26EHSPMCLMNDLRFA: RFA for Fee-for-Service Claims for Needles

The Commonwealth of Massachusetts Executive Office of Health and Human Services (EOHHS) issued a Request for Applications (RFA) for fee-for-service claims rebate agreements with needle manufacturers serving MassHealth and Health Safety Net programs. The procurement seeks one or more rebate agreements with manufacturers of sterile, single-use hypodermic needles identified by National Drug Code (NDC), with coverage extending to both fee-for-service claims processed through the Pharmacy Online Processing System (POPS) and claims paid through participating MassHealth Managed Care Entities. Qualified manufacturers must submit a completed State Rebate Agreement with Attachment A detailing proposed rebate offers, a signed cover letter describing relevant experience and clinical benefits, and contact information for the manufacturer's representative. The GNUP pricing structure requires manufacturers to propose fixed Guaranteed Net Unit Price offerings across four designation categories—Exclusive Basis, Dual Basis, 1 of Many, and Non-Preferred—calculated by subtracting the rebate amount from the Wholesale Acquisition Cost in effect at the end of each calendar quarter. Evaluation criteria assess proposal compliance, previous experience as a preferred needle manufacturer for Medicaid programs within the past five years, clinical benefits, proposed GNUP pricing, and other best value considerations. The submission deadline is March 27, 2026 at 5:00 PM via email to EOHHS-Procurement@mass.gov, with questions due by February 20, 2026 at 5:00 PM, and the anticipated contract term is 24 months beginning January 1, 2027, with optional extensions up to three additional years at EOHHS's discretion. In calendar year 2024, approximately 2,080 fee-for-service claims and 4,230 managed care entity claims were submitted for needles across approximately 3,040 total patients and members.

The RFA does not specify set-aside designations or restrictions limiting response eligibility to particular organization types or disadvantaged enterprises; however, manufacturers must have prior experience serving Medicaid programs as preferred needle vendors within the past five years. No incumbent vendors or existing contractor information is identified in the procurement materials, and manufacturers are required to submit current Wholesale Acquisition Cost pricing to First Data Bank or another national price compendium throughout the agreement term to ensure accurate rebate calculations. The contract includes mandatory record maintenance requirements for seven years with audit availability to EOHHS, the Commonwealth of Massachusetts, or federal authorities. EOHHS reserves the right to reject any bid, request clarification or best and final offers, negotiate terms, and cancel the solicitation at any time, while also retaining the ability to enter into rebate agreements with multiple needle manufacturers simultaneously. No specific award value or guaranteed volume is provided, as EOHHS explicitly does not guarantee any particular volume of utilization during the contract term, with actual rebate payments calculated quarterly based on actual units of covered needles dispensed to eligible beneficiaries.