MB-10317 - USA (California) - Third Party Administration Workers’ Compensation Claims and Managed Care Services - Deadline August 14,2026

(1) Vendor needs to provide third party administration workers’ compensation claims and managed care services.– Provide prompt, effective, and cost–appropriate medical treatment to injured workers, facilitating safe and early return–to–work.– Supervise and administer the self–insured workers' compensation program.– Investigation, adjustment, processing, supervision and resolution of workers' compensation claims.– Review and process all industrial injury cases in accordance with the requirements of the State agency for reporting and notification.– Determine compensability of injuries and illnesses in accordance with state workers' compensation laws, interpreted in the strongest way so as to prevent fraud, waste and abuse within the program.– Provide for and manage and maintain a medical provider network (MPN), and shall recommend, as requested, physicians for the first treatment of employee injury or illness and recommend medical specialists for treatment requiring long–term or specialty·– Maintain close liaison with treating physicians.– Provide information, guidance and assistance to injured employees regarding permanent disability ratings, qualified medical examiner and agreed medical examiner process and settlement of claims.– Provide a comprehensive medical bill auditing and cost–containment program that ensures accuracy, compliance, and financial stewardship.– Utilize both automated bill review software and manual auditor review for complex, high–dollar, or questionable bills.– Utilization review services.– Medical case management services.(2) All questions must be submitted no later than July 27, 2026.(3) A pre–bid meeting will be held on July 20, 2026.(4) The contract period will be for three years.