Medicare Maximization RFP

The Connecticut Department of Social Services (DSS) has issued the Medicare Maximization RFP (Solicitation Number MMX RFP 04172025) to solicit proposals from qualified organizations with proven expertise in recovering Medicaid payments resulting from unwarranted Medicare claims denials or underutilized Medicare coverage. The primary focus is on providing legal assistance to Medicaid dual eligible clients who have been inappropriately denied Medicare coverage for Skilled Nursing Facility and Home Health services, which are covered under both Medicare and Medicaid programs. The goal is to help these clients recover the benefits they are entitled to through the Medicare appeals process. Additionally, DSS is open to proposals that aim to develop other revenue projects focused on increasing cost savings through Medicare Maximization strategies. The contract is set to be awarded within a size range of $500,000 to $2,000,000, with the performance location in Connecticut. The deadline for responses is June 5, 2025, and interested parties can find more information and submit proposals through the Connecticut procurement portal. The initiative emphasizes leveraging organizations with demonstrated success in Medicare appeals and maximizing recovery efforts to improve Medicaid program efficiency and reduce unnecessary expenditures.