NYS Specialty Pharmacy Program

NEW YORK STATE DEPARTMENT OF HEALTH

A Request for Proposal for

Office of Health Insurance Programs Division of Financial Planning and Policy

RFP No. FAU 0809100808

NYS Specialty Pharmacy Program

_____________________________________________________________

Schedule of Key Events RFP Release Date Letter of Interest Due (optional) Final Date for Submission of Questions Response to Written Questions Proposal Due Date

12/01/08 12/22/08 01/05/09 01/20/09 02/09/09

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Contacts Pursuant to State Finance Law ? 139-j and 139-k

DESIGNATED CONTACTS:

Pursuant to State Finance Law ?? 139-j and 139-k,the Department of Health identifies the following designated contacts to whom all communications attempting to influence this procurement must be made:

Jonathan Mahar Bureau of Accounts Management Grants and Procurement Unit, Room 1341 Albany, NY 12231 Fax #: (518) 473-8375 Email:jpm12@health.state.ny.us

PERMISSABLE SUBJECT MATTER CONTACTS: Pursuant to State Finance Law ? 139-j(3)(a), the Department of Health also identifies the following allowable contacts for communications related to the following subjects:

RFP Release Date: Submission of written proposals or bids: Submission of Written Questions:

Carol Lindley

OR

Management Specialist III

Division of Financial Planning and Policy

NYS Department of Health

99 Washington Avenue, Suite 720

Albany, NY 12210

Fax : (518) 473-5508

Phone: (518) 474-9219

Email: nyssp@health.state.ny.us

Wendy Hebert Medical Assistance Specialist Division of Financial Planning & Policy NYS Department of Health 99 Washington Avenue, Suite 720 Albany, NY 12210 Fax : (518) 473-5508 Phone: (518) 474-9219 Email: nyssp@health.state.ny.us

Debriefings: Negotiation of Contract Terms after Award:

Carol Lindley

OR

Management Specialist III

Division of Financial Planning and Policy

NYS Department of Health

99 Washington Avenue, Suite 720

Albany, NY 12210

Fax : (518) 473-5508

Phone: (518) 474-9219

Email: nyssp@health.state.ny.us

Wendy Hebert Medical Assistance Specialist Division of Financial Planning & Policy NYS Department of Health 99 Washington Avenue, Suite 720 Albany, NY 12210 Fax : (518) 473-5508 Phone: (518) 474-9219 Email: nyssp@health.state.ny.us

For further information regarding these statutory provisions, see the Lobbying Statute summary in Section F, 11 of this solicitation.

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TABLE OF CONTENTS

A. INTRODUCTION

B. BACKGROUND

1. Medicaid Pharmacy Management Programs 2. Fiscal Agent Responsibilities 3. Medicaid Pharmacy Reimbursement 4. Enrollee Co-payments 5. Amount and Duration of Pharmacy Benefit 6. Medicaid Volume, Utilization and Expenditures

C. DETAILED SPECIFICATIONS

1. Objectives 2. General Requirements 3. Tasks 4. Reports and Project Control 5. Other Requirements

D. PROCUREMENT TIMELINE

E. PROPOSAL REQUIREMENTS

1. Introduction and General Instructions a) Proposal Specifications b) Proposal Format

2. Volume I Part I ? Corporate Qualifications Response a) Transmittal Letter 1) Letter of Credit b) General Corporate Qualifications 1) Corporate Structure and Organization 2) Financial Capacity 3) Parent Company Information 4) Affiliations 5) Experience with State and Federal Legal and Program Requirements c) Subcontractors d) Experience w/ Functions Included in this RFP e) General Operational Capacity and Experience 1) Dispensing Operations 2) Call Center Operations

3. Volume 1, Part II ? Technical Proposal a) General Organizational Structure and Operations b) Personnel c) Work Plan and Implementation Schedule

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8 10 11 25 27

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TABLE OF CONTENTS (CONT)

PAGE

d) Detailed Technical Work Plan

36

1) Maintain an Inventory of Specialty Pharmacy Drug

37

2) Coordinate the Provisions of Ancillary Supplies, Equipment

and Nursing Services

37

3) Implement and Operate a Specialty Pharmacy Dispensing and

Delivery System

38

4) Implement and Operate a Clinical Support System

38

5) Respond to General Inquiries and Complaints

39

6) Policies and Procedures

39

7) Communication

39

8) Coordination with the DOH

39

9) Plan for Transition to the Specialty Pharmacy and Continuity

Of Care

40

10) Perform Quality Assurance Monitoring

40

11) Perform Environmental Scanning

40

12) Monitoring and Performance Standards

40

13) Information Technology (IT)

40

14) Reports and Project Control

40

4. Volume II ? Financial Proposal

41

5. Method of Award

41

a) Pass Fail Requirements

42

b) Technical Proposal Score

42

c) Financial Proposal Score

42

d) Total Combined Score and Contractors' Selection

43

F. ADMINISTRATIVE INFORMATION

44

1. Issuing Agency

44

2. Inquiries

44

3. Submission of Proposal

45

4. Department of Health Reserved Rights

45

5. Payment

46

6. Term of Contract

46

7. Debriefing

46

8. Disclosure of Proposal Contents

46

9. Vendor Responsibility Questionnaire

47

10. State Consultant Services Reporting

47

11. Lobbying Statute

47

12. Accessibility of State Agency Web-Based Information

48

13. Information Security Breach and Notification Act

48

14. New York State Tax Law Section 5-a

49

G. APPENDICES FOR CONTRACT

49

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TABLE OF CONTENTS (CON'T)

PAGE

H. ATTACHMENTS

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1. Resources 2. Tables 3. Physician Enrollment 4. Co-Payments 5. Pharmacy Reimbursement 6. Bidder's Response Forms 7. NYS DOH Bid Form 8. NYS DOH No Bid Form 9. Vendor Responsibility Attestation 10. Appendix A- Standard Clauses for All New York State Contracts 11. Appendix D- General Specifications 12. Appendix E

o Workers Compensation Appendix E-1 o Disability Benefits Coverage Appendix E-2 13. Appendix H- Health Insurance and Accountability Act (HIPAA) 14. Appendix L- Standby Letter of Credit Commitment Letter 15. NYS Taxation and Finance Contractors Certification Form ST-220-TD 16. NYS Taxation and Finance Contractors Certification Form ST-220-CA 17. State Consultant Services Form A, Contractor's Planned Employment 18. State Consultant Services Form B, Contractor's Annual Employment Report

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