Government Contract | South Dakota
SD Medicaid NCCI/MUE Edits

Bid Information

Bid Alert No: 00000607473

Bid Title: SD Medicaid NCCI/MUE Edits

Agency Bid No. Title: 687

Received Date: 06/24/2016

Close Date: 07/26/2016

Purchase Type: through May 31, 2017

Delivery Point:

Delivery Date: Not Stated

Special Notices: Questions Due By Optional 06/30/2016


Specifications include, but are not limited to:This is a request for proposals (RFP) from entities interested in providing to the State of South Dakota,Division of Medical Services, the necessary service, interfaces, and support to perform the nationalcorrect coding initiative (NCCI) and medically unlikely (MUE) claims edits authorized by the Centers forMedicare and Medicaid Services (CMS) and required by section 6507 of the Patient Protection andAffordable Care Act (P.L. 111-152).The Department of Social Services (DSS) is dedicated to effectively managing the State Medicaidprogram and realizing the Departments vision of strong families being the core of South Dakotas future.Effective management of the Medicaid program requires timely, accurate and secure processing ofMedicaid claims. Maintaining and adhering to the confidentiality and security of Medicaid claims data is ofthe utmost importance to DSS and the Bureau of Information and Telecommunications (BIT) whomanage, maintain and monitor adherence to security standards required by the Federal Government, theState and State contracted entities.The Centers for Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative(NCCI) to create, promote and release to all states, a set of national correct coding methodologies. TheDivision of Medical Services currently utilizes SaaS contract services to comply with the CMS NCCI editsmethodologies and related requirements. The purpose of this request is to maintain the current SaaSmodel of NCCI and MUE edit processing, provide business process improvements and incorporatescalability for future identification of additional edits at the discretion of the State, or as mandated by CMSor Administrative Rule. It is intended that a nightly file will be transferred to the Offeror, edits performed,and information returned that same night. Edit detail should be available to DSS staff that is not tied toexisting DSS systems or MMIS. Each Offeror will provide their individual solution to the availability of editdetail

Bid Related Documents

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Product Codes: 96116, 94610, 95327

Agency Information

Issuing Agency: State of South Dakota - Office of Procurement Management

State: South Dakota

Agency Type: State and Local

Contact: Mark Close Bureau of Administration - Office of Procurement Management, 523 E. Capitol, PMB 01231, Pierre, South Dakota, 57501




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