Medicare Part D Claims Switching Services

The Texas Health and Human Services Commission is requesting bids for Medicare Part D claims switching services to support twenty-one pharmacy locations under IFB HHS0017787, with responses due August 17, 2026, at 10:30 a.m. and questions due August 6, 2026.

Services include pharmacy claim switch operations, reclaim and pre/post editing, commercial card finder eligibility searches, Medicare D eligibility and mapping searches, average wholesale price resubmissions, and prescriber schedule authority services. All work must be performed online during regular business hours (8 a.m. to 5 p.m., Central Time, Monday through Friday) with a four-hour response requirement for service calls. Bidders must demonstrate a minimum of five years of relevant experience, provide three verifiable references from similar contracts within the past five years, and complete background checks on all assigned personnel prior to contract start.

The initial contract term runs September 1, 2026, through August 31, 2028, with three optional one-year renewal periods and one additional one-year extension option at HHSC's discretion. Pricing must be submitted as firm, fixed prices on Exhibit C Pricing Sheet covering all labor, equipment, materials, and related expenses. The historical annual spend for comparable services is $47,643.18 (June 10, 2024, through June 30, 2026) provided as guidance only and not representing guaranteed volumes. Price adjustments require HHSC approval using Consumer Price Index formulas or federal minimum wage increases with supporting documentation.

Contractors must maintain comprehensive insurance: workers' compensation with employer's liability of $1,000,000 each, commercial general liability of $1,000,000 per occurrence and $2,000,000 aggregate, commercial automobile liability of $1,000,000, professional liability of $1,000,000, and umbrella liability of $1,000,000. Mandatory submissions include Exhibit A (HHS Solicitation Affirmations), Exhibit C (Pricing Sheet), and Exhibit D (Bidder Reference Form). Responses are binding offers for 240 days from submission. The contract is governed by Texas law with venue in Travis County.