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OpenSolicitation ODMR 2627-0018

Disproportionate Share Hospital Payment Auditing Services for Medicaid

Buyer
The Ohio Department of Medicaid
Place of performance
State of Ohio (key staff must be based in Ohio; work performed onsite or offsite)
Submission deadline
Dec 16, 2026

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What the buyer needs

AI summary

The Ohio Department of Medicaid seeks a vendor to provide disproportionate share hospital payment auditing services. The scope includes calculating hospital-specific limits using all Medicaid and supplemental payments, conducting front-end provider education, and holding exit interviews and conferences. Only onshore USA organizations are eligible to bid, and work will be performed onsite or offsite. Questions are due no later than November 27, 2026, and proposals are due by 2:00 PM EST on December 16, 2026. The department will evaluate proposals in four phases, scoring technical proposals up to 580 points and cost proposals up to 193 points, with 10 bonus points for submitting no exceptions. The department may also request interviews or demonstrations before recommending the highest-scoring offeror for award.

Scope of work

  • Design and conduct an audit of DSH payments to Ohio Medicaid hospital providers.
  • Issue appropriate certification required by DSH audit requirements in 42 CFR 447 and 42 CFR 455.
  • Educate hospital providers regarding DSH audit requirements, processes, and review findings.
  • Conduct exit conferences with hospitals upon completion of audit work.
  • Complete audits and submit certification and DSH reports for SPY 2025 by June 30, 2028.
  • Complete and submit MIUR report for SPY 2025 by May 30, 2028.
  • Conduct statistical analysis of hospital cost report and DSH payment data.
  • Provide additional services that CMS may subsequently require during the contract period.

How proposals are evaluated

CriterionWeight / scoring
Technical Proposal Score580 (75% of Maximum Total Points)
Cost Proposal Score193 (25% of Maximum Total Points)
Points for Submitting No Exceptions+10

Minimum qualifications

  • Certified Independent Public Accounting (IPA) firm.
  • Independent of any hospitals, hospital systems, or hospital associations.
  • Key professional staff must be certified as Independent Public Accountants.
  • Key professional, management, and technical staff must have at least 3 years experience in similar engagements.
  • Key staff must have at least 3 years experience auditing hospital/health system financial reporting and cost compliance.
  • Key professional, management, and technical staff must be based (working) in the State of Ohio.
  • Onshore (USA Organization Only).
  • Familiar with 42 CFR parts 447 and 455 and Generally Accepted Government Auditing Standards (GAGAS).

Documents to include with your response

  • Technical Proposal (single, searchable .pdf document)
  • Cost Proposal Form (Attachment C, separate submission)
  • Attachment A: Required Offeror Information Requirements (A1 through A6)
  • Attachment E: Acknowledgements, Exceptions, and Assumptions
  • Photocopy of certifications for key professionals
  • Signed letter from any proposed subcontractor(s)
  • Mandatory Contract Performance Disclosure or attestation

How to submit

Method
Electronic via OhioBuys
Instructions
Submit Technical Proposal (one single, searchable .pdf document) and separate Cost Proposal electronically through OhioBuys. Faxed or e-mailed submissions will not be accepted.
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