RFP 2025-04 Home Health Audits Addendum 1.pdf

This is an addendum to Request for Proposals #2025-04 issued by CareOregon, Inc. on behalf of CareOregon Advantage and Health Share of Oregon for Home Health and Skilled Nursing Facility Audit and Review Services. Addendum Number 1, issued on November 11, 2025, extends the deadline for submitting clarifying questions from November 11, 2025, to November 13, 2025, at 5:00 PM Pacific Time. All other terms and conditions of the original RFP remain unchanged. The original RFP was published on October 28, 2025, with proposals due by December 8, 2025, at 2:00 PM Pacific Time. The selected contractor will implement comprehensive payment integrity programs through prepayment and post-payment audits of home health and skilled nursing facility claims. The contract is scheduled to commence in January 2026 with an initial one-year term and options for two additional one-year renewals.

The RFP evaluation criteria allocate 30 points for background and qualifications, 35 points for scope of work, 10 points for equity and diversity efforts, and 25 points for fees, totaling 100 possible points. The selected vendor must employ only Certified Coding Specialists or Certified Professional Coders and maintain a medical director on staff. CareOregon processes approximately 8,247,136 Medicaid claims and 852,759 Medicare claims annually, including 346,542 home health claims and 17,336 skilled nursing facility claims. The contract will feature fixed pricing for the initial two years, with potential fee increases of up to 2% annually in subsequent years. The RFP encourages proposals from minority-owned, women-owned, service-disabled veteran-owned, and emerging small businesses. Proposals must be submitted electronically to vendorservices@careoregon.org, and questions may be directed to George Marlton, Procurement Director, at 503-488-7646 or vendorservices@careoregon.org.