Q517--FY26: VISN 8 Pharmacy Emergent First Fill Prescription Services

Solicitation / RFP / RFQ

This is a Request for Quotation (RFQ) for an Indefinite Delivery Indefinite Quantity (IDIQ) contract for VISN 8 Emergent Pharmacy First Fill Prescription Services. The government is procuring pharmaceutical benefits management products and services for Veterans Affairs (VA) beneficiaries within VISN 8 and extended services through the Clinical Contact Center to the Southeastern States Network Consortium.

• Provide Emergent First Fill and Emergency pharmaceutical benefits management products and services.

• Prescriptions must be filled only from VA-authorized providers. Non-VA authorized providers will not be reimbursed.

• Only new prescriptions will be filled; refills require pre-authorization.

• Services are required 24 hours a day, 7 days a week, including federal holidays.

• An after-hours point of contact and emergency authorization process must be available.

• An emergent enrollment process for patients, VA staff, and contract pharmacies must be in place 24/7.

• Pharmacies must be licensed and located within approximately 5 miles (or 10 miles in US Virgin Islands) of VA facilities, CBOCs, OPCs, and CBCs.

• Generic (AB rated) drugs shall be dispensed whenever possible, with the generic name displayed on all labels.

• Prescriptions filled must be the least expensive drug product the pharmacy has in stock.

• Prescriptions are limited to a 10-day supply unless pre-authorized.

• All information concerning VA beneficiaries must be kept confidential.

• Pharmacies must report adverse drug events to the cognizant Pharmacy Service.

• Payments made by the VA constitute total costs; contractors cannot bill beneficiaries or other entities.

• Pharmacists must offer counseling consistent with OBRA 1990 requirements.

• Invoices must include specific details such as contract number, patient name, prescription number, medication details, quantity, cost, and pharmacy information.

• Contract Type: Indefinite Delivery Indefinite Quantity (IDIQ)

• Period of Performance: January 24, 2026, to January 24, 2031 (Base Period and four Ordering Periods).

• Estimated Value: Not explicitly stated, but NAICS code 524292 (Pharmacy Benefit Management) with a size standard of $45.5 Million is provided.

• Questions are due no later than December 18, 2025, 10:00 AM EST.

• Quotations are due no later than December 30, 2025, 10:00 AM EST.

• The acquisition is set aside for Small Business.

• Evaluation will be based on technical acceptability (pharmacy network, electronic invoicing, quality assurance) and price.

• This acquisition is a total small business set-aside.

• NAICS Code: 524292

• Size Standard: $45.5 Million

• Telephone requests will not be accepted.

• The Government will not pay for any information or administrative costs incurred in response to this RFQ.

• System updates may lag policy updates; SAM representations may differ from solicitation provisions.

Form / Attachment / Pricing Sheet

This document is an acronym list provided as an attachment to the opportunity. It serves to define terms and abbreviations used within the solicitation documents, ensuring clarity and consistent understanding for potential bidders.

• A comprehensive list of terms and their corresponding definitions.
• Includes acronyms related to pharmacy benefits management (PBM), Department of Veterans Affairs (VA) operations, and geographical locations relevant to VISN 8.

Bidders should review this list to familiarize themselves with the terminology used in the solicitation and related documents. Understanding these acronyms is crucial for accurately interpreting requirements, scope of work, and any other specifications related to the opportunity.

Statement of Work (SOW) / Performance Work Statement (PWS)

To provide Emergent First Fill and Emergency pharmaceutical benefits management products and services to Veterans Affairs (VA) beneficiaries in VISN 8 and extended services to the Southeastern States Network Consortium.

• Provide pharmaceutical benefits management services 7 days a week, 24 hours a day, including federal holidays.

• Prescriptions must be filled only from authorized VA providers; non-VA providers will not be reimbursed.

• Only new prescriptions will be filled; refills require pre-authorization from the Chief, Pharmacy Service.

• Contractor must provide an after-hours point of contact for emergencies and non-formulary approvals.

• Maintain an emergent enrollment process available 24/7/365.

• Prescriptions are limited to a maximum of a ten (10) day supply unless pre-authorized; balance to be mailed from VA Mail-Out Pharmacy.

• Prescriptions are limited to legend drugs on the authorized "Emergency Medication Formulary List"; prior authorization is required for non-formulary or restricted medications.

• Dispense the least expensive drug product in stock, prioritizing generic (AB rated) whenever possible.

• Prescriptions must be picked up by the Veteran patient or designee with valid photo ID.

• Contractor shall not mail or deliver filled prescriptions to patients.

• Provide a minimum of three licensed pharmacies within 5 miles of each VA facility (or 10 miles in US Virgin Islands).

• Ensure all patient information is kept confidential and comply with VA privacy training.

• Allow VA representatives to audit pharmacy premises and clinical records.

• Report all adverse drug events to the cognizant Pharmacy Service.

• Pharmaceutical care must meet Medicaid standards for the state of service.

• Contractor shall not bill beneficiaries or any third party for services.

• Pharmacists must offer counseling consistent with OBRA 1990 requirements.

• Contractor shall bill the cognizant VA Hospital monthly for services rendered.

• Provide VISN 8 a listing of licensed pharmacies accepting its plan.

• Complete Contractor Security Control Assessment (CSCA) within 30 days of contract approval and annually.

• Offerors must quote the most favorable discount from a recognized drug database or MAC, along with the most favorable dispensing and administration fees.

• In emergency situations, the contractor may be authorized to provide prescription services for up to a 90-day supply under specific conditions and approvals.

• Pharmacy services to be provided 7 days/week, 24 hours/day, 365 days/year.

• 100% accuracy in filling and dispensing prescriptions according to VA provider authorization and formulary lists.

• 100% compliance with 10-day supply limit for new prescriptions unless pre-authorized.

• 100% utilization of low-cost generic equivalents when available.

• Offerors must quote the most favorable discount/MAC, dispensing fee, and administration fee.

• Pharmacists must offer counseling to all patients (100% compliance).

• Maintain at least 3 licensed pharmacies within 5 miles of VA facilities (or 2 within 10 miles in USVI).

• Notify VA of any malpractice or tort claims within 3 working days.

• Ensure 100% patient confidentiality.

• Comply with all State and Federal regulations for prescription filling and dispensing.

• Obtain signed confidentiality certificates from employees and complete annual privacy training.

• VISN 8 and extended services to the Southeastern States Network Consortium.

• Specific locations listed include numerous VA facilities and CBOCs across Florida, Georgia, Puerto Rico, and the US Virgin Islands.

• Personnel must be licensed in their respective state/territory.

• Key Personnel (Program Manager/Contract Representative) requirements and substitution procedures.

• Contractor must maintain an ongoing performance measurement and improvement process.

• Monthly and quarterly reports on RXs filled, costs, brand vs. generic, and top medications are required.

Form / Attachment / Pricing Sheet

This document, "Attachment A VISN 8 CBOC and Clinics.xlsx", provides a comprehensive list of Veterans Affairs Medical Centers (VAMCs), Community Based Outpatient Clinics (CBOCs), and other clinics within VISN 8 and VISN 7. It details their locations, operating hours, contact information, and key personnel.

• Station/Facility Name: Identifies the specific VA facility or clinic.
• Address: Full street address, city, state, and zip code.
• Hours of Operation & Days of Operation: Specifies the operating schedule for each location.
• Contact Information: Includes phone numbers and fax numbers.
• Point of Contact (COR) and Chief of Pharmacy: Lists names and email addresses for key personnel at various locations.

This attachment is crucial for bidders to understand the geographic scope and operational details of the facilities that may be involved in the opportunity. It provides essential contact information for relevant personnel and outlines the operating hours of clinics, which may be relevant for service delivery, logistics, or understanding the operational environment. Bidders should review this list to identify specific locations and contacts pertinent to their proposal. The document also includes a "CLINICAL CARE CONTACT CENTER" providing 24-hour coverage for all listed areas.