Texas DIR/ESBD #HHS0017787

Texas HHSC Solicits Medicare Part D Claims Switching Services for State Pharmacies

The Texas Health and Human Services Commission (HHSC) is seeking bids for Medicare Part D claims switching services to support its network of 21 HHSC-owned pharmacies, including State Supported Living Centers (SSLCs) and Shops. - Government Buyer: - Texas Health and Human Services Commission (HHSC), Procurement and Contracting Services (PCS) - Key contacts: Stephanie Muth (Executive Commissioner), Delia Arellano (PCS) - OEMs and Vendors: - No specific Original Equipment Manufacturers (OEMs) or named vendors are identified in the solicitation; open to all qualified providers - Products/Services Requested: - Medicare Part D claims switching services, including: - Switch services per claim - Reclaim/pre and post editing per claim - Commercial card finder eligibility search - Medicare D eligibility search - Medicare D mapping service - Average wholesale price resubmission monthly fee (per enrolled location) - Prescriber schedule authority monthly fee (per enrolled location) - Services are for 21 HHSC-owned pharmacies, SSLCs, and Shops - No part numbers specified; quantities are based on enrolled locations and claims volume - Unique or Notable Requirements: - Bidders must have at least five years of relevant experience - Firm, fixed pricing required for all services and fees - Strict compliance with Texas laws, cybersecurity, confidentiality, and ethical standards - Performance monitoring and reporting required - Contract is subject to appropriations and funding availability - Estimated contract value is approximately $96,000, based on historical spend and anticipated needs - The contract includes an initial two-year term with up to three one-year renewal options and a possible one-year extension for continuity of service

Description

The Texas Health and Human Services Commission (HHSC) is seeking competitive bids to establish contract(s) for Medicare Part D claims switching services. The contract will be available for use by both HHSC and the Department of State Health Services (DSHS). Bidders must submit comprehensive responses including all required information and documentation to demonstrate their qualifications and capacity to provide the services. The solicitation is issued under Texas Government Code 21155.144 and includes requirements for Dual CTCD/CTCM certification.

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