CDC WORLD TRADE CENTER (WTC) HEALTH PROGRAM PHARMACY BENEFITS MANAGER
ID: 75D301-254-SS-524292Type: Sources Sought
Overview

Buyer

HEALTH AND HUMAN SERVICES, DEPARTMENT OFCENTERS FOR DISEASE CONTROL AND PREVENTIONCDC OFFICE OF ACQUISITION SERVICESATLANTA, GA, 30333, USA

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

PSC

MEDICAL- PHARMACOLOGY (Q517)

Original Source

https://sam.gov/opp/1086496deb8d4b47853d25489e272781/view
Timeline
    Description

    The Centers for Disease Control and Prevention (CDC) is seeking qualified vendors to provide Pharmacy Benefits Manager (PBM) services for the World Trade Center (WTC) Health Program, which supports responders and survivors affected by the 9/11 attacks. The contract will span three years, including a 12-month implementation period, a peak operational phase, and a 12-month transition-out period, requiring vendors to demonstrate capabilities in system customization, customer care, clinical services, reporting, and cost control. This initiative is critical for ensuring compliance with the program's regulations, which mandate customized drug formularies and prior authorization processes for medically necessary treatments. Interested parties must submit their qualifications by February 14, 2025, and can direct inquiries to Laurie Presley at xnp0@cdc.gov.

    Point(s) of Contact
    Laurie Presley
    xnp0@cdc.gov
    Files
    Title
    Posted
    1.DRAFT SOW_PBM_3Year.pdf
    The World Trade Center (WTC) Health Program was created by the Zadroga Act to offer healthcare services to responders and survivors of the 9/11 attacks. The program provides medical monitoring and treatment for conditions linked to the attacks, with enrollment numbers showing a recent increase in both responders and survivors. The program presents unique challenges in managing pharmacy benefits due to its limited coverage scope, which only includes specified conditions. A prescription benefit manager (PBM) is needed to deliver comprehensive pharmacy services while ensuring compliance with federal regulations, including a need for customized technology to manage formularies and prior authorizations effectively. Key tasks for the PBM include developing a functioning pharmacy network across the US, implementing electronic systems for efficient claims processing, conducting regular audits, and establishing a quality assurance plan. The PBM must also provide transparent pricing, manage change controls, and implement an effective communications strategy to keep stakeholders informed. This contract encompasses all aspects of pharmacy benefit operations for the WTC Health Program, aimed at ensuring optimal care for enrollees while maintaining regulatory compliance and cost-effectiveness.
    2.PBMSourcesSought_3Year_Final_Sam.Gov.pdf
    The Centers for Disease Control and Prevention (CDC) is seeking interested parties to provide Pharmacy Benefits Manager (PBM) services for the World Trade Center (WTC) Health Program, aimed at administering pharmacy benefits for responders and survivors affected by the 9/11 attacks. This contract spans three years with specific implementation and operational timelines, including a transition period, a peak operational phase, and a transition-out phase. The WTC Health Program, established under the Zadroga Act, requires customized drug formularies and prior authorization processes to ensure that only medically necessary treatments are provided in line with the program's regulations. Respondents are expected to demonstrate capabilities in system customization, customer care, clinical services, reporting, and cost control. Challenges in implementation and continuity of care during transitions are acknowledged, with emphasis on the need for innovative solutions and collaboration. Interested vendors must submit their qualifications by February 14, 2025, to support the unique needs of this limited-benefit health program while ensuring compliance and operational efficiency throughout the contract duration.
    Lifecycle
    Title
    Type
    CDC WORLD TRADE CENTER (WTC) HEALTH PROGRAM PHARMACY BENEFITS MANAGER
    Currently viewing
    Sources Sought
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