Pathways Program Medicaid Reimbursement Implementation (PRS Services)

Augusta County, Virginia is issuing a Request for Quotation (RFQ 112201-26-01) to engage a qualified consultant for the Pathways Program Medicaid Reimbursement Implementation project focused on Peer Recovery Specialist (PRS) services. The procurement seeks to design and implement a comprehensive Medicaid reimbursement infrastructure under the Virginia Department of Medical Assistance Services (DMAS). Key deliverables include developing a reimbursement implementation plan, analyzing DMAS requirements and federal regulations, identifying comparable peer-service billing agencies, designing compliant documentation standards and workflows, creating billing-ready documentation systems, training peer staff on documentation and compliance, conducting trial-period documentation reviews, and integrating billing workflows into operations. The consultant must ensure alignment with HIPAA and 42 CFR Part 2 requirements, with the project structured in four phases over nine months: Assessment and Planning (Months 1-2), System Design and Development (Months 3-5), Training and Pilot Implementation (Months 6-7), and Finalization and Readiness (Months 8-9). The deadline for submission of quotations is 2:00 PM on Friday, April 10, 2026, with a pre-bid question deadline of April 6, 2026 at 5:00 PM. Quotations must include a written quote amount per hour, numerical quote, and three references with name, phone, email, and services provided. Submissions should be directed to Lacy Stajduhar, VCA Purchasing Assistant.

The RFQ does not specify any set-aside designations or restrictions limiting the types of organizations eligible to respond. No incumbent vendors or current contractors are identified in the procurement documentation. The consultant will be provided with a Pathways.org email account to ensure continuity of communications and avoid re-registration with DMAS systems. Compensation is capped at a maximum hourly rate of $80 per hour with total level of effort not to exceed 530 hours, resulting in a maximum total award value of $42,500. Work will be billed based on actual hours worked with periodic invoicing and documentation of activities. The County reserves the right to reject any and all quotations and waive any informality or technical defects at its discretion, and the successful bidder will be notified by receipt of Purchase Order and must comply with all non-discrimination, drug-free workplace, and federal, state, and local regulatory requirements.