Worker’s Compensation Medical Management Service

The agency is seeking a vendor to provide comprehensive workers' compensation medical management services. The selected provider must deliver medical cost containment services including bill review, utilization review, and peer review, alongside case management, pharmacy benefits management, and a supporting information system. The agency requires a seamless, proactive claims administration process that coordinates with third-party vendors, facilitates prompt quality medical care, and ensures fair claims management. The scope of work requires the vendor to pay third-party invoices within sixty days of receipt, accepting financial responsibility for any late payments. The vendor must secure physicians and healthcare facilities within the 504 panel to provide behavioral health support and specialty services for extremely complex injuries such as quadriplegia, paraplegia, brain injuries, amputations, total blindness, and severe burns. Additionally, the project covers establishing a detailed implementation plan and timeline for the launch of the 504 Physician Panel, creating provider credentialing and re-credentialing protocols, distributing a Provider Handbook, and establishing a complaint process for injured employees and medical providers. Bidders must perform all work offsite and must be located onshore within the United States. The agency is establishing a contract period of two years. The agency has not disclosed a specific budget and is looking for proposals to determine the cost. Bidders must submit all questions regarding this opportunity no later than July 2, 2026.