INS - Behavioral Health Insurance Provider Network Directory Quality Review Services

Background
The State of Ohio, through the Department of Administrative Services, Office of Procurement Services, is issuing this Request for Proposals (RFP) on behalf of the Ohio Department of Insurance. The Agency regulates insurance products sold in Ohio and seeks proposals for behavioral health insurance provider network directory quality review services to ensure compliance with requirements related to the business of insurance in Ohio. The goal is to verify the accuracy and collect information about insurance provider network directories.

Work Details
The Contractor will perform independent external quality review (EQR) services related to validation of compliance with behavioral health insurance provider network directory requirements as per Ohio Administrative Code section 3901-8-16. The work includes:

1. **Phase One - Directory Evaluation:**
- Develop a study methodology for evaluating on-exchange commercial individual insurers’ behavioral health provider directories.
- Create a standardized data collection tool and sampling methodology.
- Collect and analyze data, prepare a draft report, present findings to the Agency, and provide a final report.

2. **Phase Two - Telephone Surveys:**
- Develop an audit approach methodology and update the data collection tool.
- Conduct telephone surveys among sampled provider locations, prepare a draft report, present findings, revise based on feedback, and provide a final report.

**Deliverables include:** Weekly communications with the Agency, a combined final report by March 31, 2026, detailing findings from both phases.

Period of Performance
The contract term will commence upon award and continue through March 31, 2026. The State may renew the contract at its discretion for one month or by mutual agreement for up to two additional years based on satisfactory performance.

Place of Performance
The work will be performed in Ohio as specified by the Agency's requirements.