Independent Review Organization (IRO) for PRIRA reviews
Ended State & local contract Michigan Awarded
- Contract number
- MA230000000502
- Awardee
- PHYSICIANS REVIEW ORGANIZATION OF MICH
- Contracting organization
- Department of Insurance and Financial Service
Contract facts
- Cumulative value
- $120,000
- End date
- Points of contact
-
- Joseph Stoddard stoddardj6@michigan.gov (517) 730-8761
- Sarah Wohlford wohlfords@michigan.gov (517) 284-8743
- Darcie Payne payned3@michigan.gov (517) 930-9402
- Drew Simon simond13@michigan.gov (517) 930-7725
Contract details come from michigan.gov. Updated .
About this contract
This indefinite delivery vehicle provides Independent Review Organization (IRO) services for conducting external medical reviews under Michigan's Patient's Right to Independent Review Act (PRIRA). The contract authorizes the delivery of independent medical review services for health plan benefit denials, with the IRO assigned cases on a rotational basis to evaluate adverse determinations and provide recommendations to the Michigan Department of Insurance and Financial Services Director regarding whether benefit denials should be upheld or reversed. Services include clinical peer review evaluations performed by qualified medical professionals with appropriate licensure and clinical expertise to ensure compliance with Michigan law and regulatory requirements.
The prime contractor is Physicians Review Organization, Inc., headquartered in East Lansing, Michigan, and the contracting organization is the State of Michigan's Department of Insurance and Financial Services. The initial contract period runs from March 1, 2023, through February 28, 2026, with three available two-year renewal options. The State exercised the first extension option, extending performance through February 28, 2028. The contract covers the state of Michigan and has an estimated aggregate value of $120,000.00. This is a cost-reimbursable arrangement under the Department of Insurance and Financial Services contract type, with payment terms of Net 45 days and comprehensive insurance requirements including commercial general liability, professional liability, and cyber liability coverage.
Files
| File | Type | Posted |
|---|---|---|
| 230000000502.pdf |
Quick answers
Who holds contract MA230000000502?
Contract MA230000000502 was awarded to PHYSICIANS REVIEW ORGANIZATION OF MICH by Department of Insurance and Financial Service in Michigan on March 1, 2023.
How much is contract MA230000000502 worth?
Its cumulative value is $120,000.
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