- Org
- StateOfMontana
- Type
- RFP
- Title
- Utilization Review (UR)
- Number
- DPHHS-RFP-2027-0712AB
- Source
- MT_EMACS
- Status
- Open
- Event Id
- 1460241
- Open Str
- 10/21/2026, 2:00 PM MDT
- Pdf Text
- 25 October 2026
Utilization Review (UR)
DPHHS is seeking an Offeror(s) to provide utilization management and review services, which include level of care
determination, as detailed herein.
25 October 2026
Open 10/21/2026, 2:00 PM MDT Type Request for Proposal
Close 12/8/2026, 2:00 PM MST Number DPHHS-RFP-2027-0712AB
Currency US Dollar
Sealed Until 12/8/2026, 2:00 PM MST
Payment
Terms 0% 0, Net 30
25 October 2026
Contacts
Amanda Battin
Amanda.Battin2@mt.gov
Phone +1 406-444-9665
25 October 2026
Commodity Codes
Commodity Code Description
0910 Computing Equipment & Software - Software
0911 Computing Equipment & Software - Software as a Service (SaaS)
0912 Computing Equipment & Software - Software Reseller
1003 Computing Services - Cloud Services
2606 Health Related - Health Facilities Management
2611 Health Related - Medicaid Analysis & Audit
2612 Health Related - Medicaid Billing
2613 Health Related - Medical Services
2614 Health Related - Medical Research
2615 Health Related - Nursing
2617 Health Related - Pharmaceuticals
2618 Health Related - Services
3954 Professional Services - Workforce Services
25 October 202625 October 202625 October 202625 October 202625 October 202625 October 202625 October 202625 October 202625 October 2026
Description
The State of Montana, State Procurement Services Division (SPSD), on behalf of the Department
of Health and Human Services, is issuing this Request for Proposal (RFP) to provide utilization
management and review (UR) services, which include level of care determination, Preadmission
Screening and Resident Review (PASRR) activities, functional assessments, prior authorizations,
continued stay reviews, eligibility determinations, and special case reviews for the Montana
Healthcare Program (MHP) in accordance with all federal and state rules/regulations and related
state policies and procedures.
This organization must maintain its QIO or QIO-Like status throughout the contract period.
A more complete description of the Services, are provided in the Questions. Responses submitted
to this RFP must comply with the instructions and procedures.
For assistance with eMACS functionality, such as Vendor Registration, How to respond to a bid
(IFB) or Proposal (RFP), How to videos, see the eMACS Vendor Handbook. Additional resources
can be found at: https://doa.mt.gov/SPSD/eMACS-Resources
For additional eMACS help not found within the handbook or website, contact the eMACS Help
Desk at 406-444-2575.
Be sure to review and submit your response upon completion.
Required to View Event
Prerequisites Required to Enter Bid
25 October 2026
1. Review and accept the Single Point of Contact information.
2. Review and accept the conflict-of-interest notice.
3. Review and accept the Optional Pre-Proposal Conference.
4. Review and accept the Quality Improvement Organization language. Offeror(s) certifying 'yes' have
reviewed and can comply with the language included.
5. Offeror(s) must certify they have reviewed and will comply with attachments A – T located in the Buyer
Attachments, by marking ‘yes’ you certify that all documents have been reviewed and will be use to
respond and will comply with all required attachments.
6. Review and accept the Q & A Board information.
7. Review and accept the Draft Contract as provided.
8. Review and accept the Montana Prevailing Wage Requirements information.
9.
Review and accept the insurance requirements. Offeror requesting change(s) or exception(s) to these
requirements must submit the request(s) using the Contract Exception form. This form must be submitted
by the deadline as listed on the Schedule of Events. The State will not consider any changes after the
deadline. The State reserves the right to not accept any or all contract exceptions.
10. Federal funds are involved in this project. The awarded Contractor is required to have a Unique Entity ID #
(UEI #; Register @ SAM.GOV) AND complete the Federal Form NDA889.
11. Review and accept the RFP Evaluation Process information.
12. Review and accept the Product Demonstration/Interview information.
13. Review and accept the Vendor Registration information.
14. Review and accept the Montana Time Zone information.
15. Review and accept the Registration with the Secretary of State information.
16. Review and accept the Debarment information.
17. Review and accept the RFP General Information.
18. Review and accept the Submitting a Proposal information.
19. Please review and accept the eMACS Handbook - Responding to Events. Additional resources are
available at https://spb.mt.gov/eMACS-Resource
25 October 202625 October 202625 October 202625 October 202625 October 202625 October 202625 October 2026
Buyer Attachments
1. Attachment_A_Disability_Determination.pdf
2. Attachment_B_Brain_Injury_Screening.pdf
3. Attachment_C_Category_D_Services.docx
4. Attachment_D_Adolescent_Intensive_TGH.docx
5. Attachment_E_Adolescent_Acuity_Enhancement.docx
6. Attachment-F_Requirements_Response_Matrix_Base_and_UR_API.xlsx
7. Attachment_G_Module_Pricing_Schedules.xlsx
8. Attachment_H_Resource_Allocation_Schedules.xlsx
9. Attachment_I_IMD_for_HEART_Waiver.docx
1
0. Attachment_J_Service_Level_Agreements_UR.xlsx
1
1. Attachment_K_Access_Rule_Review.docx
1
2. Attachment_L_Technology_Matrix.xlsx
1
3. Attachment_M_CFCS-PCS_Program.docx
1
4. Attachment_N_Big_Sky_Waiver_Performance_Measures.pdf
1
5. Attachment_O_HEART_HCBS_Performance_Measures_Report.docx
1
6. Attachment_P_HEART_Quality_Improvement_Report.docx
1
7. Attachment_Q_HEART_TSS_CM_Metric_for_CMS.xlsx
1
8. Attachment_R_SDMI_Narrative_Report.pdf
1
9. Attachment_S_Applied_Behavior_Analysis.pdf
2
0. Attachment_T_EPSDT_DDP.docx
25 October 202625 October 202625 October 202625 October 202625 October 202625 October 2026
Questions Required Questions
Group 1: Mandatory Requirements
Instructions: To be eligible for consideration, an offeror must meet all mandatory requirements. The State will
determine whether an offeror's proposal complies with the requirements. Offerors receiving a Fail
in any of the mandatory requirements will be removed from further consideration.
1.1 Offeror must complete and upload the attached Business Information document.
1.2 Offeror must download and review the attached Scope of Work document. Thoroughly
address each item in the document and upload it to this question.
1.3 Offeror must download and review the attached Offeror Qualifications document.
Thoroughly address each item in the document and upload it to this question.
1.4 Offeror must download and review the attached Budget Worksheet. Thoroughly
address each item in the worksheet and upload it to this question. The Basis of Award
will be based on XXXX.
Group 2: Contract Exceptions
Instructions:
An offeror may submit proposed contract exceptions to the draft contract issued with the RFP.
Offerors must use the Contract Exception template attached to this question. Offerors must detail
why the exception is being sought and what specific effect it will have on the offeror's ability to
respond to the RFP.
2.1
An offeror’s proposed contract exceptions will be made available to the evaluation committee. The
contract exceptions requested will not be scored separately, but the evaluation committee may
consider an offeror’s proposed contract exceptions when assigning points for scored criteria. A
proposal may be deemed nonresponsive if the offeror’s proposed contract exceptions:
demonstrate the proposal does not satisfy RFP requirements; would violate law or materially alter
the material provisions of the contract or RFP terms; or would alter or replace all or substantially
all of the contract.
2.2 ******CONTRACT OFFICERS- PICK THE APPLICABLE QUESTION BELOW AND REMOVE THE
NON-APPLICABLE. QUESTION. DELETE THIS BEFORE POSTING*****
2.3 If the RFP is intended to result in the award of a contract to only one offeror, offerors requesting
additions or exceptions to the contract terms shall submit them with their proposals. Exceptions
submitted after deadline will not be considered.
2.4 If the RFP will establish a qualified vendor list or multiple contracts will be awarded as a result of
this RFP, offerors requesting additions or exceptions to the contract terms shall submit them to the
Q&A Board. Exceptions submitted after deadline will not be considered.
Group 3: Confidential Information
Instructions:
The State of Montana is required by both the Montana Constitution and its laws to permit the
public
to examine documents that are kept or maintained by the public agencies, other than those
legitimately meeting the provisions of Montana Constitution, Mont. Code Ann. §§2-6-1001, et seq,
Montana Procurement Act §§18-4-401, et seq., and Montana’s Uniform Trade Secrets Act, Mont.
Code Ann. §§ 30-14-401, et seq
3.1
Does your proposal contain confidential information? If you select Yes, another
question will be generated, requiring an upload of your Trade Secret Affidavit. Offerors
MUST also upload a copy of the response with all areas claimed as confidential or
proprietary redacted under Supplier Attachments.
3.2 Offerors must upload a completed Trade Secret Affidavit.
Group 4: Verification of Nondiscrimination Against Firearms Entities/Trade Associations
Instructions:
Instructions: Offeror’s certification is made in compliance with and in reference to 30-20-301, MCA
and the terms defined therein. If Offeror determines the provisions of 30-20-301, MCA do not
apply to Offeror or the contract to be awarded under this RFP, Offeror shall submit a statement
setting forth in detail the basis for such determination.
4.1
Offeror does not have a practice, policy, guidance, or directive that discriminates
against a firearm entity or firearm trade association during the term of any contract it is
awarded under this solicitation; and b. Offeror will not discriminate against a firearm
entity or firearm trade association during the term of any contract it is awarded as a
result of this solicitation
4.2
The Contractor determines the provisions of 30-20-301, MCA do not apply to the
contract, the Contractor shall submit a statement setting forth in detail the basis for
such determination.
4.3 Please confirm whether you are a governmental entity, are not a “company” that exists
to make a profit, or are a company with fewer than 10 full-time employees.
Group 5: Artificial Intelligence Disclosure
Instructions:
25 October 202625 October 202625 October 202625 October 202625 October 2026
5.1 Was artificial intelligence technology used in the development or completion of any
portion of this proposal?
5.2 I certify that all AI-generated content has been reviewed and validated by a named human
subject-matter expert who claims responsibility for accuracy.
25 October 202625 October 202625 October 202625 October 202625 October 2026
Product Line Items Product Line Items
There are no Items added to this event.
25 October 202625 October 202625 October 202625 October 2026
Service Line Items Service Line Items
1.
# Item Name, Commodity Code, Description Allow
Alternates Qty. UOM Requested Service Delivery
S1 Lump Sum Total 1 LS - Lump Sum
Lump Sum Total - Service Line Items
25 October 202625 October 202625 October 2026
- Close Str
- 12/8/2026, 2:00 PM MST
- Contact Name
- Amanda Battin
- Description
- DPHHS is seeking an Offeror(s) to provide utilization management and review services, which include level of care determination, as detailed herein.
- Contact Email
- amanda.battin2@mt.gov
- Sci Docs Fetched
- Yes
State of MontanaIssuing agency·Montana·via the Montana eMACS SciQuest procurement portal