Recovery Audit Contractor Request for Proposal (RFP #10-87242) Home Page

Audits & Investigations (A&I) has been charged with the administration and maintenance of the RAC Program.  The mission of Audits and Investigations (A&I) is to ensure that fiscal integrity of the health programs administered by the Department of Health Care Services (DHCS) and ensure quality of care provided to the beneficiaries of these programs. The overall goal of A&I is to improve the efficiency, economy, and the effectiveness of DHCS and the programs it administers. To carry out its mission A&I will:

·        Perform special audits as needed by DHCS program managers, executive staff, Health and Human Services, or the Governor's Office.

·        Perform internal audits of DHCS organizations to ensure that various internal controls are operating and effective.

·        Perform medical reviews of Medi-Cal and public health providers.

·        Provide technical assistance (financial and medical) in the development and expansion of the Managed Care program.

·        Identify and investigate Medi-Cal beneficiary and provider fraud and abuse, emphasizing fraud prevention.

·        Participate in the development or modification of DHCS policies.

 

Procurement Status:  Contract Awarded

 

(NEW - 04/05/2012)  Contract awarded to Health Management Systems, Inc.

(03/29/2012)  The Office of Medi-Cal Procurement announces the release of the Notice of Intent to Award to Health Management Systems, Inc. for the Recovery Audit Contractor Procurement (RFP #10-87013).  Click here to view and/or download the award certificate.

(12/28/2011) The Office of Medi-Cal Procurement announces an update to the Data Library link titled "REPLACEMENT- Claims Type". This link has been added to the library to provide an updated "Claims Type" document. Click here to view and/or download the bulletin.

(12/16/2011) The Office of Medi-Cal Procurement announces the release of the Administrative Bulletin 4, Addendum 2 for Proposal for the Recovery Audit Contractor Procurement (RFP #10-87013). Click here to view and/or download the bulletin.

(12/02/2011) The Office of Medi-Cal Procurement announces the release of the Administrative Bulletin 3 for Proposal for the Recovery Audit Contractor Procurement (RFP #10-87013). Click here to view and/or download the bulletin.

(11/29/2011) The Office of Medi-Cal Procurement announces the release of the Administrative Bulletin 2 for Proposal for the Recovery Audit Contractor Procurement (RFP #10-87013). Click here to view and/or download the bulletin.

(11/22/2011)  The Office of Medi-Cal Procurement announces the release of an additional data library link titled "Medi-Cal Review Branch Resources".  This link has been added to the library to give you access to the Medi-Cal Payment Error Studies (MPES) maintained on that web page.  Click here to access the data library.

(10/19/2011) The Office of Medi-Cal Procurement announces the release of the Administrative Bulletin 1, Addendum 1 for Proposal for the Recovery Audit Contractor Procurement (RFP #10-87013).  Click here to view and/or download the bulletin/addendum.

(10/18/2011)  The Office of Medi-Cal Procurement announces the release of the FINAL Request for Proposal for the Recovery Audit Contractor Procurement (RFP #10-87013).  Data library materials and links are also available on the download page.  Click here to view and/or download the RFP.

 

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Go to Office of Medi-Cal Procurement Home Page

Go to Recovery Audit Contractor RFP Download Page

 

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