Dr. MiltieAtlas by Dr. Miltie™Healthcare Grant Intelligence
ActiveAtlas Opportunity Score 88/100

Arizona AHCCCS Medicaid School-Based Claiming TPA RFP — YH27-0002

AHCCCS issued RFP YH27-0002 on September 4, 2026 to select one statewide third-party administrator for Arizona Medicaid School-Based Claiming. Questions are due September 24, Intent to Bid October 15, and proposals October 20, 2026 at 3:00 PM Arizona Time.

FundingVariable percentage/per-claim administrative compensation; no fixed contract ceiling or guaranteed quantity stated in the public RFP.
DeadlineOctober 20, 2026 at 3:00 PM Arizona Time
Last verifiedSeptember 13, 2026
Required next actionQualified Medicaid school-based claiming administrators should review the full RFP and Bidder's Library, submit questions by September 24, submit the mandatory Intent to Bid by October 15, and submit the proposal by October 20, 2026 at 3:00 PM Arizona Time.

Broad Eligibility

Prospective Offerors must be organizations capable of serving as the statewide Medicaid School-Based Claiming third-party administrator and satisfying the solicitation's claims administration, Medicaid program support, financial, bonding, security, compliance, training and operational requirements.

Atlas Analysis

Atlas Opportunity Score 88/100. N9+ Direct Vendor Fit 0/100 and QC Healthcare Fit 0/100. This is a statewide school-health Medicaid claims-administration procurement, but the prime scope requires specialized TPA, claims, reimbursement, RMTS, cost-reporting and compliance capabilities rather than clinical technology or physician coverage.

Opportunity Overview

The Arizona Health Care Cost Containment System (AHCCCS) issued RFP YH27-0002 on September 4, 2026 to select a single third-party administrator for Arizona’s Medicaid School-Based Claiming (MSBC) program. The contractor will support Local Education Agencies statewide with Direct Service Claiming and Medicaid Administrative Claiming, including claims administration, training, technical assistance, cost-based reimbursement, random moment time studies, compliance reviews and related program operations.

Deadline and Procurement Schedule

Questions are due September 24, 2026 at 3:00 PM Arizona Time. The mandatory Intent to Bid is due October 15, 2026 at 3:00 PM Arizona Time. Proposals are due October 20, 2026 at 3:00 PM Arizona Time. AHCCCS currently targets final award for January 8, 2027 and a July 1, 2027 service start.

Contract Structure

AHCCCS intends to establish a contract with one entity or organization acting as the MSBC third-party administrator. The initial contract term is three years with two one-year extension options, for a maximum five-year contracting period. The solicitation does not guarantee a minimum or maximum quantity of services.

Pricing has two components: a percentage of the amount paid for Medicaid school-based administrative-services claims and a dollar amount per Direct Medical Services claim. The public RFP therefore does not establish a fixed contract ceiling. AHCCCS reports that in SFY 2025 LEAs statewide claimed approximately $16.3 million for administrative outreach and received more than $36.5 million through Direct Service Claiming. The successful contractor must also maintain substantial performance and fidelity bonds.

School Health Significance

The MSBC program reimburses participating Arizona school districts, charter schools and the Arizona School for the Deaf and Blind for documented medically necessary services delivered to Medicaid-enrolled students. Covered school-based services described in the RFP include physical therapy, occupational therapy, speech therapy, audiology, nursing, health aides, specialized transportation and behavioral-health services. AHCCCS states that approximately 49,000 students received Medicaid-eligible services through participating LEAs in SFY 2025.

Atlas Analysis

Atlas Opportunity Score: 88/100. This is a significant statewide school-health financing and administration procurement with a clear official source, long contract term and direct connection to Medicaid-covered student services.

N9+ Direct Vendor Fit: 0/100. QC Healthcare Fit: 0/100. The controlling solicitation requires a prime contractor with specialized third-party administration experience in Medicaid claims processing, reimbursement, cost reporting, random moment time studies, compliance review, LEA education and related program administration. Dr. Miltie is not a defensible prime for this scope, and the RFP does not establish a material role for N9+ remote physical-exam technology or QC clinical coverage. Atlas should therefore publish and track the procurement but should not pursue Path A/B/C outreach unless an amendment materially changes the scope.

Next Action

Qualified Medicaid school-based claiming administrators should review the complete RFP, attachments, pricing proposal and Bidder’s Library, submit any questions by September 24, submit the required Intent to Bid by October 15, and deliver the full proposal by October 20, 2026 at 3:00 PM Arizona Time.

Official source: AHCCCS Open Solicitations — YH27-0002.

Source verificationOfficial government source · www.azahcccs.govAtlas last verified this record September 13, 2026. Always use the funder's current application materials, amendments and portal instructions as the controlling source.View source and application materials ↗