Opportunity Detail

Questions and Answers

Pharmacy Operational Support Vendor (POSV)
Document #:  ODMR20210023


Question:   Attachment C: Cost Proposal Form. RFP page. 63 - What is the annual budget and/or total contract maximum for these services overall?

Answer:   ODM does not provide budget information in advance of proposal submissions. Offerors are expected to provide their best price based on the scope of work and level of effort.

Date: 11/25/2020

Inquiry: 82375


Question:   Pg. 26, Section 4.1, Scope of Work - Does the 340B oversight described at REV_22 and REV_23 include reviews of 340B claims for provider administered drugs billed through medical claims as well as prior authorizations for drugs billed through pharmacy claims?

Answer:   The 340B reviews described in REV_22 and REV_23 are limited to pharmacy claims. The 340b reviews referenced in the RFP relate to pharmacy claims. ODM may, in its discretion, expand or alter review parameters at a future date.

Date: 11/25/2020

Inquiry: 82361


Question:   Item 3.3 Key Personnel page 13 The bid calls for a CPA, can an Actuary be used to fill this position?

Answer:   No. CPAs have the necessary training and experience in cost accounting and activity-based costing. Additionally, the State prefers CPAs with expertise in CMS cost principles, as shown in 2 CFR 200. Understanding expense categorization rules to properly assign expenses as direct, indirect, and unallowable is critical to the success of this endeavor.

Date: 11/25/2020

Inquiry: 82305


Question:   3.1 Minimum Requirements page 11 In the requirements it states that the vendor and personnel have to have 3 years of experience administering surveys to pharmacies. What if the vendor did not conduct the survey for a Medicaid agency yet collected the data for others, did not send them out, and collected all of the data and analyzed that data for 6 years? We are trying to assess if we would be disqualified right out of the gate.

Answer:   It is incumbent on the Offeror to demonstrate its capacity and capability to handle the complexities of this procurement. When reviewing submissions, ODM will focus on whether the Offeror's proposal demonstrates its capacity and capability to meet this requirement. ODM recognizes that the Offeror may demonstrate its ability in numerous ways, such as engaging the services of a qualified subcontractor or serving as a qualified subcontractor with regard to relevant experience.

Date: 11/25/2020

Inquiry: 82314


Question:   GEN_02 page 29 What do you perceive to be the difference between the plans you are requiring as part of RFP process versus those required 60-90 days after? Is it the level of detail?

Answer:   ODM believes this question is in reference to AAC_02 and REV_02. As noted in AAC_02, "Upon Contract award and execution, the Contractor must further develop the OAAC Plan by performing analyses, evaluations, and comparisons to provide ODM with drug pricing methodology recommendations." For the Oversight plan, ODM will determine the need for further refinement of the plan following review of the draft plan.

Date: 11/25/2020

Inquiry: 82313


Question:   REV_17 page 25 Will the SPBM and FFS PBA provide access to the prior authorization tools that are being used?

Answer:   To perform prior authorization reviews, the Offeror should assume it will have access to electronic copies or printed copies of all documentation for the chosen cases rather than live prior authorization system access.

Date: 11/25/2020

Inquiry: 82312


Question:   Oversight of audits REV_01 page 23 In order to provide audits will ODM provide all coverages, edits, formulary, PDL, and QLL to contractor?"

Answer:   Yes.

Date: 11/25/2020

Inquiry: 82311


Question:   Objective 2.1 page 7. The bid mentions there is a SPBM and a FFS PBA. Should these be listed as two separate functions given there will be a need for reporting, auditing and other functions for each entity?

Answer:   ODM does not understand this question. Page 7 refers to the anticipated procurement timetable.

Date: 11/24/2020

Inquiry: 82304


Question:   Item 3.3 Key P{personnel page 12 Are the names of the personnel in the proposal public knowledge or can they be redacted?

Answer:   As stated in Section 9.2 of the RFP, "[Proposals] shall become property of ODM. Proposals received are deemed to be public records pursuant to ORC § 149.43." Names of personnel may not be redacted.

Date: 11/24/2020

Inquiry: 82309


Question:   Oversight of audits REV_01 page 23 In order to perform audits, will the contractor receive daily files or data and or more frequently in order to achieve "near" real time revioews?

Answer:   The Contractor will receive files as frequently as possible to complete concurrent reviews on time.

Date: 11/24/2020

Inquiry: 82310


Question:   Pgs. 17-27, Section 4.1, Scope of Work - AAC_01 through AAC_25 reference the OAAC Plan and AAC_04 indicates that the OAAC Plan must be submitted to ODM by the Contractor within 60 days of contract execution. REV_01 through REV_28 reference the Ohio Pharmacy Oversight Plan. REV_01 appears to suggest that a draft of the Ohio Pharmacy Oversight Plan must be presented within the proposal, although REV_02 references submitting a revised Ohio Pharmacy Oversight Plan to ODM within 60 days of contract execution. For purposes of the proposal, is it the expectation of ODM that proposers submit a separate document or documents associated with either the OAAC Plan or the Ohio Pharmacy Oversight Plan, or is it sufficient to address the elements that will be addressed in the OAAC Plan and the Ohio Pharmacy Oversight Plan within the body of the proposal simultaneous to language addressing the scope of work requirements of the RFP? If ODM expects separate documents, is ODM able to provide any guidance regarding the expected level of detail that would be expected within the documents for purposes of the proposal?

Answer:   The Offeror should submit a separate document or documents associated with the draft plans. The level of detail should be sufficient to adequately demonstrate the Offeror's plans to ODM. Within the body of the proposal, the Offeror should address the scope of work requirements as outlined in the RFP.

Date: 11/23/2020

Inquiry: 82243


Question:   Pg. 45, Section 9.11, MBE Subcontracting Requirement - Section 9.11 references a “Sheltered Solicitation” requirement stating:This RFP contains a sheltered solicitation requirement which requires the Offeror to seek and set aside at least 15 percent of the work to be exclusively performed by Ohio certified MBE businesses. RFP Section 9.11.1 states In seeking solicitations from Ohio certified MBE subcontractors, the Contractor must: 1. Utilize a competitive process to which only Ohio certified MBEs may respond 2. Have established criteria by which prospective Ohio MBEs will be evaluated including business ability and specific experience related to the work requirements of this RFP and 3. Require the Ohio certified MBE subcontractor maintain a valid certification throughout the term of the Contract, including any renewals. In addition, Section 3.1, Mandatory Requirements, (5), indicates that Offerors must include documentation to support the selection of an MBE subcontractor with the proposal (further reinforced by RFP sections 3.5(6), 6.2(7) and Proposal Acceptance Criteria (10) within Attachment B). We understand that at least 15% of the contract should be dedicated to an MBE subcontractor. Please clarify the following: a) Is the Offeror required to competitively solicit MBE contractors prior to submission of the proposal? b) If so, can ODM define/describe the competitive process and documentation it requires Offerors to follow and include in their proposals? c) If the Offeror has a qualified MBE subcontractor with whom they have a proven relationship, could the competitive process be waived?

Answer:   The Offeror is required to select the Ohio certified Minority Business Enterprise subcontractor(s) through a competitive process prior to submission of proposals. This process cannot be waived. The competitive process can be a request for quote through email, or some other reasonable process, to be determined by the Offeror. The details of the procurement process are not expected to be provided to ODM unless specifically requested.

Date: 11/20/2020

Inquiry: 82250


Question:   Pgs. 23-24, Section 4.1, Scope of Work - Are the concurrent and retrospective claims review steps included in REV_03 through REV_12 limited to claims adjudicated by the SPBM, or are these steps intended to be inclusive of FFS pharmacy claims adjudicated by the PBA and medical claims for provider administered drugs adjudicated by other vendors?

Answer:   The concurrent and retrospective claims reviews are limited to claims adjudicated by the SPBM and the FFS PBA and exclude provider-administered drugs.

Date: 11/20/2020

Inquiry: 82249


Question:   Pgs. 13-31, Section 4.1, Scope of Work - In terms of required claims extracts to be obtained from ODM or its other vendors, is it ODM’s expectation that the POSV contractor would obtain the various data extracts directly from the originating source(s) (e.g., the SPBM for MCO pharmacy data, the PBA for FFS pharmacy data and potentially other sources for medical claims to include provider administered drug claims), or would a standardized set of claims extracts originate from a common data warehouse?

Answer:   It is anticipated that data will be sourced from an Enterprise Data Warehouse, but the Offeror should anticipate the possibility of receiving data directly from the SPBM and a PBA.

Date: 11/20/2020

Inquiry: 82248


Question:   Pgs. 24-25, Section 4.1, Scope of Work - With respect to the requirements to perform oversight of Medicaid rebate functions (see REV_13 through REV_16), will ODM’s rebate administrator be required to provide the contractor with data extracts and reports necessary to carry out the required rebate reviews (e.g., records of invoices, collections, disputes, prior period adjustments, reconciliations, conversion factors, postmark dates, CMS 64 reports, etc.)?

Answer:   Yes.

Date: 11/20/2020

Inquiry: 82247


Question:   Pg. 26, Section 4.1, Scope of Work - Does the 340B oversight described at REV_22 and REV_23 include reviews of prior authorizations for provider administered drugs billed through medical claims as well as prior authorizations for drugs billed through pharmacy claims?

Answer:   No, prior authorization review is limited to pharmacy prior authorizations processed by the SPBM and, until such time as it is integrated with the SPBM, the FFS PBA.

Date: 11/20/2020

Inquiry: 82246


Question:   Pg. 25, Section 4.1, Scope of Work - Do the prior authorization reviews described at REV_17 and REV_18 include reviews of prior authorizations for provider administered drugs billed through medical claims as well as prior authorizations for drugs billed through pharmacy claims?

Answer:   No, prior authorization review is limited to pharmacy prior authorizations processed by the SPBM and, until such time as it is integrated with the SPBM, the FFS PBA.

Date: 11/20/2020

Inquiry: 82245


Question:   Pgs. 17-27, Section 4.1, Scope of Work - Given the RFP requirements to address channel management options within the OAAC plan (see AAC_02), the requirements to perform oversight with respect to Medicaid rebate functions (see REV_13 through REV_16) and the requirements to perform review and consulting functions with respect to MCO Provider Administered Drug claims, should proposers assume that they will be required to receive managed care and fee-for-service medical claims in order to perform these tasks?

Answer:   Yes.

Date: 11/20/2020

Inquiry: 82244


Question:   Pg. 12, Section 3.3, Staff Experience and Capabilities - Will ODM allow an Offeror to bid two pharmacists who collectively meet the key personnel requirements instead of one individual?

Answer:   Yes. ODM will allow an Offeror to bid two pharmacists who collectively meet the key personnel requirements.

Date: 11/20/2020

Inquiry: 82242


Question:   Pg. 12, Section 3.3, Staff Experience and Capabilities - Key personnel are stated to be a “full-time employee of the Offeror.” For Offerors planning to use a subcontractor to bring ODM the best industry leading experts, would ODM allow the key personnel to be full-time employees of the Offeror or its subcontractor, with the clear understanding the Offeror is responsible for staffing key personnel positions?

Answer:   Yes. ODM will allow key personnel to be full time employees of the Offeror or subcontractors with the clear understanding the Offeror is responsible for staffing key personnel positions. ODM retains the authority to approve any subcontractor relationships and key staffing.

Date: 11/20/2020

Inquiry: 82241


Question:   Pg. 12, Section 3.3, Staff Experience and Capabilities - The description for the Technical Lead lists “The Data Analyst must be full-time employee of the Offeror.” Can you confirm that there is not also a Data Analyst position that is required?

Answer:   There was a clerical error in this section. "Data Analyst" in number 2 should refer to a Technical Lead.

Date: 11/20/2020

Inquiry: 82238


Question:   Pg.12, Section 3.2, Organizational Experience and Capabilities - The description of requirements listed in this section does not specify what should be included in “Organizational Experience and Capabilities.” The evaluation checklist, however, lists very specific experience requirements. Other than what is included in the checklist, is there additional information that should be included in our response to this section?

Answer:   There is no response required for Section 3.2. The elements listed in Section 3.2 are addressed elsewhere in the RFP.

Date: 11/20/2020

Inquiry: 82235


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Inquiry period ended:  11/25/2020 8:00:00 AM