Specifications include, but are not limited to: • Provide PA, appeals and exception management, and other UM programs AND the ability/willingness to work with EBRx or another third-party provider of those services. • Pricing proposals should reflect fees for two configurations of services o First, the PBM’s management of all services using the PBMs managed formulary and clinical rules, o Second, all services except formulary management, using UA’s current formulary and 3rd party PA services, appeals and formulary exceptions. • Confirm University of Arkansas for Medical Sciences (UAMS) Pharmacy is INN and will be the default option in specialty medication distribution when the patient is treated at UAMS. o All other specialty claims can be exclusive specialty to the PBM. • Ability/willingness to broadly coordinate with health plan TPA UMR with examples including in secondary coverage/COB records, specialty medication PA’s and exclusions. • It is highly encouraged that the PBM’s pharmacy network is broad, and includes pharmacies such as, but not limited to; Walmart, Walgreens, CVS, Rite-Aid, Kroger, as well as independent pharmacies.
