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Program Integrity Case Management / Fraud Abuse Detection Analytics Solution
7/10/2025
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Lincoln, NE
Nebraska Department of Health and Human Services
Buyer seeks a qualified vendor to provide a Program Integrity Case Management (PICM) / Fraud Abuse Detection (FAD) Analytics solution. The system will help detect and prevent fraud, waste, and abuse in Medicaid programs. The contract term will be five years with options to renew for two additional two-year periods. The solution must meet CMS certification requirements and integrate with existing state systems.
- 6/10/2025 - Last day to submit questions
- 6/25/2025 - State responds to questions
- 7/10/2025 - Proposal Due Date
- 9/1/2025 - Vendor Demonstrations
- 10/1/2025 - Intent to Award notification
- 12/26/2025 - Contract award
- 1/2/2026 - Vendor start date
Refer to RFP
- Implement Program Integrity Case Management solution
- Develop Fraud Abuse Detection Analytics
- Support CMS certification requirements
- Provide algorithm library for fraud detection
- Establish secure role-based access controls
- Create data warehousing and integration capabilities
- Implement case management tracking system
- Develop dashboards and reporting tools
- Configure audit trails and compliance monitoring
- Provide system training and knowledge transfer
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