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Medicaid Physician Review and Consulting Services
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Request Date: 5/26/2026 11:44:24 AM
Open Date: 5/26/2026
Closing Date: 6/16/2026 2:00 PM
Intent To Bid Deadline:
Est. Dollar Value: $0.00
RFQ Number: 03410-205-26
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Department of Vermont Health Access
280 State Drive
Waterbury,
VT
05671
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Locations:
Washington
Keywords:
Medical Services, Consultant Services, Health Care Services
Bid Description:
*Please use Microsoft Edge to open attachments* Through this Request for Proposal (RFP) the Agency of Human Service through the Department of Vermont Health Access is soliciting proposals to contract with an actively licensed Physician(s) to provide medical oversight, prior authorization case review and medical necessity determinations in a Medicaid Managed Care environment. The State has policies and procedures within its Clinical Operations Unit for Surveillance and Utilization Review activities. These activities are federally mandated for all State Medicaid Managed Care Organizations, as outlined in Title 42, Part 400, of the Code of Federal Regulations. The Contractor will provide consultative services on these activities, on an as needed basis, not to exceed sixteen (16) hours per week, according to a mutually agreeable schedule as established by the Contractor, the State Clinical Operations Unit Director and the State’s Chief Medical Officer.
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