Web Access To Medicaid Rules, Regulations, and Data

Agency:	State Government of Tennessee
State:	Tennessee
Type of Government:	State & Local
NAICS Category:	541511 - Custom Computer Programming Services 541512 - Computer Systems Design Services 541519 - Other Computer Related Services
Posted Date:	Aug 10, 2026
Due Date:	Aug 21, 2026
Solicitation No:	RFI 31865-00730
Original Source:	Please Login to View Page
Contact information:	Please Login to View Page
Bid Documents:	Please Login to View Page

Description

Document ID & Hyperlink:	RFI 31865-00730
Event Start - Response Due:	08/10/2026 08/21/2026
Event Name:	Web Access To Medicaid Rules, Regulations, and Data
Last Updated:

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STATE OF TENNESSEE
FINANCE AND ADMINISTRATION DIVISION OF TENNCARE

REQUEST FOR INFORMATION

FOR

WEB ACCESS TO MEDICAID RULES, REGULATIONS, AND DATA

RFI # 31865-00730

August 10, 2026

1. STATEMENT OF PURPOSE:

The State of Tennessee, Finance and Administration, Division of TennCare issues this Request for Information (“RFI”) for the purpose of gaining marketplace information from organizations with expertise in providing healthcare reimbursement and pricing tools and solutions. We appreciate your input and participation in this process.

2. BACKGROUND:

TennCare is the agency that administers Tennessee’s Medicaid and CHIP programs. In order to support its program integrity and business operations functions, TennCare is seeking information on the availability of a web-based tool that will allow designated TennCare staff to access information on Federal and State laws, rules, regulations, and policies regarding Medicare and Medicaid, including:

• U.S. code and public laws,

• The Code of Federal Regulations,

• The Federal Register,

• CMS manuals and program issuances with relevance to Medicare or Medicaid,

• State statutes and administrative code with relevance to Medicaid,

• Medicaid State Plan information,

• Court cases and decisions to identify healthcare fraud trends and outcomes,

• CMS publications including Medicare Learning Network (MLN) Matters, Local Coverage Determinations (LCDs) and Transmittals,

• CMS Provider Reimbursement Manuals and Coverage Policies, Program Integrity Resources,

• Resources from other Federal agencies including Department of Justice (DOJ), Department of Labor (DOL), U.S. Department of Health and Human Services (HHS), and Food and Drug Administration (FDA),

• News, press releases and fact sheets to keep up with recent trends and healthcare fraud cases, including Office of Inspector General (OIG) Fraud Alerts,

• Training webinars and materials that may be used for required continuing education credits for American Academy of Professional Coders (AAPC), Certified Fraud Examiners (CFE) and other credentials, and Coding information, such as real time content and tools for medical coding, compliance, and reimbursement that includes Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codebooks with the ability to search, CPT Assistance, International Classification of Diseases Clinical Modification (ICD-10-CM), ICD-10-Procedual Coding System (ICD-10-PCS), American Hospital Association (AHA) Coding Clinic, Diagnosis Related Group (DRG) codes, DRG Grouper software for inpatient claims, National Correct Coding Initiative (NCCI) edits, CMS Local/National Coverage Determination (LCD/NCD) policies, APC codes and other state Medicaid policies.

TennCare is interested in details and information regarding available tools or solutions currently in the market that also meet the following needs:

• Pricing file(s) that include HCPCS and National Drug Code (NDC) crosswalk and 340B ceiling price status.

• Capability to search for information on topics with relevance to Medicaid to enhance program integrity efforts related to policy research and the capability to electronically search HCPCS and CPT codes.

3. COMMUNICATIONS:

3.1. Please submit your response to this RFI to:
Johnathon Brock
Finance and Administration, Division of TennCare
310 Great Circle Rd. Nashville, TN 37243
615.507.6928
Johnathon.S.Brock@tn.gov

3.2. Please feel free to contact the Division of TennCare with any questions regarding this RFI. The main point of contact will be:

Johnathon Brock
Finance and Administration, Division of TennCare
310 Great Circle Rd. Nashville, TN 37243
615.507.6928
Johnathon.S.Brock@tn.gov

3.3. Please reference RFI # 31865-00730 with all communications to this RFI.

4. RFI SCHEDULE OF EVENTS:

EVENT

TIME

(Central Time Zone)

DATE

(all dates are State business days)

RFI Issued

8.10.2026

RFI Response Deadline

8.21.2026

5. GENERAL INFORMATION:

5.1. Please note that responding to this RFI is not a prerequisite for responding to any future solicitations related to this project and a response to this RFI will not create any contract rights. Responses to this RFI will become property of the State.

5.2. The information gathered during this RFI is part of an ongoing procurement. In order to prevent an unfair advantage among potential respondents, the RFI responses will not be available until after the completion of evaluation of any responses, proposals, or bids resulting from a Request for Qualifications, Request for Proposals, Invitation to Bid or other procurement method. In the event that the state chooses not to go further in the procurement process and responses are never evaluated, the responses to the procurement including the responses to the RFI, will be considered confidential by the State.

5.3. The State will not pay for any costs associated with responding to this RFI.

6. INFORMATIONAL FORMS:

The State is requesting the following information from all interested parties. Please fill out the following forms:

RFI #730

TECHNICAL INFORMATIONAL FORM

1. RESPONDENT LEGAL ENTITY NAME:

1. RESPONDENT CONTACT PERSON:

Name, Title:

Address:

Phone Number:

Email:

1. Please provide a brief description of your organization’s experience providing a healthcare reimbursement and pricing web-based tool and solution as described above.

1. Does your web-based tool/solution allow designated staff to access information on Federal and State laws, rules, regulations, and policies regarding Medicare and Medicaid, including:

• U.S. code and public laws,

• The Code of Federal Regulations,

• The Federal Register,

• CMS manuals and program issuances with relevance to Medicare or Medicaid,

• State statutes and administrative code with relevance to Medicaid,

• Medicaid State Plan information,

• Court cases and decisions to identify healthcare fraud trends and outcomes,

• CMS publications including Medicare Learning Network (MLN) Matters, Local Coverage Determinations (LCDs) and Transmittals,

• CMS Provider Reimbursement Manuals and Coverage Policies, Program Integrity Resources,

• Resources from other Federal agencies including Department of Justice (DOJ), Department of Labor (DOL), U.S. Department of Health and Human Services (HHS), and Food and Drug Administration (FDA),

• News, press releases and fact sheets to keep up with recent trends and healthcare fraud cases, including Office of Inspector General (OIG) Fraud Alerts,

1. Does your web-based tool/solution allow for altering end users during the delivery period? This would include removing one user and replacing them with another, removing users without replacement, or adding new users.

1. Does your web-based tool/solution provide pricing file(s) that include HCPCS/NDC crosswalk and 340B ceiling price status?

1. TennCare is interested in information regarding available online resources that provide instant electronic access to current and historical Medicaid policies and coding resources such as real time content and tools for medical coding, compliance, and reimbursement that includes Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codebooks with the ability to search, CPT Assistance, International Classification of Diseases Clinical Modification (ICD-10-CM), ICD-10-Procedual Coding System (ICD-10-PCS), American Hospital Association (AHA) Coding Clinic, Diagnosis Related Group (DRG) codes, DRG Grouper software for inpatient claims, National Correct Coding Initiative (NCCI) edits, CMS Local/National Coverage Determination (LCD/NCD) policies, APC codes and other state Medicaid policies.. (going back ten (10) years). Does your web-based tool/solution provide this information?

1. Does your web-based tool/solution provide capability to search for information on topics with relevance to Medicaid?

1. Provide a narrative detailing your experience, including best practices and lessons learned providing healthcare reimbursement and pricing tools and solutions. This narrative should include the Respondent’s experience developing and maintaining same.

COST INFORMATIONAL FORM

1. Describe what pricing units and products/suites you typically utilize for similar services or goods.

1. Describe your normal pricing approach and address the following:

• Is the pricing determined per number of users or per number of licenses?

• Does your pricing utilize volume discounting or tiered pricing based on the number of users or licenses?

[potentially add more].

ADDITIONAL CONSIDERATIONS

1. Please provide input on alternative approaches or additional things to consider that might benefit the State:

This page summarizes the opportunity, including an overview and a preview of the attached documents.

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Web Access To Medicaid Rules, Regulations, and Data

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