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Healthcare Provider Education Consultant

Active
State & Local

Contract Overview

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

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The Healthcare Provider Education Consultant subcontract supports prime contractors on projects for the New York State Office of the Medicaid Inspector General. The primary objective is to conduct outreach and training for home health providers to enhance demand billing compliance and streamline claims submission processes. Key responsibilities include the development of educational materials and the management of provider relations to effectively facilitate fund recovery. The successful consultant will be responsible for delivering training sessions and producing resources that lead to measurable improvements in compliance rates. This opportunity falls under NAICS code 611430 and is associated with the state of New York, with a response deadline set for November 6, 2026.

General Info

Consultant provides Medicaid compliance training and outreach for New York home health providers.

Documents

This scope was carved out of 2140006.

The full solicitation package (2 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

RFP# OMIG 26-23- Home Health Care Medicare Maximization Services (HHC MMX)

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Organization & Contact Information

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AgencyNew York → NYS Office of Medicaid Inspector General
ContactsNo contacts available
OfficeN/A
Office AddressN/A
ContactsNo contact information available

Full Description

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Performs outreach and training for home health providers for prime contractors on NYS Office of the Medicaid Inspector General (OMIG) projects. Develops training materials to improve demand billing compliance and claims submission processes. Manages provider relations to facilitate fund recovery. Delivers provider training sessions, educational materials, and improved compliance rates.

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More opportunities from New York → NYS Office of Medicaid Inspector General

Same awarding agency

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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