Vermont Agency of Human Services (AHS), Office of Vermont Health Access, Clinical and Program Integrity Units (DVHA) seeks a contractor to provide clinical criteria. DVHA has been delegated the responsibility by AHS to operate as a public Managed Care Entity under 42 CFR ¤438, financing the provision of medical services to Medicaid-eligible clients. DVHA is required by AHS to have mechanisms in effect to examine health services and make decisions regarding coverage, unit limitations, place of service, length of stay, over and under utilization, and appropriate medical necessity of services in VermontÕs Medicaid programs . . .

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RFP | August 2, 2011

Vermont Seeks Clinical Criteria

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