The vendor is required to provide Program Integrity Audit Services
- Provide up to two (2) consultants onsite for one (1) day.
• Option to be conducted remotely
- Conduct 340B Outpatient Purchasing Audit Annually (contract pharmacy):
• Phase I: Data Review:
o Review of any medicare/medicaid or private billing decisions;
o Review eligible prescription volume.
• Phase II: Verification of Program Eligibility and Review of Operational Procedures:
o Eligibility and registration review, including detailed review of the Office of Pharmacy Affairs Information System (OPAIS);
o Review of Memorandum of Understanding (MOU)/grant;
o Review of 340B policies and procedures;
o Review of contract pharmacy’s policies and operations relationships including active pharmacy services agreements (PSAs); and
o 340B purchasing account review to include purchase order and inventory management.
• Phase III: Health Resources and Services Administration (HRSA)-Style Random Sampling Audit
o Ten (10) records for prescriptions data universe per 340B ID; and
o Review 340B medications through entire accumulation to purchasing process (tracer samples)
• Phase IIII: Provide comprehensive report complete with detailed findings annually:
o Recommendations, and next steps. The report will include all eleven (11) 340B IDs; and
o A call or in-person meeting will be scheduled to review the report in detail with staff.
- Provide ongoing technical support including, but not limited to:
• Support application process for the “grantee combine purchasing and distribution request” for HRSA, which includes staff training and identification of data sources.
o Review current staff training, provide recommendations and education material as needed
• Identification of areas of improvement for data collection including collaboration among departments.
• Identification of opportunities to optimize the value of the 340B Program.
• Review of third party administrator (TPA) configuration settings.
• Evaluate and provide recommendations for 340B infrastructure, program governance, and operations.
• Ensure application of Combined Purchasing and Distribution Request is submitted timely encompasses all requirements as outlined by 340B grant program.
• Guidance of implementation of recommendations identified during the audit.
• Ongoing program operational support, regulatory compliance monitoring, and reporting.
• Program development, optimization, and implementation
• Third Party Administrator (TPA) ongoing monitoring, configuration review, and support.
• Policy and procedure development.
• HRSA 340B Program audit support.
• Manufacturer 340B Program audit support.
• Other 340B support services as needed.
- Contract Period/Term: 1 year
- Discussion Forum Cut Off Deadline: May 26, 2025