Medicaid Recovery Audit Contractor
The Department is soliciting sealed bid proposals from responsible and qualified bidders with demonstrated
experience and expertise performing services to detect and recover funds for improper Medicaid
payments made to providers arising from provider fraud and abuse, or inappropriate billing and, where
indicated, to make referrals to appropriate law enforcement agencies and recommend or implement
preventive and educational measures. The successful bidder must be able to audit all areas of the
Medicaid Program. The successful bidder will also be responsible for coordinating audits with other
audit entities, such as MFCU, MIC’s, DOJ and FBI. The bidder will also be responsible for identifying
underpayments under the State Plan and any waiver services. The bidder would use data systems to
identify fraud, ensure proper coding and billing of services, identify improper payments and seek
recoveries of overpayments from providers.
