VISN 8 Performance Work Statement Emergent First Fill

Performance Work Statement
The contractor will provide Emergent First Fill and Emergency pharmaceutical benefits management products and services to Veterans Affairs (VA) beneficiaries in the Veterans Integrated Service Network (VISN 8) and extended services by the Clinical Contact Center to the Southeastern States Network Consortium as follows: Prescriptions may only be filled from an authorized VA provider employed by the Department of Veterans Affairs under this contract. The contractor must review all prescriptions to ensure that the prescriber is a VA authorized provider. Prescriptions from non-VA authorized providers may not be filled under the contract and will not be reimbursed.

Only new prescriptions shall be filled. In rare instances where refills may be necessary, there shall be a pre-authorization by the Chief, Pharmacy Service at the responsible Veteran Affairs Medical Center (VAMC) and so noted on the invoice.

Pharmacy Benefit Management services provided under this contract shall be provided by the contractor Monday through Sunday (7 days a week) to include all federal holidays and weekends. Hours of operation (0000hrs to 2400hrs) daily.

The contractor shall provide VA with an after-hours point of contact and phone number in the event of an emergency or the provider needing to authorize a non-formulary approval for an emergent prescription.

The contractor will have an emergent enrollment process to assist patients, VA staff and contract pharmacies 24 hours per day, 7 days per week and 365 days per year.

The Community Based Outpatient Clinics (CBOC’s) normal operating hours are Monday – Friday 8:00am to 5:00pm, (excluding federal holidays). Some locations have extended hours of operation. A full list of locations and hours of operation are included in attachment A.

The VISN 8 Clinical Contact Center (CCC) provides twenty-four (24) hour coverage for all veteran beneficiaries within VISN 8 and the Southeastern States Network Consortium during off hours. The VISN 8 Clinical Contact Center operates twenty-four (24) hours a day, including all eleven federal holidays (365 days per year).

Prescriptions filled will be in written form provided by authorized VA providers and shall be identified with the name and address of each CBOC, or VISN 8 VAMC location. (VA Form 10-2577F, Security Prescription Form). Prescriptions may also be faxed or telephoned into the pharmacies by the Clinical Contact Center or at the discretion of each VAMC. When available prescriptions may be electronically written by authorized VA providers and electronically transmitted (outbound e-RX prescribing) to the contracted retail pharmacies at the discretion of the VAMCs.