EXTERNAL QUALITY REVIEW ORGANIZATION
The State Purchasing Division, on behalf of the Department of Health and Human Services, Division of Health Care Financing and Policy (DHCFP), is soliciting proposals from qualified vendors to provide external quality review (EQR) services. This includes utilization and quality review functions of Division contracted managed care organizations pursuant to 42 CFR 438, Subpart E, in support of the Title XIX (Medicaid) and Title XXI State Child Health Insurance Program (SCHIP is also known as Nevada Check Up) medical assistance programs. The DHCFP requires that all labor under this contract be performed in the United States of America and/or its territories.
Currently, DHCFP contracts with two Managed Care Organizations (MCO) both of which serve the TANF/CHAP Medicaid populations and the Nevada Check Up/SCHIP population. The DHCFP also currently contracts with one (1) external quality review organization (EQRO) to provide these services statewide for both the Medicaid and Nevada Check Up programs. The current EQRO contract has been in place since July of 2005. The current MCO contract may be found online at http://dhcfp.state.nv.us/managed.htm . The contract resulting from this RFP is anticipated to be from July 1, 2009 to June 30, 2013 (pending approval by the State Board of Examiners). The Division of Health Care Financing and Policy will be the contract administrator.
