TPA for Off-Site Inmate Medical and Pharmacy Services

RFP NOTICE
Polk County, a political subdivision of the State of Florida, requests the submittal of
proposals from vendors that are interested in providing TPA for Off-Site Inmate
Medical and Pharmacy Services as described herein. Sealed proposals must be
received in the Procurement Division, prior to the due date and time listed below.
RFP Number and Title: 26-384
Description: Provide TPA for Off-Site Inmate Medical and Pharmacy Services
Receiving Period: Prior to 2:00 p.m., September 16, 2026, at 2:00 p.m. or as soon as
possible thereafter.
This form is for RFP registration only. Please scroll down for additional information.
Special Instructions: N/A.
Questions regarding this RFP must be in writing and must be sent to Tabatha Shirah
Procurement Analyst, via email at tabathashirah@polkfl.gov. All questions must be
received by Wednesday, September 9, 2026, 5:00 p.m..
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RFP REGISTRATION
You must register using this form to receive notice of any addenda to these documents.
Please email the completed form to the Procurement Division as soon as possible. It is
the vendor's responsibility to verify if addenda have been issued.
RFP Number: 26-384
RFP Title: TPA for Off-Site Inmate Medical and Pharmacy Services
This form is for bid registration only. Please scroll down for additional information.
Carefully complete this form and return it to the Procurement Division via e-mail to
procurement@polkfl.gov. You must submit one form for each solicitation that you are registering
for.
Company Name: __________________________________________________
Contact Name: ____________________________________________________
Mailing Address: ___________________________________________________
City: _____________________________________________________________
State: ____________________________________________________________
Zip Code: _________________________________________________________
Phone Number: ____________________________________________________
Email: ____________________________________________________________
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PROPOSAL SUBMITTAL INSTRUCTIONS
Proposers must submit their proposal prior to 2:00 p.m. on the receiving date. Proposals
must be submitted in a "sealed" parcel or electronically through Polk County's secure
website, Kiteworks. Proposals will be publicly opened at 2:00 p.m. on the receiving date.
Sealed Parcel Submittal:
If you are submitting a sealed parcel proposal submit one (1) original marked
ORIGINAL and five (5) copies marked COPY of the proposal in a sealed parcel to the
Procurement Division. The parcel should be labeled "RFP #26-384, TPA for Off-Site
Inmate Medical and Pharmacy Services" and marked with the proposer's name and
address. The Proposals may be mailed or delivered to:
Polk County Procurement Division
330 West Church Street, Room 150
Bartow, FL 33830
To assist with labeling the sealed parcel, please cut along the outer border and affix this
label. Be sure to include the name of the company submitting the proposal where
requested.
Sealed Proposal. DO NOT OPEN
RFP Number 26-384
RFP Title TPA for Off-Site Inmate Medical and
Pharmacy Services
Due Date/Time: September 16, 2026, prior to 2:00 pm
Submitted by:
Deliver To: Polk County Procurement Division
330 West Church Street, Room 150, Bartow,
Florida 33830
Proposals may be mailed, express mailed or hand delivered. It is the Proposers
responsibility to ensure their package is delivered to the Procurement Division prior to
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2:00 p.m. on the Receiving date and time referenced above. Proposals delivered at 2:00
p.m. or later will not be accepted.
Electronic Proposals Submittal:
All prospective Proposers that are interested in submitting their proposals electronically
can do so via the County's secure electronic submittal website, Kiteworks. Proposers
must email tabathashirah@polkfl.gov at least 48 hours prior to opening to receive a link
to upload their submittal. Please only upload your documents as a PDF or Excel file for
the Cost Tab, if applicable. Please use the name convention of your files as follows:
"RFP 26-384 Tab 1"
"RFP 26-384 Tab 2"
"RFP 26-384 Tab 3"
"RFP 26-384 Tab 4"
For more instructions, a video tutorial has been produced to further explain the
electronic solicitation submittal process. It can be found by clicking here for RFP
Submittals: https://youtu.be/vkn_7AHgioE. If you need assistance accessing this
website due to ADA or any other reason, please email Tabatha Shirah at
tabathashirah@polkfl.gov
Procurement recommends that Proposers submitting electronically double check the
documents submitted into Kiteworks to ensure all requested tab information has been
uploaded. Failure to upload the requested tab information may result in the proposal
being deemed nonresponsive.
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POLK COUNTY
Procurement Division
Fran McAskill
Procurement Director
REQUEST FOR PROPOSAL 26-384
TPA for Off-Site Inmate Medical and Pharmacy Services
Sealed proposals will be received in the Procurement Division, Wednesday, September 16,
2026, prior to 2:00 p.m.
Attached are important instructions and specifications regarding responses to this Request for
Proposal (the "RFP"). The failure of a responding proposer (a "Proposer") to follow these
instructions could result in Proposer disqualification from consideration for a contract to be
awarded pursuant to this RFP.
This document is issued by Polk County (the "County") which is the sole distributor of this RFP
and all addenda and changes to the RFP documents. The County shall record its responses to
inquiries and provide any supplemental instructions or additional documents pertaining to this
RFP in the form of written addenda to the RFP. The County shall post all such addenda,
together with any other information pertaining to this RFP, on the County's website at
https://www.polkfl.gov/business/procurement/. It is the sole responsibility of each Proposer to
review the website prior to submitting a responsive proposal (a "Proposal") to this RFP to
ensure that that the Proposer has obtained all available instructions, addenda, changes,
supporting documents, and any other information pertaining to this RFP.
The County is not responsible for any solicitations issued through subscriber, publications, or
other sources not connected with the County and the Proposer should not rely on such sources
for information regarding the RFP solicitation.
Questions regarding this RFP must be in writing and must be sent to Tabatha Shirah, Senior
Procurement Analyst, via email at tabathashirah@polkfl.gov. All questions must be received
by Wednesday, September 9, 2026, 5:00 p.m.
Proposers and any prospective proposers shall not contact, communicate with or
discuss any matter relating in any way to this RFP with any member of the Polk County
Board of County Commissioners or any employee of Polk County other than the County
Procurement Director or the individual designated above. This prohibition begins with
the issuance of the Request for Proposal and ends upon execution of the final contract.
Any such communication initiated by a Proposer or prospective proposer shall be
grounds for disqualifying the offender from consideration for a contract to be awarded
pursuant to this RFP and for contracts to be awarded pursuant to RFPs or Requests for
Bid that the County may issue in the future.
A Proposer's responsive Proposal to this RFP may be mailed, express mailed, or hand
delivered to:
Polk County Procurement Division
330 West Church Street, Room 150
Bartow, Florida 33830
(863)534-6757
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Introduction/Background
Polk County, a political subdivision of the State of Florida, needs a Third-Party
Administrator (TPA) to provide comprehensive management of off-site inmate medical
and pharmacy services for the Polk County Jail system.
TPA services include the administration of inmate off site medical claims, management
of on site ancillary medical services, access to a network of providers, and pharmacy

benefit management (PBM) for select institutional and specialty medications utilized

within the Polk County Jail system as further outlined in the Scope of Work below.
Off-site medical services are to be provided through a network of providers contracted by
the TPA. The TPA will adjudicate and pay all off-site provider claims, and those payments
are reimbursed by the County.
TPA pharmacy services for bulk and institutional prescription drugs prescribed by onsite
contracted vendor.
Based upon the prior 12-month period, the TPA will provide approximately 7,632
outpatient claims for emergency room, non-emergent hospital outpatient services,
specialist physician services and ancillary services. The TPA is obligated to adjudicate
inpatient claims for services received by Polk County inmates and/or those not eligible for
Medical Assistance.
The Polk County Sheriff's Office (PCSO) on average housed 2699 inmates daily. They
process 27,742 intakes annually.
The Polk County Sheriff's Office provides basic healthcare through an onsite medical
service provider through a separate third-party vendor.
Inmates currently receive emergency and specialty care offsite through a contracted
network managed by Heritage Health Solutions, Inc
It is the intent of the County to enter into an agreement with one firm.
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QUALIFICATIONS:
Mandatory Licensing, Accreditation, and Compliance Requirements
The TPA, or their subcontractor engaged to perform TPA related functions under this
Agreement, must possess and maintain all qualifications as noted below.

* Florida Department of State
Certificate of Status. Proposers and any subcontractor acting as
either the TPA or PBM must have a Certificate of Status issued by
the Florida Department of State (Sunbiz), dated within 60 days of
submitting a proposal
* Licensure:
Insurance Administrator License (TPA) Proposers or their
o
proposed subcontracted TPA must hold an Insurance Administrator
License. An active Certificate of Authority as an Insurance
Administrator issued by the Florida Office of Insurance Regulation
(OIR), as required by Florida Statute 626.881.
Pharmacy Benefit Manager Registration (PBM). Proposers or
o
their proposed subcontracted PBM must hold an active Certificate
of Authority as an Insurance Administrator issued by the Office of
Insurance Regulation (OIR), as required by Florida Statute
626.881.
* URAC Accreditation:
Proposers or their proposed subcontracted TPA must hold a
current "Full" Certification from the Utilization Review Accreditation
Commission (URAC).
* Experience:
The Proposer must have a minimum of three consecutive years of
o
experience, within the past three years, providing similar size and
scope work for corrections and/or other governmental agency. Similar
size and scope include experience providing both off-site medical and
pharmacy services as outlined in this RFP under one contract with the
corrections or governmental agency.
* Provider Network Contracts:
Proposers or their proposed subcontracted TPA must currently have a
o
correctional contract or Sole Source Agreements with all 6 hospitals in
Polk County to provide inmate emergency room and non-emergency
hospital care.
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Proposers or their proposed subcontracted TPA must currently have
o
Preferred Provider Organization (PPO) correctional network contracts with
Polk County vendors to provide laboratory, radiology, ultrasound, dialysis,
vision, dental, specialized respiratory therapies, etc. services.
* IT Integration:
TPA must have the capability to interface with the PCSO's Jail
o
Management System (JMS) and Electronic Health Record (EHR) for
eligibility verification and ordering.
SCOPE OF SERVICES
The proposed award encompasses the comprehensive administration and management
of inmate medical and pharmacy services for the Polk County Jail system, including but
not limited to:
* Processing and adjudication of off-site inmate medical claims and of on-site
ancillary medical services (e.g., mobile radiology, ultrasound, dialysis, vision,
specialized/respiratory therapy, and laboratory services), including adherence to
prompt payment requirement and denial of pre-booking claims.
* Provide pharmacy services for bulk and institutional prescription medications not
covered by the base compensation to the on-site medical provider; this includes,
but is not limited to, HIV antiretroviral agents, immunosuppressants, renal and
mineral metabolism agents, and erythropoiesis-stimulating agents (ESAs).
* Application of Medicare-based statutory repricing per Florida Statute 901.35 and
House Bill 4059 (2026).
* Assuring availability of access to a contracted and credentialed correctional PPO
provider network, including all Polk County hospitals, AdventHealth-Sebring, and
ancillary service providers for both central and south county jail facilities.
* Provider contracting and relationship management to ensure network stability;
provision of an in-house call center to handle provider inquiries, minimizing direct
contact with the BOCC or PCSO.
* Utilization management and medical necessity review of precertification of
outpatient facility testing and procedures.
* Financial administration, including claims payment services and a Zero-Balance
Account (ZBA) funding model.
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* Reporting and analytics, including inmate healthcare utilization forecasting, high
dollar claims, quarterly executive report package, annual incurred but not-
reported (IBNR) calculations, and full-year claims liability projections.
* Participate in quarterly inmate billing offsite review meetings with the Polk County
Sheriff's Office.
* Integration with jail medical and records management systems.
* Claims subrogation, recovery services, and fraud prevention services.
The cost to provide the services will be negotiated during Elevation Level 4, Contract
Negotiations.
The County shall request the services on an as-needed basis. There is no guarantee
that any or all of the services described in the agreement will be assigned during the
term of the agreement. Further, the Consultant is providing these services on a
nonexclusive basis. The County, at its option, may elect to have any of the services set
forth herein performed by other consultants or County staff.
AGREEMENT
The term of this agreement will be negotiated as part of Elevation Level 4, Contract
Negotiations.
SUBMITTAL
Submittals should not contain information more than that requested, must be concise, and must
specifically address the issues of this RFP. The responses should be in the same order as the
selection and evaluation procedures. Proposals are to be printed double-sided. Unnecessarily
elaborate brochures or other presentations beyond those sufficient to present a complete and
effective submittal to this solicitation are not desired and may be construed as an indication of
the proposer's lack of cost consciousness. Elaborate artwork, expensive visual aids, and other
presentation aids are neither necessary nor desired, unless specifically requested. The proposal
submittals should be contained within a three (3) ring binder (original and each copy in separate
binders). Each submittal should contain:
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Tab 1, Introduction:
* Introduction letter describing your firm, experience, number of years in business,
contact name, title, company address, phone number and email address of contact
person. (One page, single or double sided)
* Qualifications:
Please provide the following information within Tab 1, to show your firm meets
o
the qualifications of this RFP:
Florida Department of State
o
Certificate of Status. Proposers and any subcontractor acting as
either the TPA or PBM must have a Certificate of Status issued by
the Florida Department of State (Sunbiz), dated within 60 days of
submitting a proposal.
* Please provide a copy of the Certificate of Status.
Licensure:
o
Insurance Administrator License (TPA) Proposers or their
o
proposed subcontracted TPA must hold an Insurance Administrator
License. An active Certificate of Authority as an Insurance
Administrator issued by the Florida Office of Insurance Regulation
(OIR), as required by Florida Statute 626.881.
Please provide a copy this license
Pharmacy Benefit Manager Registration (PBM). Proposers or
o
their proposed subcontracted PBM must hold an active Certificate
of Authority as an Insurance Administrator issued by the Office of
Insurance Regulation (OIR), as required by Florida Statute
626.881.
Please provide a copy of the active Certificate of Authority
URAC Accreditation:
o
* Proposers or their proposed subcontracted TPA must hold a
current "Full" Certification from the Utilization Review
Accreditation Commission (URAC).
Please provide a copy of the "Full" Certification from
o
the URAC.
Experience:
o
The Proposer must have a minimum of three consecutive years of
o
experience, within the last three years, providing similar size and
scope work for corrections and or other governmental agency. Similar
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