902795-Pharmacy Benefit Management Services

Alameda County Behavioral Health Department is requesting proposals for Pharmacy Benefit Management services under RFP 902795, with proposals due November 4, 2026 at 2:00 p.m. and a bidders conference on October 8, 2026. The Small Local Emerging Business (SLEB) program applies: non-certified SLEB bidders must subcontract with a certified SLEB for at least 20 percent of the total estimated bid amount; certified SLEB bidders and local bidders may each receive up to 5 percent bid preference points for a maximum of 10 percent combined.

The County serves approximately 50,000 patients annually with serious and persistent mental illness, administering pharmaceutical coverage for uninsured patients, HealthPAC Behavioral Health Care Specialty Service participants, Medi-Cal clients with denied prior authorizations or share-of-cost requirements, and Medicare Part D clients. During fiscal year 2024–2025, ACBHD processed approximately 1,600 prescriptions for 650 uninsured patients through 45 retail pharmacies with estimated pharmaceutical costs of $135,000. The scope requires fully transparent pass-through pricing with no retained spreads, differentials, rebates, or administrative fees except those expressly identified. The adjudication fee shall not exceed $17.00 per paid claim. The County will receive not less than 90 percent of all rebates and manufacturer remuneration attributable to County prescription claims.

Minimum qualifications include at least five years of PBM services experience with public or governmental agencies, all necessary permits and licenses, and at least two years of experience with governmental healthcare programs. Performance guarantees mandate 99.9 percent monthly claims system availability, 99.5 percent claims adjudication accuracy, 99.5 percent financial accuracy, 99.5 percent eligibility processing accuracy, and monthly claims data delivery by the third business day.

The County intends to award a three-year contract with the option to renew for two additional years. Contract start is May 1, 2027. All pricing must remain fixed and firm for the initial contract term. Written questions are due October 9, 2026; answers will be released October 22, 2026. The notice of intent to award will be issued December 11, 2026, with Board consideration and award on February 23, 2027.