DHS/Emergency Medical Assistance

The Minnesota Department of Human Services is seeking a contractor to manage, review, and process coverage determinations for Emergency Medical Assistance. The contractor will be responsible for reviewing Care Plan Certification (CPC) requests from providers, determining eligibility, and making recommendations for approval or denial. The contractor will also be responsible for maintaining an electronic document management system, providing customer service, and reporting to the state on CPC requests. The contract is expected to start on March 1, 2026, and end on February 8, 2028, with the possibility of three one-year extensions. • The contractor must employ medical professionals, including registered nurses and physicians, to perform EMA review functions. • The contractor must establish and maintain a provider call center to answer questions and provide information on CPC requests. • The contractor must review CPC requests within 15 business days and make determinations on approval or denial. • The contractor must submit monthly reports to the state on CPC requests and approvals. • The contractor must comply with all applicable laws and regulations, including those related to protected health information.