HomeMy WebLinkAboutContract 46250-A1 (2)CITY SEcRkItAWU
CONTRACT,
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5F 2 AMENDMENT NO. 1
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TO TO
Se4 PHARMACY BENEFIT MANAGEMENT SERVICES AGREEMENT
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DI anis Amendment No. 1(this "Amendment"),
is entered into by and between Envision
Pharmaceutical Services, LLC ("Envision"), and the City of Fort Worth ("Plan Sponsor").
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1
BACKGROUND
Envision and Plan Sponsor are parties to a Pharmacy Benefit Management Services Agreement,
filed as City Secretary Contract No. 46250, dated January 1st, 2015 (the "Agreement"), under
which Envision provides PBM Services to Plan Sponsor; and
The parties desire to amend the Agreement, and therefore Envision and Plan Sponsor agree as
follows:
1. Exhibit 1 shall be deleted in its entirety and replaced with Exhibit 1 attached hereto and
incorporated by this reference.
2. Exhibit 2 shall be deleted in its entirety and replaced with Exhibit 2 attached hereto and
incorporated by this reference.
3. This Amendment shall be effective January 1st, 2016 ("Effective Date").
4. All other terms or provisions of the Agreement not modified by this Amendment or any other
amendments or addenda shall remain unchanged.
IN WITNESS WHEREOF, Envision and Plan Sponsor have executed this Amendment as of the
Effective Date above.
For ENVISION:
By:
Matthew A. Gibbs, Pharm D.
Chief Commercial Officer
OFFICIAL ECORD
CITY SECRETARY
TO WORTH, TX
For PLAN SPONSOR:
aVaAA,
Alanis
tant City Manager
APPROVED AS TO PGItM AND LEGALITY:
OM City
ev
J
goor
Worth mend.-tkri-06;1815
CO Envision Pharmaceutical Services, LLC
Page 1 of 7
EXHIBIT 1
FEES, DRUG PRICING, AND FINANCIAL GUARANTEES
Administrative Fee (Payable to Envision; not including fees payable to Plan Sponsor's TPAs,
consultants, or brokeis, if any)
For Contract Year 2016, 2017 & 2018: $4.00 Per Employee, Per Month (PEPM)
Fees for Additional Services and Miscellaneous Expenses
1. Replacement by Envision of lost or stolen ID
Cards
2. Manual Claims Processing (including DMRs)
3. Claim Adjustment Checks (charged to Plan
Sponsor for reimbursements made to Covered
Individuals for Claim adjustments requested by
Plan Sponsor.)
4. Manually create or update the Eligibility File
5. Ad Hoc Computer or Report Programming
6. Clinical Prior Authorizations (Initial Coverage
Determinations)
7. Drug Therapy Care Gap Management
8. Medication Adherence and Persistency (up to
three disease states)
Drug Pricing and Dispensing Fees(A)
Supply/Source BRAND
For Contract Year
2016
30 Days' Supply at a
Retail Pharmacy
84 Days' Supply (or
greater) at a Retail
Pharmacy (non -Mail
Order)
Mail Order Pharmacy
Specialty Pharmacy
Drug Price (B)
(Annual Average
Effective Rate
Guarantee)
AWP minus 15.45%
AWP minus 20.20%
AWP minus 21.06%
$1.00 per card plus $0.15 per packet and
cost of postage
$1.50 per Claim processed
$8.50 per check
$1.00 per Covered Individual data entry
$150.00 per hour
$8.00 per authorization
$0.55 per Member per month (PMPM)
$0.55 PMPM
Dispensing
Fee (c)
(Annual
Average
Guarantee)
$1.20
N/A
N/A
GENERIC
Drug Price (B)
(Annual Average
Effective Rate
Guarantee)
AWP minus
77.50%
AWP minus
77.50%
AWP minus 80%
Dispensing
Fee (c)
(Annual
Average
Guarantee)
$1.20
N/A
N/A
(Pass -Through of Contract Rate with Dispensing Pharmacy)
/Ft. Worth Amend. No. 1 061815
n Envision Pharmaceutical Services, LLC
Page 2 of 7
Supply/Source
For Contract Year
2017
30 Days' Supply at a
Retail Pharmacy
84 Days' Supply (or
greater) at a Retail
Pharmacy (non -Mail
Order)
Mail Order Phaiivacy
Specialty Pharmacy
BRAND
Drug Price (B)
(Annual Average
Effective Rate
Guarantee)
AWP minus 15.55%
AWP minus 20.30%
AWP minus 21.06%
Dispensing
Fee tC)
(Annual
Average
Guarantee)
$1.20
N/A
N/A
GENERIC
Drug Price (B)
(Annual Average
Effective Rate
Guarantee)
AWP minus 78%
AWP minus 78%
AWP minus
80.50%
Dispensing
Feet '
(Annual
Average
Guarantee)
$1.20
N/A
N/A
(Pass -Through of Contract Rate with Dispensing Pharmacy)
Supply/Source
For Contract Year
2018
30 Days' Supply at a
Retail Pharmacy
84 Days' Supply (or
greater) at a Retail
Pharmacy (non -Mail
Order)
BRAND
Drug Price (B)
(Annual Average
Effective Rate
Guarantee)
AWP minus 15.65%
AWP minus 20.40%
Dispensing
Fee (C)
(Annual
Average
Guarantee)
$1.20
N/A
GENERIC
Drug Price (B)
(Annual Average
Effective Rate
Guarantee)
AWP minus
78.50%
AWP minus
78.50%
Dispensing
Fee (C)
(Annual
Average
Guarantee)
$1.20
N/A
Mail Order Pharmacy AWP minus 21.06% N/A AWP minus 81 % N/A
Specialty Pharmacy (Pass -Through of Contract Rate with Dispensing Pharmacy)
(A) For purposes of this Agreement the "Average Wholesale Price" or "AWP" means the average wholesale
price of a Covered Drug indicated on the most current pricing file provided to Envision by Medi-Span® (or
other applicable industry standard reference on which pricing hereunder is based) for the actual drug dispensed
using the 11 digit National Drug Code (NDC) number provided by the dispensing pharmacy Envision uses
a single source for determining AWP and updates the AWP source file at least once weekly.
(B) For purposes of this Agreement, the Annual Average Effective Rate' means, for the category of drugs
being reviewed, the result calculated by the following formula:
1. (IC/AWP)-1, where IC (the 'Ingredient Cost') is the sum of all amounts paid by Plan Sponsor for the
ingredient costs of the Covered Drugs paid to Participating Pharmacies in the designated Network
during the Contract Year, before deducting applicable Manufacturer Derived Revenue; and
/Ft. Worth Amend. No. 1 061815
C). Envision Pharmaceutical Services, LLC Page 3 of 7
2. AWP is the sum of the Average Wholesale Price amounts associated with the same Covered Drugs
during the Contract Year. If the calculated price is lower than the allowable amount under any state
Medicaid "Favored Nations' rule, Envision shall pass -through, and Plan Sponsor shall pay, the
Medicaid allowable amount.
Annual Average Effective Rate is calculated using actual price paid by Envision to Participating Pharmacies
in the designated Network, plus any Cost Share, (the Ingredient Cost) for all Claims for the applicable category
(including Claims paid at the U&C Price) during a Contract Year, excluding (i) Compound Drugs; (ii) Limited
Distribution Drugs; (iii) drugs dispensed at a Specialty Pharmacy; (iv) Claims from non -Participating
Pharmacies, LTC pharmacies, or government owned or operated pharmacies (e.g. Veterans Administration);
(v) Claims paid at government required amounts (e.g. Medicaid) (vi) 340B Claims; (vii) vaccines; (viii) non -
Prescription Drugs, and (ix) Claims from any Plan Sponsor owned o1 affiliated pharmacy which is not a
Participating Pharmacy.
(c) Annual Average Dispensing Fee is the average per Claim fee for all Claims by Envision to Participating
Pharmacies in the designated Network (including Claims paid at the U&C Price) during a Contract Year,
excluding (i) Compound Di ugs (ii) Limited Distribution Drugs; (iii) drugs dispensed at a Specialty Pharmacy;
(iv) Claims from non -Participating Pharmacies, LTC pharmacies, or government owned or operated
pharmacies (e.g. Veterans Administration); (v) Claims paid at government required amounts (e g. Medicaid),
(vi) 340B Claims; (vii) vaccines; (viii) non -Prescription Drugs; and (ix) Claims from any Plan Sponsor owned
or affiliated pharmacy which is not a Participating Pharmacy.
Annual Average Effective Rate and Annual Average Dispensing Fee Guarantee
Plan Sponsor acknowledges that the Annual Average Effective Rates and Annual Average Dispensing Fees
specified in this Exhibit 1 are conditioned upon Plan Sponsor's adherence to certain conditions under this
Agreement and that the actual Annual Average Effective Rates and Annual Average Dispensing Fees will
also depend on Plan Sponsor's drug utilization and mix of Participating Pharmacies. Within four months after
the end of each Contract Year, Envision shall provide Plan Sponsor, upon request, with a report showing the
actual Annual Average Effective Rates and Annual Average Dispensing Fees paid by Plan Sponsor for the
Contract Year. The Annual Average Effective Rates and Annual Average Dispensing Fees guarantees set
forth in Exhibit l shall be deemed to have been satisfied if the discounts passed through to Plan Sponsor for
all Claims during the Contract Year are equal to or more favorable, in the aggregate, than the drug pricing and
dispensing fee guarantees stated for each drug type or category individually. If the amounts paid by Plan
Sponsor for all Claims during the Contract Year are less favorable, in the aggregate, than the combined Annual
Average Effective Rates and Annual Average Dispensing Fees stated in Exhibit 1, Envision shall credit Plan
Sponsor with the difference. Envision shall not be liable to Plan Sponsor for shortfalls in guaranteed Annual
Average Effective Rates or Annual Average Dispensing Fees if (i) Plan Sponsor makes a change to the Benefit
Plan at any time (regardless of whether or not such change is required by law); (ii) the configuration of System
edits is modified by Plan Sponsor; (iii) Plan Sponsor does not adhere to the Envision Formulary; or (iv) the
utilization data provided by Plan Sponsor (or Plan Sponsor's agent) upon which the calculation of guarantees
were based is inaccurate, incomplete, or there is a substantial change in drug utilization patterns of Covered
Individuals. Plan Sponsor agrees that Envision's liability to Plan Sponsor for shortfalls in financial
I guarantees, in the aggregate, for any Contract Year shall be limited to amounts paid by Plan Sponsor to
Envision for Administrative Fees during the applicable Contract Year, and Plan Sponsor has no right of offset
to withhold any payment due Envision under this Agreement for any amounts Plan Sponsor believes are owed
by Envision for financial guarantees.
Annual Average Manufacturer Derived Revenue Guarantee(EmF),(G)
For Contract Year 2016, 2017 & 2018:
• For Brand Drugs at a Retail Pharmacy - $23.50 per paid Brand Drug Claim
1
/Ft. Worth Amend. No. 1 061815
c Envision Pharmaceutical Services, LLC Page 4 of 7
• For 90 day supply of Brand Drugs at the Mail Order Pharmacy- $57.10 per paid Brand Paid Claim
(E) Manufacturer Derived Revenue guarantees are stated as annual average amounts per Contract Year.
(F) Guarantees require Plan Sponsor to maintain a Benefit Plan that has a tier structure with a minimum $20
differential in Cost Share between preferred Brand Drugs and non -preferred Brand Drugs.
(G) 340B Claims and other Claims not eligible for Manufacturer Derived Revenue, and Claims from any Plan
Sponsor owned or affiliated pharmacy which is not a Participating Pharmacy, shall be excluded from the
calculation of the guarantees above.
Plan Sponsor acknowledges that the annual average Manufacturer Derived Revenue guaranteed amounts
specified in this Exhibit 1 are conditioned upon Plan Sponsor's adherence to certain conditions under this
Agreement. Nine months after the end of each Contract Year, Envision shall provide Plan Sponsor with a
report reconciling Manufacturer Derived Revenue amounts advanced to Plan Sponsor and Manufacturer
Derived Revenue amounts earned by Plan Sponsor for eligible Claims (including market share based amounts)
during the Contract Year.
(a) If the Manufacturer Derived Revenue advanced to Plan Sponsor for the Contract Year is, overall,
lower than the overall Manufacturer Derived Revenue eat ned by Plan Sponsor for the Contract Year, Envision
shall pay the difference to Plan Sponsor.
(b) If the Manufacturer Derived Revenue earned by Plan Sponsor for the Contract Year is, overall, lower
than the annual average Manufacturer Derived Revenue guaranteed amounts specified above, Envision shall
pay the difference to Plan Sponsor.
;Notwithstanding anything herein to the contrary, Envision shall not be liable to Plan Sponsor for any shortfall
in guaranteed Manufacturer Derived Revenue if: (i) Plan Sponsor makes a change to the Benefit Plan at any
time (regardless of whether or not such change is required by law); (ii) the configuration of System edits is
modified by Plan Sponsor; (iii) Plan Sponsor does not adhere to the Formulary; (iv) the utilization data
provided by Plan Sponsor (or Plan Sponsor's agent) upon which the calculation of guarantees were based is
inaccurate, incomplete or there is a substantial change in drug utilization patterns of Covered Individuals; (v)
there is a loss of rebates due to pharmaceutical manufacturer drug patent expirations manufacturer
bankruptcy, or removal of a drug from the market; (vi) there are changes in pharmaceutical manufacturer
rebate contracting terms or policies; (vii) Plan Sponsor's Benefit Plan does not meet the conditions for rebates
of pharmaceutical manufacturer contracts including market share rebates; (viii) if Plan Sponsor has been
excluded by a manufacturer; or (ix) there is any governmental regulation, ruling, or guidance that impacts I
Envision's ability to maintain current Manufacturer Derived Revenue yields. Plan Sponsor agrees that
Envision's liability to Plan Sponsor for shortfalls in financial guarantees, in the aggregate, for any Contract
Year shall be limited to amounts paid by Plan Sponsor to Envision for Administrative Fees during the
applicable Contract Year, and Plan Sponsor has no right of offset to withhold any payment due Envision under
this Agreement for any amounts Plan Sponsor believes are owed by Envision for financial guarantees.
/Ft. Worth Amend. No. 1 061815
0 Envision Pharmaceutical Services, LLC Page 5 of 7
EXHIBIT 2
PERFORMANCE MEASURES
Unless otherwise stated, targets set forth below will be measured on a Contract Year basis. The
total amount of penalties payable by Envision in any Contract Year shall not exceed ten percent
(10%) of Envision's Administrative Fee paid by Plan Sponsor during applicable Contract Year.
Unless otherwise stated, payment of penalties will be credited towards future Administrative Fees.
Failure to meet Perfoiutance Measures shall not be deemed to be a breach of this Agreement.
canc.
Pass -Through Standards
GET: 1Vl[EAStIRIh FENAL7
Manufacturer Derived Revenue 100% Pass -
(MDR) through
Network Discounts
Network Dispensing Fees
Systems Standards -
System Availability
100% Pass -
through
100% of MDR earned from pharmaceutical
manufacturers is passed through to Plan
Sponsor, in accordance with the Agreement.
100% of network discounts and dispensing fees
are passed through to Plan Sponsor upon the $40,000
effective date of any negotiated change.
Calculated as the amount of time the Claims
99.5% Adjudication System is available to process
Claims.
System Response time <4 seconds
Calculated as the time commencing immediately
after receipt of the last character of a transaction
submitted by a pharmacy until the first character
of the response is sent to the pharmacy.
Rota* and Mail Claims Processing Accuracy
Based on PBM s internal quality review.
Percent of all claims paid with >99.98% Retail Calculated as all claims audited and found to be
no errors >99.98% Mail without error of any form, divided by all claims
audited.
PBM Customer Service - Calculated per Contract Year
Percent of calls that will be
answered within 30 seconds
93% answered in
an average of 30
seconds or less
Percent of calls abandoned <5%
$40,000
$15,000
$15,000
$15,000
The amount of time that elapses between when a
call is received into the customer service queue
and the time the phone is answered by a
Customer Service Representative (CSR).
Measurement and target determination will be
based on an annual average.
Percentage of calls that are not answered by a
CSR (caller hangs up before call is answered).
Calculated as the number of calls that are not
answered divided by the number of calls
received.
Measurement and target determination will be
based on an annual average.
$15,000
$15,000
/Ft. Worth Amend. No. 1 061815
Envision Pharmaceutical Services, LLC Page 6 of 7
CATEGC)i+;Y''- T RGET'
PBM Customer Service cont.
Percent of calls with resolution
at end of first call (i.e. no further
inquiry by caller required to >90%
obtain requested information or
action)
Percent of written inquiries
responded to by paper within 10
business days or responded to 99%
electronically within 2 business
days
Pharmacy Network Access
Account Management ,
Account Management
Responsiveness
Administration
Enrollment Processing
Ongoing ID card production
Calculated per Contract Year
Percentage of all calls made to Envision that
were resolved by initial CSR. Calculated as the
total calls to Envision minus total number of
unresolved calls divided by the total number of
calls received
A7easurement and target determination will be
based on an annual average.
Response time for all written inquiries will be
based on the number of business days
subtracting the date received at Envision from
the date the response was sent.
$15,000
$15,000
Based on network pharmacy access within,
>95% 10 miles for Plan Sponsor's Covered $15,000
Individuals.
Two (2) business
days
Two (2) business
days
Five (5) business
days
Initial client inquiries will be acknowledged and
responded to within two business days.
Eligibility information submitted to Envision
will become effective within 2 business days
following the date of receipt. Assumes complete
and accurate information is sent to Envision.
Measured as the time from receipt of complete
and accurate eligibility information to the time
vendor deposits ID Cards into the mail.
$15,000
$15,000
$15,000
/Ft. Worth Amend. No. 1 061815
Envision Pharmaceutical Services. LLC Page 7 of 7