MEDICAID MANAGED CARE RATE SETTING/PROGRAM ADMIN

The State of West Virginia, through its Department of Human Services – Bureau for Medical Services, is issuing a Centralized Request for Proposals to establish a multi‑year contract for Medicaid Managed Care Rate Setting, program administration, and actuarial services. The award will provide a lead actuary, staff actuaries, technical support, clerical support, managed‑care program oversight, ad‑hoc oversight, financial services, and optional rate‑setting services. The base period covers one year with optional renewal years (up to two additional years). Services are quantified primarily by annual hour estimates (e.g., 5,000 hrs for lead actuary, 20,000 hrs for staff actuaries, etc.) and fixed‑price components for oversight and financial services. Bidders must submit a detailed technical and cost proposal by the deadline; online responses are prohibited and all questions must be submitted in writing to the listed buyer. • Scope includes actuarial analysis, rate‑setting methodology, program oversight, and related technical/clerical support. • Annual hour estimates: Lead Actuary 5,000 hrs, Staff Actuaries 20,000 hrs, Technical Support 5,000 hrs, Clerical Support 5,000 hrs. • Fixed‑price services: Managed Care Program Oversight, Financial Services, and optional Rate‑Setting. • Base contract term: 1 year with optional renewal years 1 and 2. • Submission deadline: 25 Aug 2026 13:30; solicitation issued 16 Jul 2026. • Primary contact: Crystal G. Hustead, Buyer, (304) 558‑2402, [email protected].