CDC WORLD TRADE CENTER (WTC) HEALTH PROGRAM PHARMACY BENEFITS MANAGER

The Centers for Disease Control and Prevention intends to award a sole source contract with fixed price and time & materials line items to Evernorth Federal Services, Inc. for Pharmacy Benefits Manager (PBM) Services. Unlike traditional PBM contracts, the World Trade Center (WTC) Health Program’s benefit structure necessitates highly customized adjudication processes, real-time benefit verification, and automated safeguards to ensure that only medically necessary treatments for certified WTC-related conditions are covered. Evernorth Federal Services has successfully addressed these challenges through proprietary system customizations that ensure regulatory adherence and operational efficiency. Because PBM system architectures are proprietary, using any other contractor .... Read More