Procurement for Medicaid and Supplemental Pharmacy Rebate Vendor

November 12, 2015

Medicaid and Supplemental Pharmacy Rebate Vendor Pursuant to the State Purchasing Act (Official Code of Georgia Annotated (O.C.G.A) §§50-5-50 et seq.), an electronic Request for Proposals (“eRFP”) is being issued by the Georgia Department of Administrative Services to establish a contract with a single qualified supplier who will provide Pharmacy Rebate and Supplemental Rebate services to the Georgia Department of Community Health. For the procurement announcement, please visit the following link: All questions regarding the eRFP must be directed to the eRFP Issuing Officer, Ms. Elizabeth Eason, at

This Resource Library is provided to assist potential Offerors in preparing responses to the eRFP. The library contains information relevant to the program such as the current layout for certain file feeds. However, Offerors are advised that the format is subject to change and revisions may be necessary to ensure compatibility and effective information exchange.

1. Key Pharmacy Rebate Program Statistics

2. Pharmacy Rebate Totals by Program and Quarter 2014

3. Review of Drug Utilization and Rebates

4a. GA CMO JCode Rebate Claim File Layout

4b. GA MCO Rx Layout

4c. Drug Rebate Claims File Extract

5. Disputes Analysis 2014

8. Outbound Rebate Claims Extract Layout

DMA 6 Nursing Facility ICF IID Form

DMA 6 Pediatric Form

DMA 80 Prior Authorization Request Form

DMA 81 Prior Approval for Medical Services Form

Prior Authorization for Hospital Admissions Form

2010 PASRR Form

DCH Medicaid Data Management Strategy