Austin Afo #RFP 5800 SLW3034

City of Austin Solicits Worker's Compensation Medical Management Services

The City of Austin is seeking a contractor to provide comprehensive Worker's Compensation Medical Management Services for its self-insured program covering approximately 16,425 employees. - Government Buyer: - City of Austin, Risk Management Division - Scope of Services: - Administration of an exclusive 504 Physician Panel - Medical cost containment services, including bill review, utilization review, and peer review - Case management and pre-authorization of medical services - Pharmacy benefits management - Information systems to support claims and reporting - Provider credentialing, training, and ongoing audits - Compliance with federal and Texas state laws and regulations - Timely communication, regular reporting, and data security - Notable Requirements: - Management of open claims for a large, multi-department workforce - Strict performance guarantees and penalties for non-compliance - Prohibition on the use of artificial intelligence for human decision-making in claims and medical determinations - Vendors must demonstrate experience with similar programs and provide references - Detailed implementation plans, quality control measures, and transparent cost structures required - No specific OEMs or named vendors are identified in the solicitation

Description

The City of Austin is seeking offerors to administer an exclusive 504 Physician Panel and provide comprehensive workers compensation medical management services. These services include medical cost containment, case management, pharmacy benefits management, information systems, and all other services detailed in the scope of work. The solicitation is a Request for Proposals (RFP) with a response deadline of July 23, 2026. The procurement aims to ensure effective management and cost control of workers compensation medical claims for the City workforce.

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