The vendor is required to provide pharmacy benefit services.
- Pharmaceutical services and eligibility verification:
- Proposer will provide a network of pharmacies to dispense prescriptions to eligible agency clients.
- Network pharmacy, capacity to:
• Verify participant eligibility electronically
• Verify prescription is written by an in-network prescriber
• Review prescriptions to determine if the product is covered in the formulary
• Submit for overrides/prior authorization for brand name medications, non-formulary medications, and medication restrictions
• Transmit eligibility and prescription claim information electronically
• Fill all medications to patients for self-administration in accordance with all applicable federal, state and local laws
• Counsel the patient regarding the proper method of taking the drug and any known side effects
• Counsel the patient regarding possible drug interactions, and
• Dispense the filled prescription order to the patient.
- Ensure that at no time will persons served under this contract be segregated or separated from private patients in such a way as to make them stand out from other persons being served by the proposer or in any of the program’s contracted network pharmacies.
- The capacity to supply pharmacies in the network with a description of the agency program and will provide assistance, education, and customer support to the pharmacies regarding the programs.
- All pharmacy locations shall make available all medications on the formulary (both independent pharmacies and pharmacy chains).
- The pharmacy network regarding agency updates or changes via broadcast fax, email or mail and provide copies of all pharmacy correspondence to designated county personnel.
- Efforts to regularly train and update network pharmacies for familiarity with the health program.
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: March 5, 2025