RFP - medical, medicare management consultant services

The County of San Diego, Department of Behavioral Health Services is requesting proposals for Medical, Medicare Management Consultant Services under RFP 13042, with proposals due October 19, 2026, and a pre-proposal conference scheduled for September 10, 2026. A 15 percent price preference (or $150,000, whichever is less) is available to small-local businesses that complete the required self-certification form.

The scope encompasses preparation and filing of Medicare and Medi-Cal cost reports and California Department of Health Care Access and Information (HCAI) reports for the San Diego County Psychiatric Hospital and Edgemoor Distinct Part Skilled Nursing Facility. The consultant will coordinate with County facility and financial staff to accumulate financial data, support cost report preparation, participate in audits, assist with Medicare enrollment and credentialing, and provide miscellaneous reimbursement support. Five primary deliverables are defined: Financial Statement Preparation, Cost Report Preparation, HCAI Report Preparation, Audit and Appeal Support with Miscellaneous Reimbursement Tasks (billed hourly with an estimated 80 billing milestones annually), and Individual Provider Enrollment (billed per enrollment with an estimated 50 billing milestones annually).

The contract term is anticipated to be an initial base period of one year beginning January 1, 2027, with four optional one-year renewal periods extending through December 31, 2031, plus potential six-month incremental options. The County has indicated federal funds may be expended and will follow 2 CFR 200.324 cost negotiation procedures if only one conforming proposal is received.

Evaluation criteria in order of importance are organizational capability and experience, program approach demonstrating equity and sustainability commitment, price reasonableness, organizational stability and risk assessment, and acceptance of terms and conditions. Written questions are due by September 24, 2026. Proposals must be submitted through the County's BuyNet portal or alternative submission method, formatted according to specified requirements with a maximum of 40 pages excluding attachments. Offerors must provide comprehensive financial documentation, litigation history, compliance information, three business references, and accept draft agreement terms or provide detailed exceptions with business rationale.