Informal Dispute Resolution - Outsourcing

The Texas Health and Human Services Commission (HHSC) is soliciting qualifications under RFQ HHS0017139 for outsourced Informal Dispute Resolution services, with responses due December 10, 2026 at 10:30 a.m. Central Time. Every respondent must submit a completed subcontracting plan with a VetHUB utilization goal of 26% of contract value, and a noncompliant plan results in disqualification as a material failure. No set-asides are designated.

The contractor will conduct unbiased informal dispute resolution reviews of disputed regulatory matters at long-term care facilities covering medicine, nursing, building, and fire and life safety code requirements, under 42 C.F.R. 488.331, CMS State Operations Manual Chapter 7, and Texas Government Code 526.0202. HHSC seeks one qualified contractor. Minimum qualifications include disinterested-person status, five years of IDR experience, financial solvency, and staffing with at least one Registered Nurse. Respondents must also provide three client references, audited financial statements for 2023 through 2025, and TX-RAMP Level 2 certification before award. Required insurance under Exhibit L includes $2,000,000 cyber/privacy and $2,000,000 umbrella coverage. The contract is subject to the HHS Data Use Agreement and Security and Privacy Inquiry, and bidders must correct any "No" responses before award.

For the subcontracting plan, respondents may self-perform the entire contract, notify at least two certified VetHUB vendors per subcontracting opportunity with at least seven working days to respond, or use a Mentor-Protégé relationship with a registered VetHUB through the Texas Comptroller's program. HHS VetHUB Coordinator Cheryl Bradley (512-406-2529; Cheryl.Bradley@hhs.texas.gov) offers optional courtesy reviews.

Historical compensation for similar work has been approximately $1,035,095 per State Fiscal Year, and HHSC makes no guarantee of volume, usage, or total compensation. The base term runs three years, from July 13, 2027 through July 13, 2030. HHSC may extend up to two one-year periods through July 15, 2032, or up to 12 additional months for continuity or transition.

Evaluation weights are Qualifications (25%), Experience (30%), Work Plan (30%), and Reporting Capabilities (15%), each scored 1 to 10. Pricing is not evaluated. HHSC will negotiate a fair and reasonable price with the most highly qualified respondent.

Questions are due November 13, 2026, and the subcontracting plan courtesy review deadline is November 25, 2026. HHSC expects to issue a tentative notice of award in June 2027, with the contract effective in July 2027.