This Solicitation opportunity from Georgia was posted on May 12, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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OIG Medicaid Fraud, Waste, and Abuse

Closed

41900-DCH0000143State & Local

Submission Closed05/25/2026, 10:00:00 PM UTC

Contract Overview

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

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NAICS: 518210

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AI Contract Overview

The Georgia Department of Community Health (DCH) is seeking information from vendors capable of delivering an advanced fraud, waste, and abuse (FWA) detection and prevention solution tailored for the Medicaid program. This initiative targets both the fee-for-service and managed care systems, covering approximately 2.1 million beneficiaries, including PeachCare for Kids®. The goal is to enhance program integrity by identifying fraudulent billing patterns, preventing improper payments through pre- and post-payment reviews, verifying recipient eligibility to avoid duplicate enrollments, and improving pharmacy lock-in monitoring to reduce overutilization. The solution is expected to leverage cutting-edge technologies such as artificial intelligence, cloud-based analytics, and specialized expertise, while integrating with DCH’s internal data warehouse to support rapid investigations and enable efficient referrals to law enforcement. In addition to technology capabilities, DCH is interested in options that provide local staff augmentation to bolster program integrity resources within the Office of Inspector General. This effort reflects a broader commitment to protecting public funds and modernizing the current program integrity functions, which include data analytics, investigations, and pharmacy monitoring. Vendors responding to this solicitation must provide comprehensive market intelligence on their methodologies and service models by the specified deadline, demonstrating how their solutions can effectively support DCH’s Medicaid oversight and safeguard fiscal responsibility across the state of Georgia.

General Info

Georgia DCH seeks advanced AI-based Medicaid fraud detection and prevention solution with staff augmentation.

Agency

Georgia → Department of Community Health

NAICS

518210 - Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services

Place of Performance

GA, USA

Set-Aside

NONE

Documents

Addendum 1 to RFX 41900-DCH0000143 OIG Medicaid Fraud, Waste and Abuse

amendment

High

DCH OIG Medicaid Fraud, Waste, and Abuse eRFI 41900-DCH0000142

rfi

High

State of Georgia DCH OIG Medicaid Fraud Waste and Abuse eRFI 41900-DCH0000142

rfi

High

Attachment B Agency Overview Document - Georgia DCH Medicaid Programs

agency-overview

Low

Sample Trade Secret Status Affidavit Template for Georgia Solicitation

trade-secret-affidavit

Low

Supplier Q and A Template for RFX 41900-DCH0000142 OIG Medicaid Fraud, Waste and Abuse

q-and-a

Low

AI Contract Breakdown

Uniform Contract Format

Timeline

PhaseClosed

PostedMay 12

Solicitation

Response DeadlineMay 25

Deadline has passed

Submission Closed

05/25/2026, 10:00:00 PM UTC

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Organization & Contact Information

AgencyGeorgia → Department of Community Health

Contacts1 person available

OfficeN/A

Organization / AgencyGeorgia → Department of Community Health

Office AddressN/A

Contacts

Timothy Anderson

contact@example.gov

Full Description

The Georgia Department of Community Health (DCH) is issuing this Request for Information (RFI) to identify qualified vendors capable of providing a comprehensive fraud, waste, and abuse (FWA) detection and prevention solution for the Georgia Medicaid program. DCH seeks to gather market intelligence on available technologies, methodologies, and service models that can strengthen program integrity across both its fee-for-service (FFS) and managed care delivery systems.
DCH administers Medicaid benefits to approximately 1.5 million managed care members and 591,000 fee-for-service members across Georgia, in addition to overseeing the PeachCare for Kids® program. As stewards of public funds, DCH is committed to protecting the fiscal integrity of these programs by detecting and deterring fraudulent, wasteful, and abusive billing practices among providers and recipients alike. The Office of Inspector General (OIG) currently performs program integrity functions through its Intake and Data Analytics, Review and Investigations, and Pharmacy Lock-In sub-units; however, DCH seeks to augment and modernize these capabilities through the acquisition of an advanced, technology-driven solution.
Specifically, DCH intends to procure a solution that leverages artificial intelligence, cloud-based data analytics, and subject matter expertise to: (1) detect aberrant provider billing trends and patterns of fraud, waste, and abuse in both FFS and managed care; (2) support prepayment and post-payment review functions to identify and recover improper payments; (3) verify recipient residency and eligibility to prevent duplicate enrollment across states; (4) enhance pharmacy lock-in monitoring to prevent overutilization; and (5) provide real-time access to DCH¿s internal data warehouse for rapid investigation and potential referral to law enforcement. The solution may also include a local staff augmentation component to ensure DCH maintains sufficient program integrity capacity as its Medicai