Pharmacy Benefit Management Services

The New York State Department of Health requires a vendor to provide pharmacy benefit management services, including prior authorization and utilization management support, for an onshore, six-year contract term. The selected vendor must provide 100% dedicated key personnel—such as an account manager, clinical contact center manager, clinical staff manager, stakeholder education manager, and a New York licensed pharmacist—to perform onsite work in Albany, NY. Pharmacies submit claims for automated review, and any failed criteria trigger a rejection message directing the prescriber to contact the clinical contact center. Eligible bidders must meet the specified staffing experience requirements and operate within the United States. Applicants must submit questions by November 3, 2026, and deliver their technical and cost proposals digitally via email or online using the mandatory Excel format for pricing. Evaluation is based on a composite score where the technical proposal accounts for 70% (70 points) and the cost proposal accounts for 30% (30 points), with the lowest price receiving the maximum cost points.