Medical Drug Codes Platform

The Vendor is required to provide a real time web portal for medical drug billing and reimbursement with code-level information.
- Provide to deliver a secure medical drug billing and reimbursement web portal and provide access to a complete NDC to HCPCS crosswalk with detailed code-level information.
- The platform must provide real-time data enabling agency to meet department regulatory requirements to produce a compliant physician administered drug (PAD) prior authorization (PA) list and claims adjudication.
- Requirements for Drug Website
• Provide detailed code-level information
• Indicate if codes are active or inactive with start and end dates
• Provide related Administration codes to the HCPCS code
• NDC-level price-per-code unit calculations using AWP, WAC, ASP and AP pricing
• Single-dose wastage based on available NDC’s
• Information and pricing for J-Codes, A-Codes, B-Codes, CCodes, P-Codes, Q-Codes, S-Codes and APC codes
- Data Files
• Current and historical pricing at the code-unit level
• NDC crosswalk
• NOC crosswalk
• Maximum drug dosing information with customizable weights and surface area settings
- Application Infrastructure
• The application user interface should be web-based and must support at a minimum Internet Explorer, Microsoft Edge, Google Chrome and Safari
• The application must have backward version compatibility with web browsers mentioned above.
• The application must work on all major operating systems, specifically Windows
- Scalability and Performance
• The application should have the ability to support unlimited number of users with minimal impact to response and load times for the application.
- Provide any limitations that may inhibit application access through a firewall or other network security hardware or software.
- Detail major application components and the programming language in which each was developed.
- Provide limitations of the application in terms of numbers of concurrent users, number of servers, users per server.
- Provide infrastructure, procedures, and lead times in place to support disaster recovery (DR).
- Define your Recovery Time Objective (RTO) - the duration of time and a service level within which a business process must be restored after a disaster in order to avoid a break in continuity.
- Define your Recovery Point Objective (RPO) - the interval of time that might pass during a disruption before the quantity of data lost during that period exceeds the Business Continuity Plan’s maximum allowable threshold.
- Provide details regarding your automated failover mechanism that ensures high availability and redundancy.
- Provide the scalability capabilities of your application with increases in volume of data and users.
- Provide a list of all network monitoring and management tools included to monitor application health and stability.
- List all portal solutions with which your application currently integrates.
- List other data sources (lab data, pharmacy data, etc.) with which your application currently integrates.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: April 16, 2025