RFP - CO Medicaid Nursing Facility Cost Report Audit

Background
The Colorado Department of Health Care Policy and Financing (Department) is seeking competitive proposals from experienced organizations to perform as the Colorado Medicaid Nursing Facility Cost Report Auditor and consultant. The Department serves as the Medicaid Single State Agency, developing and implementing policy and financing for Medicaid and other publicly funded health care programs for Coloradans who qualify. The Department operates the Colorado Medicaid Program, known as Health First Colorado, in accordance with the Colorado Medical Assistance Act and Title XIX of the Social Security Act.

Work Details
The contractor is required to perform auditing and consulting to review Colorado Medicaid Cost Reports from Nursing Facilities, conduct risk assessments, and engage in on-site audits in accordance with specific regulations. The contractor must develop a template for Colorado Medicaid Reporting, review templates and instructions annually, acknowledge receipt of the reports, and make them available to the Department electronically.
Additionally, the contractor must create a Risk Determination and Engagement Process, complete field engagements on high-risk facilities, conduct desk reviews on medium or low-risk facilities, calculate rate components annually, and maintain permanent engagement records for each Nursing Facility.

Period of Performance
The work is currently ongoing with an anticipated start-up period beginning on September 1, 2024, and an initial operational period lasting until June 30, 2025. The total duration of the contract is not anticipated to exceed five years.

Place of Performance
The contract will be performed in the State of Colorado.