RFP 2024-13 IBR & DRG Billing Services Addendum #2 - final.pdf

This document is Addendum #2 to Request for Proposals (RFP) #2024-13 for IBR & DRG Billing Services issued by CareOregon, a managed Medicare and Medicaid plan based in Oregon. The RFP seeks to outsource Itemized Bill Reviews (IBR) and Diagnosis Related Grouping (DRG) services for high dollar inpatient hospital claims to meet regulatory requirements from the Centers for Medicare and Medicaid Services (CMS) and the Oregon Health Authority (OHA). The addendum extends the proposal due date from September 12 to September 26, 2024 and increases the page limit for proposals from 20 to 35 pages. Additionally, CareOregon states it may or may not award to multiple vendors.

The RFP covers services in Multnomah County and the city of Portland, Oregon. No pricing terms, set asides, incumbent information, or funding details are provided in the addendum. The RFP aims to minimize claim overpayments through the implementation of payment integrity programs required by CMS and OHA for managed Medicare and Medicaid plans.