T3107 Chapter 32 Arbitration Services-DOBI

The State of New Jersey, through the Department of the Treasury, Division of Purchase and Property, is procuring arbitration services for the Department of Banking and Insurance (DOBI) related to the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (ONET). The contract will be awarded to a single experienced arbitration entity for an initial term with possible extensions. The vendor must have a minimum of 3 years' experience in healthcare pricing arbitration, access to benchmark data, employ a New Jersey licensed medical director, and the capacity to accept arbitration requests and fees electronically. The vendor will be responsible for reviewing eligibility of arbitration requests, conducting the arbitration process, issuing decisions, and providing monthly and annual reports. Compliance with HIPAA and BBA requirements, as well as providing a detailed security plan, are mandatory.

This contract opportunity has been set aside for New Jersey Small Business Enterprises and/or Disabled Veterans' Business, with subcontracting goals. The Revised Bid Solicitation indicates that the state will not be bound by any minimum or maximum number of arbitration requests during the contract term. Pricing is requested as firm-fixed unit prices for initial and completed arbitration reviews. The historical data provided shows 1,884 arbitration requests from January to August 2019, though none from self-funded plans that did not opt in. The contract term is not specified, and the state reserves the right to separately procure individual requirements during the Blanket Purchase Order term.