This Government Contract opportunity from Texas was posted on August 11, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.
Medicaid Recovery Audit Coding and Review
Contract Overview
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AI Contract Overview
This subcontract for the Texas Health and Human Services Commission focuses on Medicaid Recovery Audit Coding and Review. The selected provider will perform medical record reviews and coding audits for prime contractors to identify billing errors or fraud within Fee for Services and Managed Care Organization claims, ensuring compliance with 42 CFR Part 455 Subpart F. The primary objective is to deliver detailed audit reports that pinpoint improper payments. To execute these services, the contractor must utilize Certified Coders and maintain a Medical Director or Physician Panel for necessary clinical validation. The opportunity was posted on August 11, 2026, with a response deadline of September 9, 2026. This engagement falls under NAICS code 541219 and is managed through the Texas state agency system.
General Info
Agency
Place of Performance
TX, USASet-Aside
Documents
This scope was carved out of HHS0017023.
The full solicitation package (2 documents), including the RFP, is on the prime solicitation, not on this scope.
Recovery Audit Contractor Services
AI Contract Breakdown
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Timeline
Submission Closed
Organization & Contact Information
Full Description
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