President of the United States of

America.

8. REPORTS

8.1. Standard management reports shall be provided on an as needed basis. These reports will primarily consist of a utilization summary. Reports shall include the following information: patient name, drug name, date drug was dispensed, doctor, unit cost, total cost, quantity, associated dispensing fee and prescription number.

8.2. The Contracting Officer (CO) or the Contracting Officer’s Representative (COR) may request reports. Reports must be provided within 5 business days of request.

9. PRIVACY/SECURITY

9.1. Pharmacies authorized to fill prescriptions under the contractor's plan shall agree to the following conditions:

9.1.1. All information concerning VA beneficiaries shall be kept confidential and shall not be disclosed to any person, except as authorized in writing and according to all applicable laws.

9.1.2. Representatives of the VA are authorized to visit the premises of any pharmacy filling VA prescriptions under the contractor's plan during business hours for the purpose of auditing and evaluation, which shall include the inspection of clinical records.

9.1.3. All adverse drug events reported to the contractor's pharmacies by beneficiaries of the VA shall be reported to the cognizant Pharmacy Service. Adverse drug events include dispensing errors, drug allergies, and adverse drug reactions.

9.1.4. Pharmaceutical care provided to beneficiaries under this contract shall meet all standards applicable to Medicaid recipients in the State where the services are provided, and standards set forth in the current Joint Commission accreditation manual for Ambulatory Care/Pharmaceutical Services.

9.1.5. The contractor shall be required to enter into a Business Associate Agreement (BAA) with the CAVHS.

9.2. All contractor and subcontractor employees performing work under this contract shall complete the following training prior to being allowed to perform the function and annually thereafter:

9.2.1. Sign and acknowledge understanding of and responsibilities for compliance with the attached National Rules of Behavior relating to access to VA information and information systems.

9.2.2. Successfully complete VA Cyber Security Awareness training and annual refresher training as required.

9.2.3. Successfully complete VA General Privacy training and annual refresher training as required.

9.3. A copy of the training certificates for each applicable employee shall be provided to the contracting officer representative within (1) week of the initiation of the contract and annually thereafter, as required. These online courses are located at the following website: https://www.ccs-learning.net/.

9.4. Failure to complete this mandatory training within the timeframe required will be grounds for suspension or termination of all physical and/or electronic privileges and removal from work on the contract until such time as the training is completed.

10. PAYMENT/INVOICING

In addition to the information required by Federal Acquisition Regulation (FAR) 52.212- 4(g) the following information must me included on all invoices for each prescription being invoiced:

10.1. Patient's name

10.2. Patient's last four of Social Security Number

10.3. Contract number

10.4. Prescription number

10.5. Name of medication and NDC number of dispensed drug

10.6. Contractor's charge

10.7. Date dispensed

10.8. Quantity dispensed

11. CHANGES

Changes to the contract or this Statement of Work may only be authorized, in writing, by warranted Contracting Officers of Network Contracting Office 16 (NCO 16).