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P26003353 Medicaid Administrative Claiming Support

General Information
Solicitation Number
P26003353version:    01
Status
Released
Department
Health
Division
Executive Office on Aging
Islands (where the work/delivery is to be performed)
Statewide
Category
Goods and Services
Release Date
06/10/2026
Amendment Date & Time
06/10/2026 05:00 PM
Amendment Reason
Updated attachment
Offer Due Date & Time
07/09/2026 03:00 PM
Description
The Department of Health, Executive Office on Aging (“EOA”) seeks a qualified CONTRACTOR to provide technical, administrative, and operational support for Hawaiʻi’s Medicaid Administrative Claiming program. The CONTRACTOR shall
operate and maintain a federally compliant Random Moment Sampling (“RMS”) system, support claim development and calculation activities, provide training and technical assistance to participating agencies, and assist EOA in preparing quarterly Medicaid Administrative Claims.
The CONTRACTOR shall provide a secure, web-based solution that supports RMS administration, reporting, claim calculation, documentation, and ongoing program management. Please see RFP attached.
Contact Person
Bryant, Candice
Email
candice.bryant@doh.hawaii.gov
Phone
808-542-9914
General Comments
Procurement Officer
Candice Bryant
Attachments
RFP No. 27-054 Medicaid Administrative Claiming Support.pdf
AG-008 103D General Conditions (1.10.23).pdf

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Direct all questions regarding this Solicitation, and any questions or Issues relating to the accessibility of this Solicitation (Including the appendices and exhibits to this Document, and any other document related to this Solicitation), to: Bryant, Candice.

P26003353 Medicaid Administrative Claiming Support

Line Items
#
Title
Quantity
Unit of Measure
Commodity Code
 

1
Medicaid Administrative Claiming Support
1
JOB
524292, 923130 

Code Table
Commodity Code Description
524292 Claims processing services, insurance, third party
923130 Medicare and Medicaid administration
General
Quantity
1
Unit of Measure
JOB
Title
Medicaid Administrative Claiming Support
Description
The CONTRACTOR shall provide a secure, web-based solution that supports RMS
administration, reporting, claim calculation, documentation, and ongoing program
management.
Attachments

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Direct all questions regarding this Solicitation, and any questions or Issues relating to the accessibility of this Solicitation (Including the appendices and exhibits to this Document, and any other document related to this Solicitation), to: Bryant, Candice.

P26003353 Medicaid Administrative Claiming Support

Instructions
  • VENDOR REGISTRATION IN HAWAII COMPLIANCE EXPRESS (HCE) : Vendors can register at https://vendors.ehawaii.gov/hce via an annual subscription fee and should subscribe prior to responding to a solicitation. For more information visit the HCE Section of the FAQs at http://spo.hawaii.gov/faqs/#tabs-4.
  • VENDOR COMPLIANCE – PAPER DOCUMENTS : Vendors not utilizing HCE shall provide paper certificates that must be valid at the time of award. All applications for applicable clearances are the responsibility of the vendor, who must be compliant pursuant to HRS§103D-310(c) with the chapters 1) Chapter 237, General Excise Tax Laws; 2) Chapter 382, Hawaii Employment Security Law; 3)Chapter 386, Worker’s Compensation Law; 4) Chapter 392, Temporary Disability Insurance; 5)Chapter 393, Prepaid Health Care Act; and 6) §103D-310(c), Certificate of Good Standing (COGS) for entities doing business in the State. Upon receipt of compliance paper documents (A-6, LIR#27, COGS), the purchasing agency reserves the right to verify their validity with the respective issuing agency.
  • VENDOR NON-COMPLIANCE : NON-COMPLIANCE may result in a vendor not receiving an award, delay of payment, or cancellation of award. If the vendor does not maintain timely compliance, which is the vendor’s responsibility, an offer otherwise deemed responsive and responsible may not be awarded. State agencies may check for compliance at any time.
  • HAWAII GENERAL EXCISE TAX (GET): Unless otherwise stated in this solicitation, vendors shall include all applicable taxes in the price submitted. The Hawaii General Excise Tax (GET) shall not exceed 4.712% for the islands of Oahu, Kauai , Hawaii, and Maui.
  • OFFER DEEMED FIRM/AUTHORITY TO SUBMIT OFFER: Submission of an electronic response to the State of Hawaii constitutes and shall be deemed an offer to sell the specified goods and/or services to the State of Hawaii at the price shown in the response and under the State's Terms and Conditions. The electronic response submitter certifies that he/she is authorized to sign the response for the submitting vendor and that the response is made without connection with any person, firm, or corporation making a response for the same goods and/or services and is in all respects fair and without collusion or fraud.
  • ADDITIONAL FEES AND CHARGES: Vendors shall include all applicable fees, charges, surcharges, shipping/handling, delivery, or any other charges associated with this solicitation in the price submitted.
  • QUESTIONS ABOUT THIS SOLICITATION: Unless otherwise indicated, questions regarding this solicitation must be directed to the Buyer listed.
  • TRANSACTION FEES: The awarded vendor shall pay a transaction fee of 0.75% (.0075) of the award, not to exceed $5,000 for each award. This transaction fee shall be based on the original award amount and the awarded vendor shall be responsible for payment of the fee to Tyler Hawaii, the vendor administering the HIePRO. Payment must be made to Tyler Hawaii within thirty (30) days of receipt of invoice. The invoice is generated based on the date the award is posted.
  • COMPLIANCE AND DOCUMENTATION: Vendors are required to be compliant with all appropriate state and federal statutes. Proof of compliance is required through HCE or via paper documentation.
  • RESPONSE TO THIS SOLICITATION: Only responses submitted through HIePRO shall be considered for award.