Specifications include, but are not limited to: Services and systems to be provided include, but are not limited to, the following: Claims Processing and Operational Support The PBM must ensure claims processing policies and procedures are compliant with all applicable state and federal laws, regulations, rules, and policies. Claims adjudication is the responsibility of the PBM; however, provider payments are made by the State's current MMIS Fiscal Agent. Under this scenario, the PBM transmits the adjudicated claims electronically to the MMIS Fiscal Agent, and the MMIS Fiscal Agent performs all of the tasks associated with payments to providers and reporting to the State. In adjudicating claims the PBM would perform a number of prescribed functions, including applying DUR edits, Prior Authorizations, and COB functions. Pharmacy Point-of-Sale (POS) claims processing system The DHCFP is seeking a PBM vendor who will operate a real‐time (POS) online claims processing system with current NCPDP format and guidelines with an emphasis on drug utilization review (DUR), utilization management (UM), prior authorization, messaging, processing and reimbursement for clinical services (MTM, Immunization administration, and other), and 340B eligible drugs. The PBM’s POS claims processing system must be capable of adding, changing or removing adjudication rules, edits and customized transmission messages to accommodate required changes for its current and future pharmacy programs. The POS claims processing system may include point‐of‐sale durable medical equipment claims processing, such as diabetic supplies. In addition, the system should be capable of processing both NDC and UPC codes. The system must be capable of displaying the PDL status of a drug. The Vendor must describe their approach to providing a Point-of-Sale system.