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This Solicitation opportunity from Massachusetts was posted on October 27, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

26EHSKWTPLIIRFR: RFR for Third Party Liability Health Insurance Investigations and Recovery Claims

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BD-26-1039-EHS01-ASHWA-122275State & Local

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

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NAICS: 561440
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SV-00211711 Debt Collection Services for Out of State Tolls and Violations
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The Maryland Transportation Authority (MDTA) is soliciting debt collection services for delinquent toll payments and other debts owed by owners of vehicles registered outside of Maryland, including those from other U.S. states, territories, Canada, and Mexico. The selected contractor will manage debt portfolios using multi-channel engagement platforms such as phone, mail, digital communications, and online portals. The contract is structured for an initial three-year term with a unilateral option for a two-year renewal. Award decisions will be based on the most advantageous proposal, with technical factors, specifically offeror experience and capabilities, receiving greater weight than financial factors. Contractual requirements include adherence to Maryland law, PCI DSS or SOC security standards, and the NIST cybersecurity framework. The contractor must remit collections to the MDTA via daily ACH deposits and provide monthly invoicing for commission fees, along with required reporting by the fifth business day of each month. Proposals must be submitted in two volumes, with the financial proposal requested only from qualified offerors after technical evaluations. Key administrative requirements include the provision of performance and payment bonds, compliance with Maryland Living Wage requirements, and the submission of a corporate diversity addendum.
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Municipal Accounts Receivable Collection Services, RFP # 005 - 2026
Solicitation # 005-2026
The Town of Riverdale Park, Maryland, is soliciting proposals for municipal accounts receivable collection services to recover delinquent funds, including automated enforcement citations, parking violations, code enforcement fines, business license fees, tax balances, and permit fees. The contract is for an initial one-year term beginning December 1, 2026, with the option for two one-year extensions. Qualified proposers must have a minimum of seven years in business and provide references for similar work completed within the last five years. The selection process is managed by a Review Committee that evaluates proposals based on pricing, experience, qualifications, capacity, financial resources, and past performance. The financial structure is based on a contingency fee model for accounts categorized by their delinquency period (0 to 180 days and over 180 days), along with a per-check fee for returned checks; separate administrative or placement fees are prohibited. The contractor must remit 100 percent of gross collections to the Town monthly by the 15th of the following month, with contingency fees invoiced separately for payment within 30 days. Strict compliance with federal and Maryland state laws is required, alongside rigorous cybersecurity standards, including PCI-DSS compliance, multi-factor authentication, and data encryption. The contractor must also maintain comprehensive insurance coverages, including professional liability, cyber liability, and fidelity/crime insurance.
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NAICS: 561440
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RFP# OMIG 26-23- Home Health Care Medicare Maximization Services (HHC MMX)
Solicitation # 2140006
The New York State Office of the Medicaid Inspector General (OMIG) is soliciting proposals for the Home Health Care Medicare Maximization Services (HHC MMX) program. The primary objective of this initiative is to ensure Medicaid remains the payer of last resort by maximizing Medicare coverage for dual-eligible recipients receiving home health services. The selected contractor will be responsible for a comprehensive range of activities, including data analysis for case selection, performing medical and legal reviews, filing and tracking appeals through the Medicare Administrative Appeals Process, and coordinating with providers to recover overpayments. Additionally, the contractor will provide provider education to improve demand billing compliance and maintain rigorous reporting and audit documentation. The resulting contract is intended to be effective July 1, 2027, for an initial term of three years with two optional one-year extensions. Compensation is structured as a contingency fee percentage of gross Medicare recoveries. To ensure high-quality performance, the contractor must employ a qualified team including a Program Director, a full-time Program Manager, registered nurses, and at least one attorney licensed in New York State. Strict compliance requirements are in place, including a mandate that all work be performed and data stored exclusively within the United States, as well as significant insurance requirements, most notably a 10 million dollar cyber liability limit. Award decisions will be based on best value, evaluating organizational experience, technical expertise in Medicare appeals, and the proposed operational innovations.
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Request for Proposals - City of Chandler Debt Collection Services for Fire Department Ambulance Transportation; FR7-946-5062
Solicitation # FD7-946-5062
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DEADLINE

in 5 days

AI Contract Overview

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The Massachusetts Executive Office of Health and Human Services is soliciting proposals under bid number BD-26-1039-EHS01-ASHWA-122275 for qualified vendors to provide third party liability health insurance investigations and claims recovery services. The scope of work is divided into three primary parts: health insurance investigations, premium assistance health insurance investigations, and claims recovery for both MassHealth and the Health Safety Net. The selected contractor will be responsible for developing work plans, processing TPL referrals, performing data matches, and managing inpatient claims recovery. The contract also requires the provision of a management information system capable of handling various file formats, including XML. The contract has an initial duration of three years with four optional one-year renewals, for a maximum total duration of seven years. Performance is governed by detailed Service Level Agreements across all three parts of the contract, with benchmarks for call center metrics, investigation completion rates, and quarterly recovery targets. Payment is performance-based and contingent on the savings generated for MassHealth. Bidders must designate key personnel, including a full-time project manager, a program lead for identification and verification, a quality assurance lead, and a compliance manager. Award decisions will be based on best value overall, evaluating both programmatic and cost responses. Bidders must comply with strict submission guidelines via COMMBUYS and provide mandatory certifications, including a Supplier Diversity Program plan with a minimum 1% commitment to certified diverse businesses. Additionally, the contract includes specific provisions regarding the use of artificial intelligence, requiring non-discriminatory deployment and annual compliance certifications. The procurement is governed by the World Trade Organization Government Procurement Agreement and standard Commonwealth of Massachusetts terms and conditions.

General Info

Massachusetts seeks vendors for health insurance liability investigations and claims recovery services.

Place of Performance

Fl Boston, MA, 02108, USA

Set-Aside

NONE

Documents

47

Appendix A - Service Level Agreements for Health Insurance Investigations

DOCX, High priority: read this first4 pages · sow
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Appendix B - Service Level Agreements for Premium Assistance Investigations

DOCX, High priority: read this first7 pages · sow
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Appendix C - Service Level Agreements for Claims Recoveries

DOCX, High priority: read this first2 pages · sow
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Appendix D Third Party Agreements - Interdepartmental Service Agreement ISA

PDF, High priority: read this firstinterdepartmental-service-agreement
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Appendix G - Artificial Intelligence Provisions

DOCX, High priority: read this first3 pages · contract-document
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Attachment B - Model Contract for Third Party Health Insurance Investigations

DOCX, High priority: read this first105 pages · contract-document
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Attachment C Cost Response and Methodology

XLSX, High priority: read this first9 pages · cost-response
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BD-26-1039-EHS01-ASHWA-122275 Q&A for TPL Health Insurance RFR

DOCX, High priority: read this firstq-and-a
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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance

HTML, High priority: read this first8 pages · rfp
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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR for Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR Third Party Liability Health Insurance Investigations

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BD-26-1039-EHS01-ASHWA-122275 RFR: Third Party Liability Health Insurance Investigations

HTML, High priority: read this firstrfp
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BD-26-1039-EHS01-ASHWA-122275: Third Party Liability Health Insurance Investigations and Recovery Claims

HTML, High priority: read this firstrfp
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Commonwealth of Massachusetts Standard Contract Form

PDF, High priority: read this first2 pages · contract-document
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Commonwealth Terms and Conditions - Massachusetts State Contract

PDF, High priority: read this first2 pages · contract-terms-and-conditions
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EOHHS Required Bidder Certifications Form

DOC, High priority: read this firstcertifications
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Evaluation Criteria for RFR Third Party Health Insurance Investigations

DOCX, High priority: read this first1 page · evaluation-criteria
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Massachusetts Standard Contract Form Instructions and Contractor Certifications

PDF, High priority: read this first11 pages · instructions
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MassHealth Third Party Health Insurance Investigations RFR BD-26-1039-EHS01-ASHWA-122275

DOCX, High priority: read this first57 pages · rfr
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Supplier Diversity Program SDP Plan Form

XLSX, High priority: read this first5 pages · supplier-diversity-plan
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Attachment A-Statistics Health Insurance and MassHealth Data

DOCX, Low priority6 pages · statistics
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Contractor Authorized Signatory Listing Form CASL for Corporations

PDF, Low priority1 page · other
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Contractor Authorized Signatory Listing Form CASL for Sole Proprietors

PDF, Low priority1 page · other
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Massachusetts EOHHS Request for Responses for Third Party Liability Health Insurance Investigations

PDF, Low priority1 page · presolicitation
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Massachusetts Substitute Form W-9 (Rev 4-2022)

PDF, Low priority6 pages · tax-form
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Prompt Pay Discount Form for Commonwealth Contracts

PDF, Low priority1 page · other
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Timeline

PhaseClosed
Posted

Solicitation

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Organization & Contact Information

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AgencyMassachusetts → EHS01 - EHS
Contacts1 person available
OfficeFl Boston, MA, 02108, USA
Organization / AgencyMassachusetts → EHS01 - EHS
Office AddressFl Boston, MA, 02108, USA
Contacts
Karla WallacePurchaser

Full Description

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The Executive Office of Health and Human Services (EOHHS) is issuing this RFR to solicit proposals from qualified vendors to perform third party liability health insurance investigations and to provide claims recovery services.

More opportunities from Massachusetts → EHS01 - EHS

Same awarding agency

NAICS: 923120
SLED
27EHSCARHTPRURALPARTNERSRFA: Rural Health Transformation Program (RHTP) Rural Partners RFA
Solicitation # BD-27-1039-EHS01-EHS01-134186
The Massachusetts Executive Office of Health and Human Services is implementing the Rural Health Transformation Program (RHTP), a five-year federal investment of 800 million dollars designed to strengthen healthcare access, improve population health, and advance long-term well-being for residents of rural Massachusetts. This solicitation invites qualified rural facilities, providers, municipalities, and community organizations to apply for technical assistance, planning support, and direct grant funding across six of the seven RHTP initiatives. These initiatives encompass a wide range of activities, including facility modernization, population health, workforce development, community health, technology interoperability, and care models. Funding levels vary significantly by project type, with rural hospitals eligible for up to 2.5 million dollars per facility, rural primary care sites generally receiving between 500,000 and 1.5 million dollars, and rural nursing facilities receiving between 125,000 and 1 million dollars. Other awards include up to 1.4 million dollars for Regional TA Hubs and smaller grants for specialty care networks, FQHCs, and community chronic disease prevention networks. The initial participation period runs from October 30, 2026, through September 30, 2027, with future participation subject to new procurement processes. Applications must be submitted as PDFs via COMMBUYS and emailed to the designated procurement address by 5:00 PM ET on November 9, 2026. Required documentation includes a completed Rural Partner Application and Partner Validation Forms for any named partners. EOHHS will oversee the program through performance monitoring of established milestones and fiscal reviews to ensure expenditures align with approved budgets and scopes of work. Eligibility is strictly based on the official Massachusetts Department of Public Health Rural Definition and Town and Cluster List.
Administration of Public Health Programs

POSTED

23 days ago

DEADLINE

in 11 days
View Details
NAICS: 923120
SLED
Notice of Opportunity to Participate in the Implementation Council for One Care
Solicitation # BD-27-1039-EHS01-ASHWA-133664
The Massachusetts Executive Office of Health and Human Services, through MassHealth, is seeking diverse individuals and representatives from community-based organizations to serve on the Implementation Council for the One Care program. One Care is a coordinated health plan that integrates Medicare and MassHealth benefits for eligible adults aged 21 to 64. The Council's primary purpose is to partner with MassHealth to improve the program by monitoring healthcare access, reviewing member experiences, and advising on strategies to strengthen the delivery of mental health, substance use, and long-term services. Selected members will serve an initial two-year term with the possibility of an extension. The commitment involves attending virtual meetings via Zoom twice per month during regular business hours, with each session lasting approximately two hours. Compensation includes a 75 dollar stipend for each council meeting attended and 25 dollars per hour for approved engagement meetings or activities, such as in-person town halls. Applicants are ineligible if they have a direct or indirect employment or contractual relationship with My Ombudsman or a One Care Plan. Interested candidates must submit a completed application form by November 2, 2026, at 5:00 PM via the Mass.gov website, the COMMBUYS portal, or email. Applications are evaluated by a committee based on clarity and completeness, the applicant's understanding of the council's goals, and their relevant knowledge and experience with the One Care program. Final selections are made by the Assistant Secretary for MassHealth or their designee.
Administration of Public Health Programs

POSTED

about 1 month ago

DEADLINE

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NAICS: 622110
SLED
27PMEHSACUTEHOSPITAL: Rate Year 2027 Acute Hospital Request for Applications
Solicitation # BD-27-1039-EHS01-EHS01-133508
The Massachusetts Executive Office of Health and Human Services (EOHHS) is soliciting applications from eligible in-state acute hospitals to participate as MassHealth Providers for Rate Year 2027 under solicitation BD-27-1039-EHS01-EHS01-133508. This open market procurement establishes the reimbursement system and requirements for inpatient and outpatient services, including specific per diem rates for psychiatric services, behavioral health crisis management, and nursing facilities. The performance period for new rates begins October 1, 2026, with a transition period for members already in acute inpatient status prior to that date. The contract features a robust Clinical Quality Incentive (CQI) Program with a total aggregate funding pool of 250 million dollars. Hospitals are evaluated on a quality score between 0 and 1 based on core domains such as patient experience, patient safety, and care coordination, with data sourced from the CDC, CMS, and EOHHS. Additionally, the solicitation provides various supplemental funding pools for high public payer hospitals, specialized pediatric services, and inpatient psychiatric access, totaling over 60 million dollars in aggregate supplemental payments. Applicants must submit all required documentation, including an organizational chart and various certifications regarding data privacy and security, by September 30, 2026, at 5:00 p.m. Written questions are accepted until September 23, 2026. Participating providers must adhere to strict electronic invoicing standards using 837I and 837P formats and comply with all federal and state confidentiality laws, including HIPAA and the Massachusetts Fair Information Practices Act.
General Medical and Surgical Hospitals

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