UCLA Health understands that medical/surgical supply needs rapidly change each and every day. Although UCLA Health and its departments continue to refine and augment our EMPAC formulary list of approved products, unique and emergent cases may arise where physicians require items beyond this list for the sake of best patient outcomes. Consequently, Procurement and Strategic Sourcing has established a process that not only allows physicians to request one-time approvals of non-formulary products/technologies, but also insures that these requests are adequately vetted throughout the approval process.
A one-time request will be evaluated by Procurement and Strategic Sourcing, the requesting department manager, and Senior Administrative Leadership based on the product/technology's costs. When a request has been fully approved, the requesting physician will receive an acknowledgment email to move forward. Also, requestors are limited to one request per device per physician. Multiple one-time requests by a physician for a certain product/technology will result in the need to submit a Value Analysis Committee Request to assess its fiscal implications and medical efficacy.
Budget-Responsible Managers who receive one-time requests for non-formulary products that are ≤ $10,000 can be reviewed and approved by the appropriate department managers.
Requests for devices or products that exceed the $10,000 threshold would require a higher level review:
We hope this Instruction Guide will assist you with your one-time request for new product/technology.
If you have any questions about the One-Time Request process, please contact a Strategic Sourcing Coordinator below:
|Name||Phone||Area(s) of Responsibility|
|Eugene Cabico||(310) 794-0106||ECabico@mednet.ucla.edu||Cath Lab, Clin Lab, Interventional Radiology, Radiology|
|Ron Cail||(310) 794-0140||RCail@mednet.ucla.edu||Surgical Services|
|Victor Banh||(310) 794-0111||VBanh@mednet.ucla.edu||Surgical Services|
If you have any technical issues with the website or request form, please contact Victor Banh by email at VBanh@mednet.ucla.edu.
Click here to view all One-Time Requests (note: both One-Time Requests and Product Evaluation Requests share a single database).
Once ready to begin your One-Time Use of Non-Formulary Product/Technology Request Form, click here.
IMPORTANT: Note that there is no save feature in the One-Time Request Portal. Prior to beginning your form submission, please make sure you have all the necessary information and documentation. Requestors must also reattach their files to the form, if an error occurred during original submission. You must be connected to the UCLA network (intranet) to access the One-Time Request forms. They are intended for requesting UCLA physicians' use only.
Please note that if you are using Internet Explorer, Compatibility View should be disabled for intranet sites or a support error message will appear. We suggest using Mozilla Firefox or Google Chrome to browse these sites. You may need to contact your local IT administrator for the installation of these web browsers or for assistance changing Compatibility View Settings.
|Rick Edward Harrison, MD||William Quinones-Baldrich, MD||Philip Richard Levin, MD|
|Value Analysis Committee||Value Analysis Committee||Value Analysis Committee|