New York bid · open for prices

Pharmacy Benefit Management Services

This bid is for pharmacy benefit management services covering all of New York State.

Please quote pharmacy benefit management services, including prior authorization and utilization management, for New York State on a six-year term.

Scope: Prior authorization and utilization management for pharmacy drugs, diabetic supplies, physician-administered drugs, DME, medical supplies, and enteral nutrition.
Technology: HIPAA-compliant electronic authorization portal, eMedNY and EHR integration, three years of historical data migration, and real-time reporting dashboards.
Support: 24/7 contact center with technician, pharmacist, and physician escalation; authorization requests resolved within 24 hours with at least 95% accuracy.
Extras: Member and prescriber notices, multilingual support, provider education, clinical consulting, and appeals support.
Term: Anticipated start December 1, 2027, with implementation within six months; six-year term with one optional one-year renewal.
Volume: About 35,000 pharmacy/diabetic supply, 1,000 physician-administered drug, 1,500 DME/medical supply, and 1,500 enteral nutrition authorizations per month.

Please confirm availability and send your quote by December 8, 2026.

The original documents

Deadline: December 8, 2026

See the original on www.nyscr.ny.gov

Bidding it yourself? Get the full package and submit on nyscr.ny.gov before December 8, 2026.

ScopePrior authorization and utilization management for pharmacy drugs, diabetic supplies, physician-administered drugs, DME, medical supplies, and enteral nutrition.
TechnologyHIPAA-compliant electronic authorization portal, eMedNY and EHR integration, three years of historical data migration, and real-time reporting dashboards.
Clinical support24/7 contact center with technician, pharmacist, and physician escalation; authorization requests resolved within 24 hours with at least 95% accuracy.
Additional servicesMember and prescriber notices, multilingual support, provider education, clinical consulting, and appeals support.
TimelineAnticipated start December 1, 2027; implementation within six months; six-year term with an optional one-year renewal.
PricingProvide implementation fees, monthly operating fees, per-authorization rates, and hourly system development rates. Estimated monthly staffed authorizations: 35,000 pharmacy/diabetic supply, 1,000 physician-administered drug, 1,500 DME/medical supply, and 1,500 enteral nutrition.

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