Legal Services

The Vendor is required to provide comprehensive legal services to support the operations of a State health insurance plan.
- The firm may be responsible for providing agency with the following services:
•    Provide specialized services for the implementation of legal and regulatory requirements and new product launches;
•    Advisory and litigation work regarding legal matters relating to regulatory and compliance issue;
•    Assist agency in contractual arrangements with various managed care entities, including negotiating and drafting contracts;
•    Provide research, advice, and opinions on complex legal issues facing agency;
•    Advisory work related to the statutory and regulatory requirements of a PHL article 44 health plan, an insurance law article 43 health plan, and/or organization;
•    Support with managed care contracting, litigation, and design of new reimbursement and risk-sharing models;
•    Advisory and litigation work related to the false claims act, anti-kickback, stark law and other state and federal fraud and abuse laws;
•    Medicare and medicaid reimbursement, including general counseling, handling reimbursement and audit appeals, and providing updates on new developments; and 
•    Advisory and litigation work related to health information privacy and security, including acts, other applicable federal privacy rules, and state law privacy and security rules, cyber security, data use agreements, information technology (IT) and artificial intelligence (AI).

- Contract Period/Term: 3 years
- Pre-Proposal Conference Call Date: October 06, 2025
- Questions/Inquires Deadline: October 09, 2025