Medicaid managed care rate setting/program admin

The State of West Virginia Department of Administration, Purchasing Division is soliciting proposals on behalf of the Department of Human Services, Bureau for Medical Services for Medicaid managed care rate setting, program administration, and actuarial services under Centralized Request for Proposal BMS2700000001, with proposals due August 25, 2026 at 1:30 p.m. ET. Vendor questions are due July 30, 2026.

The scope encompasses Lead Actuary Services (5,000 hours annually), Staff Actuary Services (20,000 hours annually), Technical Support Staff (5,000 hours annually), Clerical Support Staff (5,000 hours annually), Managed Care Program Oversight Services (fixed annual amount), Managed Care Oversight Ad Hoc Services (5,000 hours annually), Actuarial Services Ad Hoc Services (5,000 hours annually), Financial Services (fixed annual amount), and Rate Setting Services (optional, fixed annual amount). All pricing is all-inclusive of general and administrative expenses, travel, training, and supplies. Staffing services are priced on an hourly basis; program oversight, financial services, and rate setting are priced as fixed annual amounts invoiced in 12 equal monthly installments. Contract payments will be made monthly in arrears, with ad hoc services requiring approved Statements of Work.

The contract term includes a base year plus five optional renewal years, with identical pricing structures required for each year. The hours listed are for bid evaluation purposes only and do not constitute annual project caps or obligations. Total cost across all services will be used for evaluation.

The State applies reciprocal preference to non-resident vendors and preferences to resident small, women-owned, or minority-owned businesses under West Virginia Code 5A-3-37. A Federal Funds Addendum establishes a dual procurement structure for state-level and county/local-level federal funds procurements; vendors must sign the Required Contract Provisions for Non-Federal Entity Contracts Under Federal Awards to participate in federal funds procurement.

Proposals must be submitted in writing to the Department of Administration Purchasing Division, 2019 Washington Street East, Charleston, West Virginia 25305. Direct inquiries to Crystal G. Hustead at (304) 558-2402 or crystal.g.hustead@wv.gov. Invoicing is directed to Health and Human Resources Bureau for Medical Services, 350 Capitol Street, Room 251, Charleston, West Virginia 25301-3709. Vendors must acknowledge receipt of all addenda using the Addendum Acknowledgement Form. No mandatory pre-bid meeting is scheduled.