New York State Contract Reporter #2139865

Medicaid Fee-for-Service Pharmacy Benefit Management Services

New York State is seeking a provider to manage pharmacy benefits for its Medicaid Fee-for-Service program. - Buyer: New York State Department of Health, Office of Health Insurance Programs, DFRS; contact: Andrew Lynch. - Services requested: Pharmacy Benefit Management (PBM) services, including operation of the Preferred Drug Program, Clinical Drug Review Program, Preferred Diabetic Supply Program, Mandatory Generic Drug program, and Brand Less Than Generic program. - Prior authorizations and pricing: Administer prior authorizations across the listed programs, price generic claims, and develop and maintain generic pricing files, including the State Maximum Acquisition Cost (SMAC) list. - OEMs and vendors: No OEMs or prospective vendors are named in the solicitation. The service reference is C043525; no product part numbers or quantities are specified. - Notable requirement: The solicitation specifies a 30% Minority- and Women-Owned Business Enterprise (MWBE) contracting goal.

Description

The New York State Department of Health, Office of Health Insurance Programs, is seeking proposals to administer the Medicaid Fee-for-Service Pharmacy Benefit Management program. Services include operation of the Preferred Drug Program and related clinical and diabetic supply programs, prior authorization administration, and generic claims pricing. The contractor will develop and maintain generic pricing files, also known as the State Maximum Acquisition Cost (SMAC) list. The contract term is December 1, 2027, through November 30, 2033.

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