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Prior Authorization (PA) Administration

Active

State & Local

Response Deadline12/08/2026, 05:00:00 AM UTC

Contract Overview

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

AI Contract Overview

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This subcontract for the New York State Department of Health focuses on the administration of the prior authorization process for prime contractors. The scope of work involves processing and adjudicating requests specifically for the Preferred Drug Program and the Preferred Diabetic Supply Program. To ensure strict adherence to state diabetic supply guidelines, the contractor will utilize specialized processing software and a clinical review team composed of nurses and pharmacists. The selected provider is responsible for delivering final adjudicated decisions and comprehensive program compliance reports. This opportunity is categorized under NAICS code 621999, with a response deadline set for December 8, 2026.

General Info

Subcontract for NYSDOH prior authorization processing for preferred drug and diabetic supply programs.

Agency

New York → NYS Department of Health

NAICS

621999 - All Other Miscellaneous Ambulatory Health Care Services

Place of Performance

NY, USA

Set-Aside

NONE

Documents

This scope was carved out of 2139865.

The full solicitation package (1 document), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Request for Proposals: C043525 Pharmacy Benefit Management Services

AI Contract Breakdown

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Timeline

PostedOct 14

subcontract

Response DeadlineDec 8

Submission deadline

Response Deadline

12/08/2026, 05:00:00 AM UTCin about 2 months

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Organization & Contact Information

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AgencyNew York → NYS Department of Health

ContactsNo contacts available

OfficeN/A

Organization / AgencyNew York → NYS Department of Health

Office AddressN/A

ContactsNo contact information available

Full Description

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Administers the prior authorization process for prime contractors on NYS Department of Health projects. Processes and adjudicates Prior Authorization (PA) requests for the Preferred Drug Program and the Preferred Diabetic Supply Program. Utilizes PA processing software and clinical review staff including pharmacists and nurses to ensure adherence to NYS DOH diabetic supply guidelines. Delivers adjudicated PA decisions and program compliance reports.

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