Solicitation Details

Solicitation Number

Department

Status Reason

Open

Opening Date

Posted Date

Commodity Code

Mandatory Conference/Site Visit

Special Instructions

Description

The North Carolina Department of Health and Human Services (“NCDHHS” or “Department”), Division of Health Benefits (“DHB” or “NC Medicaid”), through the Office of Compliance and Program Integrity (OCPI) seeks to procure an experienced and qualified partner to serve as the Fraud, Waste, and Abuse (FWA) Program Integrity Administrator. The selected Offeror shall be responsible for administering program integrity functions for (i) Prepayment Claims Reviews, (ii) Post Payment Claims Reviews, (iii) Data Analytics, (iv) Medical Necessity Reviews, (v) Investigations, (vi) Recovery Audit Contracts (RAC), and (vii) non-RAC Provider Auditing Activities.

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Solicitation Details

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