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Brass and Bronze Maintenance


Location
Wisconsin
Publication Date
12/27/2018 06:55 AM EST
Closing Date
01/29/2019 03:00 PM EST
Issuing Organization
State of Wisconsin - Department of Administration
Solicitation Number
Description

Specifications include, but are not limited to: 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes. 1. General Administration & Services Contractor must administer the plan in a manner consistent with all applicable laws and regulations, as well as with the requirements set forth by UT System in this RFP. Contractor must provide all services associated with the administration of the plan and may recover the cost of compliance with the requirements associated with general administration and services only by making provision for such cost in Section 6. Contractor must provide general administrative support, legal and technical assistance, quality assurance, and certain reporting as required for the operation of the self-funded UT SELECT Medical plan. 2. Cost Containment a) Contractor must have comprehensive cost containment programs in place that includes the following elements at minimum: • Pre-Authorization; • Fraud detection; • Emerging therapies; • Wellness and condition management; • Coverage management; • Utilization management; and • Coordination of benefits. b) Contractor must comply with all applicable state and federal laws, regulations, and protocols and must also comply with all UT System policies, which may be updated as necessary. c) Contractor must have the ability to effectively administer clinical programs in line with those currently in place. d) Contractor must provide subrogation services, as appropriate, including: • Investigating claims to determine potential third-party liability; • Contacting participants to obtain information related to third-party liability; • Initiating demands and filing liens to protect the plan’s interests; • Initiating or intervening in litigation when necessary; and • Employing or retaining legal counsel for such purposes.

Source
https://esupplier.wi.gov/psp/esupplier/SUPPLIER/ERP/h/?tab=WI_BIDDER (opens in a new window)

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