RFP SD25-00019 Health Care Provider Network and Prior Authorization Services

The California Department of Corrections and Rehabilitation / California Correctional Health Care Services is seeking qualified entities to establish and manage a comprehensive Health Care Provider Network delivering community-based specialty medical services to incarcerated individuals across California and in select bordering counties of Oregon, Nevada, and Arizona. The contract requires the successful proposer to provide full-service provider network management, prior authorization systems, and related administrative support on a cost-per-claim basis, with pricing structured separately for laboratory and non-laboratory services. The network must be 80% operational within six months of contract execution and include access to hospital-level care with 24-hour emergency services, intensive care, tertiary and transplant services, medical imaging, clinical laboratory and pathology services, and telehealth. All providers must be fully licensed and capable of adhering to CDCR/CCHCS operational protocols, including strict security policies, infection control standards, Cal/OSHA requirements, and zero-tolerance policies for sexual harassment and workplace violence. Personnel must comply with institutional rules, undergo background checks and fingerprinting, carry proper identification, and participate in mandatory orientations, including Prison Rape Elimination Act training. The contractor is obligated to comply with a broad range of legal, financial, and operational requirements, including certification under the Fair Employment and Housing Act and the Unruh Civil Rights Act, adherence to conflict of interest statutes such as GC Sections 1090 and 81000 et seq., and full alignment with HIPAA and information security protocols outlined in Exhibits F and G. Payment terms are governed by the California Prompt Payment Act, with undisputed invoices paid within 45 days, and invoicing must follow strict formatting rules including use of correct revenue codes and accompanying forms such as ADJ-01 for administrative days. The contract has a five-year initial term with five optional one-year extensions, and proposers must include amortized implementation costs over the initial period. Proposals are evaluated for best overall value based on technical approach weighting (1,189 points), additional criteria (305 points), cost (750 points), and deliverables (95 points), with responsiveness as a mandatory threshold. Submissions must be electronic PDFs delivered via email by August 18, 2026, and include mandatory certifications on DVBE status, conflict of interest, generative AI usage, good standing, tax compliance, and ethical conduct. The contractor must also supply all laboratory supplies, shipping containers, and facility labels at no additional charge to the thirty-one designated CDC