SLED Opportunity · DELAWARE · DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES
AI Summary
RFP for comprehensive pharmacy benefit management and support services for Delaware's Ryan White AIDS Drug Assistance Program, including client eligibility, claims processing, pharmacy network management, and reporting.
The Bidder agrees to provide comprehensive pharmacy benefit & information management; client eligibility administration, coordination of benefits and payer of last resort program management, statewide retail pharmacy network management, claims processing, AIDS Drug Assistance Program (ADAP) formulary management, ADAP program member technical support, and reporting and data management as described:a. Client Eligibility - Client eligibility must be managed electronically with real time data to ensure that at the time of service, eligible clients receive approved items on the ADAP formulary. All eligible clients will be issued a program eligibility card, which will assure them service at any of the private pharmacies within the network.The Department will provide client eligibility information on a specified frequency that will allow for the timely delivery of program services. The Bidder is relying on the accuracy and completeness of client eligibility information provided by the Department and the Bidder will not be responsible for any errors committed by Department.b. Coordination of Benefits and Payor of Last Resort - Clients primary and secondary insurance is billed first to ensure that Ryan White Part B/ADAP is payor of last resort.c. Statewide Pharmacy Networks – A statewide retail pharmacy network must be available to dispense program formulary items in the various geographical areas where the eligible insured program members or those approved to access the retail pharmacy network are located.d. Claims Processing – Manage electronic claims adjudication for the retail pharmacy network according to the National Council for Prescription Drug Process (NCPDP) Telecommunication Standard 5.1 or above. Process electronic claims received from the network pharmacies providing prescription benefits to insured clients and those approved by the Department to access the retail pharmacy network. Provide Ryan White Part B/ADAP program a billing statement and a claims adjudication summary twice a month.Manage electronic claims adjudication for medical supplies that have been assigned an 11-digit NDC according to the National Council for Prescription Drug Process (NCPDP) Telecommunication Standard 5.1 or above.Provide a manual claim process for the billing of medical supplies that have not been assigned an 11-digit NDC.e. Pharmacy Payment Processing – Provide fiscal intermediary services for pharmacy providers to include payment of approved dispensed prescriptions and accompanying explanation of benefits (EOB).f. ADAP Formulary Management – All network pharmacies will have an up-to-date program formulary. Only items on the formulary will be approved at the time of service.g. ADAP Program Member Technical Support – Staff a help desk to provide information regarding pharmacy locations and to provide answers to most questions regarding the Delaware ADAP pharmacy benefit.h. Reporting and Data Management – Provide electronic report data that includes all of the data fields captured within the data management system that are required for Ryan White Part B/ADAP grant requirements such as ADAP reports, ADR reports and RSR reports. Report data must be submitted prior to reporting requirement due dates as specified by the Department.Please refer to the Scope of work on pages 3-5 of the RFP document and Appendix B - Scope of Work and Technical Requirements.
| Status | Event Name | Location | Description | Dates | Mandatory |
|---|---|---|---|---|---|
| Ongoing | Open Date | Online Portal | Posting date for the Opportunity | Jul 29th 2026, 7:00 AM EDT | N/A |
| Upcoming | Questions Due Date | Online Portal | Deadline to submit Questions | Aug 12th 2026, 4:30 PM EDT | N/A |
| Upcoming | Response to Questions | GSS & Bonfire | Response to Questions | Aug 26th 2026, 11:59 PM EDT - Aug 26th 2026, 11:59 PM EDT | No |
| Upcoming | Close Date | Online Portal | Deadline for Submissions | Sep 16th 2026, 1:00 PM EDT | N/A |
| Upcoming | Estimated Notification of Award | GSS & Bonfire | Estimated Notification of Award | Oct 8th 2026, 11:59 PM EDT - Oct 8th 2026, 11:59 PM EDT | No |
| Upcoming | Estimated Project Begin Date | GSS & Bonfire | Estimated Project Begin Date | Apr 7th 2027, 7:00 AM EDT - Apr 7th 2027, 7:00 AM EDT | No |
Note: Template files for the items below (BidTables, Questionnaires) are available in the Attachments section of this opportunity.
| Name | Type | # Files | Requirement |
|---|---|---|---|
| Does the Bidder have a supplier diversity plan currently in place? | Data Type: Yes/No | N/A | Required |
| Does the Bidder have a written inclusion policy in place? If yes, please attach a clearly identifiable copy of the inclusion plan to your proposal? | Data Type: Yes/No | N/A | Required |
| Does the Bidder have any diverse Sub-Contractor(s) as outlined in Attachment 8 Tier II Sub-Contractor(s)? | Data Type: Yes/No | N/A | Required |
| The Vendor/Bidder attest to the fact that, at a minimum, shall not store or transfer non-public State of Delaware data outside the United States. | Data Type: Yes/No | N/A | Required |
| Agree to Pricing as identified in the solicitation? | Data Type: Yes/No | N/A | Required |
| Did you complete Attachment 2 - Vendor Information (contained in Appendix C) | Data Type: Yes/No | N/A | Required |
| Did you complete Attachment 3 - Non-Collusion Statement (contained in Appendix C) | Data Type: Yes/No | N/A | Required |
| Did you complete Attachment 4 - Exceptions Form (contained in Appendix C) | Data Type: Yes/No | N/A | Required |
| Did you complete Attachment 5 - Confidential Information (contained in Appendix C) | Data Type: Yes/No | N/A | Required |
| Did you complete Attachment 6 - Business References (contained in Appendix C) | Data Type: Yes/No | N/A | Required |
| Acknowledge Subcontracting is NOT permissible for this RFP, so Attachment 7 in Appendix C – Subcontractor Information is NOT needed. | Data Type: Yes/No | N/A | Required |
| Reviewed Appendix D which are templates used for contracting process (exceptions to the templates to be noted in Attachment 4 - Exceptions Form included in Appendix C-Vendor Forms) | Data Type: Yes/No | N/A | Required |
SLED stands for State, Local, and Education. These are solicitations issued by state governments, counties, cities, school districts, utilities, and higher education institutions — as opposed to federal agencies.
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