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Recovery Audit Services

Overview


Financial, Legal, HR & Staffing
Austin, Texas, United StatesPosted: August 12, 2026Deadline: September 9, 2026

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SUMMARY


The government authority is seeking a Recovery Audit Contractor to identify Medicaid improper payments, manage provider appeals, analyze large datasets, and support program integrity activities. Services must include a secure role-based portal and strong audit, risk management, and information security processes.

KEY REQUIREMENTS


BUDGET

Estimate

$10,000,000

CONTRACT DURATION


36 months

TIMELINE


Solicitation Posting Date: August 11th, 2026

Pre-proposal Conference: August 13th, 2026

Deadline for Submitting Questions: August 17th, 2026

Responses to Questions Posted: August 25th, 2026

Deadline for optional courtesy VetHUB Subcontracting Plan review: August 28th, 2026

Deadline for Submission of Solicitation Responses: September 9th, 2026

Evaluation Period: Late September – early October 2026

Tentative Date for Notice of Award: March 2027

Anticipated Contract Effective Date: April 2027

QUESTION DEADLINE


August 17, 2026

CONTACTS


Primary procurement contact — name, title, email, and phone

Additional decision-makers and their departments

Issuing Agency


Texas Health and Human Services Commission

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DESCRIPTION


The government authority located in Austin, Texas, seeks a Recovery Audit Contractor to identify Medicaid underpayments and overpayments, also referred to as improper payments, under the Medicaid state plan and any related waivers. The scope includes both Fee-for-Service and Managed Care Organization programs.

The selected vendor will conduct first-level appeal reviews and facilitate second-level appeals at the request of providers. The contractor must provide a secure, online, role-based portal for appeal reviewers, providers, and other stakeholders.

Additional responsibilities include performing program integrity risk assessments; developing logic and algorithms to analyze large datasets and produce meaningful outcomes; detecting and referring suspected fraud, waste, abuse, and improper payments; and administering the government project. Project administration will include internal controls, risk management processes, audit trail management and tracking, and information security requirements. A pre-bid meeting is scheduled for August 13, 2026, and questions must be submitted by August 17, 2026.

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Frequently asked questions


When is the submission deadline?
Submissions are due September 9, 2026. Questions must be submitted by August 17, 2026.
What is the budget for this RFP?
Settle estimates the budget at $10,000,000. The issuer has not published an official figure.
Who issued this RFP?
It was issued by Texas Health and Human Services Commission. The work is located in Austin, Texas, United States.
Who is a good fit for this opportunity?
  • Recovery audit and Medicaid program integrity specialist
  • Experience supporting both Fee-for-Service and Managed Care Organization programs
  • Expertise in healthcare payment analytics, fraud detection, waste and abuse identification
  • Capability to conduct provider appeals and administer secure role-based portals
  • Strong internal controls, risk management, audit trail, and information security experience
  • Experience delivering government healthcare projects

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    Recovery Audit Services (Due September 9, 2026) | Settle RFP Hunter