# Nevada ePro #41NHA-S3992

Nevada pharmacy benefit management services for Medicaid and PEBP

**Posted:** October 22, 2026
**Respond By:** December 29, 2026
**Identifier:** 41NHA-S3992
**NAICS:** 524292

The Nevada Health Authority is seeking a pharmacy benefit manager to administer prescription benefits for Nevada Medicaid and the Public Employees Benefits Program.
- **Government buyer:** State of Nevada, Nevada Health Authority (NVHA), Director’s Office; the Nevada Public Employees Benefits Program (PEBP) is also a program office and service population.
- **Services requested:** Statewide pharmacy benefit management for Nevada Medicaid, including Fee-for-Service, managed care, and Nevada Check Up members, plus prescription benefit management for PEBP. Services include claims processing, formulary and preferred drug list management, pharmacy networks, rebates, clinical and utilization management, member support, reporting, implementation, and transition assistance.
  - Medicaid rollout is phased: Fee-for-Service coverage in Contract Year 1, with managed care members added in Contract Year 2 and thereafter.
  - PEBP serves approximately 72,000 covered lives.
- **Notable requirements:** At least five years of experience providing pharmacy management services for a state Medicaid program; 24/7 help desk and claims operations; CMS certification support; transparent pass-through pricing with no spread pricing; and extensive security, privacy, reporting, audit, data-access, and continuity-of-care requirements. U.S.-based personnel and data handling are required, subject to stated approval exceptions.
- **OEMs and vendors:** No product manufacturers, OEMs, or proposing PBM vendors are named in the provided materials. The solicitation is open to qualified PBM providers.
- **Additional attachment:** A client reference questionnaire requests information about a proposer’s or subcontractor’s relevant experience and past performance; it does not specify a product purchase.

### Description

The Nevada Health Authority is seeking proposals for a Nevada State Pharmacy Benefits Manager. The contractor will provide comprehensive pharmacy benefit management services for Nevada Medicaid, including claims adjudication, formulary and preferred drug list management, pharmacy network management, rebate negotiation and administration, and clinical and utilization management. The solicitation also includes pharmacy benefit management services for the Nevada Public Employees Benefits Program (PEBP), as detailed in separate scopes of work and attachments. The anticipated contract period is April 1, 2028, through March 31, 2032; proposals are due December 29, 2026, at 2:00 PM.

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