Medicaid Rate Analysis and Reimbursement Services

The State of Wyoming, through its Department of Health – Division of Healthcare Financing, seeks a single contractor to provide comprehensive Medicaid rate setting, analysis, reimbursement assistance, audit, research, and policy compliance services across all Medicaid program areas. The contractor will support technical assistance for rate development, perform audits of provider cost reports, conduct policy research, and deliver ongoing reporting and on‑request support for a multi‑year contract (up to 5 years). The work includes analysis of ambulance, DME, FQHC, HCBS waivers, inpatient, outpatient, RBRVS, rural health clinics, and other programs, as well as external quality review and independent assessment activities. Deliverables are tied to specific schedule items and must be completed on a defined timeline with quarterly and annual reporting requirements. • Provide Medicaid rate development and UPL calculations for all program categories • Conduct audits, cost‑report reconciliations, and trend analyses per GAAP • Perform research, policy analysis, and support for state/federal initiatives • Deliver quarterly updates, annual EQR/IA reports, and on‑request technical assistance • Manage project with a detailed work plan, QA/QC, and regular status reporting