HHS0016074 RFO Healthcare Grouper Software

The contract involves the procurement of an integrated healthcare software solution for the Texas Health and Human Services Commission and the Department of State Health Services, aimed at generating diagnosis-related groupings and other classifications from inpatient and outpatient claims data. The software will support claims adjudication, analytics, quality measurement, and statewide data quality initiatives, with a focus on risk adjustment, Medicare Severity Diagnosis Related Groups support, and compliance with Texas security standards such as TX-RAMP. The contract is expected to span three years, with a posted solicitation date of September 11, 2025, and a response deadline of October 10, 2025. It emphasizes adherence to state and federal regulations, including privacy, security, and data use agreements, and incorporates comprehensive provisions for contractor compliance, reporting, and confidentiality. The contractual framework is governed by the Texas Health and Human Services Uniform Terms and Conditions – Vendor V.3.4, effective November 2023, which establishes the legal, financial, and operational obligations of the vendor. Additional provisions include detailed security and privacy controls aligned with NIST standards, confidentiality obligations, and requirements for insurance, record retention, and audit rights. The contract also incorporates several attachments and exhibits, notably a Security and Privacy Inquiry form and an Assumptions Form, which respondents must complete. While specific delivery schedules, performance milestones, and detailed cost breakdowns are not explicitly outlined in the available documents, the contract emphasizes the use of work orders for project-specific tasks, with separate proposals and project plans required for each. There are no explicit evaluation criteria, award basis, or proposal submission instructions detailed within the current documentation, but contact information for the procurement officer is provided for further inquiries.