Financial Proposal Instructions and Form for Hospital Claims Audit Contract

This financial proposal attachment is issued by the Maryland Department of Health (MDH) for a Recovery Audit Contract (OCMP-26-25113) designed to identify Medicaid improper payments through hospital claims audits. The vendor will audit payments made by the State to identify both overpayments and underpayments, with the contract covering a three-year base term plus two optional renewal years. The financial proposal form requires offerors to submit pricing for each contract year and option year, with the State's estimate of recovery and number of providers to be audited specified in the form. All pricing submissions must be completed in the exact format provided, with no alterations, amendments, or blank fields permitted.

The compensation structure is contingent on recovery amounts, with offerors required to propose a payment rate (expressed as a percentage) for both overpayments and underpayments identified during audits. All proposed prices must be fully loaded to include labor, profit, overhead, general operating expenses, administrative costs, and all other expenses necessary to perform the work, with no additional amounts payable to the contractor. The State indicates a standard 10% payment rate for evaluation purposes; however, vendors may propose alternative percentages. Any changes or corrections made to the financial proposal form must be initialed and dated by the offeror, and the form must be signed and dated by an individual authorized to bind the offeror to the proposed prices. Failure to adhere to these instructions may result in the proposal being determined not reasonably susceptible of selection for award.