MN HF1090

Commissioner of management and budget must issue a request for proposals by [date blank], 2011 for dependent eligibility verification audit services covering state-paid hospital, medical, and dental benefits.

Vendor must conduct a document-model audit of all plans under Minnesota Statutes sections 43A.22 to 43A.31 and identify ineligible dependents covered by the plans.

Vendor must implement an ongoing eligibility verification process following completion of the initial dependent eligibility verification audit.

Vendor must meet minimum criteria including a rules-based platform with auto-adjudication, assigned eligibility advocates, formal claims and appeals process, and prior experience performing dependent eligibility audits for other states.

Commissioner must enter into a contract by [date blank], 2011 with performance-based financing that compensates the vendor based on savings generated by the audit work.