Medicaid RFPs

Provide medicaid data consulting services. Consulting will entail advising the agency on analysis and presentation of data to enhance usability by program areas and personnel.

Medicaid transportation services contact.

To provide Third Party Liability (TPL) Services, Managed Care Secondary Recovery Services, Recovery Audit Contracting (RAC) services, Medicaid Estate Recovery (MER) services, Subrogation and Casualty Reduction services, Cost Avoidance services, Health Insurance Premium Payment (HIPP) services and Managed Care TPL Data Exchange and Evaluation services.

Provide technical, administrative, and operational support for medicaid administrative claiming program

The Alabama Medicaid Agency is soliciting bids to provide prescription eyeglasses (approved frames and lenses) for Medicaid beneficiaries statewide, including adults, children, and special‑needs recipients. The procurement is an Invitation for Bid for a one‑year fixed‑price contract with two one‑year optional renewals; it includes a $275,000 performance guarantee, HIPAA/compliance requirements, and operational metrics (≥95% monthly fill‑rate and a 10 working‑day order turnaround). Questions are due 2026-07-22 and bids close 2026-07-28, per the buyer posting information.

The purpose of selecting a qualified bidder to provide a new Medicaid Drug Rebate System (MDR).

The State of Nebraska Department of Health and Human Services is soliciting proposals to design, build, implement, certify, and operate a new Medicaid Drug Rebate (MDR) system to replace an aging legacy platform. The contract encompasses full-cycle services—requirements gathering, system architecture, development, testing, data migration, training, go-live support, CMS certification, and ongoing operations with detailed performance guarantees over a multi-year term. Written questions are due 2026-06-23 and proposals are scheduled to be opened on 2026-07-23 at 2:00 PM Central; documents were posted 2026-06-11.

Provide medical oversight, prior authorization case review and medical necessity determinations in a medicaid managed care environment. The state has policies and procedures within its clinical operations unit for surveillance and utilization review activities. These activities are federally mandated for all state medicaid managed care organizations, as outlined in title 42, part 400, of the code of federal regulations. The contractor(s) will provide consultative services on these activities, on an as needed basis, not to exceed ten (10) hours per week, according to a mutually agreeable schedule as established by the contractor, the state clinical operations unit director and the state s chief medical officer.

Seeking a qualified and experienced contractor to provide Medicaid claim submission and management services under the 1115 Medicaid Waiver. The selected vendor will be responsible for preparing, submitting, and managing all eligible Medicaid claims for incarcerated individuals who received Medicaid-covered services or medications during the final 90 days of their incarceration. This initiative supports the County’s efforts to improve continuity of care, enhance reimbursement accuracy, and ensure compliance with State and Federal Medicaid requirements.

The North Carolina Department of Health and Human Services (NCDHHS) seeks a modern, cloud-based Data Analytics Platform (DAP) to extract, analyze, migrate, and report Medicaid data, replacing legacy systems and improving transparency, reporting accuracy, and program oversight. The project includes migration of roughly 110-120 TB of historical data and conversion of over 650 reports/dashboards, development of 30 curated data products, and ongoing support phases. The initial contract term is five years with two one-year options and an anticipated go-live no later than July 1, 2029.

Procurement of a qualified Vendor to implement, manage, and operate an Open/Hybrid Model Electronic Visit Verification (EVV) solution for the Rhode Island Medicaid Optimized and Adaptable State Information System (RI Medicaid OASIS).

Soliciting quotes from contractors with qualifications, experience, and knowledge to provide medicare, medicaid, and schip extension act (mmsea) reporting services.

Provide open enrollment for independent review organization services, medicaid & chip services, medical & UR appeals.

The North Carolina Department of Health and Human Services (DHHS), Division of Health Benefits, issued an RFI to gather vendor input on best practices for transferring and maintaining third-party software licenses for Medicaid-related technology solutions. The RFI seeks feedback on license transferability, structuring agreements with third-party vendors, licensing models, legal considerations, and strategies for pricing continuity post-transfer. Responses are to be submitted electronically through the NC electronic Vendor Portal and will inform future procurement and contractual approaches.

Procurement of a SaaS tool, configuration, maintenance, and consulting services for Medicaid Information Technology Architecture (MITA) State Self-Assessment (SS-A) for the State of Delaware's Department of Health and Social Services, Division of Medicaid and Medical Assistance.

Replacing the department's medicaid management information system (MMIS) with a medicaid enterprise system (mes), also referred to as the medicaid integrated modular solution (MMIS).

Conduct external medical reviews (EMRs) for: texas medicaid managed care organization (MCO) or dental maintenance organization (DMO) benefit denials or reductions that are appealed by medicaid members or their authorized representatives and subsequently are requested for review by a contracted IRO; and eligibility decisions made by HHSC for a medicaid program in which eligibility is based on a medicaid applicant or recipient's medical or functional need.

Provide medicaid enterprise system (MES) system integration services.

Design, development, implementation, and ongoing hosting and support of a Medicaid Provider Enrollment and Management System (PEMS).

Provide Pharmacy Benefit Services (PBS) solution to modernize and support the Medicaid Pharmacy business and technical environment.