Oklahoma Supplier Systems #EV00000953

Oklahoma Health Care Authority Seeks Comprehensive Pharmacy Benefit Management Services

The Oklahoma Health Care Authority Employees Group Insurance Division (EGID), through the Office of Management and Enterprise Services (OMES) Central Purchasing, is seeking proposals for comprehensive Pharmacy Benefit Management (PBM) services. - Government Buyer: - Oklahoma Health Care Authority, Employees Group Insurance Division (EGID), via OMES Central Purchasing - Scope of Services: - Pharmacy claims adjudication - Customer service for plan participants - Comprehensive reporting and analytics - Formulary management and utilization management - Specialty pharmacy services - Medication therapy management and clinical programs - Rebate management and guaranteed manufacturer payment pass-through - Compliance with CMS and state regulations, including HIPAA and data privacy - Participants: - Over 900 employer groups, including state, education, and other governmental entities - Approximately 151,316 total participants and 28,762 Medicare Supplement (EGWP) members - Notable Requirements: - Transparent pricing and robust reporting - Execution of a Business Associate Agreement - Submission of Authority to Operate (ATO) for IT components - Market checks and pricing adjustments during contract term - Adherence to state and agency-specific terms - Bidders must provide detailed company information, references, and financials - OEMs/Vendors: - No specific OEMs or vendors named; open to all qualified PBM service providers - Contract Term: - Initial one-year contract with four one-year renewal options (up to five years total) - Financial proposals valid for three years with a two-year extension option

Description

The Office of Management and Enterprise Services (OMES) Central Purchasing division is seeking responses on behalf of the Oklahoma Health Care Authority Employees Group Insurance Division to provide Pharmacy Benefit Management (PBM) services through EGID. The contract includes pharmacy claims adjudication, customer service, reporting, and other services offered by and through EGID. The initial contract term is one year with four one-year renewal options. The solicitation aims to establish a statewide contract for these services.

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