Specifications include, but are not limited to: design and implement a pilot program for the purposes of preventing, detecting and reducing fraud, waste and abuse in the State’s Medicaid program. Successful bidder’s primary goal is to implement an innovative solution to reduce fraud, waste or abuse, which includes reducing inefficient and overutilization of services. Solutions may include, but are not limited to: identifying improper requests for services or payments before delivery or payment, preventing improper payments to providers, vendors or MCO’s and/or to recouping improper payments previously made in the Medicaid program. The bidder must also be able to demonstrate cost-effectiveness in the solution proposed, be able to monitor progress of the solution and be able to timely and accurately report results.
