NOTICE OF Request For Information (RFI)

HCA Solicitation #2024HCA9-RADDV

Request For Information (RFI): Commercial Market Risk Adjustment Data Validation (RADV) Audit

Request For Information (RFI) POSTING DATE: 9/6/2024

Response Due Date: Organizations or providers interested in responding to this RFI must send a reservation request to the RFI Coordinator at least two (2) business days prior to the scheduled conference call.  Please reference the complete solicitation on Washington’s Electronic Business Solution (WEBS).

Find the full solicitation on Washington’s Electronic Business Solution (WEBS). Vendors not registered in WEBS will not receive updates or amendments to the solicitation, which may put them at a disadvantage.

Purpose and Objectives

This Request for Information (RFI) is seeking information that will assist the Washington State Health Care Authority (HCA) in a potential procurement and implementation of a vendor to perform a Risk Adjustment Data Validation (RADV) audit for the Public Employee Benefits Board (PEBB) and School Employee Benefits Board (SEBB) programs.

HCA’s goals and objectives for this RFI are:

1. To learn – The Health Care Authority aims to use this RFI to learn from the vendor community:

• • What type(s) of vendors or organizations conduct RADV review or evaluation audits;

• • Can RADV audits be customized and applied to claims data for state employer group medical plans that exist within the commercial market;

• • How are costs assessed for the described services and what is the potential range of annual costs for a population that exceeds 500,000 members;

• • Are there any major business and/or technical complexities that vendors anticipate for this type of audit; and

2. Inform – With this RFI, HCA hopes to inform the vendor community of:

• • The potential procurement of one (1) vendor to conduct an annual RADV audit for the PEBB and SEBB programs; and

• • The framework HCA could use for the design and implementation of this RADV audit.

Solicitation Coordinator

Submit any questions or concerns regarding this solicitation to the Solicitation Coordinator shown above.