Third Party Health Insurance Verification and Reimbursement Collection

Executive Summary

The Departmentof State Health Services (DSHS) is seeking a Contractor to recover money undera subrogation or third-party reimbursement right held by DSHS arising frompayment of medical expenses, specifically medications provided by the AIDS DrugAssistance Program (ADAP).

HHSC PCS willadminister the procurement process for this Solicitation, which includes RFPpublication, handling of communications from vendors, as well as managing thereceipt of Solicitation Responses for review and evaluation.

Scope of Work

The Texas HIVMedication Program (THMP), which has been in existence since 1987, providesmedications for the treatment of HIV and its related complications forlow-income Texans. The THMP is the official ADAP for the State of Texas. ADAPis a federally funded DSHS state administered program authorized under Part Bof Title XXVI of the Public Health Service Act as amended by the Ryan White HIV/AIDS Treatment Extension Act of 2009 .In addition to the ADAP, THMP also oversees the State Pharmacy AssistanceProgram which coordinates with Medicare clients to help pay premiums and drugco-pays; and the Texas Insurance Assistance Program, which wraps around privateinsurance to help pay premiums and drug co-pays.

ADAP providesapproved medications to low-income, uninsured, or underinsured people livingwith HIV who have no other means to obtain these necessary and/or life-savingmedications. To qualify for medications for any of the three programs,potential clients who meet eligibility criteria must complete an applicationfor assistance.

Contract Term

Theinitial term of any Contract resulting from this Solicitation will be for aperiod of one (1) year. DSHS , at its sole option, may extend anyContract awarded pursuant to this Solicitation for up to four (4) additionalyears.

Followingthe base term and any allowable renewals or extensions, DSHS may extend anyresulting Contractfor not more than one additional option period to address immediate operationalor service delivery needs. If the resulting Contract does not include a definedoption period, the extension is limited to one year.

Optional/Pre-proposal Conference

WebinarInformation:

Attendees must register for the webinar at the followinglink:

https://attendee.gotowebinar.com/register/2609482383084081499

** After registration, participants will receive anotheremail with

the actual link to the webinar. **

Scheduleof Events