Provider Business Services: Solicitation No:OCMP-25-22321

The Maryland Department of Health (MDH) is seeking a Provider Business Services (PBS) healthcare vendor through Request for Proposals (RFP) No. OCMP-25-22321 to manage comprehensive provider enrollment and support services. The procurement aims to secure a vendor responsible for processing applications for new provider enrollment, reenrollment of suspended providers, revalidation of actively enrolled providers, and updating provider information. Key deliverables include operating a Maryland Provider Enrollment and Revalidation Call Center, providing training on the state's enrollment system, and potentially conducting federally required pre- and post-enrollment site visits. The contract structure includes a 7-month implementation phase followed by a 4-year base operations period with two potential one-year renewal options. Estimated annual volumes are substantial, including 22,000 new provider enrollments, 70,000 application updates, and 30,000 revalidation applications. The solicitation was posted on May 6, 2025, with a pre-proposal conference scheduled for May 13, 2025, and proposals due by June 23, 2025. Evaluation will likely focus on the vendor's ability to process applications efficiently, provide robust call center support, and meet state and federal regulatory requirements.

The RFP does not include specific Minority Business Enterprise (MBE) or Veteran-Owned Small Business Enterprise (VSBE) participation goals. The successful vendor must provide a physical office location within the 48 contiguous United States, with a preference for a location within 40 miles of MDH's Baltimore office. The contract will utilize a combination pricing model, including indefinite quantity with fixed unit prices, firm fixed price, and potential time and materials elements. Pricing will be evaluated on a per-provider, per-month basis, with additional considerations for work order and potential future site visit services. The contract will be funded through Title XIX of the Social Security Act, with federal funds representing approximately 61% of the Maryland Medical Care Programs Administration budget. The total federal funds allocated for the Medical Care Programs Administration is $8,794,338,664 in the 2024 fiscal year. Vendors should be prepared to handle an estimated provider population ranging from 130,000 in the first contract year to 160,000 in the final option year, with the ability to scale services accordingly.