South Dakota State TPA Workers' Compensation

The State of South Dakota is seeking a licensed third‑party administrator (TPA) to manage its Workers’ Compensation claims program. The vendor will be responsible for full claims administration, medical case management, bill review, and Medicare/Medicaid reporting under MMSEA, while providing a secure, real‑time reporting platform and adhering to strict state IT‑security policies. The contract runs for three consecutive fiscal years (July 1 2027 – June 30 2030) with two optional one‑year extensions, and the State will award the contract in late December 2026. • Provide 24/7 injury reporting, intake, evaluation, payment, and electronic record‑keeping for all workers‑comp claims. • Deliver medical case‑management, bill‑review services, and MMSEA compliance reporting. • Implement a secure claims‑management information system with SSO, MFA, WCAG AA compliance, and real‑time dashboards; meet BIT security standards, background‑check, and BAA requirements. • Maintain a Preferred Provider Organization network, apply statutory discount rates, and support data export to State BI tools.