County of Orange MA-042-22010711

PHARMACY BENEFITS MANAGER QUALITY ASSURANCE SRVS

The County of Orange, through its Health Care Agency, awarded a contract for Pharmacy Benefits Manager Service to Pro Pharma Pharmaceutical Consultants, Inc. DBA Pro Pharma, located in Chatsworth, CA. The contract includes quality assurance analysis and oversight of the County's Pharmacy Benefits Management (PBM) contract for the Behavioral Health Services Program (BHS), assistance with formulary development and benefit design for the Medical Safety Net (MSN) Program, and medication and pharmaceutical consultation for the California Children's Services (CCS) Program. The duties encompass financial and clinical management reviews, invoice screenings, formulary reviews, report generation, cost savings program identification, liaison services, and consultation on prior authorization requests. The contract specifies detailed reporting requirements including invoice rejection analysis, clinical screens, management screens, patient-specific queries, case callouts, report card monitoring, financials, MAC analysis, pharmacy reimbursement reports, chain discount analysis, and custom reporting. The contract period is from July 1, 2022, through June 30, 2027, with a fixed price not to exceed $1,000,000. The place of performance is Orange County, California, with invoicing directed to the Orange County Health Care Agency Accounts Payable in Santa Ana, CA. The award was made to Pro Pharma Pharmaceutical Consultants, Inc. DBA Pro Pharma, with the buyer being the County of Orange. The services include quality assurance analysis, oversight, formulary development, benefit design, medication consultation, and extensive reporting. The procurement involved a Request for Proposal process, and the contract includes a one-time setup fee, monthly fixed fees, additional charges for site visits, and hourly consulting rates. The contract is active and ongoing, with detailed reporting and performance requirements.

Description

Contract for Pharmacy Benefits Manager Quality Assurance Services for the County of Orange Health Care Agency Behavioral Health Services Program, Medical Safety Net Program, and California Children's Services Program. The contract includes quality assurance analysis, oversight, consultation, and reporting related to pharmacy benefits management. The contract term is from July 1, 2022, to June 30, 2027, with a fixed price not to exceed $1,000,000. The awardee is Pro Pharma Pharmaceutical Consultants, Inc. DBA Pro Pharma.

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