Single Pharmacy Benefit Manager

The Nevada Health Authority's Division of Medicaid is issuing a Request for Information (RFI) regarding a Single Pharmacy Benefit Manager (sPBM) to consolidate pharmacy benefit administration across Fee-for-Service and Managed Care Organization delivery models, with responses due by May 29, 2026, at 5:00 PM PST. This RFI is informational in nature and does not constitute a request for proposal or invitation to bid, nor will it result in an award; rather, it is designed to inform the State's upcoming procurement mandated by Senate Bill 389 enacted during the 2025 Legislative Session. The Nevada Health Authority seeks qualified vendors with demonstrated expertise in high-volume public health programs and sophisticated public sector employer plans to administer pharmacy benefits for approximately 800,000 Medicaid recipients and public sector employer plans. Key RFI questions address organizational capabilities in administering Medicaid and public sector pharmacy benefits; rebate negotiation and administration strategies; contracting arrangements with Medicaid MCOs under an administrative-only model; implementation timeline recommendations; efficiency and value achievement strategies across multiple markets; phased implementation approaches; and high-level cost estimates for a five-year sPBM contract with phased implementation. The RFI response template requires vendors to restate each question before providing answers, with responses limited to one to two pages per question using minimum 11-point Calibri font and one-inch margins. Vendor questions must be submitted by May 17, 2026, at 5:00 PM PST, with answers to be posted as an addendum by May 22, 2026. The State has already implemented a Single Preferred Drug List effective January 1, 2026, as a foundational step toward centralized pharmacy benefit oversight.

The RFI documentation does not specify any set-aside designations or restrictions limiting responses to particular types of organizations, such as disadvantaged enterprises or minority-owned businesses. No incumbent vendors or current contractors are identified in the available RFI materials. Interested vendors should note that the State has already established infrastructure through the implementation of the Single Preferred Drug List effective January 1, 2026, which represents existing technology and systems that successful bidders in any subsequent formal procurement may need to integrate with or build upon. The RFI does not disclose a specific budget range or award value; however, vendors are requested to provide high-level cost estimates for a five-year sPBM contract incorporating a phased implementation approach, which will inform the State's future procurement planning and budget development. Responses must be submitted to rxinfo@nvha.nv.gov, and submissions that do not follow the specified instructions may be excluded from Division review.