E.4 - Scenario 2 - Response Template.docx

This document is a response template for a federal contract opportunity related to State Medicaid Program Integrity Audits. The solicitation number is 75FCMC24RJ002 and it is issued by the Department of Health and Human Services, Centers for Medicare and Medicaid Services. The purpose of the contract is to assist CMS with reviewing state Medicaid and CHIP program integrity oversight functions, including compliance with Medicaid PI regulations and beneficiary eligibility requirements.

The template includes sections for the State to provide observations and recommendations related to the State PI Unit Overview, State and MFCU Relationship, General Managed Care Contract Compliance, Investigations, Overpayments and Recoveries, and Payment Suspensions. It also includes sections for the Managed Care Organization (MCO) to provide information on their Special Investigation Unit (SIU) Investigations, Overpayments, Payment Suspensions, Data Submission, and False Claims Act. The template does not provide any specific details on required products or services, response dates, pricing, or set asides.