Mississippi Division of Medicaid - External Quality Review Organization (EQRO) Services - RFP # 20260731 / RFx # 3160008164 (2026)
Mississippi Division of MedicaidState · Jackson, MS- Due
- Sep 18, 2026
- Deadline passed
- Posted
- Jul 31, 2026
- Contract term
- 3 years
- Primary contact
- Sharon Clark
- (601) 359-6153
The 30-second brief
The Mississippi Division of Medicaid (DOM) is seeking proposals for External Quality Review Organization (EQRO) services to support the Mississippi Coordinated Access Network (MississippiCAN) and the Mississippi Children's Health Insurance Program (CHIP). The selected contractor will perform mandatory and optional EQR activities in compliance with 42 CFR Part 438, Subpart E, including validating performance improvement projects (PIPs), validating performance measures, conducting annual quality surveys (AQS), validating network adequacy, reviewing encounter data, and assisting with quality rating systems (QRS). Additional activities include quality improvement committee participation, compliance review and CAP validation, HEDIS and CAHPS analysis, provider directory accuracy audits, and mental health and substance use disorder parity (MHPAEA) reviews. Proposals are due by September 18, 2026, at 2:00 PM CT, via DOM's secure SharePoint platform following a mandatory SharePoint Access Request due by September 9, 2026.
External Quality Review Organization (EQRO) Services, PIP Technical Papers, Annual PIP Summary Report, Annual Performance Measure Validation report, AQS Criteria Tools, AQS Deeming Table, AQS Technical Papers, AQS Summary Report, Annual Network Adequacy (ANA) report, Provider Data Validation (PDV) report, Quality-of-Care Survey report, Additional performance measures and related analyses, Focus Studies of Health Care Quality, Quality Rating System (QRS) development and data validation, Quality Companion Guide, Corrective Action Plan (CAP) validation and monitoring summary reports, Annual EQR Technical Report, HEDIS and CAHPS annual comparative analyses, Annual review of Quality Strategy effectiveness, Evaluation of Provider Directory Accuracy final reports, Behavioral Health Member Satisfaction Survey (ECHO) analysis reports, Readiness Review reports and tracking reports, Mental Health and Substance Use Disorder Parity compliance reports, Annual Cost Allocation Plan report, Annual EQRO Staffing and Work Plan, Monthly Work Plan Summary Reports, Detailed procedures and protocols, Turnover Plan, Turnover Results Report
Price (35 points / 35%), Technical Proposal - Methodology (20 points / 20%), Technical Proposal - Work Plan and Schedule (15 points / 15%), Management Proposal - Corporate Background and Experience (20 points / 20%), Management Proposal - Organization and Staffing (10 points / 10%), Transmittal Letter (Pass/Fail), Executive Summary (Pass/Fail), Ownership and Financial Disclosure Information (Pass/Fail)
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Summary
The Mississippi Division of Medicaid (DOM) is seeking proposals for External Quality Review Organization (EQRO) services to support the Mississippi Coordinated Access Network (MississippiCAN) and the Mississippi Children's Health Insurance Program (CHIP).
The selected contractor will perform mandatory and optional EQR activities in compliance with 42 CFR Part 438, Subpart E, including validating performance improvement projects (PIPs), validating performance measures, conducting annual quality surveys (AQS), validating network adequacy, reviewing encounter data, and assisting with quality rating systems (QRS). Additional activities include quality improvement committee participation, compliance review and CAP validation, HEDIS and CAHPS analysis, provider directory accuracy audits, and mental health and substance use disorder parity (MHPAEA) reviews. Proposals are due by September 18, 2026, at 2:00 PM CT, via DOM's secure SharePoint platform following a mandatory SharePoint Access Request due by September 9, 2026.
EVALUATION CRITERIA
Price (35 points / 35%), Technical Proposal - Methodology (20 points / 20%), Technical Proposal - Work Plan and Schedule (15 points / 15%), Management Proposal - Corporate Background and Experience (20 points / 20%), Management Proposal - Organization and Staffing (10 points / 10%), Transmittal Letter (Pass/Fail), Executive Summary (Pass/Fail), Ownership and Financial Disclosure Information (Pass/Fail)
REQUIRED DELIVERABLES
29- External Quality Review Organization (EQRO) Services
- PIP Technical Papers
- Annual PIP Summary Report
- Annual Performance Measure Validation report
- AQS Criteria Tools
- AQS Deeming Table
- AQS Technical Papers
- AQS Summary Report
- Annual Network Adequacy (ANA) report
- Provider Data Validation (PDV) report
- Quality-of-Care Survey report
- Additional performance measures and related analyses
- Focus Studies of Health Care Quality
- Quality Rating System (QRS) development and data validation
- Quality Companion Guide
- Corrective Action Plan (CAP) validation and monitoring summary reports
- Annual EQR Technical Report
- HEDIS and CAHPS annual comparative analyses
- Annual review of Quality Strategy effectiveness
- Evaluation of Provider Directory Accuracy final reports
- Behavioral Health Member Satisfaction Survey (ECHO) analysis reports
- Readiness Review reports and tracking reports
- Mental Health and Substance Use Disorder Parity compliance reports
- Annual Cost Allocation Plan report
- Annual EQRO Staffing and Work Plan
- Monthly Work Plan Summary Reports
- Detailed procedures and protocols
- Turnover Plan
- Turnover Results Report
REQUIRED ATTACHMENTS
20- Transmittal Letter
- Addendum 1 - Executive Summary
- Addendum 2 - Methodology
- Addendum 3 - Work Plan and Schedule
- Addendum 4 - Corporate Background and Experience (References)
- Addendum 5 - Organization and Staffing
- Addendum 6 - Ownership and Financial Disclosure Information
- Addendum 7 - Cost Proposal Worksheet
- Disclosure of Subcontractor Information
- DHHS Certification Drug-Free Workplace
- Certification Debarment
- Suspension
- Other Responsibility Matters
- Proprietary Information Form
- References
- Acknowledgement of Amendments
- Business Associate Agreement
- Proposal Response Checklist
- Financial Disclosure Information
- SharePoint Access Request Form
REQUIRED STAFFING
4- Submit to
- https://www.ms.gov/dfa/contract_bid_search/Bid?autoloadGrid=False
- Duration
- 60 months
- Scope location
- Jackson, Mississippi
Questions about this RFP
How do I respond to this RFP from Mississippi Division of Medicaid?
Review the full solicitation document for submission requirements, evaluation criteria, and deadlines. The submission deadline is September 18, 2026. The solicitation specifies required deliverables that must be addressed in your response. Be sure to include all required attachments as outlined in the solicitation. Submissions should be delivered to: https://www.ms.gov/dfa/contract_bid_search/Bid?autoloadGrid=False. For questions, contact Sharon Clark.
Can small businesses or minority-owned firms bid on this RFP?
Most government agencies, including Mississippi Division of Medicaid in MS, encourage participation from small businesses, minority-owned, women-owned, and disadvantaged business enterprises (MBE/WBE/DBE). Check the full solicitation for any small business participation goals.
What happens after the RFP submission deadline?
After the deadline, the issuing agency reviews all submissions against the stated evaluation criteria. This typically includes a compliance check, technical evaluation, cost analysis, and may involve oral presentations with shortlisted vendors.
Can I ask questions about this solicitation before submitting?
Yes, most solicitations allow vendors to submit questions during a designated period. The primary contact is Sharon Clark at (601) 359-6153. Questions and answers are typically shared with all prospective bidders.
What staffing is required for this project?
This solicitation outlines specific staffing requirements. The required roles include: Account Manager, Statistician/Data Analyst, Licensed Clinician, Behavioral Health Specialist. Proposers should demonstrate relevant qualifications and experience for each required role.
What are the key deliverables?
The solicitation specifies the following deliverables: External Quality Review Organization (EQRO) Services, PIP Technical Papers, Annual PIP Summary Report, Annual Performance Measure Validation report, AQS Criteria Tools, AQS Deeming Table, AQS Technical Papers, AQS Summary Report, Annual Network Adequacy (ANA) report, Provider Data Validation (PDV) r. Proposals should clearly address how each deliverable will be met.
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What are the evaluation criteria for this solicitation?
This solicitation includes specific evaluation criteria that will be used to score proposals. The criteria include: "Price (35 points / 35%), Technical Proposal - Methodology (20 points / 20%), Technical Proposal - Work Plan and Schedule (15 points / 15%), Management Proposal - Corporate Background and Experience (2..." Vendors should carefully align their proposals with each criterion to maximize their score.
Where can I find more RFPs from Mississippi Division of Medicaid?
All active and historical solicitations from Mississippi Division of Medicaid are tracked and searchable. As a state agency, Mississippi Division of Medicaid regularly publishes solicitations. Visit the agency profile to see current open bids, past contracts, vendor relationships, and decision-maker contacts.
What is the contract term for this solicitation?
The anticipated contract term is 3 years. Contract terms may include renewal options.
What documents are required to bid on this RFP?
Requirements vary by solicitation, but common documents include a technical proposal, cost/price proposal, proof of insurance, relevant certifications, past performance references, and any forms specified in the solicitation. This solicitation specifically requires the following attachments: Transmittal Letter, Addendum 1 - Executive Summary, Addendum 2 - Methodology, Addendum 3 - Work Plan and Schedule, Addendum 4 - Corporate Background and Experience (References), Addendum 5 - Organizat. Additionally, proposals should address staffing requirements as outlined in the solicitation. Review the full document from Mississippi Division of Medicaid for the complete list.
What is the scope of this project?
This solicitation defines a specific project scope. The scope covers the following locations: Jackson, Mississippi. Review the full solicitation for detailed scope requirements.