Utilization Review Software

The Indian Health Service seeks a site-hosted, evidence-based clinical criteria software license for utilization review at Gallup Indian Medical Center, with quotes due September 17, 2026 at 12:00 p.m. Mountain Time. This is a Total Small Business set-aside.

Place of performance is Gallup, New Mexico. The software must support a minimum of 12 simultaneous users and deliver clinical criteria evaluation across inpatient admissions, observation services, continued inpatient stays, discharge planning, ambulatory surgical service appropriateness, transition of care to rehabilitation and subacute services, substance use disorder evaluation, durable medical equipment transition needs, and retrospective quality and risk management evaluation. The license must be non-transferable with current, evidence-based clinical criteria aligned with Centers for Medicare and Medicaid Services Conditions of Participation standards and Health Services Advisory Group medical necessity determinations. All electronic and information technology deliverables must comply with Revised Section 508 Standards and Web Content Accessibility Guidelines 2.1 Level AA. Cloud-based solutions must hold current FedRAMP Certification; server-based solutions on government infrastructure are exempt from this requirement.

Contract performance runs from October 1, 2026 through September 30, 2027 for the base year, with four one-year option periods extending through September 30, 2031. Contractor deliverables include initial onsite training for a minimum of 12 IHS employees, additional web-based training modules, technical IT support services throughout the contract term, length-of-stay applications and reporting tools, and software updates to maintain current standards of care. The NAICS code is 513210, Software Publishers; PSC is 7A20, IT and Telecom—Application Development Software. Electronic payment submission is required through the Department of Treasury Invoice Processing Platform.