Pharmacy Benefit Claims Monitoring Services
Overview
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SUMMARY
KEY REQUIREMENTS
CONTRACT DURATION
TIMELINE
Release of RFP: August 19th, 2026
Written Questions due by: August 26th, 2026
Anticipated Commonwealth Response to Written Questions: August 28th, 2026
Proposals Due by: September 4th, 2026
QUESTION DEADLINE
CONTACTS
Primary procurement contact — name, title, email, and phone
Additional decision-makers and their departments
Issuing Agency
Commonwealth Of Kentucky, Personnel Cabinet, Department Of Employee Insurance
DESCRIPTION
The contracting entity seeks vendor services to monitor all pharmacy benefit claims for individuals enrolled in the public employee health insurance program. The services will assess whether pharmacy claims were billed, charged, and paid in accordance with applicable contractual terms and plan designs.
The engagement includes analyzing 100% of pharmacy invoices or claims submitted for payment, including claims submitted on or after July 1, 2026. The selected vendor will identify and correct claim errors to help prevent or reduce erroneous overpayments by contracted entities. The work will also evaluate the market competitiveness of pharmacy benefit payments, including the adequacy of payments made to pharmacies.
All questions must be submitted no later than August 25, 2026. The proposal deadline is September 4, 2026.
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Frequently asked questions
- When is the submission deadline?
- Submissions are due September 4, 2026. Questions must be submitted by August 26, 2026.
- Who issued this RFP?
- It was issued by Commonwealth Of Kentucky, Personnel Cabinet, Department Of Employee Insurance. The work is located in Frankfort, Kentucky, United States.
- Who is a good fit for this opportunity?
- Pharmacy benefit auditing and claims-monitoring specialists
- Experience reviewing large-scale healthcare claims and invoices
- Expertise in contractual compliance, plan design analysis, and overpayment recovery
- Knowledge of pharmacy reimbursement markets and payment adequacy
- Ability to analyze 100% of submitted pharmacy claims using robust data-review systems
Analysis generated by Settle AI from the source RFP.
RFP Hunter shows what is open. Settle shows what is forming.
Settle pieces together buyer signals, budgets, contract activity, and the sources your team already monitors. See why an opportunity fits and what to do before the RFP posts.