Workers Compensation Medical Bill Review Services

The Michigan Department of Labor and Economic Opportunity's Workers' Disability Compensation Agency is seeking proposals for medical bill review services under RFP 260000002170, with proposals due July 17, 2026 at 3:00 p.m. Eastern. This is a single-vendor procurement.

Bidders must be currently certified with WDCA or meet its certification requirements — the mandatory eligibility gate. The scope includes technical review services to verify coding accuracy and allowable payment amounts, and professional health care review for inpatient hospital care and claims exceeding $20,000. The vendor must complete reviews within seven business days, provide monthly cost-savings reports by fund type, and attend bi-weekly Teams meetings with State staff. Upon contract termination, the contractor must deliver all historical data to the State within 30 days. The vendor is responsible for reimbursing the State for any 3% late fees resulting from vendor delays and for recouping overpayments from medical providers or reimbursing the State directly.

The contract term is three years from October 1, 2026 through September 30, 2029, with renewal options for up to two additional one-year periods at the State's discretion. No contract value is stated.

Evaluation is technical-based: Schedule A Statement of Work Section 1 (30 points), Sections 2–3 (20 points), Sections 4–6 (30 points), and the Vendor Questions Worksheet (20 points) for a total of 100 points. Proposals scoring 80 or more points will have pricing evaluated. Award will be made to the responsive and responsible bidder offering best value; the State is not obligated to accept the lowest price.

The contractor must carry Commercial General Liability ($1,000,000 per occurrence / $2,000,000 aggregate), Automobile Liability ($1,000,000 per accident), Professional Liability ($3,000,000 per occurrence and annual aggregate), and Privacy and Security Liability ($1,000,000 employee theft per loss), with the State named as additional insured on all applicable policies. All insurers must carry A.M. Best rating A- VII or higher.

Federal provisions apply if the contract draws federal funding. Questions are due June 24, 2026, with answers posted by June 26, 2026.