Independent Review Organization (IRO) for PRIRA reviews
Ended State & local contract Michigan Awarded
- Contract number
- MA230000000500
- Awardee
- MEDICAL EVALUATORS OF TEXAS ASO, LLC
- Contracting organization
- Department of Insurance and Financial Service
Contract facts
- Cumulative value
- $120,000
- End date
- Points of contact
-
- Darcie Payne payned3@michigan.gov (517) 930-9402
- Joseph Stoddard stoddardj6@michigan.gov (517) 730-8761
- Drew Simon simond13@michigan.gov (517) 930-7725
Contract details come from michigan.gov. Updated .
About this contract
This indefinite delivery vehicle establishes Medical Evaluators of Texas ASO, LLC (doing business as MET Healthcare Solutions) as a prequalified Independent Review Organization (IRO) to conduct medical reviews under Michigan's Patient's Right to Independent Review Act (PRIRA). The contract provides independent medical review services for health insurance benefit denial appeals, encompassing both standard external reviews completed within a 14-day timeline and expedited external reviews completed within a 36-hour timeline. Additionally, the IRO performs specialized reviews for experimental and investigational treatments. The services are delivered at flat-rate, all-inclusive fees of $575 for standard reviews, $700 for expedited reviews, and $615 for experimental/investigational reviews, with a five percent discount available for prompt payment within 21 days of invoice receipt. The contractor must maintain URAC accreditation and comply with Michigan's minimum IRO standards, including maintaining qualified clinical peer reviewers, ensuring timely review completion, preventing conflicts of interest, and maintaining confidential records for three years.
The prime contractor, Medical Evaluators of Texas ASO, LLC, was awarded this contract by the Michigan Department of Insurance and Financial Services with an initial award date of March 1, 2023. The original completion date of February 28, 2026 was extended through the first two-year renewal option to February 28, 2028, with the potential for up to three additional two-year renewal periods at the State's sole discretion. The contract is valued at $120,000.00 over the initial three-year period, with payment terms of NET 45 days via Electronic Funds Transfer. This indefinite delivery vehicle covers the entire state of Michigan and is classified as a Department of Insurance and Financial Services contract type. Liquidated damages of $5,000 plus $100 per day apply for late or improper completion of reviews.
Files
| File | Type | Posted |
|---|---|---|
| 230000000500.pdf |
Quick answers
Who holds contract MA230000000500?
Contract MA230000000500 was awarded to MEDICAL EVALUATORS OF TEXAS ASO, LLC by Department of Insurance and Financial Service in Michigan on March 1, 2023.
How much is contract MA230000000500 worth?
Its cumulative value is $120,000.
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