Optical Billing and Website Maintenance Services (IFB S22942531)

The California Prison Industry Authority (CALPIA) is seeking a vendor to provide Optical Billing and Website Maintenance Services through Invitation for Bid (IFB) No. S22942531. The procurement is specifically for electronic Medi-Cal claims billing and annual maintenance of the Optical Online Ordering System (POOLS) website, with the contract covering Trinity County. The selected contractor will process approximately 1.3 million prescription claims annually, converting electronic prescription data to billing codes and maintaining the website. Bidders must have at least four years of experience in electronic Medi-Cal claims billing, be certified as a Medi-Cal Telecommunications Provider, and approved for Computer Media Claims submission. The contract will be a three-year agreement with an option to extend for one additional year, with a proposed start date of November 1, 2025. Bids are due on October 22, 2025, by 3:00 PM, and the award will be made on a best value basis, considering factors such as cost, past performance, and experience. Evaluation criteria will include the per-prescription billing rate and monthly website maintenance fee.

The solicitation includes restrictions on subcontractor participation, limiting them to no more than 50% of the contract dollar amount, with the primary contractor required to provide at least 50% of the staffing. While no specific set-aside designations for disadvantaged enterprises are explicitly mentioned, the bid documents emphasize non-discrimination policies and encourage consideration of hiring incarcerated individuals, parolees, and ex-incarcerated individuals. Contractors must comply with extensive security provisions, including mandatory background checks, gate clearance procedures, and adherence to strict facility entry requirements. The contract will require strict compliance with HIPAA regulations and maintenance of confidentiality for protected health information. Although a specific budget range is not provided, the procurement will involve processing claims and website maintenance with potential for a multi-year engagement. Bidders must also navigate complex security protocols, including restrictions on clothing, equipment, and personal items when working within California Department of Corrections and Rehabilitation facilities.