SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM Request For Proposal by fbq18059

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									                             SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
                                      Request For Proposal (RFP) YH10-0004
                                       QUESTION AND RESPONSE FORM

1.   Scope of   2. Project   6   A reference is made to $75 million in specialty drug      Yes, the RFP is for all AHCCCS enrollees.
     Work       Overview         costs for 1.19 million enrollees. Is it reasonable to     The prescription utilization data provided is for the time
                & Purpose        conclude that 1.19 million is the pool of AHCCCS          period 4/1/08 – 3/31/09 and is posted on the AHCCCS
                                 patients that a pharmacy would need to be ready to        website.
                                 service? Is there a way to find out what prescription     http://azahcccs.gov/commercial/Purchasing/open.aspx
                                 volume that correlated with?                              Click on “Attachment” under Open RFP #YH10-0004.
2.   Scope of     3.2.1      9   Must the vendor have a brick and mortar presence in       The RFP requests the 340B entity’s pharmacy or
     Work                        the State of Arizona to participate in this RFP?          contracted pharmacy network be located in Arizona;
                                                                                           however, we will evaluate all submitted proposals.
3.                               What is the anticipated effective date of the contract?   The start date will be determined and is dependent
                                                                                           upon the awarded contractor’s implementation plan.
4.                               Will utilization data be provided?                        The prescription utilization data provided is for the time
                                                                                           period 4/1/08 – 3/31/09 and is posted on the AHCCCS
                                                                                           website:
                                                                                           http://azahcccs.gov/commercial/Purchasing/open.aspx
                                                                                           Click on “Attachment” under Open RFP #YH10-0004.
5.                               Please provide AHCCCS’s current list of 340B entities.    A list of Arizona 340B entities can be obtained from
                                                                                           the Health Resources and Services Administration
                                                                                           (HRSA) website:
                                                                                           http://opanet.hrsa.gov/opa/CE/CEMedicaidExtract.aspx

6.                               How many members are currently enrolled under             The AHCCCS population as of October 1, 2009 can be
                                 Medicaid Fee For Service (FFS), and how many are          found on the AHCCCS website at
                                 enrolled under Managed Medicare?                          www.azahcccs.gov/reporting under AHCCCS
                                                                                           Population Statistics.
7.                               What are the “other publicly funded programs with a       Other publicly funded programs may, upon request and
                                 pharmacy benefit, as mentioned on pg. 4 of the RFP?       upon a contractual agreement between the parties,
                                 Does this include city, county, and state programs        utilize the AHCCCS Specialty Pharmacy and Services
                                 (e.g. Departments of Correction)?                         Program. To date, there are no additional requests
                                                                                           from agencies or programs outside of the AHCCCS
                                                                                           system.




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                               SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
                                        Request For Proposal (RFP) YH10-0004
                                         QUESTION AND RESPONSE FORM


 8.   Scope of   2. Project   4-5   Private Medicaid contracted health plans typically         Arizona is not an “any willing provider” state.
      Work       Overview           include a wide network of retail pharmacies pursuant
                    and             to state “any willing provider” laws and/or health plan    The Offeror’s implementation plan must specifically
                 Purpose            access requirements for urban and rural counties.          address meeting the needs of the AHCCCS
                                    Would restricting pharmacy access for certain              membership, in urban, rural and frontier areas of the
                                    specialty drugs run afoul of state laws or be subject to   State of Arizona.
                                    legal challenge or protest? What is contemplated in
                                    terms of actual sole source specialty fulfillment? Is it   Health plans may choose or not choose to utilize the
                                    that achieving optimal overall cost-savings on the         AHCCCS Specialty Pharmacy & Services Program;
                                    purchase of drugs at 340B facilities may well result       however, this program is expected to create greater
                                    from use of the 340B program in a targeted way (i.e.,      cost efficiencies for AHCCCS Contractors and the State
                                    obtaining certain drugs directly from a specialty          of Arizona.
                                    pharmacy contractor; obtaining certain other drugs
                                    from a 340B entity that purchases directly from a
                                    wholesaler or manufacturer and perhaps other drugs
                                    from a third source, such as the prime vendor)?
                                    Would the specialty pharmacy distribution channel
                                    become the sole distribution channel pursuant to this
                                    RFP?
 9.   Scope of      3.2       9     In regard to Item #3.21. on pg. 9 of the RFP, must the     The RFP requests the 340B entity’s pharmacy or
      Work        Specific          exclusive Specialty Pharmacy be physically located         contracted pharmacy network be located in Arizona;
                 Contractor         within the state of Arizona, or can it operate if it is    however, we will evaluate all submitted proposals
                 Requirem           licensed in Arizona and services all of Arizona?
                   ents
10.                                 Would a single-source contract with a “340B                Health plans may choose or not choose to utilize the
                                    designated entity pharmacy” mean that the specialty        AHCCCS Specialty Pharmacy & Services Program;
                                    pharmacy would be the sole contract pharmacy for all       however, this program is expected to create greater
                                    specialty drugs (that are also Covered Outpatient          cost efficiencies for AHCCCS Contractors and the State
                                    Drugs) for all 340B Covered Entities in the state of       of Arizona.
                                    Arizona? Would there be an opt-out available? Will
                                    there be a lockout of retail?                              The Offeror’s implementation plan must include the
                                                                                               expected pharmacy or network of pharmacies to
                                                                                               service the AHCCCS population under this proposal
                                                                                               and subsequent contract.


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                                  SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
                                           Request For Proposal (RFP) YH10-0004
                                            QUESTION AND RESPONSE FORM

11.                                   Does AHCCCS expect the selected specialty contract       The 340B entity will establish all pricing based on the
                                      pharmacy to utilize the “prime vendor” to negotiate      340B pricing file and any other adjustments obtained,
                                      optimal acquisition cost, such as sub-340B ceiling       including those from the Prime Vendor Contracts
                                      prices, with manufacturers or certain specialty          which are currently managed by Apexus.
                                      products?
12.   Scope of          2.1       7   Pg. 7 of the RFP indicates that AHCCCS’s                 The AHCCCS Health Plans may choose or not choose
      Work          Contract          participating health plan and program contractors may    to utilize the AHCCCS Specialty Pharmacy and
                    Utilization       access specialty pharmaceuticals, supplies and care      Services Program.
                                      coordination under the terms and conditions of this      The 340B pricing file for this program will be provided to
                                      contract: How will a health plan access 340B pricing     AHCCCS quarterly by the Offeror. AHCCCS will post
                                      for members via the sole-source specialty pharmacy       the Proposed Contracted Rates on the AHCCCS
                                      contractor if it does not purchase drugs for its owned   website as specified in the Scope of Work, paragraph
                                      or operated 340B covered entities?                       #3.2.6.

13.                                   May the dispensing fee vary by NDC in order to cover     Yes.
                                      costs associated with NDC-specific supplies (e.g.,
                                      pumps) and care coordination (e.g., REMS program)?
14.   Utilization                     Is the data provided only for 340B eligible members?     The utilization data provided on the website below is for
      data                                                                                     all AHCCCS Acute Care and Long Term Care
      attachment                                                                               members.
                                                                                               http://azahcccs.gov/commercial/Purchasing/open.aspx
15.   Utilization   Column E          Please clarify the quantity dispensed measures. Is       Quantity dispensed is the value for the number of units
      data                            prescription volume available in addition?               of each drug dispensed and relates to the Drug Label
      attachment                                                                               Name and the Generic Label Name.
                                                                                               Prescription volume is not provided; however, the
                                                                                               recipients by County are available on the utilization data
                                                                                               report.
16.   Scope of      1.            4   Who is eligible for 340B dispenses? Would AHCCCS         All AHCCCS members have the potential to be eligible
      Work          AHCCCS            members who receive care at either the Indian Health     to receive medications under the 340B pricing program
                    Overview          Service or AHCCCS American Indian Health Program         as long as the one-to-one relationship between the
                                      (AIHP) be the only eligible members for 340B drug        340B entity, prescriber and the patient is adherent to
                                      dispenses? If not, who else specifically would be        HRSA guidelines.
                                      eligible to receive 340B medications and how are they
                                      identified?
17.   Scope of      2. Project    6   Would 340B drugs be dispensed to eligible members        Yes, if requested.
      Work          Overview          who have both specialty and non-specialty

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                                 SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
                                          Request For Proposal (RFP) YH10-0004
                                           QUESTION AND RESPONSE FORM

                       and           medications?
                     Purpose                                                                  A 340B entity pharmacy or 340B entity contracted
                                     Would it apply to 340B eligible members who have         pharmacy may dispense both specialty and non-
                                     non-specialty medications?                               specialty medications if requested.
18.   Scope of         1.        4   How many total AHCCCS members are 340B eligible?         The AHCCCS population as of October 1, 2009 can be
      Work          AHCCCS                                                                    found on the AHCCCS website at
                    Overview                                                                  www.azahcccs.gov/reporting under AHCCCS
                                                                                              Population Statistics.
19.   Scope of      2. Project   5   What is the anticipated total volume of 340B eligible    Please refer to the utilization data provided
      Work          Overview         members with specialty drug needs?                       The prescription utilization data is for the time period
                       and                                                                    4/1/08 – 3/31/09 and is posted on the AHCCCS
                    Purpose                                                                   website.
                                                                                              http://azahcccs.gov/commercial/Purchasing/open.aspx
                                                                                              Click on “Attachment” under Open RFP #YH10-0004.
20.   Scope of         1.        4   Is participation in the 340B pharmacy program for        Health plans may choose or not choose to utilize the
      Work          AHCCCS           eligible members mandatory?                              AHCCCS Specialty Pharmacy & Services Program;
                    Overview                                                                  however, this program is expected to create greater
                                                                                              cost efficiencies for AHCCCS Contractors and the State
                                                                                              of Arizona.
21.   Scope of      2. Project   5   Approximately how many members are represented in        The approximate 2008 AHCCCS Member Population,
      Work          Overview         the $75 million specialty drug spend for 2008?           was 1.15M Members.
                       and
                    Purpose          Of this, how many would be eligible for 340B drug    All AHCCCS members have the potential to be eligible
                                     dispenses?                                           to receive medications under the 340B pricing program
                                                                                          as long as the one-to-one relationship between the
                                                                                          340B entity, prescriber and the patient is adherent to
                                                                                          HRSA guidelines.
22.   Scope of       Program     9   Would AHCCCS consider a Specialty Pharmacy that is The RFP requests the 340B entity’s pharmacy be
      Work          Objectives       registered with AHCCCS but be located outside of AZ? located in Arizona; however, we will evaluate all
                    . Specific                                                            submitted proposals.
                    Contractor
                    Requirem
                       ents

23.   Notice of                  1   Will AHCCCS be hosting a Bidder’s Conference             A Bidder’s Conference will not be held.
      Request for                    regarding this solicitation, prior to the proposal due

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                 SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
                          Request For Proposal (RFP) YH10-0004
                           QUESTION AND RESPONSE FORM

      Proposal       date?
24.                  The RFP refers to the pharmacy as a qualified entity.       The RFP refers to a 340 designated entity's pharmacy,
                     The pharmacy cannot be a qualified entity—it can only       which means the 340B entity may have a pharmacy
                     contract with a qualified entity for a dispensing fee.      within the entity or the 340B designated entity may
                     Since the qualified entity is the only one with access to   contract with an outside pharmacy or network of
                     340b priced drugs, how can the pharmacy report 340b         pharmacies to provide services. A list of 340B entities
                     prices?                                                     can be obtained from the Health Resources and
                                                                                 Services Administration (HRSA) website, under
                                                                                 the Office of Pharmacy Affairs (OPA):
                                                                                 http://opanet.hrsa.gov/opa/CE/CEMedicaidExtract.aspx

                                                                                 The Health plans may choose or not choose to utilize
                                                                                 the AHCCCS Specialty Pharmacy & Services Program;
                                                                                 however, this program is expected to create greater
                                                                                 cost efficiencies for AHCCCS Contractors and the State
                                                                                 of Arizona.

                                                                           The 340B-pricing file for this program will be provided to
                                                                           AHCCCS quarterly by the Offeror. AHCCCS will post
                                                                           the Proposed Contracted Rates on the AHCCCS
                                                                           website as specified in the Scope of Work, paragraph
                                                                           #3.2.6.
25.                   Does the RFP assume the covered entities, which can This proposal request is intended as a statewide
                     purchase 340b drugs, would be willing to allow their  initiative to provide improved patient monitoring and
                     340b priced drugs to solely benefit the managed care  care coordination and achieve greater cost efficiencies
                     plans (which would be the situation if the pharmacy   in the purchase of medically necessary specialty drugs,
                     bills the 340b cost plus a dispensing fee)?           services and related products and supplies for the State
                                                                           of Arizona's Medicaid program, AHCCCS.
26.                  How many patients are seen and how many scripts       The Utilization Data by County is available in excel on
                     are filled at the covered entities encompassed by the the AHCCCS website under this solicitation. (See the
                     RFP? And how many patients are seen at the Indian     attachment under Amendment 1 - 9/14/09 –
                     Health Service?
                                                                           http://azahcccs.gov/commercial/Purchasing/open.aspx.

                                                                                 The utilization data is for the AHCCCS Acute and Long
                                                                                 Term Care Plans and does not include Native American
                                                                                 Prescription data.
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      SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
               Request For Proposal (RFP) YH10-0004
                QUESTION AND RESPONSE FORM

27.       The RFP discusses a 1:1 relationship between the            The 1:1 relationship references the 340B-designated
          pharmacy, the prescribing physician and the patient.        entity, the patient and the prescriber. The 340B entity
          The 340b laws require a 1:1 relationship between the        will be responsible for ensuring that the 1:1 relationship
          contracted pharmacy and the covered entities--how do        between all parties is compliant. It is up to each Offeror
          you anticipate the pharmacy contracting process to          responding to this RFP to show how they will
          work? Is there a plan in place to ensure that each          operationalize the program to create and be compliant
          covered entity can contract with the specialty              with the one-to-one relationship. The 340B entity may
          pharmacy?                                                   use their in-house pharmacy and/or contract with a
                                                                      network of pharmacies.
          If the pharmacy has a location in Arizona, is it            The RFP requests the 340B entity’s pharmacy or
28.       acceptable for the pharmacy company to also provide         contracted pharmacy network be located in Arizona;
          certain specialty products and disease management           however, we will evaluate all submitted proposals.
          services from its Arizona licensed, out-of-state
          facilities?
29.       If a patient is not seen at one of the 340B entity sites,   AHCCCS expects the 340B entity to be compliant with
          how will the pharmacy provide 340B medications to           HRSA guidelines. In reference to the 1:1 relationship
          them?                                                       between the entity, the patient and the prescriber:

                                                                      The AHCCCS member must be a patient of the entity
                                                                      and many of our AHCCCS members are already
                                                                      patients of entities. If the AHCCCS member is not a
                                                                      patient of the entity, then the patient relationship must
                                                                      be created. The entity must provide medical care that
                                                                      results in the prescription and maintain medical records
                                                                      on the patient.

                                                                      The AHCCCS member must be cared for by a
                                                                      prescriber that is employed by, on staff, or contracted
                                                                      with the entity. The contractual agreement between the
                                                                      entity and the prescriber may be non-monetary and on
                                                                      a volunteer basis.

                                                                       The prescriber may also refer the patient to other
                                                                      specialty physicians as required. In some cases, the
                                                                      entity may use a single case agreement to contract with


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      SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
               Request For Proposal (RFP) YH10-0004
                QUESTION AND RESPONSE FORM

                                                                      the prescriber for a specific patient.

                                                                      The 340B entity may provide pharmaceutical services
                                                                      to covered patients through their outpatient pharmacy
                                                                      and the entity may also contract with a pharmacy to
                                                                      provide services. The 340B entity must purchase and
                                                                      hold title to the 340B drugs and is responsible for
                                                                      reconciling pharmaceutical inventories in accordance
                                                                      with HRSA regulations. The 340B drugs may be
                                                                      shipped to the contract pharmacy by the wholesaler.


30.       AHCCCS has stated that pharmacies may partner with          Please see the response to question 29.
          340B eligible entities. HRSA has told Arizona
          pharmacies that the one-to-one relationship required
          by statute is not satisfied solely through the
          prescription. Rather, the patient must be seen by the
          340B entity and that entity must employ the provider
          writing the prescription. How does AHCCCS
          overcome this rule?

31.       This RFP seems to contradict the HRSA guidance that         The Offeror is expected to provide an implementation
          states: “Provision (g) of the guidelines provides that      plan that is adherent to HRSA rules and regulations.
          the contractor will not resell or transfer a 340B drug to   It is up to the 340B entity to develop a work plan that
          an individual who is not a patient of the entity.” The      ensures the one-to-one relationship is created.
          patient relationship is not determined by the pharmacy,     Please see the response to question 29.
          but rather the prescriber. How does AHCCCS
          overcome this barrier?
32.       The RFP has Anemia, Osteoporosis, and Oncology              All prescription utilization data is posted. AHCCCS is
          removed as a serviceable population- what specialty         targeting several drugs/disease states for initial
          costs does this represent?                                  implementation and other will be considered at a later
                                                                      date.

33.       Why is Oral Oncology not being included in the RFP?         The RFP targeted several drugs/disease states for
                                                                      initial implementation. Other disease states and/or
                                                                      therapeutic classes will be considered for a later date.

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      SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
               Request For Proposal (RFP) YH10-0004
                QUESTION AND RESPONSE FORM

34.       IF a pharmacy or pharmacy network contracts with a         No, the scenario provided does not meet HRSA’s one-
          single contracted 340b site and both entities are          to-one relationship definition.
          contracted with all AHCCCS plans does this complete
          the one-to-one relationship?

          If YES can you provide an official statement from
          HRSA that this legally qualifies?

          If NO would the pharmacy company be required to            The 340B Entity Offeror’s proposal must include the
          contract with all contracted 340b sites in Arizona to      entity’s pharmacy or a contracted network of
          complete the one-to-one relationship?                      pharmacies to provide services under this proposal.

35.       Section 3.1.10- States “provide educational and            AHCCCS Administration does not administer these
          outreach programs.” What current programs is               programs but requires AHCCCS Contractors to provide
          AHCCCS providing?                                          various programs as they relate to Quality
                                                                     Management.
                                                                     Several pharmaceutical programs have also provided
                                                                     targeted disease state programs.
36.       Section 3.1.13- Addresses medical waste removal and        AHCCCS administration does not facilitate medical
          disposal. How does AHCCCS currently handle this?           waste removal. The Offeror must include in their
                                                                     proposal the process by which a member disposes of
          What is the service expectation of medical waste           syringes, IV tubing, empty blood modifier packages,
          removal and is this a separate billable item?              etc., for various medications and disease states, as
                                                                     appropriate. The process must include a process and/or
                                                                     container for disposal at the time of use and disposal of
                                                                     the refuse container when the container is full. For
                                                                     example, the use of a sharp’s container.
37.       Section 3.1.14- Please define a timeframe for              Time frames for various types of emergency delivery
          “emergency delivery services.”                             services must be included in the proposal.
                                                                     For example, 2 hours, 4 hours, 8 hours, next day, etc.
                                                                     The Offeror must have a mechanism in place for
                                                                     providing emergency deliveries.
38.       Section 3.2.5- States for the selected entity to           The RFP uses the word “facilitate” because nursing
          coordinate and/or facilitate nursing services- does this   services may be medically necessary as part of the
          go beyond the dispensing of medications to patient         care coordination for specialty drugs and services.
          and/or healthcare provider?                                Nursing services are separately billed to the health
                                                                     plans and should not be included in the “Fee.”
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      SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
               Request For Proposal (RFP) YH10-0004
                QUESTION AND RESPONSE FORM

39.       Section 3.2.16- Can the implementation plan be              Yes, the Offeror may propose a transition schedule in
          staged by region and/or disease state?                      the implementation plan.

          What is a reasonable time frame to have all patients        A reasonable time frame is 180 days from the
          enrolled from award date?                                   implementation date.
40.       For individuals to be considered patients of a covered      AHCCCS expects the 340B entity to be compliant with
          entity under current HRSA 340B guidelines, the entity       HRSA guidelines.
          must: (1) establish a relationship with the patient
          including maintaining records of the individual’s health    In reference to the 1:1 relationship between the entity,
          care; (2) the individual receives health care services      the patient and the prescriber:
          from a health care professional who is employed or
          under contract with the covered entity. Potentially,        The AHCCCS member must be a patient of the entity
          many patients will fail to meet these two critical          and many of our AHCCCS members are already
          requirements in a statewide pharmacy specialty              patients of entities. If the AHCCCS member is not a
          service. What is AHCCCS’ expectation for the program        patient of the entity, then the patient relationship must
          for patients who do not qualify under the definition of     be created. The entity must provide medical care that
          340B patient because they are receiving care from and       results in the prescription and maintain medical records
          are maintaining the health care relationship                on the patient.
          requirement with other institutions and/or are receiving
          health care from health care professionals not on the       The AHCCCS member must be cared for by a
          contractor’s staff or under contract with the contractor?   prescriber that is employed by, on staff, or contracted
                                                                      with the entity. The contractual agreement between the
                                                                      entity and the prescriber may be non-monetary and on
                                                                      a volunteer basis.

                                                                      The prescriber may also refer the patient to other
                                                                      specialty physicians as required. In some cases, the
                                                                      entity may use a single case agreement to contract with
                                                                      the prescriber for a specific patient.

                                                                      The 340B entity may provide pharmaceutical services
                                                                      to covered patients through their outpatient pharmacy
                                                                      and the entity may also contract with a pharmacy to
                                                                      provide services. The 340B entity must purchase and
                                                                      hold title to the 340B drugs and is responsible for
                                                                      reconciling pharmaceutical inventories in accordance
                                   Page 9 of 11                                                                                   9
                                SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
                                         Request For Proposal (RFP) YH10-0004
                                          QUESTION AND RESPONSE FORM

                                                                                               with HRSA regulations. The 340B drugs may be
                                                                                               shipped to the contract pharmacy by the wholesaler.
                                    With regards to Program Objective 3.1.2, does the          A determination has not been made at this time.
41.                                 scope of treatment sites include hospital outpatient
                                    departments and hospital-based entities (including off-
                                    campus provider-based clinics) as defined at 42 CFR
                                    413.65?
42.                                 With regards to Paragraph 2.1 Contract Utilization, if a   The payment of pharmaceuticals to a 340B entity is
                                    340B entity is not awarded the contract, must the 340B     under AHCCCS review.
                                    entity source listed specialty pharmaceuticals from the
                                    awarded contractor for AHCCCS patients be treated at
                                    the 340B entity?
                                    If a 340B entity is not awarded a contract, does           Any 340B entity may propose a contract to any of our
43.                                 anything preclude the 340B entity from contracting         health plans.
                                    with the various AHCCCS plans to provide
                                    medications covered in the Specialty Pharmacy
                                    contract at prices agreeable to the plans (i.e.,
                                    independent of the AHCCCS Specialty Pharmacy
                                    contract)?
44.   Contract      Paragraph   7   Does this mean the health plan/program contractors         The AHCCCS Health Plans may choose or not choose
      Utilization     2, 2.1        will have access to 340B pricing through this contract?    to utilize the AHCCCS Specialty Pharmacy and
                                                                                               Services Program.
                                                                                               The Offeror will provide the 340B-pricing file for this
                                                                                               program to AHCCCS quarterly. AHCCCS will post the
                                                                                               Proposed Contracted Rates on the AHCCCS website
                                                                                               as specified in the Scope of Work, paragraph #3.2.6.
45.   3. Program     3.1.16     8   What reports will be required? At what frequency?          Specific utilization reports are to be determined.
      Objectives                                                                               Reports will be required monthly, quarterly, semi-
                                                                                               annually and annually.
46.   3. Program      3.2.1     9   Can an out-of-state MA-licensed specialty pharmacy         The RFP requests the 340B entity’s pharmacy be
      Objectives                    participate?                                               licensed and located in Arizona; however, we will
                                                                                               evaluate all submitted proposals.
47.   3. Program      3.2.2     9   Arizona licensed pharmacists and technicians only.         The Offeror must have qualified staff to run a call
      Objectives                    Does this requirement include call center staff?           center. Interactions with the AHCCCS members
                                                                                               regarding their prescriptions require the call center to
                                                                                               be staffed by pharmacy technicians and in some

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                              SPECIALTY PHARMACY DRUGS AND SERVICES PROGRAM
                                       Request For Proposal (RFP) YH10-0004
                                        QUESTION AND RESPONSE FORM

                                                                                               instances a pharmacist. The call center does not have
                                                                                               to be located in Arizona.
48.   General                     What is the OPA ID number that we will attach the            This RFP is to determine the 340B entity; therefore, an
      Question                    wholesaler account to for 340B replenishment?                OPA ID is not available at this time.

49.   General                     What is the OPA 340B ID covered entity # for the             This RFP is to determine the 340B entity; therefore the
      Question                    program?                                                     OPA ID is not available at this time.
50.   General                     Who will be the Covered Entity that has the                  This RFP is to determine the 340B entity for the
      Question                    Wholesaler account needed in order for our company           AHCCCS Specialty Pharmacy & Services Program;
                                  to replenish dispensed medication?                           therefore, a specific covered entity is not available at
                                                                                               this time.
51.   General                     Can you confirm that AHCCCS is not a Covered Entity          AHCCCS is not a covered entity.
      Question                    and does not qualify for 340b pricing?
52.   General                     Is AHCCCS looking for all work related in this RFP to        The RFP requests the 340B entity’s pharmacy or
      Question                    be completed in the State of Arizona?                        contracted pharmacies are located in Arizona; however,
                                                                                               we will evaluate all submitted proposals.
53.   General                     When will the program be implemented?                        The start date will be determined and is dependent
      Question                                                                                 upon the awarded contractor’s implementation plan.
54.   General                     How will eligibility for this program be determined, i.e.,   Initially, patients will be identified through the use of
      Question                    how will patients eligible for this program be identified?   pharmaceutical data.
55.   General                     Is there a requirement for physical segregation, or is       The 340B entity will determine the most efficient
      Question                    co-mingled inventory virtually segregation acceptable?       process for inventory reconciliation according to HRSA.
56.   1. AHCCCS   Paragraph   4   Of the 1.3 million members identified in paragraph 1,        All AHCCCS members have the potential to be eligible
      Overview        1           how many are eligible for 340B pricing under this            to receive medications under the 340B pricing program
                                  specialty program?                                           as long as the one-to-one relationship between the
                                                                                               340B entity, prescriber and the patient is adherent to
                                                                                               HRSA guidelines.
57.   General                     Exceptions to the program would be dependent upon            Please refer to “Special Terms & Conditions,”
      Question                    the State’s response to some of our questions; is it         paragraph #34, for information on how AHCCCS will
                                  possible to submit exceptions with our response?             respond to exceptions submitted in writing by the
                                                                                               exceptions due date.
58.   General                     The contract provided seems to be a template with            No, AHCCCS is not willing to accept an Offeror's
      Question                    elements that are not applicable. Will the State be          contract.
                                  willing to accept our 340B contract? We can submit
                                  this without response.

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