| Technical Assistance and Support for Iowa Medicaid Enterprise Services Procurement |
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The purpose of the review is to perform a business analysis on the IME business model, it's current business operations and performance measures, and identify where the use of commercial insurance "best practices" could be used to gain efficiencies in IME operations. The QSP will also provide technical assistance to the Department in the procurement of contractors for the daily business operations of the IME, including development of RFPs. QSP will convert Iowa's Medicaid Information Technology Architecture (MITA) state self-assessment (SS-A) from MITA Framework 1.0 to the current Framework 2.0. At the conclusion of the IME services procurement process, the Technical Assistance (TA) Contractor will update Iowa�s SS-A based on newly procured IME services.
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| Actuarial Services Request for Proposal |
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This Request for Proposals (RFP) is to solicit proposals from qualified service providers to provide methods for and calculation of capitation rates for Medicaid managed care initiatives and other services that may be necessary to be provided by an actuary. These methods must be actuarially sound, acceptable to the Centers for Medicare and Medicaid Services (CMS) and readily replicated. The primary purpose is to establish a service contract that will allow for technical assistance from an experienced third party in conducting prepaid plan negotiations, rate setting and other activities.
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| Dental Home for Medicaid Eligible Children Under Twenty-one (21) Years of Age |
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The Department of Human Services, Iowa Medicaid Enterprise is seeking information to determine a means by which all children under twenty-one (21) years of age will have a dental home by July 1, 2008. RFI MED 06-025 previously issued by the Department on January 31, 2006 solicited information regarding implementation of the I-Smile Dental Home plan for children twelve (12) years of age and under. This RFI includes expansion of the dental home to all children under twenty-one years of age.
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| Correct Coding Initiative (CCI) |
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This Request for Proposal (�RFP�) seeks to solicit proposals from vendors for the purchase and installation of correct coding edit software. This can be either commercial off the shelf (�COTS�) or proprietary software.
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| Cost and Quality Performance Evaluation |
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This Request for Proposal ("RFP") seeks to solicit proposals from qualified service providers to archive the legislative mandate. The RFP is designed to provide interested bidders with sufficient information to submit bids meeting minimum requirements, but it is not intended to limit a bid's content or exclude any relevant or essential data. Bidders are encouraged to expand upon the specifications to further highlight their service capability as it relates to this RFP.
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| Medicaid Claims Payment Support Services RFP |
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The purpose of this contract is to provide support services in the form of printing, stuffing and mailing all checks and remittance advices (RA) for Medicaid providers each payment cycle. The current payment cycles are the second and fourth Mondays of each month. This contract will be responsible for supplying necessary check stock and printing all checks identified by the Core MMIS Unit of the Iowa Medicaid Enterprise each payment cycle. In addition to all checks produced, this contract will produce all remittance advices for all providers receiving checks or electronic funds transfer (EFT). Once produced, this contractor will prepare for mailing all checks and remittance advices along with requisite letters to residential care facility (RCF) guardians each cycle. Upon word to release, the contractor will mail all checks, RA�s, and RCF letters in the most effective, efficient method for timely delivery by the postal service.
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| National Provider Identifier (NPI) |
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The purpose of this RFP is to seek proposals from interested firms to provide an assessment of the Health Insurance Portability and Accountability Act (HIPAA) National Provider Identifier (NPI) requirements on the Medicaid Management Information System (MMIS) and Medicaid-related systems and Medicaid policies.
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| Iowa Medicaid Enterprise (IME) |
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The Iowa Department of Human Services (DHS or Department) is the single state agency responsible for administering the Medicaid program in Iowa. The Iowa Medicaid Program provides medical services to eligible Medicaid recipients under Title XIX (Medicaid) of the Social Security Act through enrolled providers and health plans.
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| Point Of Sale |
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This RFP is for: (1) a vendor-owned, vendor-operated Medicaid point-of-sale (POS) pharmacy claims adjudication system (including all media electronic point of sale claims, paper claims, batched, FTP, etc.), operating on vendor-owned hardware; (2) technical assistance to pharmacy providers, (3) pro-DUR services; (4) a state-of-the-art Medicaid pharmacy decision support system; (5) drug rebate and supplemental drug rebate billing, collection and accounting services; and (6) a provider friendly, member friendly transition from the current contractor to the winning bidder and from the winning bidder of this contract to the winning bidder in the next Iowa Medicaid POS re-procurement.
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| Iowa Plan |
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The Iowa Plan, which integrates treatment for mental health and substance abuse, is administered by a single statewide organization that has contracted jointly with the Iowa Department of Human Services (DHS) and the Iowa Department of Public Health (DPH) Division of Health Promotion, Prevention, and Addictive Behaviors.
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| Medicaid Managed Care Quality Plan |
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Medicaid Managed Care in Iowa started as a pilot project with one MCO contract in one county in December of 1986. In 1990 Iowa implemented a pilot PCCM program called MediPASS in seven counties. Since then the program, no longer a pilot, has expanded to 93 counties for MediPASS and 43 counties for MCOs.
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