Workers' Compensation 504 Health Care Program Management

Background
The Dallas Independent School District (Dallas ISD) is self-insured for Workers’ Compensation and is seeking offers for comprehensive workers’ compensation services. The goal of this contract is to procure vendors who can provide essential services funded by federal dollars, which may also be utilized in local, state, and grant-funded programs. This proposal adheres to Title 2 of the Code of Federal Regulations (2CFR) Part 200 requirements.

Work Details
The awarded vendor will provide the following services:
- **504 Network Program Administration**: Management of the Dallas ISD Workers’ Compensation 504 Network, including administration and recommendation of contracted medical providers, ensuring availability of healthcare services, credentialing of providers every three years, and managing subcontractors.

- **Medical Case Management**: Includes telephonic and field case management, assisting with medical appointments and referrals, providing monthly reports on managed cases, and attending quarterly claim reviews.

- **Cost Containment Services**: Involves Pharmacy Benefit Management (PBM), pre-authorization services, rehabilitation services, auditing medical bills with a turnaround time of 3-5 business days, and maintaining compliance with Texas Workers’ Compensation regulations.

- **Electronic Medical Bill Processing**: Implementation of an electronic system for processing medical bills as per Texas regulations, ensuring timely reimbursements to providers within 10-15 days after approval from Dallas ISD.

Period of Performance
The contract term will be for three (3) years with two (2) successive one (1) year extensions based on mutual consent not to exceed five (5) years total.

Place of Performance
Services will be performed within the geographic area served by Dallas Independent School District.

Bidder Requirements
Vendors must have at least five (5) years of experience in providing these services to self-insurers under Texas Labor Code Section 504.053. All subcontractors must receive approval from the District’s Workers’ Compensation Manager or Executive Director.