RFP 30-2025-003-DHB North Carolina Physician Upper Payment Limit

Agency: State Government of North Carolina
State: North Carolina
Type of Government: State & Local
Posted Date: Apr 11, 2025
Due Date: May 29, 2025
Solicitation No: Doc1534270485
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Description

Solicitation Number: Doc1534270485
Project Title: RFP 30-2025-003-DHB North Carolina Physician Upper Payment Limit
Description: The North Carolina Department of Health and Human Services (NCDHHS or Department), Division of Health Benefits (DHB), seeks to procure an experienced qualified partner to provide services for the preparation of a model to perform quarterly supplemental payment calculations using an Average Commercial Rate (ACR) to establish the maximum Medicaid payment amount. The selected Vendor will facilitate the preparation and development of (i) an annual Average Commercial Rate (ACR) calculation, (ii) a model to calculate supplemental and state-directed payments for the prescribed time periods, and (iii) annual demonstration reports. In addition, the Vendor will support the development and continued execution of the Department’s physician supplemental payment program, ensuring its ongoing compliance with evolving federal methodological guidelines, the North Carolina State Plan, and other eligibility rules.
Opening Date: 5/29/2025 3:00 PM
Posted Date: 4/12/2025
Status: Open
Department: DEPARTMENT OF HEALTH AND HUMAN SERVICES - DHHS
Solicitation Number
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Doc1534270485
Department
DEPARTMENT OF HEALTH AND HUMAN SERVICES - DHHS
Status Reason
Open
Opening Date
2025-05-29T15:00:00.0000000
Posted Date
*
2025-04-11T16:03:27.0000000Z
Commodity Code
Comprehensive health services
Mandatory Conference/Site Visit
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Special Instructions
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Description
The North Carolina Department of Health and Human Services (NCDHHS or Department), Division of Health Benefits (DHB), seeks to procure an experienced qualified partner to provide services for the preparation of a model to perform quarterly supplemental payment calculations using an Average Commercial Rate (ACR) to establish the maximum Medicaid payment amount. The selected Vendor will facilitate the preparation and development of (i) an annual Average Commercial Rate (ACR) calculation, (ii) a model to calculate supplemental and state-directed payments for the prescribed time periods, and (iii) annual demonstration reports. In addition, the Vendor will support the development and continued execution of the Department’s physician supplemental payment program, ensuring its ongoing compliance with evolving federal methodological guidelines, the North Carolina State Plan, and other eligibility rules.
Attachments
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