Health Insurance Government Bids & RFPs

This is a Statement of Objectives (SOO) for a Part D Transaction Facilitator contract. The Centers for Medicare & Medicaid Services (CMS) requires a contractor to support the accurate tracking of True Out-of-Pocket (TrOOP) costs, facilitate eligibility queries, and ensure secure and compliant exchange of Protected Health Information (PHI) for the Medicare Part D prescription drug benefit program. The contractor will be responsible for processing Part D Coordination of Benefits (COB) related transactions, ensuring HIPAA-compliant Business Associate Agreement (BAA) execution with plan sponsors, providing reliable responses to pharmacy eligibility queries (E1), maintaining a resilient system architecture with disaster recovery capabilities, ensuring full compliance with information security and privacy requirements, and providing transparent project management and reporting. Optional transition-in support and Section 508 compliance for all information and communication technology (ICT) are also required. Offerors must submit a Performance Work Statement (PWS) and a Quality Assurance Surveillance Plan (QASP) detailing their approach to meeting these objectives. Technical specifications, data formats, matching criteria, and transaction standards defined in appendices A through I are non-negotiable and must be incorporated into the PWS.

The Fulton County, Georgia anticipates that once selected, the preferred developer will begin undertaking tasks to deliver the project. These tasks would be done between selection and signing of the development agreement and other documents related to the terms of the transfer of site control and development requirements. The scope of work includes but is not limited to conducting environmental review, refining development concept and financial model, negotiating agreement terms and conditions with the county, obtaining project entitlements, and securing project funding. Further details are available in the solicitation.