The California Department of Health Care Services on July 1 released a draft RFP for the Personal Injury and Workers’ Compensation Recovery Program (PIWCRP).
A single firm or multiple firms will provide services "related to Medi-Cal recoveries for health-care costs incurred from casualty insurance claims filed with insurance carriers."
The project has a technology component. Proposing firms will be asked to describe their electronic case management system and system for discovery and identification of potential insurance cases.
The Department of Health Care Services intends to expand the PIWCRP program, according to an RFI issued earlier this year: "The current contract, which expires April 30, 2017, is limited to identification and recovery of worker’s compensation claims; however, DHCS seeks to expand the contract to include all casualty insurance and tort action claims unidentifiable by the state."
The Affordable Care Act has generated more casualty insurance and tort action claims that are subject to Medi-Cal recovery, according to the department.
The electronic case management system or systems "shall be developed to provide for the following functions: data collection and analysis, identification of potential case referrals, case development, initiation of liens or claims and demand notices, case maintenance, case recovery, case reporting, case closure, and accounting," the draft RFP says.
According to the draft bid document, "the case management system(s) will support Department of Industrial Relations (DIR) file matches, data collection, recovery, and identification data and the Medi-Cal claims management, accounting, and reporting functions."
The chosen firm will take over for an existing contractor.
