The Ohio Department of Job and Family Services’ (ODJFS) announces the release of Request for Proposals (RFP)#:  R-89-07-0931, External Quality Review Services for Medicaid Managed Care, for the purpose of obtaining a qualifying vendor to perform external quality review activities (e.g., clinical studies, statistical analysis, encounter and claims data validation, quality improvement projects, and consumer surveys) for the Medicaid managed care population.  The external quality review vendor will assist ODJFS in fulfilling federal requirements for providing an annual external quality review survey of Medicaid managed care plans (MCPs). 

 Actual RFP (click link)

 ATTACHMENTS

Attachment A     Required Vendor Information and Certifications

Attachment B     Request for Taxpayer Identification (W-9) Form

Attachment C     Declaration of Material Assistance Form

Attachment D     ODJFS Model Contract

Attachment E     Technical Proposal Score Sheet

Attachment F     Cost Proposal Form [REVISED]

APPENDICES

Appendix A        State of Ohio: Managed Health Care Glossary

Appendix B        Summary of Medicaid Managed Care Quality Strategy

Appendix C        Prior Authorization Data File Specifications

Appendix D        Methods for Medical Record Submission Rate

Appendix E         Medicaid Recipient Master File Data Specifications

Appendix F         Medicaid Provider Master File Data Specifications

Appendix G        Medicaid Fee For Service Claims File Data Specifications

Appendix H        CMS State EQRO Tool Kit for State Medicaid Agencies

Appendix I         Managed Care Plans Listing