Pharmacy Benefit Manager Dispensing Fee and Reporting

The State of Idaho Department of Insurance is conducting a Request for Proposal (RFP) for a Pharmacy Benefit Manager (PBM) Dispensing Fee Survey and Reporting contract, targeting Ada County and statewide interests. The primary objective is to engage a qualified vendor to design and conduct a comprehensive study of PBM dispensing fees in Idaho, producing a detailed report with recommendations for Department of Insurance (DOI) compliance activities related to recent PBM regulations under House Bill No. 596a. The vendor must develop a reporting structure and compliance review tools to enable ongoing PBM regulatory oversight. Key deliverables include a technical proposal demonstrating business information, organizational capabilities, and a robust scope of work that addresses regulatory compliance requirements. The initial contract term is two years, with potential extension to four years upon mutual agreement. A non-mandatory pre-proposal conference is scheduled for September 11, 2024, with proposals due by October 11, 2024. Evaluation criteria will focus on the technical proposal, with cost proposals only reviewed for the top three technically scored offerors. The contract will be awarded to the responsive, responsible offeror achieving the highest total normalized score.

The solicitation does not specify explicit set-aside designations or restrictions on responding organizations. No incumbent vendor information is provided in the documentation. Vendors must comply with state and federal laws, provide a quality assurance plan, and develop a transition plan for the DOI. While specific budget ranges are not detailed, the contract requires comprehensive regulatory compliance services for PBM dispensing fees. Potential respondents must demonstrate expertise in healthcare regulatory analysis, data collection methodologies, and reporting capabilities specific to pharmacy benefit management. The procurement approach suggests a competitive selection process emphasizing technical competence and innovative compliance solutions. Vendors will need to show capability in developing sophisticated reporting frameworks and providing actionable recommendations for regulatory oversight of pharmacy benefit management practices in Idaho.