Government Contract | Idaho
Medicaid Overpayment Recovery Audit Services

Bid Information

Bid Alert No: 00000510655

Bid Title: Medicaid Overpayment Recovery Audit Services

Agency Bid No. Title: RFP16000589

Received Date: 03/15/2016

Close Date: 04/19/2016

Purchase Type: Not Stated

Delivery Point:

Delivery Date: Not Stated

Special Notices: Pre-Bid Conference Optional 03/15/2016 09:00 AM, Other Optional 03/14/2016 10:00 AM: Registration, Questions Due By Optional 03/24/2016


Specifications include, but are not limited to:Scope of Work (SOW) Section(s) I, II and XVI are mandatory requirements and will be included in the resulting contract but do not require a response, except to affirmatively indicate a willingness to comply with each mandatory requirement.I.General Requirements.A.The purpose for this contract is for a Recovery Audit Contractor (RAC) to audit the following Idaho Medicaid services:1.Hospital;2.Durable Medical Equipment;3.Personal Care Supplies; and4.Other categories as assigned by the Idaho Department of Health and Welfare (Department).B.The Department will:1.Approve audits to be conducted by the Contractor.2.Assign case numbers.3.Issue the Notice of Overpayment to the identified providers.4.Record overpayments, and establish and collect the overpayments.5.Provide the Contractor with a monthly summary of accounts receivable and amounts collected for each provider.C.The Contractor shall:1.Comply with all provisions set forth in the contract and all applicable provisions of state and federal laws, rules, regulations, policies and guidelines as amended or modified that govern the performance of the services and that pertain to Medicaid Program Integrity.2.Abide by the Department's Business Associate Agreement as stated in Appendix E.3.Agree that no data, information, or distribution lists related to this contract may be sold or otherwise distributed by the Contractor to a third party, including to any divisions owned by or affiliated with the Contractor.4.Ensure all data transfers are secure and compliant with 45 CFR Section 164: information pertaining to audit claims or providers only to the Department, unless otherwise authorized by the Department.6.Designate a Contract Administrator to be responsible for contract acceptance, amendments, and oversight.7.Designate a Contract Manager who will be the primary contact for the Department who will cooperate fully with respect to the direction and performance of the contract. The Contract Manager for the contract shall be located on the Idaho site.8.Provide additional key personnel: medical director (shall meet Idaho licensing requirements), auditors, certified coders, and clinicians. 9.Attend a contract implementation meeting or participate via a conference call facilitated by the Department to review contract requirements and timelines. The Contractor shall attend the meeting at its own expense or may participate via conference call.10.If the Department determines for any reason that all or any part of receipts received as a result of work performed by the Contractor are not allowable under applicable laws, rules, or policies, promptly reimburse the State all fees attributable to the non-allowable receipts.

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Product Code: 94631

Agency Information

Issuing Agency: State of Idaho - Department of Health and Welfare

State: Idaho

Agency Type: State and Local

Contact: Andrea Magee, Contracting and Procurement Services Unit

Phone: 208-334-5669

Fax: 208-639-5715




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