12 8500 Medical Case Management SWIF
Open State & local contract opportunity Posted
- Solicitation number
- 6100066211
- State
- Pennsylvania
- Responses due
Opportunity facts
- Jurisdictions
- Point of contact
-
- Christine Newton chrnewton@pa.gov (717) 346-7667
Opportunity details come from emarketplace.state.pa.us. Updated .
About this opportunity
The Commonwealth of Pennsylvania, Department of Labor and Industry, on behalf of the State Workers' Insurance Fund (SWIF), is requesting bids on field-based medical case management services for workers' compensation claimants throughout Pennsylvania under IFB 6100066211, with proposals due September 22, 2026.
Bidders must hold a minimum of five years of experience providing field-based medical case management for workers' compensation claims in Pennsylvania and maintain current Utilization Review Accreditation Commission (URAC) accreditation in medical case management. All case management personnel must be Registered Nurses licensed by the Pennsylvania Department of State with workers' compensation experience, physically located within their assigned geographical territories, and employed directly by the contractor — subcontracting of RN positions is prohibited. HIPAA compliance and execution of a Business Associate Addendum are required. Contractors valued at $1 million or more must certify Iran-free procurement status.
The scope divides Pennsylvania into three territories: Territory A (Philadelphia District Office covering Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties) with 8,000 estimated annual hours; Territory B (Harrisburg, Pottsville, Sunbury, and Scranton District Offices covering 33 central and northeastern counties) with 4,000 estimated annual hours; and Territory C (Pittsburgh, Johnstown, and Erie District Offices covering 28 western and southwestern counties) with 8,000 estimated annual hours. Bidders may select any or all territories. Services include assessment of medical and rehabilitation needs, coordination of treatment, communication with medical providers and claim staff, and facilitation of return-to-work efforts. Critical performance standards require contacting claimants within 48 hours of referral, submitting initial reports within 30 days, conducting in-person visits within 24 hours for catastrophic injuries, and submitting status reports at 15-, 30-, 60-, and 90-day intervals. The Commonwealth will award contracts to all responsive and responsible suppliers on an Established Price Contract basis.
The initial contract term does not exceed three years, with two successive one-year renewal options exercisable at the Commonwealth's sole discretion. Contract awards do not guarantee work; services commence only upon issuance of a Notice to Proceed by SWIF. Contractors must maintain Worker's Compensation Insurance and Public Liability and Property Damage Insurance with minimum coverage of $250,000 per person and $1 million per occurrence. Bidders submit fixed hourly rates by territory on Attachment A — Price Rate Sheet and separately bid Workers' Compensation Medicare Set-Aside (WCMSA) services at a fixed rate, with estimated 25 cases at $25.00 per case. Enhanced minimum wage is $15.00 per hour, subject to annual cost-of-living adjustments. All questions must be submitted via email to the L & I Central Resource Account with "IFB 6100066211" in the subject line.
Opportunity text
The Commonwealth of Pennsylvania, Department of Labor and Industry, on behalf of the State Workers' Insurance Fund (SWIF), issues this Invitation for Bids (IFB) to procure professional, on-demand Field Based Medical Case Management Services.Field Based Medical Case Management Services refer to the coordination and management of medical care for injured workers receiving workers' compensation benefits. Services are provided by qualified Registered Nurses (RNs) who assess medical and rehabilitation needs, coordinate treatment, communicate with medical providers and SWIF claim staff, facilitate return-to-work efforts when appropriate, and provide ongoing case management in accordance with the Pennsylvania Workers' Compensation Act, applicable regulations, and Pennsylvania case law.This IFB seeks qualified independent contractors to provide safe, reliable, and professional Field Based Medical Case Management Services throughout the Commonwealth of Pennsylvania. Contractors shall provide labor, materials, services, skills, supervision, and necessary equipment to perform Field Based Medical Case Management Services for workers' compensation claims. Contractors must meet all agency requirements and comply with all local, state, and federal laws and regulations, including the Pennsylvania Workers' Compensation Act, Title 34 Pa. Code Sections 123.201-123.302, confidentiality requirements, and the protection of individually identifiable health information in accordance with HIPAA and applicable privacy regulations.The Commonwealth will award contracts to all responsive and responsible suppliers.The Commonwealth will issue contracts for an initial term not to exceed three (3) years, with two (2) successive one-year renewal options at its sole discretion.A contract award does not guarantee work, and no services may be performed without a Notice to Proceed issued by SWIF.BID SUBMISSION AND PRICINGOnly the cost information submitted on Attachment A - Price Rate Sheet will be considered for purposes of award. Prices, rates, or other cost information submitted anywhere other than Attachment A - Price Rate Sheet will not be considered for award.Bidders shall complete and submit the entire Attachment A - Price Rate Sheet as part of their bid response. Failure to submit a complete Attachment A - Price Rate Sheet may result in the bid being deemed non-responsive.The submission of a separate proposal is not required and will not be considered for purposes of award. Bidders should not submit a separate technical or cost proposal in lieu of the required bid documents. Any pricing contained in a proposal, narrative, cover letter, correspondence, or any other document other than Attachment A - Price Rate Sheet will not be considered for award.Bidders are requested to complete and sign the signature acknowledgment included in the Statement of Work (SOW) as part of their response to the solicitation. The signature acknowledgment confirms the bidder's acknowledgment and acceptance of the SOW requirements.If a bid response is submitted without the signature acknowledgment on the SOW, but contains all other required bid documents, including a complete Attachment A - Price Rate Sheet, the response may nevertheless be considered for award, provided the bidder otherwise meets all requirements for responsiveness and responsibility and the Commonwealth determines that the omission does not affect the responsiveness of the bid.The Commonwealth will evaluate and consider only the pricing submitted on the completed Attachment A - Price Rate Sheet. No other pricing submitted by a bidder will be considered or used in determining the award.Estimated Quantities: It shall be understood and agreed that any quantities listed in the Contract are estimated only and may be increased or decreased in accordance with the actual requirements of the Commonwealth and that the Commonwealth in accepting any bid or portion thereof, contracts only and agrees to purchase only the materials and services in such quantities as represent the actual requirements of the Commonwealth. The Commonwealth reserves the right to purchase materials and services covered under the Contract through a separate competitive procurement procedure, whenever Commonwealth deems it to be in its best interest.This IFB consists of the following documents. Items marked with an asterisk (*) must be completed as required, signed, and submitted with the bid response.Documents01 Statement of Work (SOW)02 Terms and Conditions03 Locating and Responding to a Solicitation04 Business Associate Addendum HIPAABid Forms05 Attachment A - Price Rate Sheet*06 Worker Protection and Investment Certification Form*07 Iran Free Procurement Certification Form*Instructions on how to respond to this solicitation are included in the Notes and Attachments section of this IFB under "Locating and Responding to a Solicitation." Bidders are responsible for reviewing all documents associated with this IFB in their entirety to ensure full understanding of the requirements. Failure to thoroughly review all IFB materials does not relieve the bidder of the responsibility to comply with all terms, conditions, and submission requirements.Any questions regarding this IFB must be submitted individually and in writing via email by 4:00 PM ET on Monday, October 12, 2026, to the L & I Central Procurement resource account at RA-li-OIT-BAS-Procur@pa.gov, with "IFB 6100066211 - 12 8500 Medical Case Management SWIF" in the subject line. All questions and responses will be considered an addendum to and part of this IFB. The Issuing Office is not bound by verbal information or by written information not contained within the IFB or formally issued by the Issuing Office. Submission of questions is not considered a protest of the solicitation.Only questions submitted via the L & I Central Resource Account will receive a response. Questions submitted directly to the issuing officer, or by any method other than the L & I Central Resource Account, including email or telephone, will NOT receive a response.Qualified suppliers interested in the DGS Small Business Program should use the following link to verify their status as a DGS Small Business: https://www.dgs.pa.gov/bdisbo/Pages/Verification.aspxSuppliers who become DGS Certified Small Businesses shall upload their Small Business Certificate with their bid.
Files
On GovTribe
Work this opportunity
- Track it in your pipeline
- Similar opportunities
- Ask GovTribe AI about this opportunity