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Prescription Drug & Pricing Specialist Services

Active
State & Local

Contract Overview

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

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This subcontract for Prescription Drug and Pricing Specialist Services supports prime contractors on oversight projects for the Illinois Department of Insurance. The selected specialist will provide subject matter expertise in PBM financial operations and drug pricing models, specifically analyzing MAC lists, AWP-based pricing, NADAC, and rebate structures. The primary objective is to identify steering mechanisms and evaluate the fairness of reimbursement practices to deliver comprehensive pricing model analyses and regulatory recommendations. The role requires a minimum of three years of professional experience as a pharmacist or drug specialist. Performance of the contract is centered in Springfield, Illinois, under the agency of Finance and Administration. The services fall under NAICS code 541611, focusing on administrative and management consulting to ensure rigorous oversight of pharmacy benefit management.

General Info

Pharmacist specialist provides drug pricing and PBM oversight for Illinois Department of Insurance.

Documents

This scope was carved out of 26-446DOI-FINAD-B-50721.

The full solicitation package (9 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

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

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Timeline

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Organization & Contact Information

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AgencyIllinois → Finance & Administration
ContactsNo contacts available
OfficeN/A
Office AddressN/A
ContactsNo contact information available

Full Description

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Provides subject matter expertise on PBM financial operations and drug pricing models for prime contractors on Illinois Department of Insurance PBM oversight projects. Analyzes MAC lists, AWP-based pricing, NADAC, and rebate structures to identify steering mechanisms and assess reimbursement fairness. Requires minimum 3 years experience as a Pharmacist or drug specialist. Delivers pricing model analysis and regulatory recommendations.

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Same awarding agency

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