ESBD_481913_1768244583681_IW239925.pdf

This is a scope of work document for the Texas Health and Human Services Commission (HHSC) related to contract opportunity IW239925. The document outlines requirements for Medicaid services, specifically addressing eligibility determination and enrollment processes. The scope establishes operational standards and service delivery requirements for managing beneficiary accounts, processing applications, and maintaining system access. Key deliverables include timely processing of eligibility determinations, accurate maintenance of beneficiary records, and compliance with state and federal Medicaid regulations. The contract encompasses multiple service areas with specific performance metrics and reporting requirements to ensure effective administration of Texas Medicaid programs.

The document emphasizes compliance with federal Medicaid regulations and Texas state requirements, including adherence to processing timelines and accuracy standards for eligibility determinations. Service delivery must meet established performance benchmarks and quality assurance measures. The scope includes requirements for staff training, system maintenance, and regular reporting to HHSC. Documentation requirements and record-keeping procedures are specified to ensure accountability and auditability of all Medicaid-related transactions and determinations. The contract requires contractors to maintain current knowledge of applicable state and federal regulations and adjust operations accordingly to reflect any regulatory changes during the contract term.