NIGP 95856: Health Care Management Services (Including Managed Care Services)

NIGP 95856 Health Care Management Services (Including Managed Care Services), an Item code, encompasses capitated managed care operations, plan administration, and specialized health service delivery that state and local health agencies, school districts, and health plans contract to manage enrollee populations and claims processing. Recent solicitations show state health authorities and regional health plans procuring fully-insured health plan operations, managed dental care networks, external quality review and compliance oversight, enrollment broker services, and behavioral health crisis stabilization and early intervention programs.

The issuing-body mix includes state health authorities (Washington State Health Care Authority, Texas Health and Human Services Commission, Texas General Land Office Veterans Land Board, Nevada Health Authority), county health agencies (Ventura County Behavioral Health, Ventura County Health Care Agency, Santa Clara County, San Mateo County, San Bernardino County, Fulton County, Boulder County Sheriff's Office), regional purchasing consortia (H-GAC), and specialized entities (Inland Empire Health Plan in California, New Jersey Department of Children and Families). Repeat buyers include Ventura County Behavioral Health, which has issued multiple RFPs for day treatment, crisis stabilization, behavioral health early intervention, and specialty pharmacy services in recent months. Geographic concentration appears heaviest in California (Ventura, Inland Empire, San Mateo, Santa Clara counties), Texas (statewide HHSC and Veterans programs), Washington State, Nevada, and New Jersey, with secondary activity in Georgia and Illinois. Representative current opportunities include the Washington State Health Care Authority's RFP 2025HCA5 for fully-insured health plans serving five counties with January 14, 2027 proposals due; the Texas Health and Human Services Commission's RFP HHS0017108 for statewide Medicaid and CHIP dental services with proposals due December 7, 2026 and capitation-based annual costs projected at $86.4–$120 million (Medicaid) and $77.1 million (CHIP); Ventura County Behavioral Health's RFP 6249 for specialty pharmacy services due October 10, 2026; and Inland Empire Health Plan's October 31, 2026 RFI for 24/7 virtual urgent care delivery through California board-certified physicians. Contracts in this code routinely carry set-aside requirements (26% VetHUB utilization in Texas procurements, MBE/WBE participation in Illinois, 25-point Washington small-business preference), multi-year terms (four to eight years), and substantial per-member-per-month or capitation-based payment structures.