BWC INDEPENDENT MEDICAL EXAMINATIONS AND FILE REVIEWS FOR THE BENEFIT OF OHIO’S WORKERS RFP
| Location: | Ohio |
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| Posted: | Mar 10, 2025 |
| Due: | Apr 9, 2025 |
| Agency: | State Government of Ohio |
| Type of Government: | State & Local |
| Category: |
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| Solicitation No: | SRC0000015818 |
| Publication URL: | To access bid details, please log in. |
| Solicitation ID: | SRC0000015818 |
| Solicitation Name: | BWC INDEPENDENT MEDICAL EXAMINATIONS AND FILE REVIEWS FOR THE BENEFIT OF OHIO’S WORKERS RFP |
| Original Begin Date: | 3/10/2025 3:54:30 PM |
| Begin Date: | 3/10/2025 4:18:56 PM |
| End Date: | 4/9/2025 1:00:00 PM |
| Inquiry End Date: | 4/2/2025 8:00:00 AM |
| Commodity: | Comprehensive health services |
| MBE Set Aside: | MBE Set Aside |
| Agency: |
BWC-Bur of Workers' Compensation
DAS-Administrative Services |
| Solicitation Status: | Open for Bidding |
| Solicitation Type: | Request For Proposal (RFP) (Double Envelope) |
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In an MBE set-aside solicitation, only those bidders/suppliers with an active MBE certification at the time the solicitation closes can submit a response
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Solicitation ID
SRC0000015818
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Solicitation Name
BWC INDEPENDENT MEDICAL EXAMINATIONS AND FILE REVIEWS FOR THE BENEFIT OF OHIO’S WORKERS RFP
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RFx Type
Request For Proposal (RFP) (Double Envelope)
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Lot #
1
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Solicitation Status
Open for Bidding
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Round #
2
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MBE Set Aside
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Begin Date
3/10/2025 4:18:56 PM (EST)
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Amendment?
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End Date
4/9/2025 1:00:00 PM (EST)
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Inquiry End Date
4/2/2025 8:00:00 AM
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Summary
*Amendment 1, resulting in Round 2, issued to make an administrative update in OhioBuys.
The purpose of this RFP is to solicit proposals for independent medical reviews and file reviews for the benefit of Ohio’s workers.
Purpose and Background The Ohio Bureau of Workers’ Compensation (the Agency) currently employs 1,600 employees, located throughout the state of Ohio. T he Agency is the largest exclusive state fund system in the United States, with assets of $22.4 billion and annual insurance premiums and assessments of $1.4 billion. The Agency is responsible for administrative and insurance functions, and the Industrial Commission of Ohio (IC) is responsible for adjudicative functions. As an independent agency of the State, the Agency processes claims, pays compensation and medical benefits to injured workers (IW), and underwrites workers’ compensation coverage for employers covered by the Ohio State Insurance Fund. In fiscal year 2023, the Agency provided workers’ compensation coverage to more than 258,000 employers, processed more than 80,000 new claims, paid out more than $1.2 billion in benefits, and carried an estimated $13.3 billion in discounted unpaid claim liabilities. The Agency is responsible for administering the workers’ compensation insurance program in Ohio. The Agency requires a method for injured workers residing in-state (defined as within Ohio and within 50 miles of its border in the contiguous states) and outside of Ohio (including out of country) to receive Exams and in-state file review services. The Agency operates under a managed care program, the Health Partnership Program (HPP), whereby the medical management of claims is the responsibility of Managed Care Organizations (MCO) that have applied and met requirements for providing medical management services in the Ohio workers’ compensation system. The responsibility for Exams, particularly Exams required by statute, remains with the Agency. Exams can be scheduled by the Agency and the MCO. File reviews are requested by the Agency. Exams are conducted as part of the Agency’s management of claims, with the overall goal of clarifying medical issues through objective clinical findings thoroughly documented in a written report. The Agency’s outcome of claims management is to assist the injured worker to functional improvement and return to work when possible. Agency claim operations staff request Exams and file reviews when the Agency deems it necessary or as required by statute.
Scope of Work Overview
An overview of the Work is provided below. The scope of work and requirements are provided in greater detail within Part 1, Scope of Work.
The Agency is seeking a contractor that can provide and manage the DEP, both in Ohio and for IWs residing out of State. The Contractor must follow the Agency DEP policies and procedures and train panel physicians on the documentation and billing requirements of the Agency.
Objectives
The Agency has the following objectives that it expects this Work to fulfill, and it will be the Contractor’s obligation to ensure that the personnel the Contractor provides are qualified to perform their portions of the Work: The Contractor must provide a method for injured workers residing outside of Ohio and in-State to receive the following:
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Process
OHIOBUYS TRAINING MATERIALS
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Ship To
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1 Record(s)
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3 Record(s)
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