CMS solicitation: State Medicaid Program Integrity Reviews

The Centers for Medicare and Medicaid Services (CMS) is seeking 8(a) small business offerors having the ability to assist CMS with its review, analysis and annual report development on states’ program integrity oversight of Medicaid and compliance with Medicaid Program Integrity (PI) regulations.

As part of this work, the contractor shall 1) Develop new and revise existing protocols and questionnaires to states for performing onsite State Medicaid focused PI reviews (hereinafter referred to as focused reviews); 2) Assist with performing on-site focused reviews and follow-up; 3) Assist CMS in reviewing findings, developing analysis useful to both CMS and the states, and generating reports from the focused review findings; and 4) Develop protocols and questionnaires for conducting State Medicaid PI desk reviews.

In addition, as directed by CMS, the contractor shall provide technical assistance with on-site reviews of states when CMS has identified areas of concern as problematic or non-compliant.

Read more here.

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