This electronic Request for Information (eRFI) is being issued to solicit information from interested suppliers with respect to Pharmacy Benefit Manager (PBM) Care Management Organization (CMO) Audit services for the Georgia Department of Community Health (hereinafter, the Department, DCH or the State Entity) as further described in this eRFI. The State Entity will use the information generated by this eRFI in conjunction with other information available to the State Entity to determine the solution that it is in the best interests of the State Entity to fulfill this need.

The purpose of this all-claims audit is to examine all covered outpatient prescription claims from July 1, 2020, through July 31, 2022, to ensure contract compliance of pharmacy benefit managers contracted through DCH's care management organizations. DCH desires the assistance of a qualified supplier to conduct the audit and is seeking information from such suppliers. DCH will use the information generated by this eRFI in conjunction with other information available to DCH to determine the solution that it is in the best interests of the Medicaid program.