Recovery Audit Contract OCMP-26-25113 (RAC)

The Maryland Department of Health is seeking a Medicaid Hospital Claims Audit Contractor under solicitation OCMP-26-25113 to reduce improper payments by identifying overpayments and underpayments across three hospital provider types. This is a Small Business Reserve Procurement, meaning the award is limited to certified small businesses. The contract consists of a three-year base term starting August 1, 2027, with two optional one-year renewals. The selected vendor will be compensated via a fee of 10% of properly identified payments. The procurement process utilizes a two-part submission via the eMMA system, separating the technical and financial proposals. Award decisions are based on a balanced weighting of technical and financial factors, with technical evaluation focusing on the work plan, staff qualifications, offeror capabilities, and economic benefit to the state. Key requirements include a 14% MBE and 2% VSBE participation goal, a mandatory electronic funds transfer for payments exceeding 200,000 dollars, and strict conflict of interest certifications prohibiting relationships with auditable hospitals within the last three years. The contractor must provide a detailed work plan and implementation schedule within 30 to 60 days of the contract start date.