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Pharmacy Fraud, Waste, and Abuse (PFWA) Auditor

Active

State & Local

Response Deadline10/28/2026, 12:00:00 AM UTC

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

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This subcontract opportunity is for a Pharmacy Fraud, Waste, and Abuse (PFWA) Auditor to support prime contractors on Georgia Department of Community Health Medicaid projects. The role involves performing pharmacy audits and analyzing claims data to identify irregularities, overpayments, and fraudulent billing patterns in accordance with CMS regulatory requirements. The selected provider will utilize pharmacy claims processing systems and data analytics software to deliver detailed audit reports, findings, and recovery recommendations. The contract falls under NAICS code 541211 and is associated with the Georgia agency. Interested parties must respond by October 28, 2026, following the posting date of October 29, 2025. This engagement is part of the broader Medicaid Enterprise Systems Pharmacy Benefit Services framework.

General Info

PFWA Auditor for Georgia Medicaid projects; pharmacy audits and claims analysis due 10/28/2026.

Agency

NAICS

541211 - Offices of Certified Public Accountants

Place of Performance

GA, USA

Set-Aside

NONE

Documents

This scope was carved out of 41900-DCH000013.

The full solicitation package (5 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Medicaid Enterprise Systems - Pharmacy Benefit Services (2025 - 2035)

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Timeline

PostedOct 29

subcontract

Response DeadlineOct 28

Submission deadline

Response Deadline

10/28/2026, 12:00:00 AM UTCin 14 days

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Organization & Contact Information

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AgencyGeorgia

ContactsNo contacts available

OfficeN/A

Organization / AgencyGeorgia

Office AddressN/A

ContactsNo contact information available

Full Description

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Performs audits to identify and mitigate fraud, waste, and abuse for prime contractors on Georgia Department of Community Health Medicaid projects. Conducts pharmacy audits, analyzes claims data for irregularities, and identifies overpayments or fraudulent billing patterns per CMS regulatory requirements. Uses pharmacy claims processing systems and data analytics software. Delivers audit reports, findings, and recovery recommendations.

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