Medical Care Utilization Review Services

The State of Missouri, specifically through the Department of Commerce and Insurance, is seeking Medical Care Utilization Review Services through a Request for Proposal (RFP) issued on April 19, 2022, with responses due by June 2, 2022 at 2:00 PM CDT. The procurement covers jurisdictions including Clark County and Jefferson City, with a contract term of one year and three potential one-year renewal periods. Vendors must provide comprehensive medical care utilization review services, which include reviewing medical records, assessing medical necessity, evaluating appropriateness of care, and making recommendations on care levels. Qualified vendors must have licensed medical personnel with specific areas of specialty and must submit their proposals electronically through the MissouriBUYS system. The technical proposal will be evaluated based on specific criteria outlined in the RFP attachments, including Licensed Medical Personnel Areas of Specialty and Technical Proposal Evaluation Criteria. The services will be delivered to the Department of Commerce and Insurance at 301 West High Street in Jefferson City, Missouri, with payment terms of Net 45 Days and Free On Board Destination delivery requirements.

No specific set-aside designations, disadvantaged enterprise requirements, or incumbent vendor information are mentioned in the RFP documentation. The solicitation is open to all vendors without apparent restrictions on organizational type or size. The estimated total contract value is not disclosed in the provided documents. Vendors are required to complete and submit Exhibit A and any other applicable exhibits as part of their bid response. The RFP does not specify any line items, pricing details, or funding sources. Vendors must carefully review all solicitation documents, including attachments related to personnel qualifications and technical evaluation criteria, and submit their comprehensive proposals through the MissouriBUYS electronic procurement system. The contract will be awarded to the vendor providing the best overall value to the State of Missouri, based on a thorough evaluation of the technical proposal and meeting the department's specific service requirements.