North Carolina eVP #Doc2248097243

NC DHHS Seeks Pharmacy Analytical and Clinical Support Services for Medicaid Program

The North Carolina Department of Health and Human Services (DHHS), Division of Health Benefits (DHB), is seeking a qualified contractor to provide Pharmacy Analytical and Clinical Support Services for the NC Medicaid Pharmacy Program. - Government Buyer: - North Carolina Department of Health and Human Services (DHHS) - Division of Health Benefits (DHB) - Office: Pharmacy and Ancillary Services - Scope of Services: - Comprehensive pharmacy program support, including: - SMAC (State Maximum Allowable Cost) rate listing - Specialty drug list maintenance - Preferred Drug List (PDL) management with supplemental rebates - Lock-in program analysis - Physician Administered Drug Program (PADP) updates - Vaccine Point-of-Sale (POS) fee schedules - Rebate auditing - Managed care monitoring - Data analysis, forecasting drug utilization trends, and pharmacoeconomic modeling - Financial and rebate auditing, and reporting - Statewide implementation required within 90 days of contract effective date - Key personnel must have pharmacy expertise - Products/Services Requested: - Pharmacy analytical and clinical support services (no specific products or part numbers) - Unique/Notable Requirements: - Expertise in actuarial pharmacy analysis across federal, state, and commercial levels - Compliance with Medicaid and managed care regulations (e.g., 42 CFR Part 447, Section 340B, Section 1927, NC State Plan) - Support for value-based clinical program initiatives, quality improvement, and cost containment - No specific OEMs or vendors are named in the solicitation

Description

The North Carolina Department of Health and Human Services, Division of Health Benefits, seeks to procure an experienced and qualified partner with actuarial pharmacy expertise to support analytical and clinical services. The selected offeror will assist in evaluating value-based clinical program initiatives, including quality improvement and cost containment strategies. The work includes analysis related to pharmacy, durable medical equipment, and medical coverage components of managed care in accordance with federal and state regulations. This procurement supports the NC Medicaid Pharmacy Program.

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