About this opportunity
AI summaryThe Ohio Department of Medicaid seeks information to implement new and ongoing provider enrollment and oversight activities, tools, services, and measures to prevent fraud, waste, and abuse in the Medicaid program. The requested scope includes gathering industry expertise to support expanded provider enrollment requirements, agreement management, claims suspensions, and new revalidation and credentialing activities, as well as general supervision tasks like processing provider applications, performing structural reviews, conducting incident investigations, and executing onsite visits for moderate- or high-risk provider types. Only onshore United States organizations are eligible to participate, with performance conducted offsite. Suppliers must submit questions through the Inquiry tab on Ohio|Buys by November 13, 2026, referencing the relevant solicitation sections. Responses may be submitted digitally via email or online.
Buyer and opportunity details
- Client
- Ohio Department of Medicaid
- Solicitation No.
- ODMR 2627-0011
Scope of work
- Tracking and completing provider eligibility screening as part of enrollment and revalidation
- Tracking and completing on-site visits of moderate, high-risk, and other necessary risk levels
- Tracking and completing initial and revalidation applications for waiver providers
- Tracking and performing incident management and investigations
- Tracking and completing structural reviews of providers providing waiver program services
- Managing increased volume and staffing needs from expanded revalidation work
- Supporting license verification, credential renewal, and scheduling pre-enrollment inspections
- Integrating proposed systems, data, staffing, or workflow seamlessly with the Ohio Medicaid Enterprise Solution
Minimum qualifications
- Expertise and experience with provider enrollment, oversight, revalidation, and credentialing as a provider or supplier of systems, tools, or services
Documents to include with your response
- Narrative response in a single structured PDF format addressing RFI questions
Key dates
- RFI releases on OhioBuys; Q&A period opens
- October 30, 2026
- Q&A Period Closes
- November 13, 2026 11:00am EST
- Deadline for Respondents to submit responses to ODM
- December 4, 2026 2:00pm EST
How to submit
- Method
- Electronic format via OhioBuys
- Instructions
- Must be submitted as one single .pdf document through OhioBuys by 2:00 pm on December 4, 2026. No other method accepted.
