Mississippi Procurement Portal #3160008164

Mississippi Medicaid Seeks External Quality Review Organization for Managed Care Programs

The Mississippi Division of Medicaid is seeking a qualified External Quality Review Organization (EQRO) to support oversight of Medicaid and CHIP managed care programs. - Government Buyer: - Mississippi Division of Medicaid - Scope of Services: - Comprehensive external quality review activities for Medicaid and CHIP managed care, including MississippiCAN - Validation of performance improvement projects and performance measures - Review of network adequacy and encounter data audits - Administration or validation of quality of care surveys - Corrective action plan validation and monitoring - Readiness reviews for managed care organizations - Assistance with quality rating system implementation - Contract Details: - Initial three-year contract with two optional one-year renewals - Compliance with federal regulations (42 CFR Part 438 Subpart E) and CMS protocols required - Annual reporting and deliverable management - Notable Requirements: - Strict adherence to federal and state quality review standards - No specific OEMs or technology vendors named; open to qualified organizations with relevant expertise

Description

This procurement is an Invitation for Bid issued by the Mississippi Division of Medicaid for External Quality Review Organization (EQRO) services. The selected organization will be responsible for analyzing and evaluating aggregated data concerning the quality, timeliness, and accessibility of services covered under Medicaid and CHIP, as delivered by Managed Care Organizations (MCOs). The solicitation includes detailed scope of services, procurement process, and terms and conditions. The procurement is open with a response due date of September 18, 2026.

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