Tpl Dhhs

Background
The South Carolina Department of Health and Human Services (SCDHHS) is seeking proposals for information technology and business operations services to operate its Third Party Liability (TPL) program. This program aims to reduce overall Medicaid costs by identifying beneficiaries with other health insurance coverage.

The SCDHHS administers the South Carolina Medicaid program, which provides medical assistance to needy individuals using state and federal funds.

Work Details
The contractor will be responsible for various TPL functions, including:
- Identifying and updating Other Health Insurance (OHI) through data matches for beneficiaries.
- Implementing cost avoidance strategies and managing Medicare recoupments.
- Handling casualty claims, benefit recovery, estate recovery, and special needs trusts.
- Providing operational support including billing, help desk support, reporting, and document management.
- Enhancing existing data-matching capabilities to improve the identification of third-party insurance coverage.
- Delivering a technology solution that integrates multiple data sources and improves overall functionality and automation of key operational facets.

Period of Performance
The contract is estimated to begin on October 22, 2026, and end on October 21, 2030. It includes a four-year base term with three optional one-year renewals.

Place of Performance
The services will be performed in South Carolina, specifically at locations designated by SCDHHS.

Bidder Requirements
Offerors must have a state vendor number to submit an offer. They are required to comply with all applicable provisions of the Drug-Free Workplace Act and must not be debarred or suspended from receiving contracts by any state or federal agency.