MODIFICATION
Q -- Draft RFP Elements for Comment - TRICARE Pharmacy Program, Fourth Generation (TPharm4) - AMENDMENT 1 - RFP Sections
- Notice Date
- 10/4/2012
- Notice Type
- Modification/Amendment
- NAICS
- 446110
— Pharmacies and Drug Stores
- Contracting Office
- Other Defense Agencies, TRICARE Management Activity, Contract Operations Division - Aurora, 16401 E. CenterTech Pkwy., Aurora, Colorado, 80011, United States
- ZIP Code
- 80011
- Solicitation Number
- HT9402-13-R-0001
- Point of Contact
- Bruce Mitterer, Phone: 303-676-3812, Richard A. Field, Jr., Phone: 303-676-3853
- E-Mail Address
-
bruce.mitterer@tma.osd.mil, richard.field@tma.osd.mil
(bruce.mitterer@tma.osd.mil, richard.field@tma.osd.mil)
- Small Business Set-Aside
- N/A
- Description
- DRAFT RFP Section X Composite - Guarantee (Oct 4, 2012) The Government is seeking to obtain further feedback on its replenishment process in support of the mail order component of the upcoming TPharm4 solicitation. The revised sections attempt to provide further clarity on the replenishment process and what is considered the settlement process under the current contract. A significant change is the addition of a contractor guarantee component. The offeror will bid an annual fixed price to cover the costs of agents that are not available for replenishment through the National Prime Vendor as well as those that become residual to the contract upon completion. This fixed price from the offeror will include the risk for incurring all the costs for obtaining agents not replenishable from the National Prime Vendor and the disposition of residual inventory. The feedback being requested should indicate whether the language concerning the guarantee is sufficiently descriptive and whether the objectives are apparent. Suggestions for controlling the guarantee's annual fixed price would be considered especially helpful. Any suggestions on language or program structure revisions within the intent of the language provided would be considered. Data referenced (i.e., mail order utilization, Managed Care Pricing File) in the sections revised will be provided with the final RFP. Prospective offerors are invited to comment on the sufficiency of this data in assessing potential cost/risk and proposing a premium at a fixed price. Any suggestions in this regard are welcomed. Limited distribution drugs not available from the National Prime Vendor will be excluded from the guarantee and will be treated as a network pharmacy claim. The following, for reference only, is the original posting of the Draft RFP Elements, dated August 1, 2012. ////////////////////////////////////////////////////////////////////////////////////////////////// INTRODUCTION The TRICARE Management Activity (TMA) wishes to further develop its Pharmacy Program requirements in consideration of current capabilities of commercial pharmacy benefit management (PBM) organizations that provide Home Delivery/Mail Order pharmacy (including specialty pharmacy) services, retail pharmacy networks, claims adjudication, and fiscal intermediary functions on behalf of the Government to pay for all authorized pharmaceuticals and supplies dispensed to beneficiaries at retail pharmacies. TMA is seeking information from the pharmacy industry to enable inclusion of commercial best practices into the Government's objectives and requirements in a way that will encourage competition. Suggestions from industry will be considered; however, the Government reserves the right to solicit for the required services in a manner of its choosing in accordance with applicable procurement regulations. TMA is currently in the requirements definition and acquisition planning state for the follow-on to the current TRICARE Pharmacy Program contract, which is scheduled to conclude October 2014 if all options are exercised. Before proposals are formally solicited, TMA is releasing the draft Request for Proposal elements included in this Special Notice for industry comment. To facilitate meaningful input, TMA is concurrently providing potential offerors with certain historical data. Responses to this request for comment on these RFP elements are due by 4:00 PM on August 31, 2012. DISCLAIMER This Special Notice is issued for informational purposes only and does not constitute a solicitation. Information contained herein does not necessarily reflect all requirements to be found in any future solicitation. Neither unsolicited proposals nor any other kinds of offers will be considered in response to this Special Notice. Responses to this notice are not offers and will not be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this Special Notice. All information received in response to this Special Notice that is marked Proprietary will be handled accordingly. Responses to the Special Notice will not be returned. At this time, questions concerning this Special Notice or the exact composition and requirements of the intended, future Request for Proposals will not be entertained. This posting constitutes the only draft of RFP elements that will be posted in advance of the formal RFP. TRICARE OVERVIEW The TRICARE Pharmacy Program falls under the Department of Defense (DoD) Military Health System (MHS) and TRICARE Program: TRICARE is the health care program for approximately 9.6 million active duty and retired members of the Uniformed Services (the U.S. Army, the U.S. Navy, the U.S. Air Force, the U.S. Marine Corps, the U. S. Coast Guard, the Commissioned Corps of the Public Health Service, and the Commissioned Corps of the National Oceanic and Atmospheric Administration), their spouses and children, including TRICARE for Life beneficiaries entitled to Medicare Part A and Part B based on their age, disability and/or end-stage renal disease. Also eligible are Medal of Honor recipients. Military reservists (and their families) are also TRICARE beneficiaries, for the period during which they are on active duty, or if they choose to enroll to TRICARE Reserve Select or the TRICARE Retired Reserve program(s). More information about the TRICARE benefit may be found at http://www.tricare.mil/mybenefit/home/overview/Plans. 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. While the number and size of direct care facilities has declined in recent years, it remains important that MTFs are optimized in order to maintain the clinical skills of military clinical staff to support medical readiness. 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 (TMOP). 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 on the TRICARE Management Activity website at http://www.tricare.mil/tma/default.aspx. Extensive information on TRICARE Operations, Policy, Reimbursement, and Systems may be found in the system of manuals located at http://manuals.tricare.osd.mil. REQUEST FOR COMMENT - RFP ELEMENTS This request for comment follows on to earlier Request for Information (RFI) postings and provides draft sections of a contemplated formal solicitation. TMA is seeking information and recommendations from industry that will improve its approach to a future TRICARE pharmacy benefit management service contract that will support the MHS. TMA wishes to take advantage of the expertise of the industry and incorporate best practices and appropriate incentives to ensure the sustained quality of these practices. In promoting these purposes, TMA is providing descriptive data in an effort to remove barriers to competition. Your feedback is sought on the structure of this prospective program and the adequacy of its description. Please remember there are statutory and regulatory limitations, so TMA may not be able to implement recommendations conflicting with these limitations. However, administrative practices which support a more efficient TRICARE Pharmacy Program may be acceptable within these limitations and your presentation of information concerning such practices is welcomed. Comments are being sought at this time on the following elements of the contemplated formal solicitation. Responders are asked to key their comments to specific paragraphs/sections in the documents where appropriate. The elements are included as file attachments to this Special Notice: RFP SECTIONS 1. DRAFT RFP Section B (July 30, 2012) 2. DRAFT RFP Section C (July 31, 2012) 3. DRAFT RFP Section F (July 27, 2012) 4. DRAFT RFP Section H (July 31, 2012) 5. DRAFT RFP Section L (July 31, 2012) In addition, an initial set of historical data and other information is being provided with this Special Notice in order for potential respondents to gain a better appreciation of the scope of the contemplated contract activity and to allow for more meaningful responses. It is expected that additional data will be made available from time to time as it is developed during the course of this acquisition. DATA ATTACHMENTS 1. Attach1_Utilization Data 2. Attach2_Deployed Prescription Volume 3. Attach3_MTF Workload 4. Attach4_MTF Sites 5. Attach5_SRP Sites 6. Attach6_Required Mailings 7. Attach7_Bulk Chemicals Used for Compounding Final Report 07 23 12 8. Attach8_Enhanced IA Standards Checklist IAW H4 9. Attach9_Specialty Clinical Services List CONCLUSION Please submit responses via e-mail in Microsoft Office 2003 (at a minimum) format or hard copy by 4:00 PM on August 31, 2012 to the POC. Earlier responses are encouraged. This Special Notice seeks information about approaches that could meet functional requirements. The Government seeks to understand the tradeoffs among risks, costs (initial and ongoing), and alternatives that incorporate increasing degrees of sharing - all as they may be reflected in the RFP elements included herewith. The Government welcomes alternative concepts for solutions that meet requirements including an overview of new technologies or approaches to providing the requested or similar functionality. The Government encourages creativity and outside-the-box thinking in responses to this Special Notice. To the extent simplifying assumptions are needed, respondents are encouraged to make and document such assumptions in their responses. Capability statements, promotional material, or sales pitches are not desired. Responses by consultants or attorneys shall disclose themselves as such and describe or identify the client or clientele served. Comments regarding TPharm4 postings prior to this August 1, 2012 Special Notice will not be entertained at this time. CONTACT INFORMATION Following is the Point of Contact (POC) for this Special Notice: Bruce Mitterer Contracting Officer TRICARE Management Activity 16401 E. Centretech Parkway Aurora, CO 80011 (303) 676-3812 Bruce.Mitterer@tma.osd.mil
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/notices/47f21083727f3e13c7ffcae1e4c7e75e)
- Place of Performance
- Address: Continental United States (CONUS) and Outside Continental United States (OCONUS), United States
- Record
- SN02908262-W 20121006/121004234824-47f21083727f3e13c7ffcae1e4c7e75e (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
| FSG Index | This Issue's Index | Today's FBO Daily Index Page |