Description
The Texas Department of State Health Services (DSHS) is seeking a qualified Pharmacy Benefits Manager (PBM) to administer prescription drug benefits for the Texas HIV Medication Program (THMP) and its three sub‑programs (SPAP, TIAP, TIAP‑PLUS). The PBM will act as a secondary payor, handling premium payments, copayments, claims processing, and related administrative functions for Medicare Part D plans, managed‑care organizations, self‑insured employers, retail pharmacies, and other government programs. The contract will begin with a one‑year term, with the possibility of up to five total years through extensions. Historical spend on similar contracts is about $15 million per fiscal year, and the award is anticipated in May 2027.
• Scope includes claims processing, premium and copayment administration, data security (U.S.‑based storage), and compliance with TX‑RAMP Level 2 certification for SaaS solutions.
• Mandatory deliverables: execution of Data Use Agreement, security/privacy compliance, and submission of required certifications and financial documents.
• Pre‑proposal conference (optional) on Oct 26, 2026; questions due Oct 28, 2026; final proposal due Nov 19, 2026.
• Contract term: 1 year initial, renewable up to four additional 1‑year terms plus one optional year.
• Expected annual budget ~ $15 million (subject to state appropriations).