26-446DOI-FINAD-B-50721 | RFP - Pharmacy Benefit Managers Oversight and Reform Implementation Services

The Illinois Department of Insurance is soliciting proposals under solicitation number 26-446DOI-FINAD-B-50721 for Pharmacy Benefit Manager (PBM) Oversight and Reform Implementation Services. This new initiative aims to ensure compliance with the Prescription Drug Affordability Act and related legislation by eliminating spread pricing, preventing PBM steering practices, and facilitating 100 percent rebate pass-throughs. The selected vendor or vendors will provide regulatory oversight, reform recommendations, forensic accounting, data and pricing specialist services, and the development of annual transparency reports and market conduct examinations. A key requirement includes the submission of a comprehensive training plan within 30 days of contract execution, with materials updated every six months to support Department staff. The contract features a multi-award structure consisting of primary, secondary, and tertiary vendors, with an initial five-year term that may be extended up to a maximum of ten years. Services will be requested on an as-needed basis, and the state will utilize a tiered approach where the primary vendor is offered work first. Evaluation is based on a combination of technical qualifications and a Commitment to Diversity score, with a minimum threshold of 840 points required to proceed to price evaluation. Price points are awarded based on the sum of hourly rates. All proposals, including technical documents and pricing, must be submitted electronically via the BidBuy portal. Successful vendors must execute a non-disclosure agreement and comply with Illinois state procurement regulations, including diversity and cybersecurity certifications.