Health Maintenance Organization (HMO) Audit

Agency: State Government of Wisconsin
State: Wisconsin
Type of Government: State & Local
NAICS Category:
  • 541611 - Administrative Management and General Management Consulting Services
Posted Date: Oct 17, 2023
Due Date: Dec 19, 2023
Solicitation No: S-1338 DMS-23
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Solicitation Reference #: S-1338 DMS-23
Title: Health Maintenance Organization (HMO) Audit
Available Date: 10/17/2023
Due Date: 12/19/2023 2:00:00 PM
Bid Synopsis: The Wisconsin Department of Health Services (DHS) is seeking proposals for Health Maintenance Organization (HMO) payment auditing services from a certified Independent Public Accounting (IPA) firm and intends to use the results of this process to award a Contract. The Vendor will conduct an audit of HMO 16 health plans over a period of three years. Division of Medicaid Services (DMS) anticipates the resulting vendor to begin work July 2024. DMS envisions three years of audits with 5 or 6 HMOs being audited each year to complete the 16 health plan audits by the end of the third year. DMS has requested that the audits be completed by either a separate vendor for each of the three years or by one vendor, signed for a two-year contract with 5 one-year renewals.
Agency Contact: Russell Bowe,

Phone: 608-264-8262

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