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RFP: Converged Eligibility and Enrollment (E&E) System and Appeals Management System (AMS)

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2140439State & Local

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The New York State Department of Health, Office of Health Insurance Programs, is soliciting proposals under RFP C043776 to create, maintain, and operate a Converged Eligibility and Enrollment (E&E) System and Appeals Management System (AMS). The primary objective of this initiative is to integrate the functionality of the current New York State of Health (NYSOH) System into the Medicaid Eligibility and Client Management (MECM) System. This convergence aims to provide a seamless eligibility and enrollment experience for consumers across the Department's health insurance programs. The procurement process includes several key milestones, with the RFP issued on October 29, 2026, and a final proposal submission deadline of February 19, 2027, at 4:00 p.m. ET. Other critical dates include a systems demonstration on November 30, 2026, and bidder interviews starting around March 30, 2027. The anticipated contract start date is on or before July 1, 2028. This solicitation establishes a Minority/Women Business Enterprise (MWBE) contracting goal of 30 percent. Administrative inquiries and submissions are managed by Andrew Lynch, Health Programs Administrator, at the Office of Health Insurance Programs in Albany, New York.

General Info

NYS Department of Health seeks proposals to integrate eligibility, enrollment, and appeals systems.

NAICS

N/A

Place of Performance

New York State - Statewide, NY, USA

Set-Aside

NONE

Documents

1

NYS Dept. of Health Office of Health Insurance Programs RFP

PDF, High priority: read this firstrfp
High

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Timeline

PhaseSolicitation
Posted

Solicitation

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Organization & Contact Information

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AgencyNew York → NYS Department of Health
Contacts2 people available
OfficeN/A
Office AddressN/A
Contacts
Andrew LynchHealth Programs Administrator
Andrew LynchHealth Programs Administrator

Full Description

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The New York State Department of Health (Department), Office of Health Insurance Programs (OHIP) is announcing the release of Request for Proposals (RFP) #C043776: Converged Eligibility and Enrollment (E&E) System and Appeals Management System (AMS). This RFP seeks proposals from qualified bidders to create, maintain, and operate a Converged Eligibility and Enrollment (E&E) System for the Department’s health insurance programs. Under the resulting contract, the contractor will incorporate the functionality of the current New York State of Health (NYSOH) System into the Medicaid Eligibility and Client Management (MECM) System to create a Converged E&E system in order to provide a seamless E&E experience for consumers. The full RFP listing can be found at the following link: https://health.ny.gov/funding/rfp/c043776/ The events relevant to this RFP are planned to occur on the dates and times indicated below. Dates and times are subject to change at the Department’s discretion. Event Date Issuance of RFP October 29, 2026 Deadline for Submission of Letter of Intent to Bid November 13, 2026, at 4:00 p.m. ET Deadline to Register for the Systems Demonstration November 13, 2026, at 4:00 p.m. ET Systems Demonstration November 30, 2026, at a time to be determined Deadline for Submission of Written Questions Questions due by December 21, 2026 at 4:00 p.m. ET Responses to Written Questions Posted by the Department Responses posted on or about January 19, 2027 Deadline for Submission of Proposals Proposals due on or before February 19, 2027, at 4:00 p.m. ET Anticipated Bidder Interviews Start on or about March 30, 2027 Anticipated Contract Start Date On or before July 1, 2028 Business enterprises awarded an identical or substantially similar procurement contract within the past five years: Contract # C027853 with CSRA State and Local Solutions, LLC Minority / Women Business Enterprise contracting goals (MWBE) Total MWBE Goals: 30.00%

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