Health Care Financing Administration 7500 Security Blvd., Baltimore, MD. 21244-1850

Q -- DEVELOP A SET OF REVIEW PROTOCOLS FOR INDEPENDENT QUALITY REVIEW ORGANIZATIONS TO USE WHEN MONITORING SERVICES PROVIDED TO MEDICAID BENEFICIARIES ENROLLED IN MANAGED CARE ORGANIZATIONS SOL HCFA-98-0003/HH POC HERMAN HARRIS, CONTRACT SPECIALIST (410) 786-9104 and Edward Hughes, Contracting Officer 410-786-0203 The Health Care Financing Administration (HCFA) will issue Solicitation #HCFA-98-003/HH approximately 30 days after publication of this notice.In accordance with Section 4705(a) of the Balanced Budget Act of 1997, the Secretary of DHHS in coordination with the National Governors Association, must contract with an independent quality review organization to develop protocols for assessing care provided to Medicaid beneficiaries by Managed Care Organizations (MCOs). Protocols to be used in external independent reviews are statements of the procedures and standards which the external independent review entity is to use in review of MCOs. A protocol will define the components and/or scope of an external quality review, include types of information to be gathered, procedures for gathering information, and methods for analyzing the information once obtained. Independent External Quality Review is required for all MCOs (covered under Section 1903 of the Social Security Act) that contract with state Medicaid agencies. The Health Care Financing Administration's Center for Medicaid and State Operations intends to contract with a national independent quality review organization(s) to develop national quality review protocols. The protocols will be used in Medicaid independent quality review conducted on and after January 1, 1999. The potential contractor must be able to meet the following criteria: be a national independent quality review organization recognized by HCFA or the managed care industry; have specific experience in developing and using protocols to assess the performance of MCOs, preferably Medicaid MCOs; have experience working with State Medicaid programs; and have the ability to complete the statement of work within six months of the contract award date. It is anticipated that a Fixed Price contract will be awarded (HCFA reserves the right to award other types of contract arrangements). Requests for a copy of the solicitation must be submitted via Internet (review_protocol@hcfa.gov) or in writing to HCFA, Acquisition and Grants Group, Division of Quality Contracts, ATTN: Herman L. Harris, Mail Stop C2-21-15, 7500 Security Boulevard, Baltimore, Maryland 21244-1850. No telephone requests will be accepted. (0155)

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