Active SLED Opportunity · NEW MEXICO · NEW MEXICO HUMAN SERVICES DEPARTMENT
AI Summary
RFP for a Fiscal Intermediary Agent to administer payment and reimbursement services for the New Mexico Brain Injury Services Fund, supporting individuals with brain injuries statewide. Services include financial management, provider network administration, and reporting.
The purpose of this Request for Proposals (RFP) is to solicit sealed proposals to establish a contract with a qualified professional agency to serve as the Fiscal Intermediary Agent (FIA) for the New Mexico Health Care Authority (HCA) Brain Injury Services Fund (BISF) Program. These services are funded through the Brain Injury Services Fund and administered in accordance with 8.326.10 NMAC. Contracted Fiscal Intermediary Agent services are sought to support New Mexicans with traumatic or other acquired brain injuries by administering payment and reimbursement for authorized brain-injury-specific services and goods as assessed and referred through service coordination. FIA services are provided statewide and support the delivery of BISF services authorized for eligible participants. The specific Fiscal Intermediary services required under this RFP include processing payments and reimbursements for authorized services and goods; administering a specialized provider network willing to serve individuals with brain injury; maintaining financial controls and accountability mechanisms; tracking expenditures and utilization; and producing required fiscal and programmatic reports. The FIA does not provide direct participant services and does not determine eligibility or authorize services. Offerors may submit proposals in response to both the Fiscal Intermediary Agent (FIA) RFP and the Service Coordination Agency (SCA) RFP. However, an Offeror may be awarded only one of the two service components and may not provide both Fiscal Intermediary and Service Coordination services to enrolled participants of the BISF Program. This restriction is intended to prevent actual or perceived conflicts of interest in accordance with 8.326.10 NMAC. As a payer of last resort, the BISF Program provides authorized services and goods when such services are not available through other responsible payer sources. Fiscal Intermediary services support BISF service delivery in one hundred eighty (180) day increments, until a participant becomes eligible to receive needed services through another payer source or until the identified crisis need is otherwise resolved, allowing the individual to function independently in their home and community. The projections outlined below are intended to inform Offerors of anticipated service demand and contractor capacity expectations over the upcoming contract terms. BISF Enrollment Trend and Projected Enrollment FY24 (actual) FY25 (actual) FY26 (as of Q2) FY27 (Projected) FY28 Projected FY29 (Projected) FY30 (Projected) 138 112 99 125 130 135 140 All Fiscal Intermediary services shall be delivered in accordance with 8.326.10 NMAC, BISF Service Standards, and any subsequent regulations, policies, or written guidance issued by HCA.
SLED stands for State, Local, and Education. These are solicitations issued by state governments, counties, cities, school districts, utilities, and higher education institutions — as opposed to federal agencies.
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