Medicaid RFPs

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 health care administration (agency) under centers for medicare and medicaid services.

Provide health care administration (agency) under centers for medicare and medicaid services (CMS).

The South Carolina Department of Health & Human Services is seeking a qualified vendor to replace and enhance its Third-Party Liability (TPL) enterprise Medicaid recovery platform. The project includes design, development, integration with the Medicaid Enterprise System, and four years of operations and maintenance. This fixed-price contract features a base period of four years with three optional one-year extensions.

Provide Pre-Admission Screening Resident Review (PASRR) Level II evaluations for individuals seeking admission to, or residing in, Medicare/Medicaid Certified Nursing Facilities (NFs).

Cook County Health (Health Plan Services) is soliciting proposals to deliver Condition Management Services for Medicaid enrollees with specified chronic conditions including Asthma, ADHD, and Autism. The selected vendor will implement evidence-based programs, identify and engage members, and support self-management while meeting state Medicaid reporting requirements. The contract term is 48 months with options for five one-year extensions and one six-month extension.

The Alabama Medicaid Agency is seeking a contractor to takeover, modernize, and operate its Medicaid Management Information System (MMIS) and deliver Claims Processing and Management Services (CPMS), including cloud migration to a Microsoft Azure Government tenant. The work is organized into a Takeover Phase, a Maintenance and Operations Phase, and an Enhancement Phase, with performance based in Montgomery, Alabama. The procurement estimates an overall value in the range of $50,000,000 - $150,000,000 with a projected contract execution start date of July 1, 2027.

Provide licensed mold professional services related to government funded purchase, Medicaid Waiver HSRN and rehabilitation projects. These projects are predominately single-family homes. See attached file.

Provide the medicaid enterprise vision and organizational support for project staff during both the planning & design development and implementation (DDI) phases of the project along with the maintenance and operations (M&O) phase of the project.

Seeking to procure licensed mold professional services related to government funded purchase, Medicaid Waiver HSRN and rehabilitation projects. These projects are predominately single-family homes. The purpose of this RFP is to obtain proposals from qualified firms to provide mold assessment and remediation project scopes for a period of three years.

The Massachusetts Executive Office of Health and Human Services has posted a solicitation to procure and implement a new Medicaid Management Information System (MMIS). The solicitation is published on the Commonwealth's CommBuys site as OPEN, shows a bid opening/closing placeholder date of 2099-12-31, and lists Geraldine Sobkowicz as the information contact.

The Minnesota Department of Human Services is seeking information to define 'medically frail' for the implementation of new Medicaid requirements. This initiative is mandated by Public Law 119-21, Section 71119, to ensure compliance with federal standards. Interested parties are invited to provide feedback and data to help shape the state's definition and implementation strategy.

The Massachusetts Executive Office of Health and Human Services is seeking applications from hospitals to make presumptive Medicaid eligibility determinations and assist presumptively eligible individuals with completing full MassHealth applications. Selected hospitals will enter into a non-financial agreement with EOHHS, participate in training, and be monitored using state-developed performance standards.

The Oregon Health Authority issued an informational notice describing ArrayRx pharmacy services for public sector purchasers, including pharmacy benefit management, prescription discount options, and managed Medicaid support. The posting is informational (Notice/Informational), listed as OPEN, and is intended to inform public agencies about options to achieve better value for pharmacy services.

Texas Health and Human Services Commission seeks contractors for statewide Demand Response Transportation Services (DRTS) to provide nonemergency medical transportation (NEMT) for Medicaid clients and other eligible individuals in Texas counties. Contractors must meet specific qualifications and provide services using buses, vans, or sedans, ensuring timely and satisfactory transportation to covered health care services.

The Alaska Mental Health Trust Authority is soliciting proposals to provide technical assistance and consultation to support Home and Community Based Services (HCBS) system design and Medicaid waiver work. The contract period is set to begin in July 2026 and runs through June 2027, with options for three one-year renewals. Proposals are due by June 22, 2026, and a pre-proposal conference is scheduled for early June.

The State of Oregon is soliciting proposals for Financial Management Agent Services to provide payroll, payment, and related financial management services to Common Law Employers and the Oregon Department of Human Services. The scope includes administering payroll, tax withholdings, and HIPAA-compliant records for Personal Support Workers delivering in-home support services. Proposers must demonstrate experience with Medicaid beneficiaries and knowledge of federal and Oregon tax and labor laws.

The State of Wyoming is soliciting a vendor to design, develop, and implement a statewide health information exchange called the Wyoming Frontier Information (WYFI), including training and ongoing support. The contract is expected to run 10 years with an estimated budget of approximately $13,896,645, and proposals must include technical and cost proposals with pricing schedules. Vendors should have previous HIE software and services experience, including at least one HIE contract with a State Medicaid Agency.

The Garrett County Health Department is seeking proposals from qualified contractors to provide insurance contracting and credentialing services for clinicians and programs at rural local health departments. Funded by the Maryland Rural Health Transformation Program, the contractor will manage payer enrollment and credentialing with Medicaid, Medicare, and commercial insurers to improve local billing and access to services. Proposals must be submitted via mail or hand-delivery to the issuing office by the deadline of June 15, 2026.

The Texas Health & Human Services Commission (HHSC) issued an Invitation for Bids to establish contracts for battery and capacitor replacement services for UPS systems at the Texas Medicaid & Healthcare Partnership in Austin. The scope includes supplying, removing, and recycling specified batteries and replacing capacitors with warranty coverage and a four-hour emergency response option. The contract period runs from the date of award through August 31, 2026, with an option for a one-year extension.