FY27 EMERGENCY EXTENSION for: Quality Improvement and Utilization Management

The Illinois Department of Health and Family Services is extending an emergency contract with Keystone Peer Review Organization, LLC dba Acentra Health for Quality Improvement Organization (QIO) services through March 31, 2027, with proposals for a competitive replacement due November 6, 2026 — this is a republished notice of extension (originally B54470, now reissued as HFS B50676) following inadvertent cancellation.

This is an emergency extension, not a new solicitation. The extension runs from October 25, 2026 through March 31, 2027, valued at $750,000 (estimated), and carries no Business Enterprise Program (BEP) participation due to the short contract term; BEP goals will be restored in the forthcoming competitive IFB. The incumbent is Keystone Peer Review Organization, LLC dba Acentra Health, continuing from the prior expired contract with eQHealth Solutions, LLC (which ended October 29, 2025). This represents HFS's fourth emergency extension due to BEP compliance issues, vendor-requested contractual changes, and prolonged approval processes.

The scope encompasses utilization management and quality assurance for Medicaid members across multiple care settings: inpatient hospital (medical necessity determinations, continued-stay reviews), outpatient hospital services, psychiatric residential treatment facilities, long-term acute care hospitals, integrated health homes, and community-based treatment settings. Services include pre-payment and post-payment utilization reviews, appeals and reconsideration reviews, quality-of-care investigations, web-based referral and authorization platform operations, provider outreach and training, and standard and ad hoc reporting.

The extension is necessary to maintain federal compliance with 42 CFR Part 476 and prevent service lapse while HFS conducts a competitive IFB with anticipated award in March 2027 and contract execution by March 31, 2027, allowing new-contract commencement April 1, 2027. The State Chief Procurement Office approved the extension on October 23, 2026, and recommends early termination if the competitive procurement results in contract execution prior to March 31, 2027.