New Mexico Health Care Authority

Buyer seeks a qualified contractor to develop and maintain a preferred drug list and supplemental rebate program for the state's Medicaid program. The contractor will establish a Pharmaceutical and Therapeutics Committee, negotiate supplemental rebates with manufacturers, and process rebate payments. Currently, Fee-for-Service Medicaid does not have an aligned preferred drug list, representing an opportunity for cost savings within the state. The program covers 838,000 lives with nearly 167,000 in Fee-for-Service.

• 4/16/2025 - Issue RFP
• 4/23/2025 - Acknowledgement of Receipt Form
• 4/25/2025 - Deadline to Submit Written Questions
• 4/30/2025 - Response to Written Questions
• 5/12/2025 - Proposal Due Date

• Create and maintain a preferred drug list (PDL)
• Establish a Pharmaceutical and Therapeutics (P&T) Committee
• Negotiate supplemental rebate agreements with pharmaceutical manufacturers
• Process and collect supplemental rebates
• Present clinical monographs at P&T Committee meetings
• Develop prior authorization and step-care criteria
• Analyze rebate data to enhance savings
• Produce systematic therapeutic class reviews
• Invoice for medications dispensed in Fee-for-Service and Managed Care
• Interface with PBA and other vendors