Specifications include, but are not limited to: The purpose of this Request for Proposals (RFP) is to solicit proposals that will enable the Department of Health and Human Services (Agency) to select the most qualified Bidder to provide Pharmacy Benefit Administration (PBA) services for Claims Processing and Pharmacy Clinical Services. PBA services are necessary to support several critical functions, including Point-of-Sale (POS) claims adjudication, automated and manual Prior Authorization (PA), Provider and Member communications, Drug Rebate, Utilization Management (UM), Clinical support, and Reporting and Analytics for the fee-for-service (FFS) population of Iowa Medicaid, as well as managed care program oversight.
