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TABLE OF CONTENTS
SECTION I - PROCUREMENT OVERVIEW
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SECTION II - OVERVIEW OF THE EPIC PROGRAM, AMERICAN INDIAN
HEALTH AND NEW YORK PRESCRIPTION SAVER CARD
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SECTION III - STATEMENT OF WORK
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SECTION IV - PROPOSAL REQUIREMENTS
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SECTION V - NEW YORK STATE ADMINISTRATIVE REQUIREMENTS
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APPENDIX I – CONTRACT REQUIREMENTS9
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APPENDIX I
CONTRACT REQUIREMENTS
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Appendix I – Contract Requirements
TABLE OF CONTENTS
CONTRACTOR RESPONSIBILITIES
1
2
3
4
5
6
7
8
9
General Contractor Duties
Accounting Requirements
Ownership Rights
Software Licenses
General Warranties
Hardware & Software Warranties
Year 2000 Warranty
Equipment
Reconsiderations/Fair Hearings
I-3
I-3
I-4
I-6
I-6
I-8
I-9
I-10
I-11
CONTRACTOR PROCEDURES
10 Subcontracting
11 Modification
12 Termination
13 Agreement Duration and Contract Amendments
14 Disputes
15 Conflicts
16 Litigation/Claims
17 Contractor Responsibilities/Conflict
18 Sufficiency of Personnel & Equipment
19 Contract Insurance Requirements
20 Access Requirements
I-11
I-12
I-12
I-16
I-17
I-17
I-17
I-18
I-19
I-19
I-20
FISCAL SAFEGUARDS
21 Letter of Credit & Bonding
22 Indemnification of the State
23 Availability of Key Personnel
I-22
I-23
I-24
GENERAL PROVISIONS
24
25
26
27
28
29
30
31
Independent Capacity of Contractor
No Third Party Beneficiaries
Assignment of Contract
Employment Practices
Confidentiality of Client & Provider Information
Legal Assurance of Authority to Perform
Force Majeure
Notification
,
I-25
I-25
I-25
I-25
I-26
I-26
I-27
I-27
Appendix I – Contract Requirements
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
Patent or Copyright Infringement
No Waiver
Choice of Law
Severability
Assignment of Contractor Claims
Provisions Related to NYS Procurement Lobbying Law
Provisions Related to Consultant Disclosure Legislation
Provisions Related to NYS Information Security Breach & Notification Act
Technology Purchases Notification
Remedies
Superintendence by Contractor
Lead Guidelines
Disqualifications
Award
Captions
Entire Agreement
,
I-27
I-27
I-28
I-28
I-28
I-28
I-28
I-29
I-29
I-29
I-30
I-30
I-30
I-30
I-30
I-31
Appendix I – Contract Requirements
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1. General Contractor Duties
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2. Accounting Requirements
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2.1Internal Controls
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2.3
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3. Ownership Rights
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Appendix I – Contract Requirements
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4. Software Licenses
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5. General Warranties
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,
Appendix I – Contract Requirements
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,
Appendix I – Contract Requirements
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6. Hardware and Software Warranties
6.1
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,
Appendix I – Contract Requirements
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7. Year 2000 Warranty
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,
Appendix I – Contract Requirements
7.2
Warranty Disclosure
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8. Equipment
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,
Appendix I – Contract Requirements
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9. Reconsiderations/Fair Hearings
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Contract Procedures
10. Subcontracting
10.1
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10.2
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10.3
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10.3.1 $GHVFULSWLRQRIWKHVXSSOLHVRUVHUYLFHVWREHSURYLGHGXQGHUWKHSURSRVHG
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10.3.3 7KHSURSRVHGVXEFRQWUDFWSULFHDQG
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,
Appendix I – Contract Requirements
10.4
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10.5
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10.6
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10.7
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10.8
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11. Modification
11.1
11.2
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12. Termination
12.1
Basis for Termination
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,
Appendix I – Contract Requirements
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12.1.2.a
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12.1.2.c
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12.1.3d
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12.1.3.e
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,
Appendix I – Contract Requirements
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12.2
Procedures on Termination
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12.2.1
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12.2.2
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Appendix I – Contract Requirements
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12.2.8
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12.2.9
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12.2.11
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12.2.12
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Appendix I – Contract Requirements
12.2.13
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13. Agreement Duration and Contract Amendments
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13.3 7KH'HSDUWPHQWUHVHUYHVWKHULJKWWRVWRSWKHZRUNFRYHUHGE\WKLVSURSRVDODQGWKH
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13.1
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Appendix I – Contract Requirements
13.4
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7KH&RQWUDFWRUVKDOOQRWPDNHDQ\FKDQJHVLQWKHVFRSHRIZRUNDVRXWOLQHGKHUHLQDW
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14. Disputes
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15. Conflicts
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16. Litigation/Claims
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,
Appendix I – Contract Requirements
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17. Contractor Responsibilities/Conflicts
17.1
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17.2
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17.3
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17.4
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17.5
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17.6
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17.7
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17.8
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Appendix I – Contract Requirements
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18. Sufficiency of Personnel and Equipment
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19. Contract Insurance Requirements
19.1
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19.2
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Appendix I – Contract Requirements
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20. Access Requirements
20.1
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Appendix I – Contract Requirements
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20.3
Records Retention
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20.3.2 7KH&RQWUDFWRUVKDOOEHUHVSRQVLEOHGXULQJWKHWHUPRIWKLV&RQWUDFWIRU
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,
Appendix I – Contract Requirements
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VWRUDJHRIDFFHVVWRDQGUHWULHYDORIDOOFDQFHOHGFKHFNVERWKPDQXDODQG
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20.3.4 7KH&RQWUDFWRUVKDOOEHUHVSRQVLEOHIRUDVVXULQJWKDWWKHSURYLVLRQVRIWKLV
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Fiscal Safeguards
21. Letter of Credit and Bonding
21.1
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,
Appendix I – Contract Requirements
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21.2
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DSSURYDO
22. Indemnification of the State
22.1
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22.2
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22.3
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22.4
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,
Appendix I – Contract Requirements
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22.5
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22.6
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22.7
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22.8
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22.9
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23. Availability of Key Personnel
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,
Appendix I – Contract Requirements
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GENERAL PROVISIONS
24. Independent Capacity of Contractor
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25. No Third Party Beneficiaries
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26. Assignment of Contract
26.1
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26.2
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27. Employment Practices
27.1
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,
Appendix I – Contract Requirements
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27.2
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27.3
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27.4
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28. Confidentiality of Client and Provider Information
28.1
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28.2
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28.3
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28.4
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29. Legal Assurance of Authority to Perform
29.1
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29.1.1 WKH&RQWUDFWRUKDVFRUSRUDWHDXWKRULW\WRSHUIRUPDOOGXWLHVUHTXLUHGRILWE\
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29.1.2 WKH&RQWUDFWRULVTXDOLILHGWRGREXVLQHVVLQWKH6WDWHRI1HZ<RUN
,
Appendix I – Contract Requirements
29.2
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30. Force Majeure
30.1
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30.2
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31. Notification
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HDFKSDUW\WRWKHFRQWUDFWUHWXUQUHFHLSWUHTXHVWHGRUDIRUPDOWUDQVPLWWDOGHOLYHUHGYLDH
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32. Patent or Copyright Infringement
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33. No Waiver
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VXFKZDLYHURUFRQVHQWWREUHDFKVKDOOEHLQZULWLQJDQGVLJQHGE\WKHSDUW\FODLPHGWRKDYH
ZDLYHGRUFRQVHQWHG1RFRQVHQWE\DSDUW\WRRUZDLYHURIDEUHDFKXQGHUWKH&RQWUDFW
VKDOOFRQVWLWXWHFRQVHQWWRDZDLYHURIRUH[FXVHIRUDQ\RWKHUGLIIHUHQWRUVXEVHTXHQW
,
Appendix I – Contract Requirements
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34. Choice of Law
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JRYHUQHGE\DQGFRQVWUXHGLQDFFRUGDQFHZLWKWKHODZVRIWKH6WDWHRI1HZ<RUNZLWKRXW
JLYLQJHIIHFWWRLWVFRQIOLFWRUFKRLFHRIODZVSULQFLSOHV$OOGLVSXWHVFRQWURYHUVLHVRU
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FRPSHWHQWMXULVGLFWLRQZLWKLQ1HZ<RUN6WDWH7KHSDUWLHVDJUHHWRZDLYHDQ\ULJKWWRDWULDO
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35. Severability
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36. Assignment of Contractor Claims
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37. Provisions Related to New York State Procurement Lobbying Law
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IRXQGWKDWWKHFHUWLILFDWLRQILOHGE\WKH&RQWUDFWRULQDFFRUGDQFHZLWK1HZ<RUN6WDWH
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38. Provisions Related to Consultant Disclosure Legislation
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RIHDFKVWDWHILVFDO\HDULQFOXGHGLQWKLVFRQWUDFWWHUP7KLVUHSRUWPXVWEHVXEPLWWHGWR
D7KH1<6'HSDUWPHQWRI+HDOWKDWWKH6WDWH¶VGHVLJQDWHGSD\PHQWRIILFHDGGUHVV
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WK)ORRU$OEDQ\1<$771&RQVXOWDQW5HSRUWLQJRUYLDID[DW
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,
Appendix I – Contract Requirements
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39. Provisions Related to New York State Information Security Breach and
Notification Act
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QHJOLJHQWRUZLOOIXODFWVRURPLVVLRQVRIWKH&RQWUDFWRU¶VDJHQWVRIILFHUVHPSOR\HHVRU
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40. Technology Purchases Notification
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SXUFKDVHFDQEHDVVLPSOHDVDQRUGHUIRUQHZRUUHSODFHPHQWSHUVRQDOFRPSXWHUVRU
IRUDFRQVXOWDQWWRGHVLJQDQHZV\VWHPRUDVFRPSOH[DVDPDMRUV\VWHPV
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RYHURUZKHUHWKH'HSDUWPHQWGHWHUPLQHVWKDWWKHSRWHQWLDOH[LVWVIRU
FRRUGLQDWLQJSXUFKDVHVDPRQJ6WDWHDJHQFLHVDQGRUWKHSXUFKDVHPD\EHRILQWHUHVW
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41. Remedies
41.1
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41.2
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XQVXFFHVVIXODIWHUPDNLQJUHDVRQDEOHDWWHPSWVXQGHUWKHFLUFXPVWDQFHVWKHQ
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FRPSDUDEOHTXDOLW\RQDWLPHO\EDVLVWKH'HSDUWPHQWPD\DFTXLUHDQDFFHSWDEOH
UHSODFHPHQWSURGXFWRIOHVVHURUJUHDWHUTXDOLW\6XFKSXUFKDVHVPD\DWWKH
,
Appendix I – Contract Requirements
GLVFUHWLRQRIWKH'HSDUWPHQWEHGHGXFWHGIURPWKH&RQWUDFWTXDQWLW\DQGSD\PHQWV
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41.3
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41.4
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41.5
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42. Superintendence by Contractor
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43. Lead Guidelines
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44. Disqualifications
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45. Award
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WKHELGRSHQLQJGXULQJZKLFKSHULRGELGVVKDOOQRWEHZLWKGUDZQXQOHVVWKHELGGHUGLVWLQFWO\
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46. Captions
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Appendix I – Contract Requirements
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47. Entire Agreement
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Attachments
Numerical Series
ATTACHMENT 1 (A & B) ....................................................................................A-4
1 a NYS Elder Law .................................................................................................. {see Link}
1 b NYPS Legislation ......................................................................................................... A-5
ATTACHMENT 2....................................................................................................A-6
EPIC Regulations ................................................................................................ {see.ZIP file}
ATTACHMENT 3 (TABLES 1-7)..........................................................................A-6
Table 1 Claims & Enrollment {All Programs} ......................................................... {see.ZIP file}
Table 2 Monthly Participant Applications Statistics ............................................................... A-7
Table 3 EPIC Enrollee Tax Match Statistics............................................................ {see.ZIP file}
Table 4 Request For Additional Information {RFAI} Forms ................................................... A-9
Table 5 Annual Reassignments ......................................................................................... A-10
Table 6 Middleware Cost .................................................................................................. A-11
Table 7 Bank Charges by Program .................................................................................... A-12
ATTACHMENT 4 (TABLES 1-4)....................................................................... A-13
Table 1 EPIC Provider Reimbursement .............................................................................. A-13
Table 2 Helpline & Written Correspondence Statistics ............................................ {see.ZIP file}
Table 3 EPIC Monthly Reimbursables – Postage/Printing/Applications .................................. A-15
Table 4 Contractor Staffing Plan (FTE’s) ............................................................................ A-16
ATTACHMENT 5................................................................................................. A-17
Software List
ATTACHMENT 6................................................................................................. A-18
EPIC Annual Report (10/08 thru 09/09) .................................................................... {see Link}
ATTACHMENT 7 (CHARTS A-C) .................................................................... A-19
a - Brand Generic Algorithm Flow Chart ................................................................ {see.ZIP file}
b – Brand Generic pricing Chart ........................................................................... {see.ZIP file}
c – EPIC Pricing Formula .................................................................................................. A-20
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ATTACHMENT 8 (APPLICATIONS A-C) ...................................................... A-21
a – EPIC Application ........................................................................................... {see.ZIP file}
b – EPIC Application - SPANISH ........................................................................... {see.ZIP file}
c – EPIC Renewal Form....................................................................................... {see.ZIP file}
ATTACHMENT 9 {PURPOSELY LEFT BLANK} ......................................... A-22
ATTACHMENT 10............................................................................................... A-23
Performance Standards
ATTACHMENT 11 (Instructions & Cost Exhibits) .................................................... A-38
Pricing Schedule Instructions ............................................................................................ A-39
COST EXHIBITS ............................................................................................ A-42
A.1 Implementation Fee And EPIC Per Claim Fee ............................................. {see.ZIP
A.2 AIH Per Claim Fee ................................................................................... {see.ZIP
A.3 NYPS Per Claim Fee ................................................................................. {see.ZIP
A.4 Claims Fee breakdown by Function ........................................................... {see.ZIP
A.5 Systems Change Hours ............................................................................ {see.ZIP
A.6 Key Staffing Plan & Daily Rate Per FTE ...................................................... {see.ZIP
A.7 Additional Staffing Pricing......................................................................... {see.ZIP
A.8 Generic Drugs – State Maximum Allowable Cost {Per NDC} ......................... {see.ZIP
file}
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ATTACHMENT 12............................................................................................... A-43
NYPS Rebate Agreement .................................................................................................. A-44
ATTACHMENT 13............................................................................................... A-51
Dispute Resolution Process
ATTACHMENT 14............................................................................................... A-54
Listing of Reports ........................................................................................................... A-55
ATTACHMENT 15 (A&B) .................................................................................. A-58
a – FMG File Specifications ............................................................................................... A-58
b – Premium Remittance Advice File Specifications ............................................................. A-59
ATTACHMENT 16 (A&B) .................................................................................. A-60
a – EPIC Provider Agreement .............................................................................. {see.ZIP file}
b – NYPS Provider Agreement ............................................................................. {see.ZIP file}
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ATTACHMENT 17............................................................................................... A-61
NYPS Additional Rebate Processing
ATTACHMENT 18............................................................................................... A-66
Base Operations Staffing Plan & Credentials.......................................................... {see.ZIP file}
ATTACHMENT 19............................................................................................... A-66
Contractor Staff Qualifications & Credentials ......................................................... {see.ZIP file}
ATTACHMENT 20............................................................................................... A-67
Corporate Experience & References
ATTACHMENT 21 (TABLES 1-5)..................................................................... A-68
Table 1a NYPS Trial Invoice ................................................................................. {see.ZIP
Table 1b NYPS State Invoice ............................................................................... {see.ZIP
Table 1c NYPS Manufacturer Invoice .................................................................... {see.ZIP
Table 2 NYPS Prior Period Rate & Utilization Adjustment Report ............................. {see.ZIP
Table 3 NYPS Monthly Statement ......................................................................... {see.ZIP
Table 4 NYPS Weekly Update Rebate Report ....................................................... {see.ZIP
Table 5 MDRP State Invoice Format ..................................................................... {see.ZIP
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ATTACHMENT 22 (TABLE 1 & 2) ................................................................... A-68
Table 1 2008 Quarterly Pricing File Layout ............................................................ {see.ZIP file}
Table 2 2008 Product File Layout ......................................................................... {see.ZIP file}
ATTACHMENT 23............................................................................................... A-68
NYPS Pricing Matrix ............................................................................................ {see.ZIP file}
ATTACHMENT 24............................................................................................... A-69
Rebate Reports .................................................................................................. {see.ZIP file}
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Section 280 of New York State Public Health Law
* § 280. Prescription drug discount program. The prescription drug discount
program is hereby established in the department. The drug discount card
shall be available to any resident between the ages of fifty and sixty-four,
and any resident of any age who has been determined to meet the
disability criteria in 20 C.F.R. § 404.1505, who: meets the income eligibility
levels established under subdivision one or two of section two hundred forty-two
of the elder law; is not in receipt of medical assistance under title eleven
of article five of the social services law. The drug discount card shall offer
discounts on drug purchases which are not covered by other public or private
third party payment sources. Provided, however, that participation by a
provider pharmacy and drug manufacturers shall be voluntary and reimbursement
to the provider pharmacy under the drug discount card program shall be
adjudicated
and paid within two business days for any rebates,
dispensing fees and drug costs not paid by the resident eligible for such
program at the point of sale. * NB Repealed June 15, 2012
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APPENDIX A
STANDARD CLAUSES FOR NEW YORK STATE CONTRACTS
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STANDARD CLAUSES FOR NYS CONTRACTS
APPENDIX A
TABLE OF CONTENTS
Page
1.
Executory Clause
3
2.
Non-Assignment Clause
3
3.
Comptroller’s Approval
3
4.
Workers’ Compensation Benefits
3
5.
Non-Discrimination Requirements
3
6.
Wage and Hours Provisions
3
7.
Non-Collusive Bidding Certification
4
8.
International Boycott Prohibition
4
9.
Set-Off Rights
4
10.
Records
4
11.
Identifying Information and Privacy Notification
4
12.
Equal Employment Opportunities For Minorities and Women
13.
Conflicting Terms
5
14.
Governing Law
5
15.
Late Payment
5
16.
No Arbitration
5
17.
Service of Process
5
18.
Prohibition on Purchase of Tropical Hardwoods
19.
MacBride Fair Employment Principles
6
20.
Omnibus Procurement Act of 1992
6
21.
Reciprocity and Sanctions Provisions
6
22.
Compliance with New York State Information Security Breach and Notification Act
6
23.
Compliance with Consultant Disclosure Law
6
24.
Procurement Lobbying
6
25.
Certification of Registration to Collect Sales and Compensating Use Tax by Certain
State Contractors, Affiliates and Subcontractors
7
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APPENDIX A
STANDARD CLAUSES FOR NYS CONTRACTS
STANDARD CLAUSES FOR NYS CONTRACTS
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VI.
however, that Business Associate shall not indemnify for that portion of any
claim, loss or damage arising hereunder due to the negligent act or failure to act of
the STATE.
Miscellaneous
A.
Regulatory References. A reference in this AGREEMENT to a section in the
Code of Federal Regulations means the section as in effect or as amended, and for
which compliance is required.
B.
Amendment. Business Associate and Covered Program agree to take such action
as is necessary to amend this AGREEMENT from time to time as is necessary for
Covered Program to comply with the requirements of HIPAA, HITECH and 45
CFR Parts 160 and 164.
C.
Survival. The respective rights and obligations of Business Associate under
(IV)(C) of this Appendix H of this AGREEMENT shall survive the termination of
this AGREEMENT.
D.
Interpretation. Any ambiguity in this AGREEMENT shall be resolved in favor of
a meaning that permits Covered Program to comply with HIPAA, HITECH and
45 CFR Parts 160 and 164.
E.
HIV/AIDS. If HIV/AIDS information is to be disclosed under this
AGREEMENT, Business Associate acknowledges that it has been informed of the
confidentiality requirements of Public Health Law Article 27-F.
Appendix H Page 4
Appendix G
NOTICES
All notices permitted or required hereunder shall be in writing and shall be transmitted either:
(a)
via certified or registered United States mail, return receipt requested;
(b)
by facsimile transmission;
(c)
by personal delivery;
(d)
by expedited delivery service; or
(e)
by e-mail.
Such notices shall be addressed as follows or to such different addresses as the parties may from
time to time designate:
State of New York Department of Health
Name:
Title:
Address:
Telephone Number:
Facsimile Number:
E-Mail Address:
[Insert Contractor Name]
Name:
Title:
Address:
Telephone Number:
Facsimile Number:
E-Mail Address:
Any such notice shall be deemed to have been given either at the time of personal delivery or, in
the case of expedited delivery service or certified or registered United States mail, as of the date of
first attempted delivery at the address and in the manner provided herein, or in the case of
facsimile transmission or email, upon receipt.
The parties may, from time to time, specify any new or different address in the United States as
their address for purpose of receiving notice under this AGREEMENT by giving fifteen (15) days
written notice to the other party sent in accordance herewith. The parties agree to mutually
designate individuals as their respective representative for the purposes of receiving notices under
this AGREEMENT. Additional individuals may be designated in writing by the parties for purposes
of implementation and administration/billing, resolving issues and problems, and/or for dispute
resolution.

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