Informal Dispute Resolution - Outsourcing

The Texas Health and Human Services Commission (HHSC) is seeking proposals from qualified, disinterested organizations to conduct Informal Dispute Resolutions (IDR) regarding regulatory compliance for medicine, nursing, and building fire and life safety codes. This Request for Qualifications (RFQ) focuses on selecting a vendor to perform unbiased reviews of disputed matters using a two-level review process and optional conferences. The selected contractor must adhere to statutory timeframes and federal standards, including the CMS State Operations Manual, and must obtain TX-RAMP Level 2 certification prior to the contract award. The contract features an initial three-year term from July 13, 2027, to July 13, 2030, with options for two one-year extensions and a potential 12-month transition extension. Award selection is based on best value, with scoring weighted across experience (30%), work plan (30%), qualifications (25%), and reporting capabilities (15%). Pricing is not considered during the initial evaluation; instead, HHSC will negotiate a fair price with the most qualified respondent. Minimum requirements include five years of IDR experience, the inclusion of at least one Registered Nurse on staff, and demonstrated financial solvency.