Medicaid Waiver Services

The agency is seeking a contractor to provide Medicaid claim submission and management services under the 1115 Medicaid Waiver. The selected provider will prepare, submit, and manage all eligible Medicaid claims for incarcerated individuals who received Medicaid-covered services or medications during the final ninety days of their incarceration. Initial implementation will focus 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 necessary for eligibility verification and claims processing. Additionally, the agency will approve and support technical integrations between county and jail systems and the billing platform, coordinate among internal departments and healthcare providers for data transmission, 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 performance of all contracted work must take place offsite. The agency has not disclosed a specific budget and is looking for proposals to define the financial terms. The contract period will span six years. The agency will host a virtual pre-bid meeting on June 10, 2026. Bidders must submit all questions regarding this opportunity no later than June 17, 2026.