Request for Information (RFI) - Independent Review and External Medical Review Organizations

The State of New Jersey Department of the Treasury's Division of Purchase and Property, on behalf of the Department of the Treasury's Division of Pensions and Benefits (DPB), has issued a Request for Information (RFI) seeking input from the independent medical review industry. The purpose of the RFI is to gather information on solutions that could provide independent medical review of claims denials when requested by providers who have exhausted internal appeals. The RFI seeks feedback on implementation strategies, timelines, and pricing models for such a solution. Responses are due by February 6, 2024 at 2:00 PM and should provide background information on the respondent's organization, an overview of their solution, their implementation approach, customer service offerings, and general pricing details without submitting specific pricing. The State aims to use the information gathered to make informed decisions about potential next steps in establishing an external medical review process for its self-insured health insurance programs.

The RFI does not solicit proposals or result in a contract award, but the State may issue a formal Request for Proposals in the future based on the information gathered. The RFI does not specify any set-aside designations or restrictions on the types of organizations that can respond. The State has not provided any information on incumbent vendors, current contractors, or existing infrastructure or technology that may require integration. Additionally, the RFI does not include any details on possible award values or budget ranges.