NON-EMERGENCY MEDICAL TRANSPORTATION

The South Carolina Department of Health and Human Services (SCDHHS) and the State Fiscal Accountability Authority are seeking a Non-Emergency Medical Transportation (NEMT) Coordinator to manage transportation services for Medicaid members statewide. The procurement is a comprehensive contract to provide transportation coordination, scheduling, and management through a risk-based capitated payment model. The selected contractor will be responsible for establishing and maintaining a statewide network of qualified transportation providers, operating a multi-lingual contact center, verifying member eligibility, approving and arranging transportation, and providing reimbursement to providers. Key requirements include maintaining a contact center operating Monday through Friday from 8:00 AM to 6:00 PM ET, answering 80% of calls within 30 seconds, and ensuring 90% on-time arrival for scheduled appointments. The solicitation requires bidders to have at least five years of NEMT experience with a program of similar size and scope. Proposals are due by April 16, 2025, at 11:00 AM EST, with a pre-bid conference scheduled for February 11, 2025, at 2:00 PM EST via Microsoft Teams. The evaluation will be based on a 1,250-point scale, with 1,000 points for technical approach, 250 points for qualifications, and a pass/fail rating for rate methodology. Up to three highest-ranked offerors will be required to provide a two-hour live demonstration of their proposed solution.

The solicitation does not specify specific set-aside designations or restrictions on the types of organizations that can respond. No incumbent vendor information is explicitly detailed in the provided documents. The contract term is three years, starting July 1, 2025, through June 30, 2028, with two potential one-year renewal options that could extend the contract through June 30, 2030. While specific budget ranges are not directly stated, the contract will transition from a current fee-for-service model to a risk-based capitated payment structure, with rates to be determined through an actuarially sound methodology. The contractor must develop comprehensive systems including scheduling, prior authorization, credentialing, and a mobile application for managing NEMT services. The contract requires extensive provider network development, including various transportation modes such as ambulances, wheelchair vans, stretcher vans, and common vehicles. Transportation providers must meet strict credentialing requirements, including background checks, drug testing, proper licensing, and maintaining appropriate insurance coverage. The ultimate goal is to improve member access to transportation, increase transportation provider participation, deliver quality services, reduce fraud and waste, and implement robust performance measures.