The State of Connecticut Department of Social Services (“Department” or “DSS”), the State Medicaid Agency, is requesting proposals from qualified organizations with demonstrated capabilities in projects involving recovery of Medicaid payments due to unwarranted Medicare claims denials or underutilized Medicare coverage. The Department seeks proposals from qualified bidders to provide legal assistance for Medicaid dual eligible clients to assist them in recovering denied Medicare coverage to which they are entitled. The bidders must demonstrate a record of accomplishments in obtaining Medicare coverage through the Medicare appeals process. Specifically, the Department seeks such assistance for Medicaid dual eligible clients inappropriately denied Medicare coverage for Skilled Nursing Facility (“SNF”) services and Home Health (“HH”) services covered by both the Medicare and Medicaid Programs. The Department is also accepting the proposal of other revenue projects to increase cost savings related to Medicare Maximization (“MMX”).
