06926P0003-Home Care Services RFx Medical Review Services

Background
The New York City (NYC) Human Resources Administration (HRA)/Department of Social Services (DSS) is seeking qualified proposers to provide medical review services to Medicaid-eligible individuals who are medically and/or physically disabled and/or frail elderly.
The goal is to assess the service needs of home care applicants and recipients, offering professional judgments regarding their appropriateness for home care and related services based on federal and state regulations.

Work Details
Proposers must provide medical personnel (physicians) to perform ongoing professional services for the Home Care Services Programs (HCSP).
The staff will assess clients' needs and determine the type and level of care required.
Services include reviewing clients' medical records to ensure that HCSP plans meet clients' needs, considering language, cultural, religious, and other expressed preferences.
The contract will cover citywide medical review services across all five boroughs of NYC.

Period of Performance
The anticipated contract term is from July 1, 2026, to June 30, 2029, with two options to renew for three years each.

Place of Performance
Services will be provided citywide across the five boroughs of New York City.

Bidder Requirements
Proposers must have a valid New York State license to practice medicine.
The Minority-and-Women-owned Business Enterprise (M/WBE) utilization goal for this contract is 30% directed towards Black American M/WBEs.
Proposers must document their experience in providing medical review services and demonstrate organizational capability with qualified staffing.
They are also required to maintain commercial general liability insurance of at least $2 million per occurrence.