T2590 - Fiscal Agent for the Division of Mental Health and Addiction Services (DMHAS)

The New Jersey Department of Treasury, Division of Purchase and Property, is soliciting proposals for a Fiscal Agent to manage authorization, claims processing, and payment services for the Division of Mental Health and Addiction Services (DMHAS) Substance Use Disorder (SUD) fee-for-service initiatives. The selected contractor will develop a web-based fiscal agent system that interfaces with the existing New Jersey Substance Abuse Monitoring System (NJSAMS), providing comprehensive functionality for client authorization, claims entry and adjudication, provider credentialing, electronic claim payments, and reporting. Key deliverables include a fully operational system within six months of contract award, with capabilities to support 142 licensed providers across 260 sites serving approximately 1,075 active users. The system must comply with HIPAA, HITECH, and 42 CFR Part 2 regulations. A non-mandatory pre-quote conference was held on November 18, 2024, with electronic questions due by November 26, 2024, and final quotes required by January 16, 2025 at 2:00 p.m. Eastern Time. Proposals will likely be evaluated based on system functionality, technical capabilities, compliance, and pricing.

There are no specific small business or disabled veteran-owned business set-asides mentioned for this procurement. The current SUD fee-for-service initiatives network processed 556,054 claims in the previous fiscal year with an 8.56% denial rate. Total funding for these initiatives was $52,980,981 in State Fiscal Year 2024. The pricing structure requires bidders to provide a one-time fixed cost for initial system development and implementation, plus annual maintenance and support costs for years 1-4. Based on the pre-quote conference attendance, Gainwell Technologies appears to be a potential incumbent or interested bidder. The new fiscal agent system must integrate with the existing NJSAMS, suggesting a need for careful technical planning and potential data migration strategies. While no specific award value is explicitly stated, the annual funding level and system complexity indicate a significant contract opportunity for the selected vendor.