Description: Provide independent and objective managed care Utilization Reviews (UR) of Carrier internal appeal decisions as defined.
StateAgency · NJ, US
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New Jersey Department of Banking and Insurance
State AgencyNJ
-
Closes
Aug 25, 2026
Procurement of an Independent Utilization Review Organization for the Independent Health Care Appeals Program.
Texas Health and Human Services Commission
State AgencyTX
Nov 14, 2023
Closes
Oct 31, 2026
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.
Texas Health and Human Services Commission
State AgencyTX
Feb 1, 2025
Closes
Jan 31, 2028
Provide open enrollment for independent review organization services, medicaid & chip services, medical & UR appeals.
State AgencyMD
Aug 10, 2026
Closes
Aug 31, 2026
Surveillance and utilization review subsystem (SURS).
Procurement and program contacts connected to New Jersey Department of the Treasury.
