Bill Text: MN HF233 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Department of Human Services required to issue a request for proposals for a Medicaid fraud detection and business intelligence contract.
Spectrum: Partisan Bill (Republican 9-0)
Status: (Introduced - Dead) 2011-05-04 - Author added Murray [HF233 Detail]
Download: Minnesota-2011-HF233-Introduced.html
1.2relating to state government; requiring the Department of Human Services
1.3to issue a request for proposals for a Medicaid fraud detection and business
1.4intelligence contract.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. REQUEST FOR PROPOSALS.
1.7(a) The commissioner of human services shall issue a request for proposals
1.8for a contract to use technologically advanced software and services to improve the
1.9identification and rejection of improper Medicaid payments before payment is made to
1.10the provider. The request for proposals must ensure that a system recommended and
1.11implemented by the contractor will:
1.12(1) implement a more comprehensive, robust, and technologically advanced
1.13improper payments identification program;
1.14(2) utilize state of the art fraud detection methods and technologies such as predictive
1.15modeling, link analysis, and anomaly and outlier detection;
1.16(3) have the ability to identify and report improper claims before the claims are paid;
1.17(4) include a mechanism so that the system improves its detection capabilities over
1.18time;
1.19(5) leverage technology to make the Medicaid claims evaluation process more
1.20transparent and cost-efficient; and
1.21(6) result in increased state savings by reducing or eliminating payouts of wrongful
1.22Medicaid claims.
1.23(b) Based on responses to the request for proposal, the commissioner must enter into
1.24a contract for the services specified in paragraph (a) by October 1, 2011. The contract
2.1shall incorporate a performance-based vendor financing option whereby the vendor shares
2.2in the risk of the project's success.
2.3EFFECTIVE DATE.This section is effective the day following final enactment.
1.3to issue a request for proposals for a Medicaid fraud detection and business
1.4intelligence contract.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. REQUEST FOR PROPOSALS.
1.7(a) The commissioner of human services shall issue a request for proposals
1.8for a contract to use technologically advanced software and services to improve the
1.9identification and rejection of improper Medicaid payments before payment is made to
1.10the provider. The request for proposals must ensure that a system recommended and
1.11implemented by the contractor will:
1.12(1) implement a more comprehensive, robust, and technologically advanced
1.13improper payments identification program;
1.14(2) utilize state of the art fraud detection methods and technologies such as predictive
1.15modeling, link analysis, and anomaly and outlier detection;
1.16(3) have the ability to identify and report improper claims before the claims are paid;
1.17(4) include a mechanism so that the system improves its detection capabilities over
1.18time;
1.19(5) leverage technology to make the Medicaid claims evaluation process more
1.20transparent and cost-efficient; and
1.21(6) result in increased state savings by reducing or eliminating payouts of wrongful
1.22Medicaid claims.
1.23(b) Based on responses to the request for proposal, the commissioner must enter into
1.24a contract for the services specified in paragraph (a) by October 1, 2011. The contract
2.1shall incorporate a performance-based vendor financing option whereby the vendor shares
2.2in the risk of the project's success.
2.3EFFECTIVE DATE.This section is effective the day following final enactment.
