Medicaid Waiver Services

The issuing agency is seeking a contractor to provide Medicaid claim submission and management services under the 1115 Medicaid Waiver. The agency needs to resolve the challenge of preparing, submitting, and managing eligible Medicaid claims for incarcerated individuals who receive Medicaid-covered services or medications during the final ninety days of their incarceration. The initial implementation focuses exclusively on medication-assisted treatment participants, with plans to expand to all inmates receiving Medicaid-eligible medical care as the program matures. The scope of work requires the contractor to provide a dedicated account manager to oversee all billing operations and add billing specialists as needed based on claim volume. The agency will provide inmate demographic, booking, custody, and release data for eligibility verification and claims processing. The contractor must approve and support technical integrations between County and jail systems and the billing platform, coordinate among internal departments and healthcare providers, and establish service-level expectations for response times, issue resolution, and data exchange. Eligibility is restricted to onshore organizations based in the United States. The contractor must perform all work offsite. The contract period spans six years, and the agency is looking for budget proposals to determine the cost of the services. The agency will conduct a virtual pre-bid meeting on June 10, 2026. Bidders must submit all questions no later than June 17, 2026. The agency has not specified the final proposal submission deadline in the provided details.