Medicaid Fraud and Abuse Detection SystemBid Documents

Background
The State of Indiana, through the Indiana Department of Administration (IDOA) on behalf of the Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP), is seeking to procure a Medicaid Fraud and Abuse Detection System.
The goal of this contract is to enhance the State's capabilities in detecting, investigating, measuring, and deterring fraud, waste, and abuse within the Medicaid program.

Work Details
The selected Contractor will provide a comprehensive fraud and abuse detection system that includes maintenance and support services.
Key responsibilities include:
- Implementing systems and technologies for provider peer comparisons.
- Managing case management processes.
- Generating reports related to fraud detection.
- Conducting audits and investigations.
- Performing prepayment reviews.
- Recovering overpayments.
- Providing education to providers regarding compliance.
- Overseeing managed care plans.
The estimated cost for the four-year base term of this contract is $16,136,383.26.

Period of Performance
The contract will be executed for a period of four (4) years from the date of contract execution, with an option for two (2) one-year renewals, totaling a potential six (6) years.

Place of Performance
The services will be performed in Indiana as specified by the contract requirements.

Bidder Requirements
Respondents must have at least one year of experience providing similar solutions to at least two state government clients.
The majority of work must be performed by the Respondent as the prime contractor.
All subcontractors must not have any conflicts of interest related to this scope of work.
Additionally, there are specific participation goals for Minority Business Enterprises (8%), Women Business Enterprises (11%), and Indiana Veteran Owned Small Businesses (3%).