This Solicitation opportunity from Idaho was posted on April 15, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.
Recovery Audit Services for Medicaid Payments
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The State of Idaho Department of Health and Welfare is soliciting proposals for a Recovery Audit Contractor to identify and collect Medicaid overpayments and identify underpayments within fee-for-service and managed care billings. This solicitation, RRFP2404, seeks a partner to ensure compliance with federal and state Medicaid integrity laws through secure data handling, audit execution, and comprehensive reporting. The contract features an initial two-year term beginning January 1, 2025, with the potential for a total duration of five years. Payment is structured as a contingency fee based on the actual recovery of overpayments and underpayments. Award will be based on a best-value trade-off evaluation totaling 1,000 points, with the highest weight placed on the Scope of Work (490 points) and Cost Proposal (400 points), the latter of which is only evaluated for the top three technical scorers. Mandatory requirements are pass/fail, and failure to meet them results in a non-responsive designation. Key requirements include the provision of a Medical Director licensed in Idaho, strict adherence to HIPAA and NIST-800-53 security standards, and a prohibition on offshore data access. Additionally, contractors must certify they are not owned or operated by the government of China.
General Info
Agency
Place of Performance
ID, USASet-Aside
Timeline
Submission Closed
Organization & Contact Information
Full Description
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