Pharmacy Management Services

The vendor required to provide pharmacy management services include, but are not limited to daily operations management, staffing, clinical pharmacy consultation, cost containment, productivity measures, patient safety, medication management, and regulatory compliance.
- Requirement:
1. Pharmacy operations management
•    Manage day-to-day pharmacy operations, including prescription processing, dispensing, labeling, and medication distribution.
•    Provide 24/7 on-call pharmacy coverage for after‑hours, weekends, and state holidays in addition to normal business hours of Monday through Friday 8:00 a.m. To 4:30 p.m. Local time.
•    Coverage must be provided by the director of pharmacy or a registered pharmacist.
•    Ensure ongoing compliance with hospital, network, and regulatory standards.
•    Maintain accurate, contemporaneous patient medication records and required documentation.
•    Utilize the agency electronic health record (EHR) system to document and coordinate medication management activities.
•    Maintain regular, documented communication with hospital administration, medical staff, nursing leadership, and other departments as required.
•    Participate in medical staff and hospital committees, as well as designated network-level work groups (examples include infection control, antibiotic stewardship, pharmacy and therapeutics, and the agency system integration council). 
•    Demonstrate continuous efforts to maximize the efficient use of state funds while maintaining the highest standards of quality patient care.
2. Staffing and training
•    Provide appropriately licensed pharmacists and certified pharmacy technicians in numbers sufficient to meet all service requirements and applicable regulations.
•    Maintain staffing levels required to meet patient care needs and regulatory obligations; include contingency staffing plans for absences and surge demands. 
•    Deliver ongoing staff training on psychiatric pharmacotherapy, medication safety, documentation standards, and regulatory compliance.
•    Complete hospital-assigned training within designated timeframes, in accordance with hospital policy.
3. Clinical pharmacy services
•    Provide medication therapy management (MTM) tailored to the needs of psychiatric patient populations.
•    Collaborate with medical and behavioral health providers to develop and implement patient treatment plans.
•    Participate in multidisciplinary patient treatment teams and documented care conferences.
•    Perform drug utilization reviews (DURS) and medication reconciliation at transitions of care.
•    Provide education to hospital staff on psychotropic medications, monitoring requirements, and best practices.
4. Medication procurement and inventory control
•    Procure pharmaceuticals, medical supplies, and equipment exclusively from state‑approved vendors or other sources specifically authorized by the state.
•    Implement and maintain inventory controls to prevent shortages and avoid excess stock; establish minimum and maximum par levels and reorder triggers.
•    Ensure secure storage of all medications in compliance with state requirements; implement chain‑of‑custody protocols and controlled substance diversion prevention measures.
•    Maintain complete and accurate records documenting the receipt, storage, dispensing, and disposal of controlled and non‑controlled medications.
5. Regulatory compliance and quality assurance
•    Comply fully with HIPAA, DEA, FDA, DSCSA, applicable state pharmacy laws and regulations, and standards established by the joint commission and CMS.
•    Conduct routine internal audits and inspections; document and report findings and corrective actions to designated hospital representatives.
•    Establish and maintain comprehensive medication safety programs that include adverse drug event surveillance, root cause analysis, and corrective action planning.
•    Maintain complete documentation required for regulatory reporting and inspections.
6. Reporting and documentation
•    Submit all required reports electronically to designated hospital representatives.
•    Provide monthly operational reports that include, at minimum: prescription volume, pharmacy productivity metrics, inventory status, controlled substance reconciliations, and compliance metrics.
•    Provide quarterly audit reports and compliance assessments, including identified corrective actions and implementation timelines.
•    Maintain and produce staff training records and competency evaluations upon request.
•    Provide strategic recommendations for pharmacy program improvements and a timeline for implementation.
7. Financial and billing management
•    Manage pharmacy billing, claims submission, and reimbursement processes in full compliance with Medicaid, medicare, and private payer requirements.
•    Reconcile revenue and provide regular financial reports and detailed cost analyses.
•    Provide budget recommendations and identify opportunities for cost containment that do not compromise patient care.