Contract 166149 amendment 6 extension and funds increase request

The State of Utah Department of Health and Human Services Division of Integrated Healthcare is seeking to extend Contract 166149 for drug rebate management services supporting Medicaid pharmacy operations without engaging in a standard competitive procurement process. This Notice of Intent to Award represents an amendment 6 extension and funds increase request with a public comment period concluding on February 12, 2026. The scope of services includes evaluating pharmacy rebates from point-of-sale claims, invoicing manufacturers, managing rebate payments, handling disputed invoices for both fee-for-service and accountable care organization claims, reconciling state invoices with prior quarter adjustments, calculating interest on late payments, generating quarterly invoices, completing Centers for Medicare and Medicaid Services 64.9R forms, and managing dispute resolution processes with drug manufacturers. The contract extension covers a six-month period from April 1, 2026, through September 30, 2026, with no renewal options, and is intended to maintain continuous rebate management services until a new point-of-sale system is implemented on October 1, 2026. The extension is justified as necessary to prevent the loss of federal funds and to enable continued receipt of services during implementation delays of a newly awarded contract, as an RFP has been completed and a new point-of-sale vendor has been selected but unanticipated delays have extended the new vendor's go-live date by six months.

The incumbent vendor for this contract is Change Healthcare Pharmacy Solutions, Inc., which has operated under Contract Number 166149 since its original award in 2011 as a sole source procurement, making this a single-source non-competitive award based on transitional cost considerations and operational continuity requirements. All responding vendors must certify compliance with Utah Code 63G-27 regarding economic boycotts and boycotts of the State of Israel. The estimated contract extension value is $137,683.72 with no freight costs, bringing the current total contract amount from $2,309,045.72 to $2,446,729.44, representing a 143 percent increase from the original contract total of $1,005,000.00 awarded in 2011. Claimants may submit Business Confidentiality Claims in accordance with Utah Code provisions 63G-2-305 and 63G-2-309 for trade secrets or commercial financial information included in proposals, with both redacted and non-redacted versions required for proper consideration. Contract funding may be supplemented if the legislature provides additional appropriations for the identified scope of work.