Drug & Rebate Agreement Manager (DRAM) RFP

Background
The Ohio Department of Medicaid (ODM) is seeking a vendor to serve as its Drug and Rebate Agreement Manager (DRAM). The purpose of this RFP is to obtain a vendor capable of performing rebate management, pharmacy and medical claim analytics and reporting, coordinating Pharmacy and Therapeutics (P&T) Committee meetings, and managing the Unified Preferred Drug List (UPDL).

The selected vendor will assist ODM in fulfilling its obligations under ORC 5164.7510 and the Federal Medicaid Drug Rebate Program (MDRP). ODM provides health care coverage to over 3 million Ohioans through a network of more than 165,000 providers, with an annual pharmacy expenditure of approximately $5 billion. Recent initiatives include enhancing home- and community-based care, implementing a new managed care program, launching a comprehensive primary care program, and integrating physical and behavioral health care.

Work Details
The selected Offeror will be responsible for:
1. Maintaining a Unified Preferred Drug List (UPDL) for both Fee-for-Service (FFS) and Managed Care Entity (MCE) programs. This includes integrating utilization data from the Single Pharmacy Benefit Manager (SPBM), providing clinically- and fiscally-sound UPDL recommendations, establishing a Secure File Transfer Protocol (SFTP) site for data exchange, providing quarterly PDL monitoring reports, performing supplemental rebate invoicing, and delivering weekly UPDL drug files.

2. Acknowledging receipt of communications from ODM within one business day and resolving issues within three business days.

3. Participating in stakeholder meetings and disseminating timely information to prescribers and pharmacy providers.

4. Supporting ODM’s P&T Committee by developing, implementing, and administering the PDL program, attending P&T Committee meetings in person, facilitating communication with stakeholders, maintaining ODM-approved business rules for P&T and PDL, reviewing the current PDL for cost-effectiveness, creating prior authorization workflows for drug classes on the PDL, and presenting at relevant conferences as requested.

Period of Performance
The contract period is expected to run from contract award through June 30, 2027, with the possibility of one renewal through June 30, 2029.

Place of Performance
The services will be performed primarily in Columbus, Ohio.