YH27-0002 AHCCCS Medicaid School-Based Claiming RFP

Arizona’s Health Care Cost Containment System is seeking a single‑entity third‑party administrator to manage the state Medicaid School‑Based Claiming (MSBC) program. The contractor will act as the point of contact for all Local Education Agencies (LEAs), provide a statewide toll‑free help line, develop and manage Model Participation Agreements, deliver extensive education, training, and technical assistance, and process both Direct‑Medical (DSC) and Administrative (MAC) claims. The work includes a compliance‑review program, electronic pre‑payment review system, quarterly certification of state matching funds, annual audited financial reporting, and strict security requirements (GovRAMP, HIPAA BAA, insurance, performance and fidelity bonds). The contract term is three years with two one‑year renewal options (up to five years total).