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Tennesseans 12+: Now Eligible for a COVID-19 Vaccine

Upcoming Procurements

Estimated Release Dates provided are based on calendar year and are subject to change.

MCO

  • RFP # 31865-00603
  • Release Date: June 11, 2021
    • * Posted (see link below)
  • Summary: 
    • The Division of TennCare seeks to secure contracts with three successful Respondents for the provision of statewide Medicaid managed care services for TennCare and CoverKids members and Medicare services for full benefit dual eligible beneficiaries who elect to enroll in the MCO’s aligned Dual Eligible Special Needs Plan (D-SNP). Tennessee's integrated, full-risk, Medicaid managed care program provides covered services to approximately 1.4 million Tennesseans and operates with an annual budget of approximately $12 billion. TennCare covers approximately 20 percent of the state’s population, 50 percent of the state’s births, and 50 percent of the state’s children.

Integration Services

  • Procurement Number: 31865-00616
  • Release Date: February 4, 2021
    • * Posted (see link below)
  • RFP Amendment 1 Release Date: February 16, 2021
  • RFP Amendment 2 Release Date: March 5, 2021
  • Summary:
    • TennCare will seek qualified respondents to support the design, development, implementation, operations, and maintenance of a public cloud-based Integration Services Layer that supports enterprise-wide configurations of multi-modular solutions/applications, among additional functionality.

      The Integration Services Layer (ISL) will include the following components:
      • Application Program Interface (API) Gateway and Proxy
      • Enterprise Service Bus (ESB)
      • Electronic Data Interchange (EDI)
      • Managed File Transfer (MFT)
      • Enterprise Content Management (ECM)

        The ISL vendor will also be expected to take-over and enhance TennCare’s current implementation and operation of:
      • Identity and Access Management (IAM)
      • Horizontal Portal

Data Ecosystem

  • Procurement Number: 31865-00619
  • Release Date: May 13, 2021

* Posted (see link below)

  • Summary:
    • TennCare will seek qualified respondents to support the design, development, implementation, operation, and maintenance of comprehensive Data Ecosystem consisting of data cleansing and loading, storage, analytics and data management functionality.
    • The State seeks a cloud-based Data Ecosystem Solution (DE Solution) for the following four (4) Data Ecosystem Components (DE Components):
      • Enterprise Data Warehouse (EDW)
      • Data Quality (DQ)/Extract-Transform-Load (ETL) Pipeline
      • Master Data Management (MDM)
      • Decision Support System (DSS)

Estate Recovery

  • Procurement Number: RFP #31865-00622
  • Release Date: April 1, 2021
    • * Posted (see link below)
  • Summary:
    • TennCare seeks to identify a Contractor to assist in the State’s Estate Recovery (ER) efforts by establishing and maintaining an ER case management system (ER CMS) to track those TennCare enrollees who die while receiving LTSS benefits, hereinafter referred to as “decedent” or “decedents,” and determining whether the decedents owned any real or personal property that can be accessed through the TennCare ER process to recoup the cost of care paid for by TennCare.

*Tentative release date and scope pending formal review and approval by TennCare.

Third Party Liability (TPL) Services

  • Procurement Number: RFP #31865-00624
  • Estimated Release Date: Q3 2021
  • Summary:
    • Third Party Liability (“TPL”) refers to the legal obligation of third parties (for example, certain individuals, entities, insurers, or programs) to pay part or all the expenditures for assistance furnished under a State Medicaid program (TennCare is the State’s single state agency Title XIX Medicaid program.)
    • The purpose of this RFP is to identify a supplier to (1) Identify TPRs and assist TennCare with maintenance of TennCare’s Resource File, (2) Identify and recover casualty subrogation related to Pharmacy Claims, Dental Claim and Mass Torts, (3) Provide Medicare Outreach to encourage TennCare Members who are eligible for Medicare to apply for Medicare, (4) Perform an annual review of the payment of Medicare crossover claims by TennCare and its Partners, (5) Provide Credit Balance Audits and recover recoupments, (6) Perform go-behind billing, and (7) Perform additional recovery projects as authorized by TennCare and agreed to by the parties.

*Tentative release date and scope pending formal review and approval by TennCare.

Fraud, Waste, and Abuse

  • Procurement Number: 31865-00620
  • Estimated Release Date: Q3 2021
  • Summary:
    • TennCare Seeks a Program integrity (PI) solution that meets the following identified needs:
      • A case management (CM) solution to manage the process, communications, assignments, documentation, status, and results throughout the life cycle of a referral/lead being escalated, investigated, and settled/prosecuted
      • A data analytics component to improve TennCare’s ability to triage, validate, and escalate both self-generated and third-party-referred leads related to Fraud, Waste, and Abuse (FWA), and to help prevent improper payments related to FWA before payments are made. This includes components that include controls to minimize the risk of increasing volume due to false positives.

*Tentative release date and scope pending formal review and approval by TennCare and CMS.

If you are interested in any of the above procurements and would like further information, please email matt.brimm@tn.gov with a cc to Donovan.Morgan2@tn.gov.

*POSTED – Central Procurement Office (CPO) Request for Proposals (RFP) Opportunities

http://tn.gov/generalservices/procurement/central-procurement-office--cpo-/supplier-information/request-for-proposals--rfp--opportunities1.html