South Carolina Sfaa Sfaa #5400029919

South Carolina Medicaid NEMT Coordinator Services Solicitation

South Carolina is seeking a contractor to coordinate statewide Non-Emergency Medical Transportation (NEMT) services for Medicaid members. - Government Buyer: - South Carolina Department of Health & Human Services (SCDHHS), managed by the State Fiscal Accountability Authority, Division of Procurement Services - Scope of Services: - Comprehensive management of Medicaid NEMT, including: - Establishing and credentialing a network of transportation providers - Operating a staffed contact center for members and providers - Verifying member eligibility and arranging transportation - Scheduling and dispatching trips using automated software - Timely and accurate reimbursement to transportation providers - Complaint management and member engagement/education - Maintaining a secure member database and encounter data reporting - Providing and maintaining a public website and mobile application - Ensuring compliance with federal and state regulations (Title XIX, HIPAA, South Carolina State Plan) - Notable Requirements: - Risk-based, capitated payment structure - Emphasis on operational efficiencies, timely access standards, and quality assurance - Optional value-added enhancements to improve member experience and program performance - Compliance with federal lobbying restrictions and South Carolina tax withholding for nonresident contractors - No specific OEMs or technology vendors are named; IT solutions (scheduling software, website, mobile app) are required but open to contractor selection - Contract Term: - Initial three-year term with automatic one-year renewals, plus two one-year optional renewals - Estimated Contract Value: - Based on statewide Medicaid transportation coordination, likely in the multi-million dollar range annually - Potential Competitors: - National and regional NEMT coordinators and technology-enabled healthcare transportation firms

Description

This solicitation is for Non-Emergency Medical Transportation (NEMT) Coordinator Services in South Carolina. The contractor will manage all aspects of transportation provided under the NEMT program, including establishing a network of qualified transportation providers, operating a contact center, verifying member eligibility, approving and arranging transportation, and providing reimbursement to providers. The contract is risk-based and aligns with Title XIX of the Social Security Act and the South Carolina State Plan for Medical Assistance. The initial contract term is three years with automatic one-year renewals unless notice is given otherwise.

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