DHHS-Department of Health & Human Services-NHIssuing agency·New Hampshire·via the NH DAS Procurement & Support Services portalThe New Hampshire Department of Health and Human Services, Division of Program Quality and Integrity (“Department”) is seeking responses to this Request for Proposals ("Solicitation" or "RFP") from qualified Vendors to provide External Quality Reviews (EQRs) of healthcare services provided to New Hampshire Medicaid beneficiaries enrolled in the Medicaid Care Management, statewide. EQRs evaluate and analyze aggregated information on quality, timeliness, and access to health care services provided by state contracted Managed Care Plans. EQRs serve to improve the state’s ability to oversee and manage the managed care plans they contract with and help managed care plans improve their performance.
Qualified Vendors must confirm that they meet all the qualifications of an External Quality Review Organization (EQRO) as outlined in 42 CFR 438.354.
Pursuant to 42 CFR 438, Subpart E, States are federally required to contract with an EQRO to provide rigorous assessments of their contracted Managed Care Plans.
The Department anticipates awarding one (1) or more contracts for the services in this solicitation. Vendors must submit one (1) proposal that includes services for both Part A and Part B.
The Contractor must provide External Quality Reviews (EQRs) of healthcare services provided to New Hampshire Medicaid beneficiaries by Department-contracted Medicaid managed care entities (MCEs), including three Managed Care Organizations (MCOs), one Dental Organization (DO), and any MCEs added during the contract. Services include validation of MCO and DO performance measures, validation of performance improvement projects (PIPs), validation of provider network adequacy, validation of encounter data, implementation of secret shopper surveys, conduct of focus studies of health care quality, implementation of member focus groups and surveys, review of contractual compliance, and production of annual EQR Technical Reports. The Contractor must also host bi-weekly conference calls, provide written status reports, and maintain all qualifications of an EQRO as outlined in 42 CFR 438.354.
We post new professional & consulting services opportunities in New Hampshire as agencies publish them. Get them in one email — free, and unsubscribe whenever.
Most New Hampshire 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: New Hampshire DAS Procurement (solicitation b5ec8693-3ff5-4954-a296-bb3ab9e47dfc), retrieved via the NH DAS Procurement & Support Services portal. View the official posting, and always confirm requirements and deadlines with the issuing agency.
