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TRICARE: Defense Health Agency Issues Request for Information Regarding Formulary Management – Submission Deadline: February 5, 2019

The Defense Health Agency (DHA), which manages the TRICARE health care benefits, has issued a Request for Information (RFI) regarding inpatient-clinic administered pharmaceuticals formulary management.  In other words, responding vendors have the opportunity to shape the standard list of drugs prescribed across all military medical treatment facilities (MTFs), as well as the broader program administering the list.  Responses are due February 5, 2019.  The RFI seeks commercial best practices in formulary management focusing on inpatient and medical benefit drugs, but also opens the door for responding vendors to describe their capabilities to train a formulary management staff, to develop approaches to formulary management, to compare program results, to maximize acceptance of an implemented program, and to utilize pharmacists in an inpatient setting.

DHA issued this RFI as part of a larger effort to integrate the Military Health System under its sole administration, in response to Section 702 of the National Defense Authorization Act (NDAA) of 2017, as amended by Section 711 of the 2019 NDAA, which dictates that DHA will assume responsibility for administration of all MTFs by September 30, 2021. The DHA set forth its current phased plan for the transition in its 2018 Final Report to Congress.  DHA’s administration responsibilities will include any drug formulary for inpatient services provided through TRICARE at MTFs.  DHA’s pharmacy operations currently cover only outpatient prescribed drugs, hence the agency’s interest in commercial best practices for inpatient settings.

Although DHA’s primary interest is in solutions to MTF settings, DHA is also interested in solutions that may apply to “Purchased Care” settings by network and non-network providers.

Instructions for responding to the RFI, as well as the RFI in full, are available here. While declining to respond to this RFI does not preclude vendors from participating in a future Request for Proposals, providing input could be advantageous to vendors that want to help shape the formulary program on which they may ultimately propose and perform.

Copyright © 2020, Sheppard Mullin Richter & Hampton LLP.


About this Author

Keeley A. McCarty, Sheppard Mullin, Government Investigations Lawyer, International Trade Attorney

Keeley McCarty is an associate in the Government Contracts, Investigations & International Trade Practice Group in the firm's Washington, D.C. office.

Ms. McCarty’s practice focuses on government contracts litigation and counseling, including contract termination appeals, litigation and arbitration of subcontractor disputes, and internal investigations.  Ms. McCarty has counseled clients on a broad range of legal topics, including FAR mandatory disclosure rules, title passage under government contracts, and corporate compliance with the FCPA...