Medicaid Drug Rebate System (MDR)

The State of Nebraska Department of Health and Human Services is requesting proposals for a new Medicaid Drug Rebate System (MDR) under RFP #124528, with written questions due June 23, 2026 and proposals due July 23, 2026 at 2:00 p.m. Central Time.

The scope encompasses design, development, testing, implementation, and five-year operational support of a comprehensive system to manage Medicaid drug rebates, including rebate calculations, claims processing, vendor management, and reporting. The system must integrate with Nebraska's Medicaid Management Information System (MMIS), Health Insurance Administration (HIA), Centers for Medicare & Medicaid Services (CMS), managed care organizations, and pharmacy benefit managers across eighteen defined data interfaces using SFTP, NDM, and other transmission methods. The contractor must capture rebate data for timely invoicing within 60 days of each quarter end, generate automatic delinquent letters within 10 business days, complete quarterly rebate file generation within 1 business day of invoice cycle completion, and provide dispute resolution support within 5 business days of DHHS request. The system must comply with Section 1927 of the Social Security Act, applicable CFR provisions (42 CFR 447.509, 447.511, 447.520), HIPAA regulations, and NIST standards. The contractor must designate Privacy and Information Security Officials, implement administrative, physical, and technical safeguards, and notify DHHS of breaches to federal information within one hour of discovery and all other confidential information within 15 days. The contractor bears all costs for breach investigation, mitigation, and notification.

The initial contract term is five years with one optional three-year renewal; pricing must remain fixed for the first five years. The contract includes performance guarantees with daily monetary penalties ranging from $500 to $5,000 per incident for non-compliance across six requirement categories. The vendor must provide trained operational staff 30 calendar days prior to Go Live and replace key personnel within 30 calendar days. The vendor must develop and submit a DHHS-approved Turnover Plan at least 180 days before contract end. The evaluation period runs July 30 through August 13, 2026, with Intent to Award expected August 27, 2026. The State may consider resident disabled veteran and designated enterprise zone preferences under Nebraska Revised Statutes and reserves the right to conduct best and final offer rounds and vendor demonstrations. Contract finalization is targeted for September and October 2026, with a January 2027 award and start date.