DSH Audit, UPL Calculations, Cost Settlementand MIUR

The contract involves comprehensive financial oversight and reporting for North Dakota’s Medicaid program, specifically focusing on conducting annual audits of the Disproportionate Share Hospital (DSH) program, calculating hospital Upper Payment Limits (UPL) for inpatient, outpatient, and mental health facilities, performing Medicaid Institutional Payment Transparency reporting for Intermediate Care Facilities (ICFs), and determining annual cost settlements and Medicaid Inpatient Utilization Rates (MIUR). The work is to be performed under a firm fixed-price arrangement, with the initial contract running from January 1, 2026, through December 31, 2027, and options for renewal or extension up to an additional 12 months. The deliverables include detailed annual reports, calculations, and audits, with the contractor responsible for ensuring compliance with federal and state regulations, including Medicaid standards, GAGAS auditing standards, and HIPAA privacy requirements through a Business Associate Agreement. The procurement emphasizes transparency, accuracy, and regulatory adherence, with proposals evaluated on understanding of scope, experience, management approach, and cost, culminating in a best-value award process. The solicitation, numbered 325-25-415-027, is issued by the North Dakota Department of Human Services, with a response deadline of September 23, 2025. The contract incorporates various legal and procedural clauses, including compliance with federal civil rights laws, nondiscrimination, confidentiality, conflict of interest disclosures, and the requirement for the successful vendor to be a licensed CPA with relevant experience. The contract documents specify that all proposals must be submitted electronically through the State Procurement Office online portal, separated into technical and cost components, with strict adherence to file size and naming conventions. The agreement also includes provisions for amendments, contract modifications, and the potential for renewal, with the contractor required to maintain all necessary licenses and registrations, including registration with the North Dakota Secretary of State and taxpayer identification for payment processing. Overall, the contract aims to ensure rigorous, compliant, and transparent management of Medicaid financial operations through professional auditing and reporting services.