Medicaid Utilization Review Services
Montana > State Procurement Services Division > Department of Public Health and Human Services
Original Solicitation Links
DPHHS-RFP-2027-0712AB
]utilization review (ur)
Contact
Submission Instructions
Description
The State of Montana is seeking an organization to provide utilization management and review services for the Montana Healthcare Program. The scope includes level-of-care determinations, Preadmission Screening and Resident Review activities, functional assessments, prior authorizations, continued-stay reviews, eligibility determinations, and special case reviews in accordance with applicable federal and state requirements. The contractor must maintain Quality Improvement Organization (QIO) or QIO-like status throughout the contract period. The work also includes clinical and administrative reviews across multiple Medicaid programs and service areas, associated reporting and performance measurement, and support for brain-injury screening activities. The proposal requires responses to the requirements and technology matrices, pricing and resource-allocation schedules, and other specified proposal materials. The solicitation states that federal funds are involved and requires the awarded contractor to have a Unique Entity ID and complete Federal Form NDAA889.
Classification Codes
Smart Codes
Specifications
Timeline
Requirements
- Minimum 2 references
- Within the last 7 years
Location
Documents
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