Syringes Questions and Answers.docx
DOCX document 29 KB Posted
- Solicitation number
- BD-26-1039-EHS01-EHS01-125137
- Issued by
- Suffolk County, Massachusetts
About this file
This is a Questions and Answers document issued by the Massachusetts Executive Office of Health and Human Services (EOHHS) on March 13, 2025, addressing inquiries regarding the Request for Applications for Rebates for Fee-for-Service Claims for Syringes. The RFA seeks rebate agreements from qualified syringe manufacturers to supply medical devices through pharmacy claims for MassHealth members and Health Safety Net patients. Syringes are defined as medical devices used to inject or withdraw fluids from the body and include disposable and reusable varieties in various sizes. The RFA covers both fee-for-service claims and claims paid through participating Managed Care Organizations and Accountable Care Partnership Plans. Calendar year 2024 utilization data indicates approximately 9,900 fee-for-service claims for approximately 4,720 members or patients and approximately 10,490 managed care claims for approximately 4,840 members. The application deadline is March 27, 2026, at 5:00 PM, with an anticipated contract start date of January 1, 2027, for an initial 24-month term extendable for up to three additional years at EOHHS's discretion.
Pricing is structured around Guaranteed Net Unit Prices (GNUP) calculated as Wholesale Acquisition Cost (WAC) minus the rebate amount on a per-unit basis, with automatic recalculation if WAC changes while GNUP remains constant. Applicants must propose fixed per-unit rebate rates for each 11-digit National Drug Code across four designations: Exclusive Basis, Dual Basis, 1 of Many, and Non-Preferred. MassHealth will invoice manufacturers quarterly through its pharmacy benefit administrator, with manufacturers required to pay invoices within 38 days of receipt via wire transfer or check. Syringes will be dispensed by pharmacies to eligible members, not purchased directly by EOHHS. Rebate disputes are reported through the Reconciliation of State Invoice (ROSI)/Prior Quarterly Adjustment Statement (PQAS) process. No patient-identifiable information or protected health information will be provided to manufacturers. EOHHS reserves the right to enter into agreements with one or more manufacturers based on best value determinations rather than lowest price alone, and applicants must demonstrate prior experience as preferred syringe manufacturers for state Medicaid programs within the past five years.
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Other files
| File | Type | Posted |
|---|---|---|
| Syringes RFA.doc | DOC document | |
| Syringes Agreement.doc | DOC document | |
| Evaluation Criteria~12.docx | DOCX document |
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Text version
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES
ONE ASHBURTON PLACE, 11TH FLOOR
BOSTON, MASSACHUSETTS 02108
QUESTIONS AND ANSWERS
regarding the Request for Applications for Rebates for Fee-for-Service Claims for Syringes Document #: 26EHSKACLMSYRFA Q&A Issued: March 13, 2025 This document contains responses to questions received regarding the Request for Applications for Rebates for Fee-for-Service Claims for Syringes (the RFA) issued by the Executive Office of Health and Human Services (EOHHS) on February 6, 2026. Answers have been provided to those questions which are of general interest and relevant to the preparation of a Response to the Request for Applications.
What kinds and volume of syringes are being requested of manufacturers?
MassHealth is seeking qualified vendors of syringes. Syringes are defined in the Model State Rebate Agreement as medical devices used to inject fluids into or withdraw fluids from the body. Syringes typically consist of three main parts including the barrel, plunger, and needle. Syringes are commonly used in medicine for administering injections, drawing blood, and delivering medications. They can be disposable or reusable and come in various sizes depending on the intended use.
As described in RFA Section V, in calendar year 2024, MassHealth or HSN was the primary payer for approximately 9,900 claims for Syringes submitted for approximately 4,720 MassHealth Members or HSN Patients on a FFS basis. In calendar year 2024, MassHealth MCEs were the primary payer for approximately 10,490 claims for Syringes submitted for approximately 4,840 MassHealth Members.
In regard to syringe volume, MassHealth is seeking qualified vendors of syringes used for self-administration of medications.
Is this RFA for diabetic syringes?
This RFA is for all syringes, not limited to diabetic syringes.
Will there be an additional RFA for pen needles?
MassHealth is seeking qualified vendors to supply pen needles. Please visit COMMBUYS and find the pen needles RFA (Bid Solicitation: BD-26-1039-EHS01-ASHWA-125145).
Is the RFA for fee-for-service only, or will this include fee-for-service members and members enrolled in managed care?
It includes both. As described in RFA Section I, EOHHS is issuing this Request for Applications (RFA) from manufacturers of Syringes to pay rebates to EOHHS based on Pharmacy fee-for-service (FFS) claims for the manufacturer’s Syringes 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).
What level of market exclusivity is MassHealth considering for preferred syringes?
As described in RFA Section III, Attachment A to the Agreement (posted on COMMBUYS) must be completed in its entirety, which will constitute the manufacturer’s proposed Rebate offer for each 11-digit NDC for Syringes 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 Syringe) 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.
Do you have an item number for syringes?
The following United Nations Standard Products and Services Code (UNSPCS) codes are identified on the COMMBUYS listing: 42-14-00 (patient care and treatment products and supplies), and 42-14-16 (syringes and accessories).
Q.7. Are all sales directly between the manufacturer and Massachusetts EOHHS, or if not, how many new direct customer account setups would be involved to comply with/administer this agreement?
MassHealth expects syringes to be dispensed to members by a pharmacy. MassHealth is not intending to support direct customer accounts. MassHealth will then invoice manufacturers for the agreed-upon rebate amount.
Q.8. Would vendors receive orders and invoice the customer(s) via POPS (Pharmacy Online Processing System)?
No. POPS is used to adjudicate pharmacy claims. It is not an ordering or manufacturer invoicing portal. Vendors are expected to supply syringes to pharmacies for dispensing to eligible members.
Q.9. Are rebate invoices through POPS (Pharmacy Online Processing System)?
No. As described in the RFA Section II, MassHealth will provide contracted vendors with rebate invoices on a quarterly basis. Invoices are delivered by our pharmacy benefit administrator (PBA).
Q.10. What is the transmission method of rebate discrepancies to Massachusetts EOHHS (are we expected to transmit discrepancies via POPS)?
Rebate disputes are reported on the vendors’ Reconciliation of State Invoice (ROSI)/Prior Quarterly Adjustment Statement (PQAS).
Q.11. What is the expected payment method of rebate invoices to the EOHHS (Wire/Check)?
EOHHS accepts rebate payments via wire and/or check.
Q.12. Is there a minimum Unit of Measure (UOM) requirement for rebate invoices, or could we receive a rebate invoice for UOM each (EA)?
Rebate invoicing is based on Units at the NDC level. Rebate invoices for syringes will be delineated by number of syringes (i.e., EA).
Q.13. Are there any POPS training materials available for review prior to executing these agreements?
The POPS billing guide is available at https://www.mass.gov/doc/pops-billing-guide-10/download. Individual questions relating to POPS can be addressed during contract negotiations with successful Applicants.
Q.14. Syringes Model Rebate Agreement Section 2.3 Patient Information: Will manufacturers receive receiving identifying information, including customer name and address?
As described in the Model State Rebate Agreement Section 2.3, MassHealth will not provide vendors with patient-identifiable information or protected health information (PHI).
Q.15. Syringes Model Rebate Agreement Section 3.3: How is a manufacturer expected to notify the EOHHS of any “incomplete rebate submissions?” Is this done in the POPS (Pharmacy Online Processing System)?
As described in Section 5.3 of the Model State Rebate Agreement, any notice required or permitted to be given by either party to the other shall be given in writing, in person or sent, with confirmation of receipt, by first class mail or express delivery, or by e-mail, addressed to the other party at the address set forth in the Model State Rebate Agreement.
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