NIGP 94843: Health Information Services

NIGP 94843 Health Information Services, an Item code, encompasses state and local procurement of telehealth platforms, health record administration, eligibility verification and enrollment systems, claims processing and third-party administration, occupational health services, and care-coordination software supporting public health plans, aging services, behavioral health networks, and Medicaid programs. The issuing bodies span health authorities, county health systems, regional aging agencies, school districts, public entity risk pools, state health departments, and special-purpose districts managing benefits for public employees and vulnerable populations. Recent solicitations demonstrate active procurement across multiple service lines: Inland Empire Health Plan (California) is gathering vendor capabilities for 24/7/365 virtual urgent care delivery via California board-certified physicians (RFI, response due October 31, 2026); Metrocare Services (Texas) is soliciting comprehensive Individual Coverage Health Reimbursement Arrangement administration for approximately 1,000 employees with a best-value evaluation weighting cost at 10 percent and requiring minimum five years of ICHRA experience (RFP, response due September 24, 2026); Nevada Health Authority is procuring Medicaid Third Party Liability, Recovery Audit Contracting, and Estate Recovery services with single-award intent and a four-year initial term beginning May 1, 2027 (RFP, response due August 10, 2026); and CIS, a public entity risk pool serving approximately 270+ Oregon public employers covering 13,000 active employees and retirees, is seeking medical third-party administration services (RFP, response due October 14, 2026) and Dependent Eligibility Verification Audit services for 19,000 dependents (RFP, response due July 22, 2026).

Activity concentrates in California, Texas, Oregon, Nevada, New Jersey, Georgia, Florida, and Illinois, with notable repeat buyers including Nevada Health Authority, CIS (Oregon risk pool), and state Medicaid and aging-services departments. School districts (Austin Independent School District, Maricopa County Community College District) and county health systems (Clackamas County Oregon, County of Santa Clara, Harris County Texas) also solicit under the code for student health services, clinical decision-support tools, and community engagement platforms. The issuing-body mix reflects both centralized state health programs (Medicaid administration, quitline services, pharmacy reimbursement benchmarking) and distributed local purchasing by counties, cooperatives, and health plans. Representative opportunities span telehealth and urgent care (immediate demand), benefits administration and eligibility verification (standard recurring procurement), and specialized technology platforms including aging-services data management, clinical decision support, and integrated care-coordination systems. Multi-year terms with renewal options are standard; cost evaluation typically accounts for 10 to 30 percent of total scoring, with technical capability, vendor experience, and implementation approach commanding 50 to 70 percent. Set-asides for Small Business Enterprises, Disadvantaged Business Enterprises, and Veteran-Owned Businesses appear in Oregon and Texas solicitations; security certifications (SOC 2, TX-RAMP, HIPAA Business Associate compliance) are mandatory. Insurance requirements typically include general liability ($1 million to $2 million per occurrence), professional liability, and cyber liability.