26EHSKWTPLIIRFR: RFR for Third Party Liability Health Insurance Investigations and Recovery Claims
Contract Overview
Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.
AI Contract Overview
The Executive Office of Health and Human Services (EOHHS) in Massachusetts is soliciting proposals for third party liability health insurance investigations and claims recovery services. The selected vendor will be responsible for claims recovery, data management, and reporting, with a specific focus on achieving service level agreement targets such as billing 14 million dollars in claims per month. Performance is measured through monthly and quarterly reports, including BARS and Claims Lifecycle data, and must adhere to strict privacy and security standards including HIPAA, NIST 800-53, and M.G.L. c. 66A. The contract utilizes a best-value award methodology, evaluating programmatic responses based on comprehensiveness, feasibility, and effectiveness alongside cost reasonableness. Compensation is structured as a combination of fixed monthly fees for investigations and a percentage of estimated savings for recoveries. Key personnel requirements include a Project Manager, Program Lead, Quality Assurance lead, Fair Hearing Coordinator, and Compliance Manager, all of whom must possess at least three years of relevant experience. Proposals must be submitted electronically via COMMBUYS by September 17, 2026, and must strictly follow specified formatting and tabbed organizational requirements.
General Info
Agency
NAICS
Place of Performance
Fl Boston, MA, 02108, USASet-Aside
Timeline
Response Deadline
Organization & Contact Information
Full Description
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