RFP ADDENDUM. North Carolina Department of Health and Human Services Division of Medical Assistance

Transcription

1 RFP ADDENDUM North Carolina Department of Health and Human Services Division of Medical Assistance Bidders: Your failure to sign this addendum and return it to the agency at the address specified in the RFP by the filing deadline shown below may result in the rejection of your proposal. RFP Number: 30-DHHS Date RFP Posted: October 15, 2015 Description of Services Sought: Addendum Number: 1 Subject of Addendum: Date Addendum Posted: October 21, 2015 Deadline for Filing Proposals: External Quality Review Services and Evaluation of the State s Quality Strategy Agency Answers to Vendor Questions 2:00 PM on November 2, 2015 Date & Time of Public Opening of Proposals: 2:00 PM on November 2, 2015 The undersigned hereby certifies that [check one]: This addendum was posted before the Vendor submitted its proposal; the Vendor s proposal was prepared with knowledge of the contents of this addendum; and a signed copy of this addendum is enclosed in the Vendor s proposal; or This addendum was posted after the Vendor submitted its proposal and the Vendor has determined that its proposal does not need to be amended as a consequence of this addendum; or This addendum was posted after the Vendor submitted its proposal; the Vendor has determined that it does need to amend its proposal as a consequence of this addendum; and the changes to the Vendor s proposal are described in the attachment to this signed addendum. Vendor s Printed or Typed Name Signature of Vendor s Authorized Agent Date Printed or Typed Name of Vendor s Authorized Agent Title Signature of Witness Date Printed or Typed Name of Witness Title Questions and Answers Begin on Next Page

2 Question Citation Vendor Question The State s Response Number 1. RFP Section 2.6 Proposal Contents, p. 10 Letter x states Documentation that at least one member of the Vendor s proposed staff has the experience required by RFP Section 4.6. The experience requirements listed in Section 4.6 appear to be for multiple staff. Please clarify. Is a vendor only required to meet the experience requirements of RFP Section 4.6 as to one staff member of its choosing? 2. RFP Section 5.3 Task, number 5, Validation of Performance Measures, p RFP Section 5.3 Task, number 7, Semi-Annual Audit, p. 21, under letter a 4. RFP Section 6.2 Post Award Meetings, p RFP Attachment C, Cost Proposal, p. 44 The section requires the vendor to validate (b) waiver measures and (c) waiver measures. Under letter c the RFP indicates the current measures are attached in ATTACHMENT M for reference. Could you clarify which measures in ATTACHMENT M are the (c) waiver measures? The requirement indicates that the first audit report is due by July 1, However, the due date listed in the Deliverable Table on page 31 lists the due date as Dec. 1 and every six months after. Please clarify the correct due date for the first audit. The 3rd paragraph appears incomplete. The Vendor shall attend up to Project Review meetings per year. How many Project Review meetings is the Vendor required to attend per year? The number per year for the Annual Summary Report is listed as 8. However, in the Deliverables Table on page 32 No. The experience qualifications outlined in the contract are for at least one member of the vendor s staff to meet each of the experience requirements, not one staff member for one requirement of its choosing. The correct reference should be Attachment L and the measures are on page 62 of the RFP labeled I/DD. The first Audit report for the new vendor is due on July 1, 2016 and every six months after. Four project review meetings. There will be one per year for each of the PIHPs, for a total of 8. That number will be reduced when the MCOs begin to merge in SFY DMA Addendum 1 Page 2 of 11

3 6. RFP Section 2.6 (j) (1), p. 9, and 4.8 (1), p RFP Section 4.8 (l), p RFP Section 2.6 (u), p. 10 the quantity for the Annual Summary Report is listed as one per year. Please clarify how many Annual Summary Reports are required Section 2.6 (j) (1) asks for information about any criminal convictions of employees; section 4.8 (1) refers specifically to criminal felony conviction, or conviction of any crime involved moral turpitude, including but not limited to fraud, misappropriation or deception There seems to an inconsistency about the information required. In the first instance, any would include minor misdemeanors as well as the felonies and moral turpitude and fraud listed in the second section. Please clarify. Section requires background checks prior to beginning work with the State. Are background checks required to be re-done immediately preceding the contract, or is it sufficient to have a previous background check on file with periodic certifications from employees? (RS) This section requires at least 3 references for team members (staff). Please clarify what is considered an acceptable reference: colleagues, supervisors, customers, former Section 2.6 (j) requires the vendor to submit the details of section 2.6 (j) 1-4 (if any) with the proposal. Section 4.8 requires the awarded vendor to provide the details of section 4.8 (1-5) prior to beginning work with the State. Vendor and its personnel are required to provide or undergo background checks prior to beginning work with the State We require supervisors, customers, or fomer employers. employers? 9. RFP Section 4.6.c Does the State propose that all The positions can be filled by contracted personnel listed in 4.6.c be personnel. Please keep in mind, if you are employed by the prime hiring contract employees, references can contractor or can the stated only be provided by customers or former function be filled by contracted employers. personnel? 10 RFP Section 4.6.c. Will the State please define the A minimum of 30 hours per week. 30-DMA Addendum 1 Page 3 of 11

4 2 hour allocation meant by the term full-time? 11. RFP Section 4.6.c. 2 Is it the intent of the State that the Contract Manager s time be solely allocated to this contract? Would it be acceptable for vendor to propose a Contract Manager who is a full-time employee of the vendor and available during normal full-time business hours? The Contract Manager position may not always have full-time work to perform solely on this contract, in which case the cost to the State may be more competitive if the State does not intend this resource to be solely allocated to this contract. 12. RFP Section 4.6.c.1 Can the State please clarify the phrase EQR activities? Is this in reference to only Medicaid related external quality reviews or will the state accept other external quality review experience? 13 General Question What is anticipated budget of the contract resulting from this RFP on an annual basis? 14. RFP Section 2.3, p. 7 The RFP schedule anticipates 10 days to incorporate what may be substantial agency responses to vendor questions. Would the agency consider revising the proposal due date by any length of time, up to two weeks? The Contract manager s time does not have to be solely allocated to the contract, but if the state requests items or reports from the vendor, or if DMA management requests a meeting with the Contract manager, the Contract manager should be available within a reasonable time frame (No later than 48 hours). EQR activities refer to Medicaid related external quality review experience. At this time we do not want to provide a proposed budget in order to allow all bidders to submit the most reasonable budget estimates based on the outlined deliverables. The RFP proposal due date will reamin 11/2/ RFP Section Deliverables in section 5 The performance measure validation is a 5.3(5), p. 21 and suggest (1) performance part of the CMS EQR process. Due to the RFP Section measure validation, and (2) length of time it will take to validate 5.3(18), p. 29 proposing measures, but there measures for each MCO, the vendor must are no specific reporting recommend a few select measures to requirements in the contracts review each year. The current measures deliverables section (section are included in Attachement L, not 5.3(18)). Does the state desire Attachment M. The reporting process 30-DMA Addendum 1 Page 4 of 11

5 16. RFP Section 5.3(12), p. 25 And RFP Section 5.3(18), p RFP Section 5.3(18), p RFP Section 4.6(c)1, p. 17 a specific reporting process? RFP Section 5.3(12) requires familiarity with federal law and a review of each PIHP s Compliance Plan, along with several other requirements. There is no stated deliverable to document each review. However, contract deliverables state review and ad hoc reports. Does the state expect a formal reporting mechanism? For ease of responding and subsequent evaluation, it would be helpful if the state indexed each of these deliverables in RFP Section 18 (for example, 18.A, 18.B, etc.) RFP Section 4.6(c)(1) includes a mandatory requirement for a Project Manager with a Degree in Behavioral Health or Social Science. Would the state consider revising this mandatory requirement to a preferred requirement, as it did in the January 2015 RFP? It appears that given the twopronged nature of this position (oversees all EQR activities, and functions as a DMA liaison), the position requirements can be met by experts in managing EQR activities but who may have a number of any degrees or professional certifications, and that a mandatory requirement as worded here could be restrictive to competition. should include the items outlined in the attached link The state does expect a formal reporting mechanism forthe Program Integrity section. Also, section 2.6, page 9 outlines the need for a work plan for each deliverable. Section 5.3 does just that. Starting with 5.3# 2-19, each deliverable is outlined. The accepted degrees are as follows: Anthropology, Nursing/Medicine, Audiology, Child Development/Family Relations, Occupational Therapy, Community Mental Health, Chemical Dependence Administration, Physical Therapy, Counseling/Guidance, Law, Psychology, Public Administration, Public Health, Public Policy, Criminal Justice, Recreational Therapy, Rehabilitation Counseling, Social Work, Education, Sociology, Gerontology, Special Education, Health Administration, Speech Pathology, Health Education, Vocational Counseling. 19. RFP Section The RFP does not define what The accepted degrees are as follows: 4.6(c)1, p. 17 degrees qualify as a Degree in Behavioral Health or Social Anthropology, Nursing/Medicine, 30-DMA Addendum 1 Page 5 of 11

6 Science or what level of degree is expected (cf. RFP 4.6(c)(7), requiring Bachelor s Degree ; RFP 4.6(c)(6), requiring Master s Degree ). Please provide a list of degrees acceptable under Behavioral Health or Social Sciences. Audiology, Child Development/Family Relations, Occupational Therapy, Community Mental Health, Chemical Dependence Administration, Physical Therapy, Counseling/Guidance, Law, Psychology, Public Administration, Public Health, Public Policy, Criminal Justice, Recreational Therapy, Rehabilitation Counseling, Social Work, Education, Sociology, Gerontology, Special Education, Health Administration, Speech Pathology, Health Education, Vocational Counseling. 20. RFP Section 13.A. Surveys, P RFP Section 13.A. Surveys, P RFP Section 13.B. Surveys, P. 26 and RFP Section 13.H. Surveys, P. 27 Since there are numerous CAHPS surveys that AHRQ maintains, which survey is the state looking to use for this contract? Previously, it was the ECHO CAHPS survey, which is geared more towards behavioral health. Is this still the intent? Does the state desire a Vendor that is certified by NCQA as proof of their ability to adequately perform CAHPS surveys? In subpart b the RFP states that the Vendor must conduct 400 surveys with sampling at the plan-level; while in subpart h states that A minimum four hundred (400) surveys must be completed for each PIHP. These seem to be contradictory, conduct surveys usually refers the number of surveys to be sent out while completed surveys usually refers to the amount of surveys returned that is deemed complete by the CAHPS instructions. Which interpretation is the state expecting for this proposal? The state will still require the ECHO CAPHS survey only. No. The vendor must show, through it s previous survey work, or select a contracted vendor, who has the experience and staffing to conduct the survey in the manner outlined in the RFP. The 400 is the total number distributed per plan. Overall, a minimum 30% response rate per plan is required. 23. RFP Section 13.E. The state is requesting Further stratification may be required sampling done at the plan level based on recommendations from so that the results are legislators, stakeholders, or leaders within 30-DMA Addendum 1 Page 6 of 11

7 Surveys, P RFP Section 14.G. Provider Surveys, P RFP Section 2b, P. Number 20 generalized to all PIHPs. Confirm that the state does not require further stratification within each plan s sample? Stratification typically entails additional costs to the customer. Based on historical surveys, most plans barely have 400 unique, active providers in their network. It is unrealistic to expect a 100% response rate, and not meet this requirement of 400 minimum completed surveys per PIHP. Is it sufficient for a vendor to meet the 30% response rate? Are bidders expected to submit a draft Annual EQR work plan with their proposals, or is this only a contract deliverable 26. RFP Section 3.4, The evaluation criteria of Vendor Qualifications does not appear anywhere else in the RFP. Will the State please qualify what will be evaluated under the Vendor Qualification criteria, and whether references will be evaluated under the category? 27. RFP Sections 13 and 14, P. 27 Will DMA approve the use of Vendor-developed Provider survey tools? DHHS. The data requested from the plans and format of data should allow the state and PIHPs flexibility for data analysis. The 400 is the total number distributed per plan. Although the providers usually conduct services in all eight plans, we expect a distinct evaluation of each plan by the providers who have agreed to respond. Overall, a minimum 30% response rate per plan is required. The bidders are required to submit a draft work plan. Sections 4.5 through 4.10 make up Vendor Qualifications. DMA will consider the use of other vendor developed Provider satisfaction tools as long as most of the questions are related to the current questions that are included in DMA/PIHP developed survey. Yes. 28. RFP Sections 13 Will DMA permit oversampling and 14, P. 27 to increase response rates? 29. RFP Section 2.0 The RFP states, By execution No alternatives, additional or modified General and delivery of tis RFP terms and conditions will be accepted. Information, 2.2, Response, the Vendor agrees page 6 that any additional, or modified terms and conditions... shall have no force or effect, and will be disregarded. Is the Department willing to consider alternatives to the RFP terms and conditions in order to 30-DMA Addendum 1 Page 7 of 11

8 avoid a situation where the Department is required to reject a favorable proposal with a request for limited revisions and to select a less favorable proposal with no requested revisions? If yes, how should the Vendor provide their recommended alternatives? 30. RFP Section 5.3, Task 4) Validation of PIHP Performance Improvement Projects, a), page RFP Section 5.3, Task 5) Validation of Performance Measures, page 21 We consider the lack of limits of liability to be a significant concern. To the extent permitted by law, would the State consider an appropriate financial limitation of liability cap? The State has accepted limitation of liability in other contracts. Would the State consider the same revisions for this contract? If so, we will submit our proposal with suggested appropriate language for your consideration. How many performance improvement projects per plan? How many of the Performance Improvement Projects will require validation by administrative data vs chart review vs a hybrid approach? Is medical record review validation performed as part of the performance measure validation? If yes, how many measures require medical The vendors are required to submit three PIPS per plan. Please see the link to the CMS requirements as well. The PIP may require a hybrid approach or a chart review depending on the PIPs submitted by the plan. Please see the link to the CMS PIP validation process for further guidance. The medical record review validation is required as a part of the onsite review, not as a part the performance measure validation. record review? 32. RFP Section 5.3, The RFP states that the first The first Audit report for the new vendor is Task 7) Semi- audit report is due by July 1, due on July 1, 2016 and every six months Annual Audit, a), 2016, but in Section 18, page after. page 21 31, within the Deliverable Table, states that the due dates is Dec 1. Can you please 30-DMA Addendum 1 Page 8 of 11

9 33. RFP Section 5.3, Task 13) Surveys, b), page RFP Section 5.3, Task 13) Surveys, e), page RFP Section 5.3, Task 13) Surveys, l), page RFP Section 5.3, Task 14) Provider Surveys, a), page RFP Section 5.3, Task 14) Provider Surveys, c), page RFP Section 5.3, Task 18) Contract Deliverables, Administrative Interviews, page 29 confirm as to which date is correct? The RFP states that the Vendor must conduct 400 consumer surveys samplings at the planlevel. Is the 400 goal the number of completed surveys returned or the number of surveys initially distributed per plan? The consumer satisfaction surveys must be done all at one time with the sample done at the plan-level to allow the results to be generalized to all PIHPs. Besides Spanish, for which additional languages do you already know that translation services will be needed? The expected minimum response rate of 30% only applies to the Provider Survey and not the Surveys. Is that correct? The RFP state The work plan must cover all mandatory activities related to the survey and... Does the State anticipate distributing separate provider surveys that work with Adult and Child populations? States that the Assessment tool would be completed by the PIHP. However, the information in Section 5.3, Task 3) Administrative Interviews, page 20, contains no indication that the tool will be completed by the PHIP. Please confirm who would be responsible for completing the Administrative Interview tool. The 400 is the total number distributed per plan. Overall, a minimum 30% response rate per plan is required. Yes, that is correct. Only Spanish at this time. No. It applies to both the Provider and the Survey. No. There should be one provider survey for all disability types. You are responsible, as a potential vendor for creating Administrative Interview tool/guide. Please see the details outlined below. Administrative Interviews shall be conducted annually onsite with each PIHP and shall assess the PIHP s day-to-day operations. The Vendor shall utilize the administrative interviews to provide technical assistance 30-DMA Addendum 1 Page 9 of 11

10 to the State staff involved in the oversight of the PIHP programs through planning meetings, review of organizational charts, policies and procedures and other documents, preparation of a review tool for on-site interviews, and participation in the on-site review and debriefing. The Vendor shall develop an Administrative Interview Guide for use in conducting Annual Administrative Reviews. The guide shall be reviewed and edited as necessary by the Vendor on an annual basis. The Administrative Interview Guide shall meet the requirements outlined in the CMS protocols specified in 42 CFR attachment-a.pdf attachment-d.pdf The Vendor shall summarize the results of the on-site reviews and update the PIHP administrative interview guide for use by DMA in oversight activities. The Vendor shall help DMA create PIHP corrective action plans as needed. 39. RFP Section 5.3, Task, 18) Contract Deliverables, page 31 Please provide additional information regarding what DMA is looking for in reference to item #18 Program Integrity Reviews and Ad Hoc Reports. Are the ad hoc reports specific to program integrity or can they be related to other issues? Please see Section 5.3, item 12. The section outlines what is expected in the Program Integrity reviews and reports. 30-DMA Addendum 1 Page 10 of 11

11 40. RFP Section 5.3, Task 19) Quality of Care Reports, page RFP Section 6.2 Post Award Meetings, page Attachment C: Cost Proposal, page 44 The RFP identifies the (b) and (c) measures included in ATTACHMENT M. Please clarify if the intention was to reference Attachment L N.C. Medicaid waiver performance measures. Please also clarify if the tables on pages referencing the I/DD only is the (c) waiver performance measure list. Please also discuss the status of the (b) and (c) waiver data. What is the source of the data? Do the metrics have a standard definition all of the plans use to produce the data? And will it be provided in a standard format? Will the data have been validated? The text says, The Vendor shall attend up to Project Review meetings per year. How many Project Review meetings do you anticipate? For the Evaluation of the State s Quality Strategy, the quantity is once during the first 2 year contract period. Please confirm the Unit Cost and the Annual Cost should be the same, i.e., they should reflect the full cost for this deliverable, which will be billed during the year it is provided, and none of that same proposed full unit cost would be billed during the other year of the two-year contract period. The correct reference should be Attachment L and the measures are on page 62 of the RFP labeled I/DD. The MCOs currently self-report the data. In the future the expectation is that the data will be generated from Encounter data. The metrics all have a standard definition that is outlined in the MCO Performance Measures Guidelines Manual. There is also a standard report format for the submission of the performance measures. The data will be validated through the Encounter Data validation process, which is one of the deliverables outlined on page 23 of the RFP. Four project review meetings. Your budget should include the cost of the Evaluation of the Quality Strategy. It should be an Annual cost that should reflect the full cost of the deliverable. 30-DMA Addendum 1 Page 11 of 11