MS DIVISION OF MEDICAIDIssuing agency·Mississippi·via a public procurement portalRFP for External Quality Review Organization
Category: PERSONNEL SERVICES NON-IT
The Contractor shall provide all services, activities, reports, and deliverables necessary to perform EQRO functions for DOM in accordance with all applicable federal and state requirements, including but not limited to 42 CFR §§ 438.350-364 and 457.1250. The Contractor shall conduct all EQR activities under the direction and oversight of DOM, including validation of performance improvement projects (PIPs), validation of performance measures, review of compliance with Medicaid and CHIP managed care regulations via an Annual Quality Survey (AQS), validation of network adequacy, validation of encounter data, administration or validation of quality-of-care surveys, calculation of additional performance measures, implementation of additional performance improvement projects, conducting focus studies of health care quality, and assisting with a quality rating system for MCOs. Additional activities include participation in quality improvement committees, development of a Quality Companion Guide, corrective action plan validation and monitoring, preparation of an Annual EQR Technical Report, analysis of HEDIS and CAHPS survey data, conducting quality improvement activities, evaluation of provider directory accuracy, behavioral health member satisfaction survey validation, conducting readiness reviews, and mental health and substance use disorder parity analysis. The Contractor shall also conduct an independent technical review and analysis of MCO manual reports, and provide various deliverables including work plans, staffing plans, and monthly progress reports.
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Most Mississippi work asks for the two below, and the solicitation documents are where it’s stated. Here’s what each costs through Light RFP if you need one.
Source: MS DIVISION OF MEDICAID (solicitation 46424), retrieved via a public procurement portal. View the official posting, and always confirm requirements and deadlines with the issuing agency.
