This Solicitation opportunity from New Hampshire was posted on October 14, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.
External Quality Review Organization
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The New Hampshire Department of Health and Human Services is soliciting proposals for a qualified External Quality Review Organization to conduct External Quality Reviews of healthcare services for Medicaid beneficiaries enrolled in statewide Medicaid Care Management. The selected vendor will be responsible for evaluating and analyzing aggregated data on the quality, timeliness, and access to services provided by contracted Managed Care Plans and Dental Organizations. Key duties include validating performance measures, evaluating Performance Improvement Projects, verifying provider network adequacy, and validating encounter data in accordance with 42 CFR 438 and CMS protocols. The contract is anticipated to begin in December 2026 or January 2027, with a proposed end date of April 30, 2030, and potential four-year renewal options. Qualified vendors must meet all requirements of an External Quality Review Organization as outlined in 42 CFR 438.354 and submit a single proposal covering both Part A and Part B services. The evaluation process is not based on low cost but on a scoring system of technical responses. Awardees must comply with strict federal and state regulations, including HIPAA, the HITECH Act, and Title VI compliance regarding Limited English Proficiency. Required certifications include drug-free workplace and anti-lobbying attestations. Payment is structured on a monthly basis and is issued only upon the Department's acceptance of completed deliverables.
General Info
Place of Performance
Not specifiedSet-Aside
Timeline
Submission Closed
Organization & Contact Information
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