Independent Review Organization (IRO) for PRIRA reviews
Ended State & local contract Michigan Awarded
- Contract number
- MA230000000504
- Awardee
- PROPEER RESOURCES, LLC
- Contracting organization
- Department of Insurance and Financial Service
Contract facts
- Cumulative value
- $120,000
- End date
- Points of contact
-
- Drew Simon simond13@michigan.gov (517) 930-7725
- Darcie Payne payned3@michigan.gov (517) 930-9402
Contract details come from michigan.gov. Updated .
About this contract
This indefinite delivery vehicle provides Independent Review Organization (IRO) services for the Patient's Right to Independent Review Act (PRIRA), enabling the State of Michigan to procure external medical reviews of health insurance benefit denials. ProPeer Resources, LLC delivers three distinct service categories at established flat rates: standard reviews at $525.00, expedited reviews at $650.00, and experimental or investigational reviews at $750.00. The contractor conducts objective clinical evaluations of disputed insurance coverage decisions and submits recommendations to the DIFS Director within statutorily mandated timeframes—14 days for standard reviews and 36 hours for expedited reviews. The IDV ensures consistent, URAC-accredited review services that maintain rigorous quality assurance, confidentiality compliance, and adherence to all PRIRA statutory requirements through qualified clinical peer reviewers.
ProPeer Resources, LLC serves as the prime contractor under this Michigan Department of Insurance and Financial Services IDV, which was originally awarded on March 1, 2023, with an initial term extending through February 28, 2026. Following the exercise of the first two-year extension option in December 2025, the contract now extends through February 28, 2028, with two additional optional two-year renewal periods available. The contract covers statewide Michigan procurement and carries an estimated aggregate value of $120,000.00. The vehicle operates under the Department of Insurance and Financial Services contract type, with a 5% payment discount incentive available for remittance within 15 days of invoice.
Files
| File | Type | Posted |
|---|---|---|
| 230000000504.pdf |
Quick answers
Who holds contract MA230000000504?
Contract MA230000000504 was awarded to PROPEER RESOURCES, LLC by Department of Insurance and Financial Service in Michigan on March 1, 2023.
How much is contract MA230000000504 worth?
Its cumulative value is $120,000.
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