Government Contract | Maine
Administrative Services Organization (ASO)

Bid Information

Bid Alert No: 00000610501

Bid Title: Administrative Services Organization (ASO)

Agency Bid No. Title: 201604100

Received Date: 06/27/2016

Close Date: 09/29/2016

Purchase Type: July 1, 2017 June 30, 2018

Delivery Point:

Delivery Date: Not Stated

Special Notices: Questions Due By 06/29/2016 05:00 PM


Specifications include, but are not limited to:Each Bidder must, in their proposal, address all expectations/requirements listed below, including the particular qualifications the Bidder has and the resources and methods/strategies to be utilized upon contract implementation to meet the listed expectations/requirements: A.Overview The Department is seeking proposals for provision of Utilization Management Services, which includes: Utilization Review (UR), reporting and Quality Management and Improvement (QMI) activities as performed by an Administrative Services Organization (ASO) licensed in Maine as a Medical Utilization Review (MUR) Entity, related to individuals seeking to receive or currently receiving Behavioral Health Services through MaineCare or through State and/or federally funded programs. These services are required for the following categories of eligible individuals: 1) MaineCare Members; and 2) non-MaineCare eligible individuals who are either: a) Bates Consent Decree members; b) Baxter School for the Deaf members; or c) individuals eligible to receive LTSE. These categories require separate tracking and reporting due to federal financial participation requirements. The Awarded Bidder will perform all such services Statewide to ensure efficient and appropriate provision of Behavioral Health Services. The Awarded Bidder, as the ASO, must submit all proposed Utilization Management Services criteria and all other service authorization criteria to the Department for its consideration and written approval, prior to implementation. All Utilization Management Services criteria for Non-MaineCare-funded Services must also be reviewed and approved by the court master for consistency with the Bates Consent Decree. The Utilization Management Services will be performed by the ASO to assure that Recipients are receiving the right level of care for the appropriate intensity and duration of treatment. The ASO will use standardized clinical protocols to guide Utilization Management Services decisions. The Utilization Management Services System must have mechanisms in place to accurately and reliably detect under-utilization and over-utilization of services and must be under the direction of an appropriately qualified clinician. UR will include the following elements: Prior Authorization (PA), Registration, Continued Stay Review (CSR), Retrospective Review, Pending Eligibility Review, preventing the duplication of services and eligibility verification according to the criteria dictated in rule, policy or by the Department, or developed and implemented by the Administrative Services Organization (ASO) with prior written approval by the Department.

Bid Related Documents

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Product Code: 94807

Agency Information

Issuing Agency: State of Maine - Department of Health and Human Services

State: Maine

Agency Type: State and Local

Contact: 286 Water Street, 4th Floor, 11 State House Station, Augusta, Maine, 04333



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