Award

Montana Department of Public Health and Human Services DPHHS-RFP-2020-0238R

Utilization Management and Review Services

Recipient

Not Specified

Awarded

December 19, 2019

Identifier

DPHHS-RFP-2020-0238R

The Montana Department of Public Health and Human Services (DPHHS) has awarded a contract to a contractor, specifically a Quality Improvement Organization (QIO) or QIO-like organization, to provide utilization management and review (UR) services. These services include level of care determination, PASRR activities, functional assessments, prior authorizations, continued stay reviews, and special case reviews for Montana Healthcare Programs. The contract requires compliance with federal and state rules, regulations, and related state policies and procedures. The procurement involved a Request for Proposal (RFP) process, with no specific OEMs or vendors mentioned. The services fall under multiple commodity codes related to computing, financial, health-related, and professional services. The contract emphasizes adherence to evaluation criteria and cost evaluation based on the average cost submitted by offerors.

Description

The Department of Public Health and Human Services is seeking a contractor to provide utilization management and review (UR) services which includes level of care determination, PASRR activities, functional assessments, prior authorizations, continued stay reviews and special case reviews for Montana Healthcare Programs in accordance with federal and state rules/regulations and related state policies and procedures.

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