Specifications include, but are not limited to: The objectives of this RFP are to seek Offerors capable of providing the Department with retrospective review services as the Department’s Recovery Audit Contractor (“RAC”), and with TPL services, including data exchanges and post-payment recoveries. The selected Offeror for Lot 1 will utilize data exchanges to identify other health care coverage that is primary to MA to enable the Department to cost-avoid claims where primary coverage is available; recover reimbursement from primary health care coverage where MA payment has already been made; and identify and report health care coverage available for child support cases. The selected Offeror for Lot 2 will supplement the Department’s fraud, waste, and abuse prevention and detection program. The Department is required to establish a Medicaid RAC program to assist in identification and recovery of improper payments on a contingency fee basis. Lot 1: • Conduct data exchanges for resource identification and cost avoidance; • Maintain relationships with all health insurance carriers; and • Perform post payment recoveries. Lot 2: • Identify improper overpayments and underpayments; • Identify potential scenarios of fraud, waste and abuse; • Analyze, audit and validate all identified improper payments; • Generate timely correspondence and reports through each step of the review process; • Provide customer service measures and assist the Department in resolution of claim disputes; and • Manage cases, track and retain records.