North Carolina eVP #30-2026-002-DHB

NC DHHS Seeks Pharmacy Analytical and Clinical Support Services Partner

The North Carolina Department of Health and Human Services (DHHS), Division of Health Benefits, is seeking a qualified partner to provide comprehensive pharmacy analytical and clinical support services for its Medicaid Pharmacy Program. - Government Buyer: - North Carolina Department of Health and Human Services (DHHS) - Division of Health Benefits - Office: Pharmacy and Ancillary Services - Products/Services Requested: - Pharmacy Analytical and Clinical Support Services - Includes: SMAC rate listing, specialty drug list maintenance, Preferred Drug List (PDL) with supplemental rebates, lock-in program analysis, Physician Administered Drug Program (PADP) updates, vaccine POS fee schedules, rebate auditing, managed care monitoring, and various reporting and analysis services - Data analysis, forecasting drug utilization trends, financial auditing, pharmacoeconomic modeling, and monitoring of Medicaid managed care plans - Notable Requirements: - Demonstrated expertise in actuarial pharmacy analysis at federal, state, and commercial levels - Key personnel with pharmacy expertise required - Statewide implementation within 90 days of contract effective date - Compliance with federal and state regulations (e.g., 42 CFR Part 447, Section 340B, Section 1927 of the Social Security Act) - No specific OEMs or commercial vendors are named in the solicitation - Contract term is three years, with up to three one-year renewal options

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. The solicitation requires responses by August 6, 2026, and is open to vendors registered with the State of North Carolina's Electronic Vendor Portal.

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