26EHSKACLMLRFA: RFA for Fee-for-Service Claims for Lancets

The Massachusetts Executive Office of Health and Human Services (EOHHS) is issuing a Request for Applications (RFA) for rebate agreements from lancet manufacturers to provide rebates on lancets dispensed to MassHealth members and Health Safety Net patients through pharmacy fee-for-service claims and participating MassHealth Managed Care Entities. Applicants must submit a completed signed State Rebate Agreement with specific rebate offers expressed as a fixed Guaranteed Net Unit Price (GNUP) per lancet unit by National Drug Code (NDC), along with a cover letter describing relevant experience and clinical benefits, and contact information. The procurement targets the integration with the existing Pharmacy Online Processing System (POPS) and MassHealth MCEs, with anticipated lancet utilization of approximately 43,300 fee-for-service claims for 21,760 members in calendar year 2024 and 38,840 claims through MCEs for approximately 18,200 members. The initial agreement term spans 24 months, effective January 1, 2027, through December 31, 2028, with potential extension in increments for up to three additional years at EOHHS's discretion. Manufacturers must provide quarterly rebates calculated as the difference between wholesale acquisition cost (WAC) and the GNUP, maintain customer service and training support, publish WAC pricing through CMS-designated national price compendia, and ensure providers can purchase covered lancets below WAC. Evaluation criteria assess proposals on compliance with response requirements and best value factors, including previous experience as a preferred lancet manufacturer for state Medicaid programs within the past five years, clinical benefits, proposed GNUP pricing competitiveness, and other value-related considerations. The deadline for question submission is February 20, 2026, at 5:00 PM, with all application responses due by March 27, 2026, at 5:00 PM via email to EOHHS-Procurement@mass.gov and through the COMMBUYS system.

This procurement contains no explicit set-aside designations for disadvantaged enterprises or restrictions limiting eligible respondents to specific organization types; however, EOHHS reserves the right to modify any provision of the agreement or establish one or more preferred lancets based on best value considerations. No incumbent vendors or current contractors are identified in the solicitation materials, suggesting this may be a new or re-competed procurement. The RFA does not specify guaranteed minimum or maximum award values or budget ranges; instead, compensation is structured as quarterly rebates calculated on a per-unit basis using the GNUP formula, with actual rebate amounts dependent on manufacturer-proposed pricing and utilization volumes. EOHHS explicitly reserves the right to enter into agreements with one or more manufacturers and does not guarantee any particular volume of utilization, meaning award values will be contingent upon actual claims processed and the GNUP prices offered by selected manufacturers. Manufacturers must comply with all applicable state and federal laws, retain all records for seven years, and accept that EOHHS retains the unilateral right to modify contract terms, scope, and rebate amounts at its sole discretion.