RFI Event - Due Process Appeals Clearinghouse

The North Carolina Department of Health and Human Services, Division of Health Benefits (NC Medicaid) has issued a Request for Information (RFI) 30-2025-026-DHB for a comprehensive Due Process Appeals Clearinghouse Solution. The procurement seeks a single web-based platform capable of providing consistent, reliable reporting and analysis through an integrated database that allows secure electronic upload and storage of adverse determination letters across multiple delivery systems. Key objectives include developing a solution that can handle thousands of pages of documents daily, support expedited appeal processes, and enable secure document sharing among authorized agencies including the Office of Administrative Hearings, Managed Care Plans, and Utilization Review Vendors. The RFI specifically requires a system with robust electronic data interchange capabilities, comprehensive analytics and reporting functions, and full compliance with state and federal regulations, including HIPAA requirements. Vendors are expected to demonstrate experience in developing and deploying such solutions, with the RFI aiming to gather market feedback, obtain cost estimates, and inform a future Request for Proposal. The response deadline is July 30, 2025, at 2:00 p.m. EST, with respondents required to provide detailed information about implementation, software licensing, maintenance, and cloud hosting costs.

While the RFI does not explicitly outline specific set-aside designations or vendor restrictions, it indicates a preference for vendors with proven experience in developing complex healthcare document management systems. The proposed clearinghouse must integrate with the state's existing identity management system and provide user-friendly interfaces supporting both routine and ad-hoc reporting capabilities. The system must maintain document storage dating back to 2010 and offer secure, multi-agency document access and tracking. Although no specific budget range is mentioned in the documentation, the RFI suggests the solution will require significant technological investment to meet the comprehensive requirements. The procurement appears designed to replace or significantly upgrade existing document management infrastructure, with a focus on creating a centralized, efficient appeals processing system for Medicaid beneficiary documentation. Potential vendors will need to demonstrate advanced technological capabilities, robust security protocols, and a deep understanding of healthcare regulatory compliance to be competitive in this procurement process.