30-2026-002-DHB_PACSS RFP_Issued 20260604.pdf

RFP #30-2026-002-DHB Pharmacy Analytical and Clinical Support Services

STATE OF NORTH CAROLINA

Department of Health and Human Services

Division of Health Benefits

Pharmacy Analytical and Clinical Support Services

Request for Proposal #30-2026-002-DHB

STATE OF NORTH CAROLINA

Request for Proposal

#30-2026-002-DHB

For internal State agency processing, please provide your company’s Federal Employer Identification

Number or alternate identification number (e.g., Social Security Number). Pursuant to NCGS 132-1.10(b) this identification number shall not be released to the public. This page will be redacted before the procurement file is made available for public inspection.

This page is to be filled out and returned with your Proposal.

ID Number:

Federal ID Number or Social Security Number

Offeror Name

RFP #30-2024-002-DHB MFP Transition Coordination Services Page 3 of 130

EXECUTION

In compliance with this Request for Proposal (RFP), and subject to all the conditions herein, the undersigned Offeror offers and agrees to furnish and deliver any or all services proposed, at the cost proposed and within the time specified herein. By executing this proposal, the Offeror confirms it has read, understands, and will comply with all specifications and requirements in the RFP and any addenda in the event of contract award. By executing this proposal, the undersigned Offeror certifies that this proposal is submitted competitively and without collusion (NCGS § 143-54), that none of its officers, directors, or owners of an unincorporated business entity has been convicted of any violations of Chapter 78A of the General Statutes, the Securities Act of 1933, or the Securities Exchange Act of 1934 (NCGS § 143-59.2), and that it is not an ineligible Contractor as set forth in NCGS § 143-59.1. False certification is a Class I felony. Furthermore, by executing this proposal, the undersigned certifies to the best of Offeror’s knowledge and belief, that it and its principals are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal or State department or agency. As required by NCGS § 143-48.5, the undersigned Offeror certifies that it, and each of its subcontractors for any Contract awarded as a result of this RFP, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its employees through the Federal E-Verify system. NCGS § 133-32 and Executive Order 24 (2009) prohibit the offer to, or acceptance by, any State Employee associated with the preparing plans, specifications, estimates for public Contract; or awarding or administering public Contracts; or inspecting or supervising delivery of the public Contract of any gift from anyone with a Contract with the State, or from any person seeking to do business with the State. By executing this proposal, you attest, for your entire organization and its employees or agents, that you are not aware that any such gift has been offered, accepted, or promised by any employees of your organization. Failure to execute/sign proposal prior to submission shall render proposal invalid and it WILL BE REJECTED. Late proposals will not be accepted.

OFFEROR:

STREET ADDRESS: P.O. BOX: ZIP:

CITY & STATE & ZIP: TELEPHONE NUMBER: TOLL FREE TEL. NO:

PRINCIPAL PLACE OF BUSINESS ADDRESS IF DIFFERENT FROM ABOVE

PRINT NAME & TITLE OF PERSON SIGNING ON BEHALF OF

OFFEROR:

FAX NUMBER:

OFFEROR’S AUTHORIZED SIGNATURE: DATE: EMAIL:

Offer valid for at least 240 Calendar Days from date of proposal opening unless extended by the State in writing. After this time, any withdrawal of offer shall be made in writing, effective upon receipt by the agency issuing this RFP.

ACCEPTANCE OF RESPONSE

If any or all parts of this proposal are accepted by the State of North Carolina, an authorized representative of the Department of Health and Human Services shall affix their signature hereto and this document and all provisions of this Request for Proposal along with the Offeror’s proposal, and the written results of any negotiations shall then constitute the written agreement between the parties. A copy of this acceptance will be forwarded to the successful Offeror.

STATE OF NORTH CAROLINA

Department of Health and Human Services

Refer ALL Inquiries regarding this RFP to:

Kimberly Lozada Contract Development Specialist Medicaid.Procurement@dhhs.nc.gov

Request for Proposal: # 30-2026-002-DHB

Date RFP Issued/Posted: June 4, 2026

Date RFP Submissions due to the Department: August 6, 2026 by 2:00 p.m. EST

Proposals will be opened: August 6, 2026

Contract Type: Open Market

Commodity Number: 8510 – Comprehensive Health Services

Description: Pharmacy Analytical and Clinical Support Services

Using Agency: Department of Health and Human Services, Division of Health Benefits

Requisition No.: N/A

FOR STATE USE ONLY: Offer accepted and Contract awarded this _______ day of _______________, 20______, by

(Authorized Representative of NC Department of Health and Human Services)

Table of Contents

EXECUTION

I. INTRODUCTION

A. Intent

B. Background and Program Information

II. GENERAL PROCUREMENT INFORMATION AND NOTICE TO OFFERORS

A. Important Notices

B. General Procurement Information and Instructions

C. Request for Proposal Functionality and Related Notices

D. Schedule and Important Events

E. Submission of Proposal and Offeror’s Response

F. Confidentiality and Prohibited Communications During Evaluation

G. Evaluation Process and Contract Award

III. DEFINITIONS, CONTRACT TERM, GENERAL TERMS AND CONDITIONS, OTHER PROVISIONS &

PROTECTIONS

A. Definitions

B. Acronyms and Abbreviations

C. Contract Term

D. General Terms and Conditions

E. Confidentiality, Privacy and Security Protections

F. Public Records and Trade Secrets Protections

IV. MINIMUM QUALIFICATIONS

A. Acceptance of Terms and Conditions

B. Eligibility to Contract

C. Financial Stability and Legal Disclosure

D. Experience Requirements

V. SCOPE OF SERVICES AND PERFORMANCE REQUIREMENTS

A. Pharmacy Analytical and Clinical Support Services Objectives

B. General Requirements

C. Qualifications and Program Administration Requirements

D. Pharmacy Analytical and Clinical Support Services Requirements

E. Technology Specifications

F. Customer Support

G. Staffing

H. Training

I. Reports

J. Implementation

K. Quality Assurance

L. Business Continuity Plan

VI. CONTRACT PERFORMANCE

A. Contract Violations and Noncompliance

B. Notice of Deficiency

C. Remedial Actions and Corrective Action Plans

D. Liquidated Damages

E. Process to Appeal a Contract Performance Action and Dispute Resolution

F. Performance Standards and Liquidated Damages

VII. Attachments to the RFP Attachment A: Minimum Qualifications Response

Attachment B: Offeror’s Response to Technical Evaluation Questions

Attachment C: Cost Proposal

Attachment D: Contract Administrators

Attachment E: Certification of Financial Condition and Legal Action Summary

Attachment F: State Certifications

Attachment G: Federal Certifications and Disclosures

Attachment H: Disclosure of Litigation and Criminal Convictions

Attachment I: Location of Workers Utilized by Contractor

Attachment J: Offeror Request for Proposed Modifications to the Terms and Conditions

Attachment K: Business Associate Agreement

Attachment L: Subcontractor Identification Form

Attachment M: Legal Grounds for Marking Information Confidential

Attachment N: Evaluation Methodology

Attachment O: GenAI Disclosure and Fact Sheet

RFP #30-2024-002-DHB MFP Transition Coordination Services Page 6 of 130

I. INTRODUCTION

A. Intent

The North Carolina Department of Health and Human Services (“NCDHHS” or “Department”), Division of Health Benefits (“DHB” or “NC Medicaid”) seeks to procure an experienced and qualified partner with actuarial pharmacy expertise on a federal, state and commercial level to support analytical and clinical services for the Department. The selected Offeror shall be responsible for assisting the Department in the evaluation of all value-based clinical program initiatives including quality improvement and cost containment strategies, as well as provide analysis related to the pharmacy, durable medical equipment, and medical coverage component of managed care in accordance with 42 C.F.R. Part 447; Section 340B of the Public Health Service Act; Section 1927 of the Social Security Act [42 U.S.C. 1396r-8]; and the North Carolina State Plan.

B. Background and Program Information NC Medicaid uses state and federal funds to provide health benefits to eligible adults, children, pregnant women, seniors, and people with disabilities under the North Carolina Medicaid Program. It covers more than three (3) million people in North Carolina, including children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments. Operating within NC Medicaid, the North Carolina Medicaid Pharmacy Program (“Pharmacy Program”) offers a comprehensive prescription drug benefit, ensuring low-income North Carolinians have access to the medicine they need. Program management through stakeholder collaboration, effective use of drug rebates, and careful selection of drugs to be covered by NC Medicaid ensures the Pharmacy Program is able to provide access to the right drugs while providing the overall best value to beneficiaries, providers, and the State.

II. GENERAL PROCUREMENT INFORMATION AND NOTICE TO OFFERORS

A. Important Notices

Offerors are Cautioned to Read Carefully

1. Read, Review, and Comply: It is the Offeror’s responsibility to read this document in its entirety, review all attachments, tables, charts, exhibits, diagrams, and appendices, and comply with all instructions.

2. Execution of Proposal: Failure to sign the Execution Page in the indicated space and return all attachments, tables, charts, exhibits, diagrams, and appendices completed and signed where required, may render the proposal non-responsive, and the proposal may be rejected.

3. Resulting Contract: Under the State’s procurement process, any contract resulting from this RFP will consist of the RFP and the Offeror’s response, along with any addenda to the RFP, written clarifications, Best and Final Offers (BAFO), and negotiation documents. The Contractor will be obligated to perform services as proposed in its offer, unless otherwise modified by clarification, BAFO, negotiation, or Contract amendment, or superseded by a document with higher order of precedence. See Contract Section III.D.21. ENTIRE AGREEMENT AND ORDER OF PRECEDENCE for more information and the order of precedence of the contract documents. See Section II.C. Request for Proposal Functionality and Related Notices for more information on the RFP, changes in specifications, and instructions regarding modifications to the terms and conditions.

4. Potential Negotiations: The Department reserves the right to enter into negotiations with one or more Offerors to establish a contract that is in the best interest of the Department.

Negotiations are specific to each Offer and shall be conducted to maximize the State’s ability to obtain the most advantageous offer based on the evaluation factors set forth in the RFP.

Such negotiations are at the Department’s sole discretion and may result in modifications to the RFP and/or Offeror’s proposal/ response to the RFP.

5. Events and Deadlines:

a. Pre-proposal Conference will be hosted by the Department on June 11, 2026, at 2:00 p.m.

EST. See Section II.D.2. Pre-Proposal Conference for details and instructions.

b. Questions concerning this RFP must be submitted in writing by June 25, 2026, at 2:00 p.m. EST. See Section II.D.3. Questions Concerning this Request for Proposal for details and instructions.

c. Submission of Proposals will be accepted until August 6, 2026, at 2:00 p.m. EST. See Section II.E. Submission of Proposal and Offeror’s Response for details and instructions.

B. General Procurement Information and Instructions

1. INFORMATION AND DESCRIPTIVE LITERATURE: The Offeror shall furnish all information requested as part of this RFP. Each Offeror shall submit detailed information with their proposal (e.g., narratives, diagrams, exhibits, examples, sketches, descriptive literature, complete specifications) to support the services and products offered.

2. RECYCLING AND SOURCE REDUCTION: It is the policy of the State to encourage and promote the purchase of products with recycled content to the extent economically practicable, and to purchase items which are reusable, refillable, repairable, more durable, and less toxic to the extent that the purchase or use is practicable and cost-effective. The State also encourages and promotes using minimal packaging and the use of recycled/recyclable products in the packaging of commodities purchased. However, no sacrifice in quality of packaging will be acceptable. The Offeror remains responsible for providing packaging that will adequately protect the commodity and contain it for its intended use. Offerors are strongly urged to bring to the attention of purchasers those products or packaging they offer which have recycled content and that are recyclable.

3. MISCELLANEOUS: Pronouns, whether masculine, feminine, or gender-non-specific, shall be read to be inclusive of all genders and shall be read to include the plural and vice versa.

4. INFORMAL COMMENTS: The Department shall not be bound by informal explanations, instructions or information given at any time by anyone on behalf of the Department prior to or during the competitive process or after award, including but not limited to policy papers or any written or verbal statements whatsoever made outside of this RFP and any formal Addenda issued herewith. The Department is bound only by information provided in this RFP and in formal Addenda issued.

5. COST FOR PROPOSAL PREPARATION: Any costs incurred by an Offeror in preparing or submitting proposals are the Offeror’s sole responsibility. The Department will not reimburse any Offeror for any costs related to proposal preparation and submission, or protest of award.

6. OFFEROR’S REPRESENTATIVE: Each Offeror shall submit with its proposal the name, title, email address, physical address, and telephone number of the person(s) with authority to bind the Offeror and answer questions or provide clarification concerning the Offeror's proposal. This information must be included in the Offeror’s proposal/ response.

7. INSPECTION AT OFFEROR’S SITE: The Department reserves the right to inspect, at a reasonable time, the equipment/item, plant, or other facilities of a prospective Offeror prior to Contract Award, and during the Contract Term as necessary for the Department to determine that such equipment/item, plant or other facilities conform with the specifications/requirements and are adequate and suitable for the proper and effective performance of the Contract.

8. DISCLOSURE OF ARTIFICIAL INTELLIGENCE (AI) USE: The Offeror shall disclose whether Artificial Intelligence (AI), including generative AI tools, was used in the preparation of any portion of its response to this RFP. If AI tools were utilized, the Offeror affirms that it has reviewed and verified the accuracy, completeness, and appropriateness of all AI-generated content. The Offeror shall remain solely responsible for the content of its submission, including any errors, omissions, or misrepresentations resulting from the use of AI.

C. Request for Proposal Functionality and Related Notices

1. RFP Functionality

a. This RFP serves two functions:

i. Define the specifications of the services sought by the Department; and

ii. Provide the requirements and terms and conditions of any contract resulting from this procurement.

b. All Terms and Conditions in this RFP shall be enforceable. The use of phrases such as

“shall”, “will”, “must”, “required”, and “requirements” are intended to create enforceable Contract conditions. In determining whether proposals should be evaluated or rejected, the Department will take into consideration the degree to which the Offeror has proposed or failed to propose solutions that are responsive to the Department’s needs as described in this RFP.

2. Notices Regarding RFP and Terms and Conditions

a. It is the Offeror’s responsibility to read all instructions, terms and conditions, specifications, requirements, attachments and appendices, and any other components made a part of this RFP and comply with all instructions and directives. The Offeror is responsible for obtaining and complying with all addenda and other changes that may be issued relating to this RFP.

b. All questions and issues regarding any term, condition, instruction, or other component within this RFP must be submitted in accordance with Section II.D.3. Questions Concerning this Request for Proposal. If the Department determines that any changes will be made because of the questions asked, then such decisions will be communicated in the form of an Addendum posted on the North Carolina electronic Vendor Portal (NC eVP). The Department may also elect to leave open the possibility for later negotiation and amendment of specific provisions of the Contract that have been raised during the question and answer period. Other than through this process, and except as provided in RFP Section II.C.3. Proposed Modifications to Terms and Conditions, the Department rejects and will not be required to evaluate or consider any additional or modified terms and conditions submitted with Offeror’s proposal. This applies to any language appearing in or attached to the RFP document as part of the Offeror’s proposal that purports to vary any terms and conditions, or Offeror’s Instructions therein to render the proposal non-binding or subject to further negotiation.

c. The Offeror’s proposal to this RFP shall constitute a firm offer. By execution and delivery of a proposal to this RFP, the Offeror agrees that any additional or modified terms and conditions, whether submitted purposely or inadvertently, or any purported condition to the offer, shall have no force or effect, and will be disregarded. Noncompliance with, or any attempt to alter or delete, this paragraph shall constitute sufficient grounds to reject the Offeror’s proposal.

3. Proposed Modifications to Terms and Conditions

a. Offerors are urged and cautioned to inquire during the question period, in accordance with the instructions in this RFP, about whether the specific language proposed as a modification is acceptable to or will be considered by the Department.

b. Identification of objections or exceptions to the terms and conditions in the proposal itself shall not be allowed and shall be disregarded or the proposal rejected.

c. If the Offeror wishes to suggest changes to any of the terms and conditions included in Sections III.D.-F. of this RFP, those must be submitted in Section VII. Attachment J: Offeror Request for Proposed Modifications to the Terms and Conditions. The Department, in its sole discretion, may consider any proposed modifications identified by the Offeror.

Where necessary, any modification(s) to the terms and conditions agreed upon by the Department may be incorporated as part of an Addendum to the RFP, BAFO, negotiation document, Execution of Contract, or Contract Amendment after award. Other than through this process, the Department rejects and shall not be required to evaluate or consider any additional or modified terms, conditions, or instructions included in the Offeror’s proposal.

4. Changes in Requirements and Specifications

a. The Offeror is cautioned that the requirements of this RFP can only be altered by written

Addendum or other document issued by the Department as described in this RFP, and that oral or emailed communications from whatever source(s) are of no effect.

b. The Department reserves the right to modify any requirement or specification contained herein without modifying the timelines in this RFP. Any modification will be specified in an Addendum which shall be posted on the North Carolina electronic Vendor Portal (eVP) prior to the opening of proposals or through Negotiation after the opening of proposals.

5. Rights Reserved

a. The Offeror is made aware, pursuant to 01 NCAC 05B .0501, that in soliciting offers, any or all offers received may be rejected. The basis for rejection may include, but is not limited to the following:

i. The offer is deemed unsatisfactory as to quantity, quality, delivery, price or service offered;

ii. The offer fails to comply with conditions of the solicitation document or with the intent of the proposed Contract;

iii. The Department determines there is a lack of competition;

iv. Error(s) in specifications or indication that revision(s) would be to the State's advantage;

v. Cancellation of or changes in the intended project or other determination that the proposed requirement is no longer needed;

vi. Limitation or lack of available funds;

vii. Circumstances which prevent determination of the most advantageous offer and selection in accordance with NCGS § 143-135.9; or

viii. Any determination that rejection would be to the best interest of the State.

b. If all offers are rejected, the solicitation may be cancelled in its entirety, or the Department may negotiate with one or more sources of supply that may be capable of satisfying the requirements.

c. The Offeror is cautioned that this is a Request for Proposal, not a request to contract, and the Department reserves the unqualified right to reject all offers deemed failing to meet minimum qualifications, not responsive, incomplete, or non-compliant with the requirements described herein; or when such rejection is deemed to be in the best interest of the Department or the State of North Carolina.

d. The Department may also:

i. Modify provisions of this RFP in response to changes in law or as required by CMS;

ii. Waive any formality or informality;

iii. Waive a specification or requirement of the RFP if it is in the best interest of the

Department;

iv. Waive any undesirable, inconsequential, or inconsistent provisions of this RFP;

v. Negotiate directly with one or more Offerors, to achieve a contract that is in the best interest of the Department, if the responses to this solicitation demonstrate a lack of competition, or offers are found non-responsive; and/or

vi. Cancel this RFP at any time. Notice of Cancellation will be posted on the North Carolina electronic Vendor Portal (eVP) website.

e. In the event all proposals are rejected, and the Department enters into negotiation, pursuant to 01 NCAC 05B .0503, the Department reserves the right to award a contract to the Offeror or Offerors, which, in its opinion, has (have) made the best proposal through the negotiation process.

D. Schedule and Important Events

1. The Department will make every effort to adhere to the schedule detailed below in Section

II.D. Table 1: RFP Schedule. The Department reserves the right to adjust the schedule and will post an Addendum on the North Carolina electronic Vendor Portal (eVP) for any schedule changes occurring prior to the opening of proposals.

Section II.D. Table 1: RFP Schedule

Activity Responsible Party Due Date Issue Request for Proposal Department June 4, 2026 Pre-proposal Conference Department June 11, 2026, at 2:00 p.m. EST

Deadline to Submit Written Questions Offeror June 25, 2026, at 2:00 p.m. EST

Issue Addendum with Responses to Questions Department July 23, 2026

Deadline to Submit Proposals Offeror August 6, 2026 at 2:00 p.m. EST Conduct Evaluation of Proposals Department August 10, 2026 – November 3, 2026

Contract Award Department November 4, 2026

2. Pre-proposal Conference

a. The Department will hold a Pre-proposal Video Conference on June 11, 2026, from 2:00 p.m. to 3:00 p.m. EST via Microsoft (MS) Teams. No purchase is required to use the MS Teams app.

b. The purpose of the conference is to allow the Department to review key priorities and objectives of the RFP and to review the submission requirements and instructions.

c. While attendees may ask questions at the Pre-proposal Conference, the Department is not required to respond during the conference. The Department will respond to written questions per the process described in this RFP.

d. Potential Offerors are not required to attend the Pre-proposal Conference in order to submit responses to this RFP; however, they are urged and cautioned to attend the Pre-proposal Conference to apprise themselves of the conditions and requirements of the submission.

e. To ensure receipt of the video conference invite and instructions for participation, interested parties are required to pre-register for the conference by sending an email to Medicaid.Procurement@dhhs.nc.gov stating the name of the potential Offeror, the names and email addresses of representatives who will attend, the current title or role of each representative, and requests for a sign language interpreter or other accommodations. Interested parties must pre-register at this email address no later than 10:00 a.m. EST on June 9, 2026.

f. The Department reserves the right to limit the number of representatives attending on behalf of each vendor or organization to ensure adherence to videoconference capacity limits.

g. Audio and video recording of the Pre-Proposal Conference will not be permitted.

Statements and materials discussed at the conference are informational only, are not binding upon the Department and do not replace reading, reviewing and complying with this RFP.

h. Attendees will be required to announce their name or otherwise confirm their presence via a roll call during the video conference.

3. Questions Concerning this Request for Proposal

a. Written questions concerning this RFP will be received until June 25, 2026, at 2:00 p.m.

EST.

b. Questions must be sent via email to Medicaid.Procurement@dhhs.nc.gov and include “Questions Regarding Pharmacy Analytical and Clinical Support Services RFP #30-2026- 002-DHB” as the subject of the email. The questions should be submitted in the format below.

RFP Section RFP Page Number Offeror Question Example: V.B.1. a.

c. The Department will prepare responses to all written questions submitted by the stated deadline and post an addendum to North Carolina electronic Vendor Portal(eVP). The Offeror is cautioned that contacting anyone other than the individual noted on the Execution Page of this RFP may be grounds for rejection of said Offeror’s response.

mailto:Medicaid.Procurement@dhhs.nc.gov

4. Tabulation of Proposals The Department will post a tabulation on North Carolina electronic Vendor Portal (eVP) following the Proposal Opening. The Tabulation will include the name of each Offeror for which a proposal was opened. The Department will not post information regarding Offerors’ cost proposals.

E. Submission of Proposal and Offeror’s Response

1. Consideration

a. The Offeror must meet the minimum qualifications of this RFP, as provided in Section IV.

Minimum Qualifications, for its proposal to be evaluated.

b. Offeror’s proposal must clearly demonstrate compliance with all the requirements stated within this RFP. The Department reserves the right to reject proposals deemed incomplete, non-responsive, or non-compliant with the RFP requirements; or when such rejection is deemed to be in the best interest of the Department or the State of North Carolina.

c. The Offeror must demonstrate it will comply with the scope of services and all of the requirements in this RFP and must provide a detailed description to demonstrate its ability to completely fulfill each requirement and service.

d. The Department will accept digital electronic signatures.

2. Responses to RFP Requirements and Scope of Services

a. The Offeror must complete and return all documents and attachments required in this

RFP. Failure to complete and return all documents and attachments as indicated may result in disqualification.

b. The proposal must clearly articulate and address all requirements of this RFP. The Offeror must provide detailed narrative descriptions with supporting information that may include diagrams, exhibits, examples, samples, sketches, descriptive literature, etc.

c. For some requirements, the Offeror may need to provide an affirmative statement to the question or requirement by, at a minimum, checking a box to confirm adherence/agreement or inserting the word CONFIRM adherence/agreement in its proposal.

d. The Offeror must describe any limitations, qualifications or contingences impacting the ability to perform as required by the RFP.

e. The Offeror must not include any assumptions in its proposal. The Offeror should seek clarity on any questions or concerns during the defined question period.

f. The Offeror should exercise due diligence to ensure their response is consistent with all instructions, clearly written and addresses all requirements and questions of the RFP.

g. By submitting its response to this solicitation, Offeror represents and warrants that it has carefully reviewed, understands, and intentionally submits each section of Offeror’s response. In the event Offeror had assistance developing and drafting its response to this RFP, including but not limited to assistance from outside resources, computer programs, RFP automation technology or Artificial Intelligence (AI), Offeror warrants and represents that it has carefully reviewed, understands, and intentionally submits all portions of its response drafted by or with such assistance. The Department is not responsible for, nor is it required to excuse or consider for relief to the Offeror, any omissions or errors in Offeror’s response that result for any reason.

3. Required Proposal Documents To demonstrate the Offeror is qualified to meet the ongoing demands of the Department and comply with federal and state requirements, the Offeror is required to return all of the following documents, completed and signed where indicated and in the order listed, with their RFP response, the entirety of which shall be called the Pharmacy Analytical and Clinical Support Services (PACSS) Proposal.

a. Offeror’s Technical Proposal Response must include the following:

i. RFP Cover Page with Title and RFP Number;

ii. Completed Offeror Name and Tax ID Number page;

iii. Completed and signed Execution Page;

iv. The entire body of this RFP, excluding attachments;

v. Each addendum released in conjunction with the RFP, including all pages of the addendum and the signed execution of the addendum page;

vi. Completed and signed Attachment A: Minimum Qualifications Response; to address minimum qualifications within this RFP;

vii. Completed Attachment B: Offeror’s Response to Technical Evaluation Questions to address technical requirements and specifications identified within this RFP;

viii. Completed Attachment D: Contract Administrators;

ix. Completed and signed Attachment E: Certification of Financial Condition and Legal

Action Summary;

x. Completed and signed Attachment F: State Certifications;

xi. Completed and signed Attachment G: Federal Certifications and Disclosures;

xii. Completed Attachment H: Disclosure of Litigation and Criminal Convictions;

xiii. Completed and signed Attachment I: Location of Workers Utilized by Contractor;

xiv. Completed Attachment J: Offeror Request for Proposed Modifications to the Terms and Conditions;

xv. Completed and signed Attachment K: Business Associate Agreement;

xvi. Completed Attachment L: Subcontractor Identification Form;

xvii. Completed Attachment M: Legal Grounds for Marking Information Confidential;

xviii. Attachment N: Evaluation Methodology; and

xix. Completed and signed Attachment O: GenAI Disclosure and Fact Sheet

b. Offeror’s Cost Proposal Response must include Completed and signed Section VII.

Attachment C: Cost Proposal

c. Offerors are required to use and complete the MS Word and Excel versions of documents, templates and attachments (e.g. System Security Plan outline example) posted on the North Carolina electronic Vendor Portal (NC eVP) for proposal submission.

d. Offeror’s must sign and include all posted addenda from the NC eVP website.

4. Proposal Submission

a. The Offeror must submit its proposal in response to this solicitation to the NC eVP.

Paper and email copies will be deemed non-responsive, and the proposal will not be considered. Proposals submitted by physical mail delivery or in person delivery in response to this solicitation will be deemed non-responsive and will not be considered further. Files must not be password-protected and must be capable of being copied to other media.

For Offeror training on how to use the NC eVP to view solicitations, submit questions, develop responses, upload documents, and submit offers to the State, Vendors should go to the following site: https://eprocurement.nc.gov/training/vendor-training.

Questions or issues related to using the NC eVP itself can be directed to the North Carolina eProcurement Help Desk at 888-211-7440, Option 2. Help Desk representatives are available Monday through Friday from 7:30 AM EST to 5:00 PM EST.

b. INSUFFICIENCY OF REFERENCES TO OTHER DATA: Only information that is received in response to this RFP will be evaluated. Reference to information previously submitted or Internet Website Addresses (URLs) will not suffice as a response to this solicitation.

The Department will not click on any links to access information.

c. It is the responsibility of the Offeror to submit their proposal in accordance with these instructions to the NC eVP by the specified time and date specified in Section II.A.5.

Events and Deadlines and Section II.D. Table 1: RFP Schedule. All electronic proposal submissions are subject to the conditions made a part hereof. Offeror shall bear the risk for late electronic submission due to unintended or unanticipated delay, including but not limited to internet issues, network issues, local power outages, or application issues.

d. Proposal and Section VII. Attachment C: Cost Proposal must be submitted to the NC eVP.

e. Offeror’s Proposal and Section VII. Attachment: C Cost Proposal must be separate files and clearly named (e.g. 30-2026-002-DHB PACSS RFP, Offeror’s Name, Technical Proposal) and (e.g. 30-2026-002-DHB PACSS RFP, Offeror’s Name, Attachment C: Cost Proposal).

f. If your proposal is being submitted as multiple files, then the file names must be clearly noted. For example: 30-2026-002-DHB PACSS RFP, Offeror’s Name, Technical Proposal 1 of 2; 30-2026-002-DHB PACSS RFP, Offeror’s Name, Technical Proposal 2 of 2.

g. Proposals must be submitted with the Execution page signed and dated by an official authorized to bind the Offeror’s firm. Failure to submit a signed proposal shall result in disqualification. Electronic signatures will be accepted.

h. Offeror must submit one (1) electronic copy of Offeror’s redacted proposal to the NC eVP in accordance with Chapter 132 of the General Statutes, Public Records, identified as RFP 30-2026-002-DHB, Offeror’s Name, PACSS Proposal Redacted. For the purposes of this RFP, redaction means to edit a document by obscuring or removing information that is considered confidential and/or proprietary by Vendor and that meets the definition of Confidential Information set forth in G.S. 132-1.2. If Vendor’s proposal does not contain Confidential Information, Offeror must submit a signed statement to that effect as 30- 2026-002-DHB PACS RFP, Offeror’s Name, Statement of Confidential Information. If no redacted proposal is submitted by the Offeror, then the Department may use the unredacted proposal for any public record requests. Redacted copies provided by the Offeror to the Department may be released in response to public record requests without notification to the Offeror.

https://eprocurement.nc.gov/training/vendor-training

i. This RFP is available electronically on the NC eVP at the following website:

https://evp.nc.gov.

j. Proposal documents as submitted must include the entire RFP, proposal, and all addenda.

Linked or referenced documents from web or other locations cannot be included and will not be considered or evaluated. Hyperlinks and uniform resource locators (URLs) are not permitted in any of the proposal documents.

5. Falsified Information: The Department may initiate proceedings to debar an Offeror from participation in the offer process and from Contract Award as authorized by North Carolina law if it is determined that the Offeror has withheld relevant or provided false information.

F. Confidentiality and Prohibited Communications During Evaluation

1. As provided for in the North Carolina Administrative Code (NCAC), including but not limited to 01 NCAC 05B .0103, 09 NCAC 06B .0103 and 09 NCAC 06B .0302, all information and documentation whether electronic, written or verbal relative to the development of a contractual document for a proposed procurement or contract shall be deemed confidential in nature. In accordance with these and other applicable rules and statutes, such materials shall remain confidential until the award of a contract or until the need for the procurement no longer exists. Any proprietary or confidential information, which conforms to exclusions from public records as provided by NCGS § 132, must be clearly marked as such with each page containing the trade secret or confidential information identified in boldface as “CONFIDENTIAL.” If only a portion of each page marked “CONFIDENTIAL” contains trade secret information, the trade secret information shall be designated with a contrasting color or by a box around such information. In addition to marking confidential information as required by NCAC 05B.0103, confidential pages or portions of the proposal shall be reflected in the redacted copy submitted as instructed in Section II.E.4 as applicable. By submitting a redacted copy, the Offeror warrants that it has formed a good faith opinion, having received such necessary or proper review by counsel and other knowledgeable advisors, that the portions marked Confidential and Redacted meet the requirements of NCGS § 132. The Offeror must identify the legal grounds for asserting that the information is confidential, including the citation to state law, by completing Section VII. Attachment M: Legal Grounds for Marking Information Confidential to this RFP. However, under no circumstances shall price information be designated confidential.

2. Except as otherwise provided above, pursuant to NCGS § 132-1, et seq., information or documents provided to the Department in response to this RFP are Public Record and subject to inspection, copy and release to the public unless exempt from disclosure by statute, including, but not limited to, NCGS § 132-1.2. Redacted copies provided by the Offeror to the Department may be released in response to public record requests without notification to the Offeror.

3. During the period spanning the issuance of the RFP to Contract Award, possession of proposals, accompanying information, and subsequent negotiations are limited to personnel of the Department and any third parties involved in this procurement process.

4. Each Offeror submitting a proposal (including its representatives, subcontractors, and suppliers or other pilot partners or affiliates) is prohibited from having any communications https://evp.nc.gov/ with any person inside or outside the using agency, issuing agency, other government agency office, or body (including the purchaser named above, department secretary, agency head, members of the General Assembly and Governor’s office), or private entity, if the communication refers to the content of Offeror’s proposal or qualifications, the content of another Offerors proposal, another Offeror’s qualifications or ability to perform the contract, and/or the transmittal of any other communication of information that could be reasonably considered to have the effect of directly or indirectly influencing the evaluation of proposal and/or the award of the contract. An Offeror not in compliance with this provision shall be disqualified from Contract Award, unless it is determined in the Department’s discretion that the communication was harmless, that it was made without intent to influence and that the best interest of the Department would not be served by the disqualification. An Offeror’s proposal may be disqualified if its subcontractor and supplier engage in any of the foregoing communications during the time that the procurement is active (i.e., the issuance date of the procurement until the date of the Contract award). Only those discussions, communications or transmittals of information authorized or initiated by the issuing agency for this RFP or general inquiries directed to the purchaser regarding requirements of the RFP (prior to proposal submission) or the status of the Contract Award (after submission) are excepted from this provision.

5. The Department may serve as custodian of Offeror’s confidential information and not as an arbiter of claims against Offeror’s assertion of confidentiality. If an action is brought pursuant to NCGS § 132-9 to compel the Department to disclose information marked confidential, the Offeror agrees that it will intervene in the action through its counsel and participate in defending the Department, including any public official(s) or public employee(s). The Offeror agrees that it shall hold the Department, State of North Carolina, and any official(s) and individual(s) harmless from all damages, costs, and attorneys’ fees awarded against the Department in the action. The Department will provide reasonable notice to the Offeror in writing of any action seeking to compel the disclosure of Offeror’s confidential information.

The Department shall have the right, at its option and expense, to participate in the defense of the action through its counsel. The Department shall have no liability to Offeror with respect to the disclosure of Offeror’s confidential information ordered by a court of competent authority pursuant to NCGS § 132-9 or other applicable law.

G. Evaluation Process and Contract Award The Evaluation process will commence soon after responses are due as defined in this RFP. The Department will evaluate each Offeror’s proposal in accordance with the method, process, and evaluation criteria stated herein as further described in Section VII. Attachment N: Evaluation Methodology.

1. Evaluation Committee and Method

a. An Evaluation Committee (Committee) will be established to review each Offeror’s proposal and to make an award recommendation. The Department may designate other individuals or subject matter experts, including individuals from outside the Department, to assist in the evaluation process. The Department reserves the right to alter the composition of the Committee or designate other staff or vendors to assist in the process.

b. The Committee will review and evaluate all responsive and qualified proposals received by the deadlines specified in this RFP. The Committee will be responsible for the entire evaluation process, including any clarifications, negotiations, and BAFOs.

c. The Committee’s evaluation determination and recommendation will be by consensus.

2. Investigation, Validation, and Inspection

a. The Department may make reasonable investigations or reviews to validate Offeror’s proposal or determine the ability and readiness of the Offeror to perform the services under this RFP. The Offeror shall furnish to the Department all such information and data within requested timeframes to complete investigations, reviews, or validations under this section.

b. The Department reserves the right to inspect Offeror’s physical facilities, including any located outside of North Carolina prior to award and at any time during the Contract period to satisfy questions regarding the Offeror’s capabilities or performance.

Department’s investigation or inspection of Offeror’s ability and physical facilities includes any entity or site used in the performance of any obligation under the Contract.

c. The Department further reserves the right to reject any offer if the evidence submitted by, or investigations, reviews or validations of, the Offeror and its proposal fail to satisfy the Department that the Offeror is properly qualified to carry out the obligations of the Contract and to provide the required services.

d. The Department may request to review any policy, procedure, process, script, manual or other material used to fulfill a Scope of Services requirement and require changes as a condition of participation under the Contract.

e. Nothing in this section is intended to limit or conflict with the ACCESS TO PERSONS AND RECORDS clause.

3. Evaluation Process: The following descriptions are to provide general information about the Department’s evaluation process. The Department reserves the right to modify the evaluation process, including the order or content of the following evaluation process components:

a. The Committee will review each Offeror’s proposal to validate all required proposal documents are included and completed, and all Instructions to Offerors have been followed. Failure to adhere to these requirements may render the Offeror’s response incomplete and may be grounds for rejection during any part of the evaluation process.

b. The Committee will determine if Minimum Qualifications are met as required in Section IV. Minimum Qualifications. If the Offeror does not provide the required information, or the Department determines that the Offeror does not meet the Minimum Qualifications, that Offeror’s response may be excluded from further consideration and evaluation.

Exclusion from further consideration may occur upon the Department’s initial review or at any time during the evaluation process upon Department’s determination that the Offeror fails to meet the Minimum Qualifications.

c. The Committee will review and evaluate the Offeror’s Pharmacy Analytical and Clinical Support Services Proposal relative to the evaluation criteria specified in the RFP and Section VII. Attachment N: Evaluation Methodology.

d. The Committee will make a recommendation to award to the Offeror meeting the RFP requirements and whose offer is determined to be most advantageous in accordance with NCGS § 143-135.9 to the Department, based on the criteria described in the RFP, and the Committee’s ranking of proposals and the basis and reasons for the selection decision.

Upon approval of the recommendation by the Department, the notice of award will be issued with the Department executing a Contract with the successful Offeror.

4. Clarifications, Negotiations, and BAFOs

a. The Department reserves the right to request Clarifications at any time from any Offeror, and such Clarifications must be submitted in writing to the Offeror to respond. However, the Department is not required to request Clarifications from any Offeror, Clarifications are at the discretion of the Department, and Offerors should exercise due diligence to ensure its response is clear and addresses all the requirements and specifications of the RFP. Pursuant to 01 NCAC 05A .0112, Clarification means communications between the State and an Offeror that may occur after receipt of Offeror’s proposal made for the purpose of eliminating irregularities, informalities, or apparent clerical mistakes in an Offer. A Clarification may also be used in order for the State to interpret an Offer or Offers or to facilitate the State's evaluation of all Offers. A Clarification shall not be used to cure material deficiencies in an Offer, alter the scope of an Offer, or to negotiate. The Department may refuse to accept or consider, in whole or in part, the response to a Clarification provided by an Offeror.

b. The Department reserves the right to enter into negotiations with one or more Offerors to establish a contract that is in the best interest of the Department. Such negotiations may result in modifications to the RFP and/or Offeror’s proposal/response.

c. The Department may issue a BAFO request to any Offeror(s), requesting one or more Offerors change their initial Offer.

5. In-Person or Oral Presentations The Department reserves the right to request in-person or oral presentations from any Offeror as part of the Committee’s evaluation of proposals. In-person presentations shall be conducted in Raleigh, NC at a site chosen by the Department or held virtually by video conference. Oral presentations may be conducted by conference call. The presentations will address specific topics provided in advance to the Offeror. However, the Department is not required to request in-person or oral presentations from any or all Offerors and may limit any presentations only to those Offerors which are deemed competitive. Additional details regarding the scheduling of any in-person or oral presentations will be provided to selected Offerors by the Department upon determination that such presentation is needed. The Offeror is solely responsible for any costs associated with making in-person or oral presentations, including but not limited to travel and the preparation of additional materials.

6. Quality Review The Department reserves the right to conduct a quality review of the RFP evaluation. Any changes to evaluation documentation, ratings, determinations or recommendations or other records of the Evaluation Committee as a result of the quality review will be made by consensus of the Committee.

7. Rescission The Department may, at its discretion, allow an Offeror to rescind certain statements in the Offeror’s Proposal. Offeror’s authorized signatory should send a request for a rescission to Medicaid.procurement@dhhs.nc.gov, clearly indicating the statement(s) to be rescinded. If allowed, the Department will handle and document such rescissions as Clarifications;

however, the Department is not required to allow statement rescissions from any Offeror.

mailto:Medicaid.procurement@dhhs.nc.gov

8. Evaluation Criteria, Determination of Ratings and Award Recommendation

a. The Department will evaluate the Offeror’s response for completeness and responsiveness to determine if…