Lancets RFA.doc

kerisCOMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

OFFICE OF MEDICAID

REQUEST FOR APPLICATIONS FOR REBATES

for Fee-for-Service Claims for Lancets for MassHealth Members and Health Safety Net Patients and Members Enrolled with Participating MassHealth Managed Care Entities Document Number:26EHSKACLMLRFA Issued: February 6, 2026 I. Description of Program The Executive Office of Health and Human Services (EOHHS) is the single state agency responsible for administering the Commonwealth’s Medicaid program and its Children’s Health Insurance Program (together, MassHealth) in accordance with M.G.L. c. 6A, § 16, Titles XIX and XXI of the Social Security Act, M.G.L. c. 118E and other applicable federal and state laws, regulations, waivers and demonstration projects. EOHHS is also responsible for administering the Health Safety Net (HSN) pursuant to M.G.L. c. 118E and applicable regulations. EOHHS’s mission as a single state agency is to purchase high-quality health care for the financially needy that is affordable, promotes independence, and provides customer satisfaction.

EOHHS is issuing this Request for Applications (RFA) from manufacturers of Lancets to pay rebates to EOHHS based on Pharmacy fee-for-service (FFS) claims for the manufacturer’s Lancets submitted to EOHHS through the Pharmacy Online Processing System (POPS), including for MassHealth Members enrolled in the MassHealth Primary Care Clinician (PCC) Plan or a MassHealth Primary Care Accountable Care Organization; claims for HSN Patients submitted through POPS; and claims that are paid through Participating MassHealth Managed Care Organizations (MassHealth MCOs) and MassHealth Accountable Care Partnership Plans (MassHealth ACPPs) (collectively, Managed Care Entities or MCEs).

EOHHS, at its option, may enter into agreement(s) to accept Rebates from one or more manufacturers of Lancets, and reserves the right to establish one or more preferred Lancet(s).

Posted separately is the standard form of State Rebate Agreement for Lancets (State Rebate Agreement or Agreement), which will be utilized for each manufacturer with whom EOHHS enters into a Rebate Agreement pursuant to this solicitation.

II. Rebate Agreement Specifications

Specifically, EOHHS intends to enter into an Agreement with one or more manufacturers of Lancets in accordance with the following specifications and as set forth more fully in the attached Agreement:

1. Rebate offers must be expressed as a final fixed Guaranteed Net Unit Price (GNUP) for each proposed National Drug Code (NDC) for Lancets the manufacturer proposes to include as subject to Rebate under an Agreement.

2. With respect to each such Covered Product (each NDC), the GNUP shall be calculated as follows on a per-Unit basis: (i) the Wholesale Acquisition Cost (WAC) for the Covered Product as in effect on the last day of the calendar quarter that corresponds to the calendar quarter for which the State utilization is reported to the manufacturer, minus (ii) the Rebate.

3. The Agreement covers claims for MassHealth and HSN Patient FFS claims paid through POPS and claims paid to Pharmacies through Participating MassHealth MCEs.

4. EOHHS may, at its option, begin collecting Rebates on FFS claims for the manufacturer’s Covered Products dispensed by Pharmacies and paid through POPS on a different date than it begins collecting Rebates on claims for the manufacturer’s Covered Products dispensed and paid through Participating MassHealth MCEs.

4. The initial term of the Agreement shall be for 24 months, with an anticipated start date of January 1, 2027. The Agreement may be extended in any increments for up to three additional years at EOHHS’s option, upon terms agreed to by the parties.

5. EOHHS will invoice the manufacturer on a quarterly basis. Information on this invoice will include:

a. Per-unit utilization at the NDC level separately identified for FFS MassHealth members, for HSN Patients; and for members enrolled in Participating MassHealth MCEs; and

b. Separately calculated Rebate for MassHealth Members, for HSN Patients; and for members enrolled in Participating MassHealth MCEs.

EOHHS reserves the right, at its sole discretion and at any time after release of the RFA and during the term of the Agreement, to modify any provision in the Agreement when EOHHS deems necessary or reasonable to reflect any change in policy or program goals, including, without limitation, to modify the scope of the Agreement and Rebate amounts. EOHHS additionally reserves the right, at its sole discretion and at any time after release of the RFA and during the term of the Agreement, to amend the Agreement to implement state or federal statutory or regulatory requirements, judicial orders, settlement agreements, or any state or federal requirements, initiatives or changes affecting the MassHealth FFS, HSN programs and MassHealth’s managed care program. In the event that EOHHS seeks to implement such changes in the Agreement, EOHHS will provide written notice to the Manufacturer and will initiate negotiations with the Manufacturer.

III. Response Instructions To apply for a Rebate Agreement with the Executive Office of Health and Human Services MassHealth program, manufacturers are instructed to submit a response package to EOHHS as follows:

6. Manufacturers must return a copy of the State Rebate Agreement, which must include Attachment A, completed as set forth in paragraph 2, immediately, below.

7. Attachment A to the Agreement must be completed in its entirety, which will constitute the manufacturer’s proposed Rebate offer for each 11-digit NDC for Lancets the manufacturer proposes to include as subject to Rebate under the Agreement. All columns of Attachment A must be completed in their entirety for each such NDC, including the manufacturer’s offer for the fixed per Unit (per Lancet) GNUP that will apply under the Agreement for the applicable designations: “Exclusive Basis (1 of 1)”; “Dual Basis (1 of 2)”; “1 of Many (1 of 3 or more)” and “Non-Preferred”, respectively. Attachment A contains descriptions of what each of those designations mean for purposes of the Agreement.

8. Manufacturers must submit a signed cover letter that includes:

c. A description of any experience the manufacturer has serving as a preferred Lancet manufacturer for State Medicaid programs in the past 5 years;

d. Any information the manufacturer wishes to share concerning its Lancets’ clinical benefits; and

e. The name, title, address, phone number and e-mail address of the individual in the manufacturer’s organization who should be contacted regarding any aspect of the manufacturer’s response to this solicitation.

By your cover letter signature, you are certifying that your response to this RFA shall remain in effect until all contracts resulting from this solicitation (if any) are executed by the selected manufacturer(s) and EOHHS.

1. Submit the completed package by email by March 27, 2026, at 5:00 PM, to:

Massachusetts Executive Office of Health and Human Services One Ashburton Place, 11th floor

Boston, MA 02108

Attention: Kalinda Collins Email: EOHHS-Procurement@mass.gov IV. Selection and Negotiation EOHHS, in its sole discretion, may:

9. Enter into an Agreement with one or more manufacturers of Lancets who respond to this solicitation based on EOHHS’s determination of which proposal(s) provide(s) the best value to the MassHealth and HSN programs, taking into account the interests of the Commonwealth, MassHealth Members and HSN Patients, as well as cost. EOHHS is not required to choose the manufacturer that proposes the lowest GNUP.

10. Request clarification of any information provided in response to this solicitation.

11. Request a best and final offer (BAFO) from any manufacturer.

12. Request, verify and contact references from any manufacturer at any time during the evaluation process. EOHHS may also consider relevant information about the manufacturer known to EOHHS during the evaluation process.

13. Negotiate a change in any element of this solicitation or of a manufacturer’s offer.

EOHHS is not obligated to enter into an Agreement with a manufacturer as a result of this solicitation, and may cancel the solicitation at any time.

V. Additional Information

14. All claims for Lancets submitted to MassHealth or HSN on a FFS basis through POPS, for which MassHealth or HSN is primary payer, will be eligible for Rebate under an Agreement. In calendar year 2024, MassHealth or HSN was the primary payer for approximately 43,300 claims for Lancets submitted for 21,760 MassHealth Members or HSN Patients on a FFS basis.

15. MassHealth Member utilization of Lancets through MassHealth MCEs will also be included under the Agreement. In calendar year 2024, MassHealth MCEs were the primary payer for approximately 38,840 claims for Lancets submitted for approximately 18,200 MassHealth Members.

16. EOHHS does not warrant or guarantee any particular volume of MassHealth Member utilization of Lancets during the term of any State Rebate Agreement resulting from this RFA.

17. Manufacturers may submit written questions regarding this Request for Applications for Rebates by e-mail to EOHHS-Procurement@mass.gov by February 20, 2026 at 5:00 PM. The subject line of the e-mail should read Questions Regarding the Agency’s RFA for Lancets.

EOHHS reserves the right to edit or delete any submitted questions that raise any of these issues or that are not in the best interest of the Commonwealth, or this Bid or are duplicative of other submitted questions. Questions may also be edited for brevity or clarity. No acknowledgement of receipt will be given.

EOHHS will review questions received before the deadline and will identify questions for which written answers will be prepared, at its discretion. Any written answers of general interest and relevant to the preparation of a response to the RFR will be posted on the COMMBUYS website for this procurement. EOHHS reserves the right to accept additional written questions after the date and time specified in this section, at its discretion, prepare written responses to those it determines to be of general interest and relevant to the preparation of an application in response to the RFR. These additional responses will also be posted on the COMMBUYS website. However, EOHHS makes no guarantee that it will answer questions received after the deadline

18. No Agreement shall be effective unless it is signed by the authorized representative of EOHHS.

VI. Response Review and Evaluation Criteria

EOHHS may select the Bids that demonstrate the best value overall, including any proposed alternatives to the services described in this RFA that will achieve the goals of this RFA. EOHHS and a selected Bidder may negotiate a change in any element of performance or cost identified in the RFA or the selected Bidder’s Bid which results in lower prices or a more cost effective or better value than was presented in the selected Bidder’s original Quote.

Bids shall be evaluated by an Evaluation Committee (“Committee”) appointed by EOHHS. The Committee shall evaluate each Bidder’s Bid. Bids will be evaluated based on comprehensiveness, appropriateness, feasibility, clarity, effectiveness, and responsiveness to the needs of EOHHS. In addition, EOHHS may also consider any relevant information about the Bidder known to EOHHS.

The Committee will evaluate each response for:

19. Compliance with response requirements; and

20. Best value for the MassHealth program, which involved a review of the following for responsiveness to EOHHS’s needs:

a. Previous experience serving as a preferred Lancet manufacturer for State Medicaid programs in the past 5 years;

b. Manufacturer’s Lancets’ clinical benefits

c. Proposed GNUP inclusive of MCE claims; and

d. Other best value considerations.

In reviewing proposals for best value, the Committee will (1) evaluate each element of a manufacturer’s proposal in accordance with the criteria described above and (2) give a composite rating of “excellent,” “very good,” “good,” “fair” or “poor” for each category of the proposal other than the GNUP, which will be assessed for reasonableness and competitiveness; (3) assign an overall rating to each proposal; and (4) compare the proposals to one another.

Price will be one factor, but not the sole factor, the Committee considers in its overall evaluation. EOHHS is not required to choose the Bidder that proposes the lowest price but will choose the Bidder that offers the best value to the Commonwealth.

EOHHS reserves the right to reject a Bidder’s Bid at any time during the evaluation process if the Bidder:

21. Fails to demonstrate to EOHHS’ satisfaction that it meets all RFA requirements;

22. Fails to submit all required information or otherwise satisfy all Response Requirements in Section 3;

23. Receives a rating of “Poor” or “Non-Responsive” in the evaluation of one or more categories of its Response; or

24. Has any interest that may, in EOHHS’ sole determination, conflict with performance of services for the Commonwealth or be anti-competitive.

The Committee, in its sole discretion, may determine whether non-compliance with any of the above requirements is insubstantial. In such cases, the Committee may seek clarification, allow the Bidder to make minor corrections, apply appropriate penalties in evaluating the Response, or apply a combination of all three remedies.

At any time during its review, the Committee may determine some element of a Bidder’s Bid requires clarification to verify its responsiveness to the RFA or facilitate a fair comparison with competing Responses. In such cases, the Committee may seek written clarification from the Bidder. All Bidders will be accorded fair and equal treatment with respect to any opportunity for clarification.

VII. COMMBUYS

1. COMMBUYS Market Center.

COMMBUYS is the official source of information for this Bid and is publicly accessible at no charge at www.commbuys.com. Information contained in this document and in COMMBUYS, including file attachments, and information contained in the related Bid Questions and Answers (Q&A), are components of the Bid, as referenced in COMMBUYS, and are incorporated into the Bid and any resulting contract.

Bidders are solely responsible for obtaining all information distributed for this Bid via COMMBUYS.

It is each Bidder’s responsibility to check COMMBUYS for:

a. Any amendments, addenda, or modifications to this Bid, and

b. Any Bid Q&A records related to this Bid.

The Commonwealth accepts no responsibility and will provide no accommodation to Bidders who submit a Quote based on an out-of-date Bid or on information received from a source other than COMMBUYS.

2. COMMBUYS Registration.

Bidders may elect to register for a free COMMBUYS Seller account which provides value-added features, including automated email notification associated with postings and modifications to COMMBUYS records. However, to respond to a Bid, Bidders must register and maintain an active COMMBUYS Seller account.

c. Quote Submission Method

Online Quote Submission via COMMBUYS is required.

All Bidders must submit Quotes online using tools available only to Sellers registered in COMMBUYS. COMMBUYS provides Seller registration functionality at no charge. To register, go to www.COMMBUYS.com and click on the “Register” link on the home or landing page.

b. COMMBUYS Support

Technical assistance is available during the procurement process. Every effort is made to respond to inquiries within one business day.

Website: Go to www.mass.gov/osd/commbuys to access COMMBUYS resources, including new bid postings, job aids, and training schedules for buyers, among others.

Email: Send inquiries to the OSD Help Desk at OSDHelpDesk@mass.gov

Telephone: Call the OSD Help Desk at 1-888-MA-STATE (1-888-627-8283). The Help Desk is staffed from 8:00 a.m. to 5:00 p.m., Monday through Friday Eastern Time, except on federal and state holidays.

Bidders are advised that COMMBUYS will be unavailable during regularly scheduled maintenance hours of which all users will be notified.

25. Acceptable Forms of Signature

Effective June 15, 2021, for all 1) CTR forms, including the Standard Contract Form, W-9s, Electronic Funds Transfer (EFT) forms, ISAs, and other CTR-issued documents and forms, or 2) documents related to state finance and within the statutory area of authority or control of CTR (i.e. contracts, payrolls, and related supporting documentation), CTR will accept signatures executed by an authorized signatory in any of the following ways: 1. Traditional “wet signature” (ink on paper); 2. Electronic signature that is either: a. Hand drawn using a mouse or finger if working from a touch screen device; or an uploaded picture of the signatory’s hand drawn signature 3. Electronic signatures affixed using a digital tool such as Adobe Sign or DocuSign. If using an electronic signature, the signature must be visible, include the signatory’s name and title, and must be accompanied by a signature date. Please be advised that typed text of a name not generated by a digital tool such as Adobe Sign or DocuSign, even in computer-generated cursive script, or an electronic symbol, are not acceptable forms of electronic signature.

� Capitalized terms not defined herein shall have the meaning ascribed to them in the attached Agreement.

� Pursuant to Attachment A of the Agreement, should the per Unit (per NDC code) WAC change during the term of any Agreement, the Rebate will automatically be recalculated. The GNUP will remain constant for the term of the Agreement.

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Request for Applications for Rebates for Lancets February 6, 2026