Worker's Compensation Medical Management Service

The City of Austin, Texas is requesting proposals for worker's compensation medical management services, including exclusive 504 Physician Panel administration, cost containment, case management, pharmacy benefits management, and information systems, with proposals due July 23, 2026.

A local business preference applies to entities headquartered within the Austin-Round Rock-San Marcos Metropolitan Statistical Area. Small business preference is available for entities holding recognized small business certifications meeting SBA size standards. No MBE/WBE subcontracting goals have been assigned due to insufficient subcontracting opportunities; use of certified small business subcontractors is encouraged, though a subcontracting plan is optional and requires City approval.

The awardee must administer an exclusive 504 Physician Panel and deliver comprehensive medical management services across the City's operations. Employee distribution data indicates the service area encompasses the greater Austin metropolitan region and surrounding communities across central Texas counties (Travis, Williamson, Hays, Bastrop, Caldwell, and Bexar), with limited out-of-state presence across 13 states. Supporting exhibits include historical loss run reports as of September 30, 2023, and open claims data as of September 30, 2024, documenting workers' compensation claims activity across Austin Energy, Austin Resource Recovery, Austin Water Utility, Austin Transportation, Code Compliance, Watershed Protection and Development Services, and Development Services Department. Claims data analysis by specialty informs offerors' understanding of medical utilization patterns and cost drivers.

Offerors must certify compliance with Texas Government Code provisions regarding boycotts of Israel and energy companies, LGBTQ+ conversion therapy prohibitions, cybersecurity and critical infrastructure protections, and firearm entity non-discrimination clauses, along with the City's anti-lobbying ordinance, local government officer conflict-of-interest rules, and wage theft adjudication requirements. Proposals must acknowledge receipt of the entire solicitation packet and any addenda.