MDHHS seeks proposals for pharmacy benefits administration

The goal of today's press release is Medicaid access to necessary medications "consistently, affordably and without unnecessary barriers.”

In the same breath, we have MDHHS, PBMs, and DTMB.

Besides state Medicaid, of course.

At what point is one allowed to call three strikes?

https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2025/12/15/pharmacy-rfp

MDHHS seeks proposals for pharmacy benefits administration

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) has issued a request for proposal (RFP) for entities interested in serving as the state’s Pharmacy Benefit Administrator. The initial contract will be for three years through 2029, with the potential for four additional years.

MDHHS pharmacy programs provide prescription drug coverage for individuals enrolled in Medicaid and related health programs. In 2024, more than 24.5 million claims were processed and more than $2 billion in rebates were invoiced, highlighting the critical need for experienced vendors to manage these complex operations.

The Pharmacy Benefit Administrator provides pharmacy point-of-sale claims processing, prior authorization, clinical advisory support and Medicaid drug rebate administration services for MDHHS. Vendors can bid on either the claims processing component or drug rebate administration component separately, or as a combined proposal.

“Our priority is ensuring Michigan residents enrolled in Medicaid and other programs can access the medications they need consistently, affordably and without unnecessary barriers,” said MDHHS Director Elizabeth Hertel.

The Michigan Department of Technology, Management & Budget will manage the request for proposal process on behalf of MDHHS. The RFP is posted on the state’s SIGMA Vendor-Self Service system online. Interested bidders are encouraged to refer to the proposal instructions for additional information regarding submission of questions and deadlines.

To bid on proposals, all vendors must first be registered with SIGMA Vendor Self-Service. Registration is free, and information on how to register and obtain an account to bid on open solicitations is available online: DTMB – How to Register as a Vendor.

Awards for new contracts are anticipated by July 3, for implementation Thursday, Oct. 1, 2026.

# # #