Enhanced Provider Network Auditing Program

The State of Florida, Agency for Health Care Administration (Agency) has issued a Request for Information (RFI) to solicit information from entities with experience in conducting network adequacy reviews for the purpose of auditing provider networks, including secret shopper activities and other methods to verify provider networks. The Agency is seeking innovative ideas and best practices for continuously reviewing and validating provider network adequacy, such as identifying true appointment wait times, access to behavioral health services, validating online provider directories, confirming after-hours availability, and evaluating network utilization. The RFI also seeks information on auditing access to long-term care services and network adequacy for dental plans. Responses to this RFI are due by 2:00 PM EST on November 13, 2023, and the Agency may hold meetings with respondents to clarify the information received. This RFI is for planning purposes only and will not result in a contract award.

The RFI does not provide any details on set-asides, incumbents, funding requirements, or sources. Respondents are responsible for all costs associated with preparing a response, and the Agency will not be responsible for any respondent costs. The RFI outlines the process for identifying and protecting any trade secret or proprietary information included in the responses, and all RFI responses received will be public records subject to the provisions of Chapter 119, Florida Statutes. The Agency has not provided an estimated timeframe or anticipated contract value associated with this RFI, as it is for planning purposes only.