TRICARE Pharmacy Program, Fourth Generation (TPharm4)

Added: Feb 14, 2014 2:19 pm This Federal Business Opportunities (FBO) notice is posting amendment 6 to the subject RFP. The Final Proposal Revision due date is reflected in the amendment as well as this FBO posting.

Added: Jan 13, 2014 3:39 pm This Federal Business Oppotunities notice is posting updated files provided to potential offerors. The following files and data packages are updated:

1. Exhibit L-10.14, Managed Care Pricing File - TMOP Sample
2. Exhibit L-10.15, Managed Care Pricing File - MTF Sample (Pt. 1 of 3)
3. Exhibit L-10.16, Managed Care Pricing File - MTF Sample (Pt. 2 of 3)
4. Exhibit L-10.17, Managed Care Pricing File - MTF Sample (Pt. 3 of 3)
5. Data Package 5
6. Data Package 6
7. Data Package 7
8. Data Package 9
9. Data Package 10
10. Data Package 13
11. Data Package 14
12. Data Package 17
13. Data Package 18
14. Data Package 19
15. Data Package 20

This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Sep 19, 2013 6:37 pm This Federal Business Opportunities (FBO) notice is posting amendment 5 to the subject RFP. The proposal due date has been extended and is reflected in the amendment as well as this FBO posting.

Separate from amendment 5, this FBO notice is also posting a clarification to set #9 questions (141 and 144) received from potential offerors on the subject RFP.

Added: Sep 17, 2013 6:05 pm This Federal Business Opportunities (FBO) notice is to inform potential offerors that as the result of the exchange with potential offerors on 5 September 2013, the government intends to amend the solicitation, which will affect the due date for receipt of proposals.

Added: Sep 10, 2013 5:25 pm This Federal Business Opportunities (FBO) notice is posting the ninth set of answers to questions received from potential offerors during the extended Q&A period ending on 5 September 2013.  There are currently no further questions.  This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Aug 30, 2013 5:07 pm

This Federal Business Opportunities (FBO) notice includes multiple topics:

1) Posting of amendment 4 to the subject RFP. The proposal due date has been extended as reflected in the amendment as well as this FBO posting.

2) Posting of the eighth and final set of answers to questions received from potential offerors regarding the subject RFP.

3) Since the RFP has been amended and additional data has been made available subsequent to receipt of prior questions, potential offerors may submit new questions regarding the data and the RFP through amendment 4. Questions may be submitted anytime, but no later than 8:00 AM MST, 5 September 2013. Any questions received after this date and time may not be responded to.

4) Posting an update to Data Package 17. This update is not considered an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

5) The contracting officer invites potential offerors to an exchange of information related to Section H.1. of the RFP. The contracting officer will review the offered retail network guarantee, RFP proposal instructions, and the post award incentive. Potential offerors will have the opportunity to provide feedback. The contracting officer and acquisition team is available to conduct an exchange with each potential offeror individually for one hour each by telephone. Potential offerors who are interested are asked to coordinate a date and time with Matthew Anderson at matthew.anderson@tma.osd.mil or 303-676-3754. The target date for the exchange is 5 September 2013.

Added: Aug 15, 2013 5:58 pm

This Federal Business Opportunities (FBO) notice is posting amendment 3 to the subject RFP. The proposal due date has been extended and is reflected in the the amendment as well as this FBO posting.

Seperate from amendment 3, this FBO notice is also posting the seventh set of answers to questions received from potential offerors on the subject RFP. Additional answers to questions will be posted in future notices. This posting also includes an updated attachment to CDRL M190.   

Added: Aug 08, 2013 6:11 pm This Federal Business Opportunities notice is posting the sixth set of answers to questions received from potential offerors on the subject RFP. Additional answers to questions will be posted in future notices. This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Aug 08, 2013 2:15 pm This Federal Business Opportunities (FBO) notice is posting amendment 2 to the subject RFP.

Seperate from amendment 2.  This FBO notice is also re-posting the following exhibits in an Miscrosoft Excel format:

1. EXHIBIT_L-5 DoD Formulary Restrictions and Limitations (April 4, 2013)
2. EXHIBIT_L-8 Draft TFL (Over 65) Mandatory Mail Drug List (May 15, 2013)

Added: Aug 06, 2013 6:37 pm This Federal Business Opportunities notice is posting the fifth set of answers to questions received from potential offerors on the subject RFP. Additional answers to questions will be posted in future notices. This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Aug 01, 2013 6:24 pm

This Federal Business Opportunities (FBO) notice is posting the fourth set of answers to questions received from potential offerors on the subject RFP. Additional answers to questions will be posted in future notices.

This FBO notice is also posting the following updates to the data packages provided to potential offerors:

1. Data Package 1, Tab 1.03 (TRICARE Retail Pharmacy Claim Volume)
2. Data Package 2, Tab 2.03 (TRICARE Retail Pharmacy Claim Volume)
3. Data Package 9 (Historical MTF Claim Volume) adds Tab, MTF Claim Data Integrity Report

This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Jul 31, 2013 4:13 pm This Federal Business Opportunities (FBO) notice is posting amendment 1 to the subject RFP. The proposal due date has been extended and is reflected in the the amendment as well as this FBO posting.

Added: Jul 29, 2013 6:44 pm This Federal Business Opportunities notice is posting the third set of answers to questions received from potential offerors on the subject RFP. Additional answers to questions will be posted in future notices. This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Jul 25, 2013 12:12 pm This Federal Business Opportunities notice is posting the second set of answers to questions received from potential offerors on the subject RFP. Additional answers to questions will be posted in future notices. This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Jul 22, 2013 1:03 pm

This Federal Business Opportunities notice is posting the first set of answers to questions received from potential offerors on the subject RFP. Additional answers to questions will be posted in future notices. This is not an amendment to the RFP. Any amendments will be clearly stated and posted on a Standard Form 30.

Added: Jun 27, 2013 5:53 pm This is the official release of the REQUEST FOR PROPOSAL (RFP) for the TRICARE Pharmacy Program, Fourth Generation (TPharm4) requirement.
 

Potential offerors may submit questions by email to the Contracting Officer at TPharm4@tma.osd.mil.  Any questions and answers will be posted publically on this page. Questions may be submitted anytime, but no later than 2:00 PM MST, 16 July 2013. Any questions received after this date and time may not be responded to. Please note that the period for industry input has passed, so any comments or suggestions submitted will be not be responded to and only questions regarding the RFP will be responded to.

Draft data files have been previously posted with the pre-solicitation notice on 22 May 2013. These files have not been modified since the pre-solicitation notice, are no longer drafts, and are reposted with this notice releasing the RFP.

Potential offerors that have not previously requested confidential and protected information should do so at this time. The ordering instructions for confidential and protected information are located in exhibit L-11.

Links to information regarding TRICARE and the TRICARE Pharmacy Program can be found on the pre-solicitation notice. The TRICARE Operations, Policy, Reimbursement, and Systems manuals referenced in the solicitation may be found at http://manuals.tricare.osd.mil/ .Offers must be submitted no later than 2:00 PM, MST, on 15 August 2013.

Added: May 22, 2013 6:06 pm PRE-SOLICITATION NOTICE

This is the PRE-SOLICITATION NOTICE for the acquisition of the TRICARE Pharmacy Program, Fourth Generation (TPharm4) requirement, in support of the Department of Defense (DoD), Military Health System's (MHS) pharmacy benefits program.

The TRICARE Management Activity (TMA) anticipates posting the Request for Proposal (RFP) no earlier than 30 days from this notice with an approximate release in late June 2013. When this solicitation is released, the requirements will be for a Full and Open competition. In addition to this posting on Federal Business Opportunities, the solicitation will also be posted and accessible at an external TMA web site http://www.tricare.mil/tma/AMS/ams_solicitations.aspx .

Pharmacy Benefits Management (PBM) services under this RFP provide Mail Order Pharmacy (MOP) and retail pharmacy services to all eligible beneficiaries. See below for an overview of the TRICARE and Pharmacy programs.

TMA is providing data files (attached to this pre-solicitation notice) to potential offerors in advance of the solicitation release. These data files will be added to and updated with the issuance of the solicitation and are for informational purposes only. The data files included with this notice are listed in the attachment titled "Summary of Pre-Solicitation Data Files".

In addition to the attached data files, potential offerors may also request information that is designated as "Confidential and Protected Information". This information is not included as attached files to this notice but may be requested by following the instructions in the listed attachment titled "Instructions to Order - Confidential and Protected Information". This attachment also lists the confidential and protected information available to potential offerors.

TRICARE OVERVIEW

The TRICARE Pharmacy Benefits Program falls under the Department of Defense (DoD) Military Health System (MHS) and TRICARE Program:

TRICARE is the DoD health care program administered by the TMA by means of the MHS for approximately 9.7 million MHS eligible beneficiaries, including Medicare eligible beneficiaries meeting statutory requirements as authorized under 10 U.S.C. § 1086. More information about the TRICARE benefit may be found at http://tricare.mil/Welcome/Plans.aspx/ .

The MHS must be prepared not only to provide a high quality, cost-effective health care benefit to its eligible members during peacetime, but also must be prepared to support the armed forces during exercises, contingencies, operations other than war, and in wartime. The MHS provides quality medical care through: (1) a network of health care providers and pharmacies in the United States and its territories; and (2) direct care Military Treatment Facilities (MTFs) - (hospitals, health and dental clinics) in the Continental United States and overseas. The direct care system cannot fully support the total demand for health care services; therefore, TRICARE uses the direct care system as the main delivery system, and through contracts, augments the direct care system through a civilian network of providers and facilities serving its eligible members.

TRICARE PHARMACY BENEFITS PROGRAM

TRICARE provides a world-class pharmacy benefit to all eligible beneficiaries through the integration of state of the art technologies to enhance patient safety, efficiency, and cost effectiveness. DoD administers an integrated TRICARE Pharmacy Benefits Program offering pharmacy services through direct care pharmacy services at MTFs located at various military bases; retail network pharmacies; authorized retail non-network pharmacies; or delivery through the TRICARE Home Delivery/Mail Order Pharmacy (MOP). Retail pharmacy services are available in all 50 states and the District of Columbia, Guam, Puerto Rico, and the Virgin Islands.

Features of the pharmacy benefits program include the use of the DoD Uniform Formulary; a tiered cost sharing structure; and a preference for generic over branded products. The DoD formulary lists the pharmaceutical agents, by therapeutic classes, that are authorized as basic program benefits. Prescriptions for selected pharmaceutical agents may be subject to prior authorization or utilization review requirements to assure medical necessity, clinical appropriateness and/or cost effectiveness. DoD has established tiered cost-sharing by which beneficiaries partially defray costs of administering the pharmacy benefits program. Cost-sharing amounts that a beneficiary pays for each prescription will differ based on the classification of a pharmaceutical agent as generic, formulary, or non-formulary, in conjunction with the point of service from which the agent is acquired.

See 32 CFR 199.21 and Chapter 55 of Title 10 USC Section 1074g for additional information. Additional information is also available at on the TRICARE Management Activity World Wide Web site at http://www.tricare.mil/tma/ . Extensive information on TRICARE Operations, Policy, Reimbursement, and Systems may be found in the system of manuals located at http://manuals.tricare.osd.mil/ .