Pharmacy Services

The vendor required to provide pharmacy services for the state drug assistance program (SDAP) eligible for residents of state who are living with or at risk of acquiring human immunodeficiency virus (HIV), sexually transmitted infections (STI), or viral hepatitis (VH).
- Work plan
1. Sub-activities #1
•    Provide walk-in pharmacy services at a physical location, direct shipping to client addresses, or local delivery services (at least one method required; multiple methods preferred). 
•    Dispense medications as prescribed to eligible SDAP clients within
•    Business days of prescription receipt and prior authorization approval.
•    Conduct drug utilization reviews for all prescriptions dispensed. 
•    Maintain comprehensive patient profiles and medication histories. 
•    Provide patient counseling and pharmaceutical education in accordance with state pharmacy practice standards.
2. Sub-activities #2
•    Dispense medications to eligible SDAP clients from their existing pharmacy inventory.
•    Replenishment orders to department contracted supplier on behalf of department, specifying drugs by ndc-11, unit quantities, and other required data elements.
•    Receive shipments of 340b-priced drugs from department contracted supplier to replenish dispensed inventory. 
•    Inspect all replenishment shipments immediately upon receipt and reconcile against dispensing records. 
•    Track all 340b drug inventory by 11-digit national drug code (NDC) number. 
•    Notify department designated PBM of any discrepancies between 340b drugs dispensed and replenishment orders received within five (5) business days of receipt. 
•    participate in the "true-up" process for drugs dispensed but not replenished due to package size thresholds, 340b exclusions, or supplier availability issues.
•    Participate in good faith to generate ending inventory reports and conduct final reconciliation of over and under replenishment status within sixty (60) days of contract termination.
•    Receive any direct payment from department for services performed under the contract. 
•    They will be provided compensation through the SDAP PBM in the form of dispense and shipping fees, and for any medications that are not available through the bill to – ship to process in the form of a “true-up” payment.
3. Sub-activities #3
•    The office of pharmacy affairs information system (OPAIS) as a contract pharmacy for department during the next available quarterly registration period. 
•    The contractor shall not begin providing 340b services until OPAIS registration is complete and approved by health resources and services administration (HRSA). 
•    Providing services on the first day of the quarter following successful OPAIS registration. 
•    Implement and maintain robust tracking systems to prevent drug diversion to ineligible individuals. 
•    Ensure 340b drugs are dispensed only to patients who meet HRSA's definition of eligibility as determined by department designated PBM. 
•    Dispense 340b drugs for prescriptions reimbursable by state Medicaid fee-for-service programs or other excluded government programs that would result in duplicate discounts. 
•    Maintain separate identification of 340b inventory and transactions. 
•    Cooperate with department to establish and maintain effective diversion prevention protocols
•    Conduct monthly internal contract pharmacy reviews to ensure program compliance, including verification that:
o    The patient is enrolled in SDAP at the time-of-service 
o    An 11-digit NDC match can be documented for each 340b dispensation 
•    Separate 340b medications from non-340b medications in accordance with department monitoring requirements.
4. Sub – activities #4
•    Maintain detailed electronic or written records for every 340b prescription dispensed to an SDAP client, including: 
o    Prescription number or unique serial number 
o    Calendar date of the claim 
o    Patient identifiers (name, date of birth, gender, unique id number) 
o    Pharmacy identifiers (name, national provider identifier [NPI]) 
o    Drug information (ndc-11 number, name, strength, dosage form, quantity dispensed, generic and brand designation) 
o    New or refill indicator 
o    Financial information (dispensing fee, administrative fee, patient co-payment when applicable) 
o    Sliding-scale co-payment level, when applicable
•    All pharmacy records related to 340b services for the duration of the contract term plus seven (7) years, or as required by applicable state or federal law, whichever period is longer. 
•    Grant department and its designated PBM 24/7 electronic access to tracking systems providing real-time, complete claims data for monitoring and audit purposes. 
•    Permit on-site inspections and audits during normal business hours by department representatives, department designated PBM, HRSA, the office of inspector general, or other authorized federal agencies.
•    Participate in annual compliance audits and site visits to verify program integrity.
•    Make all books, records, invoices, and prescription files related to providing pharmacy services to SDAP clients available to department and applicable state and federal regulatory agencies as necessary to comply with the terms of this contract.
5. Sub – activities #5
•    Execute a formal 340b contract pharmacy services agreement with department. 
•    Execute a separate network provider agreement with department designated pharmacy benefits manager (PBM). 
•    Obligations under are contingent upon maintaining an active PBM provider agreement.
•    Enroll with and maintain active ordering relationships with department contracted drug wholesaler(s) through coordination with the designated PBM. 
•    Maintain appropriate act-compliant business associate agreements with department PBM and any other entities involved in processing protected health information.
- Budget: $15.50

- Contract Period/Term: 1 year
- Questions/Inquires Deadline: November 13, 2025