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Professional Services for Medicaid Policy and Program Support

Active

27-630-8000-0012State & Local

Response Deadline10/26/2026, 10:00:00 PM UTC

Contract Overview

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

General Info

Agency

New Mexico Human Services Department

NAICS

N/A

Place of Performance

NM, USA

Set-Aside

NONE

Documents

11

Appendix D Cost Response Form

rfp

High

Appendix E Letter of Transmittal Form

other

High

Campaign Contribution Disclosure Form

disclosure-form

High

Certification Regarding Lobbying / SF-LLL

lobbying-certification

High

Draft Professional Services Contract (Appendix C)

contract-document

High

RFP 27-630-8000-0012 Medicaid Policy and Program Support

rfp

High

RFP Appendix A Acknowledgement of Receipt Form

rfp

High

Submitted Questions Form – RFP 27-630-8000-0012

q-and-a

High

Organizational Reference Questionnaire

past-performance

Low

Suspension and Debarment Requirement Form

suspension-and-debarment-certification

Low

HCA RFP Professional Services for Medicaid Policy and Program Support.docx

AI Contract Breakdown

Uniform Contract Format

Contract not broken down yet

CLEATUS splits the solicitation into Uniform Contract Format (UCF) sections: scope, pricing, deliverables, and evaluation criteria.

Timeline

PhaseSolicitation

PostedSep 28

Solicitation

Response DeadlineOct 26

Submission deadline

Response Deadline

10/26/2026, 10:00:00 PM UTCin 21 days

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Organization & Contact Information

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AgencyNew Mexico Human Services Department

ContactsNo contacts available

OfficeNM, USA

Organization / AgencyNew Mexico Human Services Department

Office AddressNM, USA

ContactsNo contact information available

Full Description

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The State of New Mexico Health Care Authority (HCA), Medical Assistance Division (MAD), is issuing this Request for Proposals (RFP) to solicit competitive, sealed proposals from qualified Offerors to provide Medicaid policy and program consulting services. These services will support a range of initiatives aimed at strengthening the Turquoise Care managed care program, advancing Medicaid policy innovation, and enhancing the overall administration of Medicaid services in New Mexico. The selected Offeror(s) will assist HCA with Medicaid reporting requirements, federal waivers, policies, regulations, programs and managed care. Through this procurement, HCA seeks partners who can help improve access to care, promote better health outcomes, and increase the efficiency and effectiveness of Medicaid programs statewide.

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DEADLINE

Medicaid Managed Care Actuarial ServicesThis subcontract for Medicaid Managed Care Actuarial Services supports the New Mexico Human Services Department by providing actuarial development, setting, and certification of capitation rates for prime contractors on New Mexico Health Care Authority projects. The scope of work includes developing risk-based capitation rates, analyzing utilization patterns for cost profiles, and calculating rate cells in accordance with CMS rules. The final deliverables consist of signed actuarial certification reports and detailed rate cell exhibits. To qualify for this engagement, the provider must be a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries. The opportunity was posted on September 11, 2026, with a response deadline of October 12, 2026. The project falls under NAICS code 541990 and is managed through the New Mexico Human Services Department.

All Other Professional, Scientific, and Technical Services

POSTED

DEADLINE

Professional Services for Medicaid Financial and Actuarial Support

Solicitation # 27-630-8000-0009

The New Mexico Health Care Authority (HCA), Medical Assistance Division, is soliciting proposals under RFP 27-630-8000-0009 for professional actuarial and financial consulting services to support the Turquoise Care Medicaid Managed Care Program. The selected contractor will be responsible for developing, setting, and certifying actuarially sound risk-based capitation rates for all Medicaid Managed Care Organization cohorts, providing Section 1115 budget neutrality modeling, and conducting financial analyses to improve program efficiency and health outcomes. Key deliverables include annual capitation rate certification packages compliant with 42 CFR Part 438 and CMS guidelines, risk score calculation files, and risk corridor evaluation reports. All work must adhere to Applicable Actuarial Standards of Practice and American Academy of Actuaries qualifications. Proposals must be submitted electronically via the designated portal by October 12, 2026. Mandatory submission requirements include a signed Letter of Transmittal, a Campaign Contribution Disclosure Form, a Certification Regarding Lobbying, and a Suspension and Debarment Requirement Form; failure to provide these will result in disqualification. Evaluation is based on the total cost of implementation and organizational experience, verified through at least three organizational references. The contract is subject to state and federal regulations, including HIPAA and HITECH Act requirements for safeguarding protected health information. Payment is issued within thirty days of service acceptance, provided invoices are submitted no later than fifteen days after the end of the fiscal year.

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