About this opportunity
AI summaryThe government authority located in New Hampshire requires an external quality review organization service. The selected vendor must provide statewide external quality reviews (EQRs) of healthcare services delivered to New Hampshire Medicaid beneficiaries enrolled in Medicaid care management. EQRs evaluate and analyze aggregated information regarding the quality, timeliness, and access to health care services provided by state-contracted Managed Care Plans. These reviews aim to improve the state's oversight and management of contracted managed care plans and assist those plans in improving their performance. Eligible bidders must be an onshore USA organization. The contractor will perform the work offsite. The buyer is looking for proposals regarding the budget, and applicants can submit their responses digitally via email or online. The provided text does not contain evaluation criteria or key-date details.
Buyer and opportunity details
- Client
- New Hampshire Department of Health and Human Services
- Solicitation No.
- RFP-2027-DPQI-02-EQRO
Scope of work
- Validation of Managed Care Organization performance measures
- Validation of Performance Improvement Projects
- Validation of provider network adequacy
- Validation of encounter data reported by MCOs and Dental Organizations
- Conduct annual quality focus studies
- Administer member and provider surveys
- Conduct contract compliance audits
- Produce annual EQR Technical Reports
Minimum qualifications
- Onshore (USA Organization Only)
- Maintain all qualifications of an External Quality Review Organization (EQRO) as outlined in 42 CFR 438.354
Documents to include with your response
- Appendix H - IT Requirements Workbook
Key dates
- MCO Implementation Plan due
- 8/1/2027
- DO Implementation Plan due
- no later than August 8/1/2027
- Initial draft of Technical Report due annually
- no later than December 1st
- Final Technical Report due annually
- no later than April 30th
- Final DO Technical Report due
- no later than 4/1/2028
How to submit
- Method
- Digitally via Email or Online
Contract details
- Place of performance
- Offsite
- Funding
- Medicaid
