RFP for Laboratory and Collection Services

The Oregon Health Authority (OHA) has issued a Request for Proposals (RFP S-44300-00010245) for comprehensive laboratory billing and collection services for the Oregon State Public Health Laboratory (OSPHL). The procurement seeks a qualified contractor to manage billing claims for Medicaid, Medicare, Oregon Coordinated Care Organizations, and other third-party payers, with an anticipated annual volume of approximately 105,000 claim records. The project requires electronic claims submission, payment posting, detailed monthly reporting, and adherence to complex billing rules across multiple healthcare facilities and testing categories. Key deliverables include implementing a subscription-based software solution for laboratory billing, maintaining high service availability (99.99%), and ensuring robust security and privacy measures compliant with state and federal regulations. Evaluation criteria will focus on the proposer's experience, key personnel qualifications, technical approach, and implementation strategy, with a multi-round scoring process. The RFP was released on October 17, 2025, with proposals due by November 14, 2025, at 3:00 PM Pacific Time, and a voluntary pre-proposal conference scheduled for October 22, 2025. The initial contract term is expected to be five years, with potential renewal options, and implementation targeted by May 29, 2026.

The OHA encourages participation from small businesses, with preferential consideration given to enterprises certified as disadvantaged, minority-owned, woman-owned, or service-disabled veteran-owned. The procurement involves complex billing protocols across six healthcare facilities in Oregon and Washington, including rural health centers, county health departments, clinics, and a university student health center. Billing categories range from A to Z, with specific CPT code charges varying by location and test type, demonstrating a nuanced pricing structure. While specific contract value details are not publicly disclosed, the comprehensive nature of the project suggests a significant investment in laboratory billing infrastructure. Proposers must demonstrate expertise in medical billing, compliance with healthcare regulations, and the ability to integrate with existing systems. The contract requires advanced technical capabilities, including a trouble ticket management system, comprehensive disaster recovery plans, and adherence to Oregon Statewide Information Technology Control Standards. Successful vendors will need to navigate intricate billing rules, including scenarios for Medicaid coverage, self-pay patients, and specialized testing programs.