Workers Compensation Third Party Administration Services

RFP Published: April 24th, 2026

Question Submittal Deadline: May 5th, 2026

RFP Due Date: May 15th, 2026

Advisory Committee Evaluation & Selection: June 2026

The City seeks a vendor to provide comprehensive workers compensation third party administration services. The selected Third-Party Administrator (TPA) will be responsible for claims administration and monitoring, medical case management, utilization review, and case management services for all active, past, current, and future claims. Responsibilities include the receipt, processing, filing, and maintenance of all claim-related forms, reports, and notices in compliance with Massachusetts state law.

Additional services required are utilization review and verification of all medical services billings—including medications and durable medical equipment—and determination of the lowest state-authorized payment rates, with particular attention to claimants granted accidental disability retirement. The TPA must conduct timely follow-up with doctors and claimants and, where necessary, investigate cases to reduce exposure and costs. The vendor will provide recommendations on claimants’ earning capacity status for final decisions and make direct payments to medical providers as well as manage payments for lost time to employees through direct payment or a voucher system.

The TPA must also advise on and assist with the monitoring of injured employees’ medical care and treatment, supplying routine reports to assigned claims handlers, the City Solicitor’s office, and department heads as requested. All questions regarding this RFP must be submitted by May 5, 2026.