This Request for Proposals (RFP) is published to solicit proposals for a Pharmacy Benefit Manager (PBM) to adjudicate pharmacy claims for the New Hampshire Department of Health and Human Services, Division of Medicaid Services, Medicaid Fee-for-Service (FFS) Program, and the Division of Public Health Services (collectively, the “State” or “Department” ), and ensure accuracy in the payment to New Hampshire Medicaid enrolled pharmacies and individuals, and Public Health enrolled pharmacies. The primary objectives include: • Improving the quality of pharmacy services for individuals and providers; • Maintaining access to needed pharmaceuticals; • Improving business processes; • Improving the cost structure of the New Hampshire Medicaid and Public Health Programs; and • Informing the State of industry changes and making recommendations for improvements. The State in the future may require the use of a single PBM for all Medicaid Managed Care Organizations (MCOs).
