PHAR-2216 - USA (Bartow, Florida) - Inmate Medical and Pharmacy Services - Deadline September 16,2026

(1) Vendor needs to provide off–site inmate medical and pharmacy services to the government authority located in Bartow, FL. – Provide comprehensive management of off–site inmate medical and pharmacy services for the agency.– Third–Party Administrator (TPA) services include the administration of inmate off‑site medical claims, management of on‑site ancillary medical services, access to a network of providers, and Pharmacy Benefit Management (PBM) for select institutional and specialty medications utilized within the agency.– Provide TPA pharmacy services for bulk and institutional prescription drugs prescribed by onsite contracted vendor.– Provide approximately 7,632 outpatient claims for emergency room, non–emergent hospital outpatient services, specialist physician services and ancillary services.• Processing and adjudication of off–site inmate medical claims and of on–site ancillary medical services (e.g., mobile radiology, ultrasound, dialysis, vision, specialized/respiratory therapy, and laboratory services), including adherence to prompt payment requirement and denial of pre–booking claims.• Provide pharmacy services for bulk and institutional prescription medications not covered by the base compensation to the on–site medical provider; this includes, but is not limited to, HIV antiretroviral agents, immunosuppressants, renal and mineral metabolism agents, and erythropoiesis–stimulating agents (ESAs).• Utilization management and medical necessity review of precertification of outpatient facility testing and procedures.• Financial administration, including claims payment services and a Zero–Balance Account (ZBA) funding model.• Reporting and analytics, including inmate healthcare utilization forecasting, high dollar claims, quarterly executive report package, annual incurred but not–reported (IBNR) calculations, and full–year claims liability projections.• Participate in quarterly inmate billing offsite review meetings with the agency.• Integration with jail medical and records management systems.• Claims subrogation, recovery services, and fraud prevention services.(2) All the questions must be submitted no later than September 9, 2026.