RFP SD25-00019 Health Care Provider Network and Prior Authorization Services

The California Department of Corrections and Rehabilitation/California Correctional Health Care Services is soliciting proposals to develop and operate a statewide health care provider network and prior authorization system serving approximately 90,000 incarcerated persons across 30 institutions and 13 Reentry Programs facilities, with proposals due August 18, 2026 at 4:00 PM PDT.

Mandatory qualifications include at least three continuous years of experience delivering a full range of medical provider services to at least one public U.S. entity with a minimum of 50,000 enrolled members, prior experience as a prime contractor managing subcontractors on comparable projects, licensure in all California counties and counties in Oregon, Nevada, and Arizona bordering CDCR/CCHCS institutions, and the capacity to provide 24-hour emergency care services. All work must be performed within the United States.

The scope encompasses hospital care, specialty physician services, ambulatory surgery centers, laboratory and pathology services, medical imaging, telehealth services, skilled nursing facilities, and medicated assisted treatment services. Contractors must use CDCR/CCHCS's designated Third-Party Administrator for claims processing and develop an electronic prior authorization system integrating with the TPA and CDCR/CCHCS electronic medical records system. Performance standards mandate appointment scheduling within 90 days for routine care and 21 days for urgent care, 30-minute maximum wait times at provider locations, and 48-hour clinical documentation submission. The contractor must implement the full network within six months of the effective date or face fee reductions.

The initial contract term is five years (December 1, 2026 through November 30, 2031) with options for five additional one-year extensions through November 30, 2036. Contract award is anticipated October 1, 2026.

Proposer conferences are scheduled for July 8 and August 10, 2026 at 11:00 AM PDT via Microsoft Teams. A mandatory CDCR/CCHCS institution tour is scheduled for July 23, 2026 at Folsom State Prison. Proposer interviews are scheduled September 3–17, 2026. No formal protest procedures are available under this RFP, which operates under substitute procedures authorized by the U.S. District Court for the Northern District of California in Plata v. Schwarzenegger.