RFP # 23CSMC-213C. -Independent Medical Review (IMR)

The California Department of Insurance (CDI) is issuing a Request for Proposal (RFP) # 23CSMC-213C for Independent Medical Review (IMR) services. CDI intends to award a single contract for a three-year term, with up to two optional 12-month extensions. The scope of work includes reviewing and determining the medical necessity of disputed health care services and experimental/investigational therapies. Proposers must demonstrate experience providing IMR, standard of care assessments, or similar analyses, as well as the ability to recruit qualified medical reviewers, manage the review process, and maintain confidentiality. Key dates include a written question submittal deadline of 04/26/2024, a proposal submission deadline of 05/17/2024, and a proposed award date of 06/24/2024. The contract will be a zero-dollar agreement, with services paid directly by insurance companies seeking an IMR review. CDI anticipates a maximum contract value of $750,000 during the term.

The RFP indicates that proposers may be eligible for small business and disabled veteran-owned business incentives. The selected contractor must comply with insurance, confidentiality, and reporting requirements outlined in the California Insurance Code. The RFP does not specify any incumbent vendors or existing infrastructure, but notes that the information in the RFP may be requested through a Public Records Act request.