Medicaid Estate Recovery Services

The vendor is required to provide Medicaid estate recovery existing programs and cases for action, develop and implement recovery procedures for Medicaid estate recovery and Medicaid liens, and fulfill the recovery requirements of the Medicaid state plan.
a. Estate recovery
•    Create and maintain a secure data system for handling Medicaid information. 
•    Program administrator will have access to the contractor’s secure data system. 
•    Develop and maintain a process for presenting and preserving estate recovery claims and liens in all potential arenas through the use of agreements, mediation, litigation, and other viable means. 
•    Program administrator will have final approval on agreements made to recover said funds. 
•    Acquire and receive information from families, attorneys, creditors and interested persons concerning the assets of a Medicaid recipient subject to recovery in a timely manner. 
•    Timely manner is defined as not to exceed 30 business days. 
•    Program administrator for permission to exceed the 30 business days. 
•    Identify and recover assets of the deceased Medicaid recipients that are available for estate recovery of Medicaid expenditures. 
•    Identify and recover assets from living Medicaid recipients using lien procedures that are available for recovery of Medicaid expenditures. 
•    Responsible for reviewing, documenting, and recommending proper course of action for any refund requests. 
•    All requests for refunds with attached documentation shall be forwarded to the program administrator for decision and disbursement of refund requests in accordance with applicable law. 
•    The state of in acquiring or determining any evidence necessary to process disbursement requests. 
•    Develop and maintain documentation on cases for review and audit purposes. the documentation will follow federal act guidelines. 
•    Program administrator will have access to the contractor’s system where the documentation resides.
•    Provide monthly reports of case issues and recovery amounts to the program administrator for use in preparing reports for the centers for medicare and Medicaid services (CMS). 
•    The report is due 3 business days after the month end. 
•    Program administrator an annual report on case recovery activity. 
•    This report is due 30 days after the state fiscal year ends. 
•    The state fiscal year is defined as July 1- June 30. 
•    Program administrator on the report design. 
•    All calls and correspondence regarding criminal restitution, debt setoff, and accounts receivable files to the program administrator. 
•    The correspondence shall be numbered, batched, and tracked in the secure data system.
•    All payments and or recoveries of funds to the program administrator within 48 hours but no later than noon (12:00 p.m.) of the business day following the 48 hours for processing and deposit. 
•    The successful bidder will work with the program administrator on the report deposit design.
•    Have a program manager devoted exclusively to the state of estate recovery and Medicaid lien program
•    The ability to send and receive secure electronic e-mails, faxes.
•    The ability to communicate telephonically including conference calls
b. Audit and logging
•    System will have detailed logging of user and administrator activities, system events and changes to case data for auditing and accountability, including but not limited to all of the following: date or time, login, logout, actions performed, and IP address. 
•    The system will produce an audit trail and system event log, including but not limited to each change or version of data, on and off boarding of user accounts, and login and log out activity.

- Contract Period/Term: 4 years
- Questions/Inquires Deadline: November 4, 2025