Medicaid Administrative Claiming Support

The Hawaii Department of Health, Executive Office on Aging is requesting proposals for technical, administrative, and operational support of Hawaii's Medicaid Administrative Claiming program, with proposals due August 10, 2026 under RFP 27-054.

The contractor shall establish and maintain a federally compliant Random Moment Sampling (RMS) system, develop and calculate Medicaid administrative claims, provide training and technical assistance to participating state agencies, and support EOA in preparing quarterly Medicaid Administrative Claims submissions to ensure compliance with federal Medicaid regulations and maximize recovery of allowable administrative costs.

The RFP document (10MB) and General Conditions template (AG-008 103D) are attached. The General Conditions outline standard contractual framework, performance standards, and operational relationship between EOA and the contractor, including provisions for contract modification, termination, dispute resolution, and compliance requirements, though specific contract term length, renewal options, award date, pricing structure, and funding amounts are not detailed in the summarized content. No set-asides, preference programs, incumbent contractor information, or mandatory site visit or bidder conference dates are identified in the available materials. Bidders should consult the complete RFP document for detailed submission requirements, evaluation criteria, budget parameters, contract duration, and all material terms.