Medicaid NonEmergency Medical Transportation (NEMT) Credentialing, Auditing, and Complaint Management Solution

Background
The State of Tennessee, Division of TennCare (TennCare), Office of Contract Management (OCM) issues this Request for Information (RFI) to identify all available market solutions utilizing blockchain technology to perform online credentialing, auditing, and complaint management of the Medicaid Non-Emergency Medical Transportation (NEMT) benefit. TennCare is seeking information and insight from vendors with an existing commercial-off-the-shelf (COTS), software-as-a-service (SaaS), or platform-as-a-service (PaaS) solution. This RFI is intended to identify existing commercial-off-the-shelf (COTS), software-as-a-service (SaaS), or platform-as-a-service (PaaS) solutions in the market that meet specific needs related to NEMT credentialing, auditing, and complaint management.

Work Details
The work involves providing a web-based platform that employs blockchain technology to include a credentials repository, an audit tool capable of measuring compliance in real-time, and a complaint intake, referral, and management system for transportation providers, transportation brokers, and managed care organizations. It also includes establishing a collaborative credentialing network among NEMT transportation providers, NEMT brokers, managed care organizations (MCOs), and TennCare; standardizing unique NEMT transportation provider, NEMT transportation broker, managed care organization and TennCare credential taxonomies; providing blockchain infrastructure to establish provenance of all credentials, render them immutable, and permanently traceable; utilizing blockchain technology to establish credential chain-of-custody and primary source verification; facilitating web access and secure online transmission of credentials between NEMT transportation providers, NEMT transportation brokers, managed care organizations, and TennCare; creating an approach for converting historic and future credentials into electronic records; offering tools to set and/or change the audit criteria, perform real-time compliance checks, automate auditing processes and receive, triage, escalate, and monitor trends of complaints received against NEMT transportation providers, NEMT transportation brokers or managed care organizations; ensuring credentialing processes and infrastructure support national accreditation standards by the Non-Emergency Medical Transportation Accreditation Commission (NEMTAC); ensuring technology tools meet CMS and healthcare security standards; providing credentialing, technical, and customer support services.

Period of Performance
The RFI was issued on July 15th, 2024. The deadline for RFI responses is 3:00pm on July 31st, 2024.