Independent Review Organization (IRO) for PRIRA reviews
Ended State & local contract Michigan Awarded
- Contract number
- MA230000000507
- Awardee
- MICHIGAN PEER REVIEW ORGANIZATION
- 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
- Darcie Payne payned3@michigan.gov (517) 930-9402
- Sarah Wohlford wohlfords@michigan.gov (517) 284-8743
- Drew Simon simond13@michigan.gov (517) 930-7725
Contract details come from michigan.gov. Updated .
About this contract
The Michigan Department of Insurance and Financial Services contract establishes an indefinite delivery vehicle for Independent Review Organization (IRO) services to conduct external medical reviews under Michigan's Patient's Right to Independent Review Act (PRIRA). The vehicle provides three distinct review types at fixed rates: Standard Reviews at $550, Expedited Reviews at $650, and Experimental/Investigational Reviews at $550, with all costs inclusive of labor and materials. These reviews assess the medical necessity and appropriateness of health care decisions, enabling patients to obtain independent external evaluations of insurance coverage determinations. The IRO must maintain URAC accreditation and comply with Michigan statutes MCL 550.1911-550.1923, while meeting stringent performance standards including 14-day turnaround for standard reviews and 36-hour turnaround for expedited reviews.
Michigan Peer Review Organization, doing business as iMPROve Health, serves as the prime contractor under this indefinite delivery vehicle with the Michigan Department of Insurance and Financial Services. The initial contract period runs from March 1, 2023, through February 28, 2026, with an estimated value of $120,000 over the three-year term. The contract includes three additional two-year renewal options exercisable at the State's sole discretion, with pricing remaining firm throughout all option periods. The contractor must maintain professional liability insurance of $2,000,000 per occurrence and $3,000,000 annual aggregate, with liquidated damages of $5,000 plus $100 per day assessed for late or improper completion.
Files
| File | Type | Posted |
|---|---|---|
| 230000000507.pdf |
Quick answers
Who holds contract MA230000000507?
Contract MA230000000507 was awarded to MICHIGAN PEER REVIEW ORGANIZATION by Department of Insurance and Financial Service in Michigan on March 1, 2023.
How much is contract MA230000000507 worth?
Its cumulative value is $120,000.
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