The purpose of this Request for Proposal (RFP) is to solicit offers from qualified TPAs to assist with administering the RMA and ORR-funded medical assistance for URMs. On average, there are 2,000 active RMA beneficiaries and each beneficiary receives up to eight months of health coverage, with the exception of the ORR-funded Medical Assistance for URM populations. USCRI is looking to ensure we have a financially competitive and affordable TPA with a strong knowledge of Medicaid and previous experience working with immigrants.
The scope of medical services must adhere to 45 CFR §400.105 and provide at least the same services in the same manner and to the same extent as under the state’s Medicaid program. The TPA must negotiate reimbursement rates for medical services that align with Medicaid rates in each state of operation. RMA has no copay, deductible or co-insurance.
TPAs responding to this proposal must be recognized claims administrators of self-insured medical assistance programs licensed to do business Texas, Maine, Kansas, Missouri, and Tennessee.
This RFP provides detailed program requirements. Each TPA must address these program requirements in their proposal submission. USCRI is looking for a TPA partnership that will provide claims processing in a timely and professional manner; maintain strong communications with USCRI and our partners; demonstrate organizational agility; and provide quality services to RMA beneficiaries. Preference will be given to a TPA with a competitive administrative cost.
Click here for a full copy of the Refugee Medical Assistance TPA RFP – 06.03.19