Opportunity Detail

Questions and Answers

External Quality Review Services for Medicaid Managed Care
Document #:  JFSR1415078059


Question:   RFP Section: SECTION IV. SCOPE OF WORK & SPECIFICATIONS OF DELIVERABLES Title: 4.4 Specifications of Deliverables, Activity A: Assessment of compliance with federal Medicaid Managed Care regulations and state requirements Page: Page 16 of 79 1. Task 5 states that the vendor can conduct a desk review and/or on-site review. If the vendor chooses to complete on-site reviews in one of the required years stated, would reviews of the MCPs and ICDSs be instate or a combination of in and out of state? 2. Does the OMA have a set time frame for the completion of the compliance audits? RFP Section: Section II Procurement Process Information, Title: 2.1 Anticipated Procurement Timetable, Page: Page 5 of 79. Question: October 28, 2013 is the Implementation estimation date and June 30, 2015 is the Project Completion date. Is the period of performance for “SFY2014” equate to October 28, 2013 through June 30, 2014 and “SFY2015” equate to July 1, 2014 through June 30, 2015? RFP Section: Section V Proposal Format & Submission, 5.2 Format for Organization of the Proposal Title: B. Cost Proposal Page: Page 67 of 79. Question: Vendors are to submit their cost proposal for SFYs 2014, 2015, 2016, 2017, 2018, and 2019. What is the period of performance for the SFY period? For example is SFY2015 equating to July 01, 2014 through June 30, 2015? RFP Section: Attachment D Title: Cost Proposal Form for External Quality Review Services: JFSR1415078059 Page: Pages 117-118. Question: Deliverable H3: Technical Assistance’s Cost Per Unit and Definition of Unit, combined, states “Included in H1 and H2”. Does this denote no-cost entry for this deliverable, for each SFY, because it is included in the previously listed deliverables H1 Encounter data validation study of delivery payment encounters and H2 Validation Study of Managed care plan encounter data? RFP Section: Section IV Scope of Work & Specifications of Deliverables Title: 4.6 Selected Vendor Compensation Structure Page: Page 63 of 79. Question: The contractor shall be permitted to submit an invoice requesting up to fifty percent for each activity by unit at the point that the particular activity is at least fifty percent completed. Please define specifically per Deliverable, per SFY, what will determine that a Deliverable has reached the fifty percent completion requirement? RFP Section: Section IV Scope of Work & Specifications of Deliverables Title: 4.6 Selected Vendor Compensation Structure Page: Page 63 of 79. Question: Upon completion of the deliverable, the contractor may invoice for the remaining amount due. Please define specifically per Deliverable, per SFY, what will determine that a Deliverable has reached the completion requirement? Is this invoice upon completion requirement, dependent on the approval process of the 20% performance holdback which is payable by the ODM at the end of the fiscal year? RFP Section: Section IV Scope of Work & Specifications of Deliverables Title: 4.6 Selected Vendor Compensation Structure Page: Page 63 of 79. Question: Each deliverable shall be subject to a 20% performance holdback which shall be payable by ODM by the end of the fiscal year in which the deliverable was completed and accepted by the ODM Contract Manager. How many days, after the end of the fiscal year, does it take to perform the approval process and release of the 20% performance holdback by the ODM Contract Manager? RFP Section: Attachment D Title: Cost Proposal Form for External Quality Review Services: JFSR1415078059 Page: Pages 117-118. Question: Is the Cost Per Unit for SFY2014 only? If not, how should we account for the standard incremental changes, such as the scope of work and labor costs, in the subsequent years SFY2015 through SFY2019?

Answer:   Question 1.--ANSWER: ODM will prescribe the preferred method of review to the vendor. On-site reviews will primarily be conducted in the state of Ohio. Question 2.--ANSWER: ODM is interested in receiving the findings, results, and/or recommendations in a timely manner in order to initiate corrective actions with the MCPs. ODM is unable to establish a set timeframe given the variation in the scope of the reviews and whether the reviews are being completed for the first time or repeated. Question 3--ANSWER: Yes. Question 4.--ANSWER: The period of performance is the state fiscal year which extends from July 1 to June 30. The exception for this contract is the SFY 2014 term which will be October 1 to June 30. Question 5--ANSWER: The vendor should not submit a separate cost for technical assistance for H3. The cost of technical assistance must be included in the costs for activities H1 and H2. Question 6.--ANSWER: The ODM contract manager and the contractor will agree to the fifty percent completion point for each activity after the contract is awarded and work plans and timelines are finalized. At this point, ODM is unable to define the fifty percent completion point for each activity. Question7.--ANSWER: The ODM contract manager and the contractor will agree to the final completion point for each activity after the contract is awarded and work plans and timelines are finalized. The invoicing for the 20% performance holdback amount can be independent of, but subsequent to, the invoicing of the final completion point. Question 8.--ANSWER: On the contractor’s final invoice for a SFY, or on a separate invoice submitted at approximately the same time, the vendor should identify all deliverable amounts held-back for that SFY’s completed work. That invoice would then be processed for approval and payment like all others, and should therefore take essentially the same amount of time for payment to be received. Question 9.--ANSWER: The cost proposal form will be modified so that the cost per unit can be established for each two year term. The cost per unit will be constant for each two year contract term. A separate cost proposal form must be completed for SFY 2014/2015, 2016/2017, and 2018/2019.

Date: 7/25/2013

Inquiry: 28975


Question:   Section 8.8, Minority Business Enterprise, page 74 of 79 Should the Vendor include a separate schedule in the Cost Proposal indicating the amount and percent of the total contract price subcontracted to a certified MBE?

Answer:   No. This is not necessary. Vendors who use subcontractors will need to follow instructions per RFP Section 8.9 (and Section 8.8 if the subcontractor is an MBE). Also vendors using subcontractors will need to complete the required information in Section I: #10 of Attachment A of the RFP. Please be aware that vendors are NOT to include any dollar amounts for work (for either themselves or their subcontractor) in their technical proposals or they shall risk disqualification. Required subcontractor information (RFP Sections 8.8 and 8.9) must be included in Tab 1 of the vendor’s proposal (see page 66 of the RFP).

Date: 7/18/2013

Inquiry: 28972


Question:   Section 5.2., Format for Organization of the Proposal, item B., Cost Proposal, page 67 of 79 Will ODM provide an Excel version of Attachment D--Cost Proposal Form?

Answer:   Yes. The Cost Proposal Form will be added to OMA’s Program Resource Library at: http://jfs.ohio.gov/ohp/bmhc/rfp-eqro/index.stm. [Important: Please note that the excel version is a revised version of the Cost Proposal Form that was originally posted with the RFP.]

Date: 7/18/2013

Inquiry: 28969


Question:   Section 3.2., Organizational Experience and Capabilities, item B., page 10 of 79 Please define “Staff Years” and give an example of the calculation.

Answer:   Staff years is defined as the total sum of the number of years the vendor's staff has as of the RFP submission date performing external quality review activities for all states identified in Section 3.2.A. An example calculation and preferred presentation of the information is as follows: Staff A (3 total years)+ Staff B (10 total years) + Staff C (4 total years) =Grand total of 17 staff years. The average number of staff years= 17 years/3 staff = 5.7 years ODM prefers that the response to 3.2.B for staff years be presented in a table format as illustrated in the above example. VENDOR PROPOSALS MUST TAKE THIS INTO CONSIDERATION.

Date: 7/18/2013

Inquiry: 28968


Question:   Activity G2 Quality of Life Surveys, RFP p26 Does Ohio currently perform QOL surveys for the children in the ABD program? If so, please provide a copy of that survey instrument. If so, does the state find that instrument to be acceptable? If so, is data available in raw source for previous years so as to be able to establish trends? Would the State find use of participant incentives (financed through contract funds) to be acceptable? Are MCO resources available to solicit participation? Does the State OMA have an institutional review board? Is IRB approval required? This link from the program resource library regarding SPMI Health Homes appears to be defective. The rfp states on page 50, section Activity O2: 2. Paragraph two that “…but a detailed methodology has not yet been documented.” Can alternate approaches be proposed? http://mentalhealth.ohio.gov/assets/medicaid/health-home-web-page/6-20-2012-ohio-health-home-spa.pdf

Answer:   1) Ohio Medicaid does not currently perform QoL surveys for the ABD child population. 2) The State would not approve the use of participant incentives for this activity. Please note, however, that ODM Quality of Life surveys administered to ABD adult consumers in the past achieved significantly high response rates (e.g., 62% in 2009 and 57% in 2011) without the use of incentives. 3) The State would not approve the use of participant incentives for this activity. Please note, however, that ODM Quality of Life surveys administered to ABD adult consumers in the past achieved significantly high response rates (e.g., 62% in 2009 and 57% in 2011) without the use of incentives. 4) ODM does not have an IRB and IRB approval is not required. 5) A new URL will be provided in the program resource library. A general approach for calculating cost-savings is described in the state plan amendment. ODM will rely on the vendor to develop and recommend a detailed methodology that supports the general approach in the SPA.

Date: 7/18/2013

Inquiry: 28987


Question:   Attachment C, Phase II: Criteria for Scoring of Technical Proposal, Item #29 Can ODM clarify where the Proposer should include the requested written, signed statement?

Answer:   Please include this written statement in Sub-Tab 2b., of your proposal submission (see page 66 of the RFP).

Date: 7/18/2013

Inquiry: 28985


Question:   Section 1.1, Purpose, item B., page 2 of 79 Can ODM clarify what is meant by “combined experience”?

Answer:   The total years of experience for at least two states must be greater than or equal to 5 years. For example, if the vendor has 10 years of experience with only one state, this would not meet the minimum qualification. If the vendor has 4 years of experience with State A and 1 year of experience with State B for a total of 5 years, this would meet the minimum qualification.

Date: 7/18/2013

Inquiry: 28984


Question:   Section 4.4, Specifications of Deliverables, Activity O2: Calculation of health home performance measures and cost savings, page 50 of 79 For the cost savings calculation, will the selected vendor be required to have an actuary review and certify the cost assessment, or (if necessary) will that be handled by ODM/third party?

Answer:   The selected vendor will not be required to have an actuary review and certify the cost assessment.

Date: 7/18/2013

Inquiry: 28983


Question:   Section 4.4, Specifications of Deliverables, Activity J3: Non-HEDIS Performance Measures: Development, Calculation and Reporting, page 39 of 79 The RFP states that the selected vendor must conduct technical assistance. How many hours of technical assistance should the vendor anticipate providing?

Answer:   100 hours per year.

Date: 7/18/2013

Inquiry: 28982


Question:   Section 4.4, Specifications of Deliverables, Activity J3: Non-HEDIS Performance Measures: Development, Calculation and Reporting, page 39 of 79 The RFP states that the selected vendor must conduct ad hoc analyses for OMA. How many ad hoc analyses should the vendor anticipate performing on an annual basis? Will ad hoc analyses extend beyond the scope of the non-HEDIS measures evaluated under Activity J3?

Answer:   ODM anticipates approximately between 15 and 20 ad hoc analyses on an annual basis under Activity J3. The ad hoc analysis for J3 would involve at least one of the measures included under Activity J3, but may be linked to specific quality improvement initiatives, programs, and/or other performance measures not included in J3.

Date: 7/18/2013

Inquiry: 28981


Question:   Section 4.4, Specifications of Deliverables, Activity G2: Quality of Life Surveys, page 26 of 79 It is understood that the two populations will need to be surveyed separately, but please provide clarification if: (1) the same survey instrument will be used for both the MCPs and ICDS plans (with potentially only slightly different supplemental questions), or (2) separate survey instruments comprised of different questionnaires will be used to evaluate the MCPs and ICDS plans.

Answer:   ODM will rely on the selected vendor to recommend, select, and/or develop the survey instrument(s) to be used for this activity. In doing so, the selected vendor will advise as to whether or not the same or separate survey instrument(s) should be used for the two populations.

Date: 7/18/2013

Inquiry: 28980


Question:   Section 4.4, Specifications of Deliverables, Activity G1: Care Management Surveys, page 25 of 79 It is understood that the two populations will need to be surveyed separately, but please provide clarification if: (1) the same survey instrument will be used for both the MCPs and ICDS plans (with potentially only slightly different supplemental questions), or (2) separate survey instruments comprised of different questionnaires will be used to evaluate the MCPs and ICDS plans.

Answer:   ODM will rely on the selected vendor to recommend, select, and/or develop the survey instrument(s) to be used for this activity. In doing so, the selected vendor will advise as to whether or not the same or separate survey instrument(s) should be used for the two populations.

Date: 7/18/2013

Inquiry: 28979


Question:   Section 4.4, Activity C: Validation of Managed Care Plan Provider Network Submissions and Performance Measurement, page 17 of 79 Can ODM clarify whether the provider networks will be different for MCPs that also serve as ICDS plans and thus whether the contractor should approach these validation activities as distinct and separate reviews for MCPs that may also serve as an ICDS plan or if there is a potential for coordination of validation activities?

Answer:   ICDS provider network requirements are different than the network requirements for MCPs serving non-ICDS beneficiaries mostly because the ICDS plans are subject to the Medicare network standards. Although there may be some potential for coordination of validation activities, ODM anticipates that the framework for review of ICDS plans will be distinct and that separate findings will be published for ICDS plans.

Date: 7/18/2013

Inquiry: 28978


Question:   Section 4.4, Activity C: Validation of Managed Care Plan Provider Network Submissions and Performance Measurement, Frequency, page 18 of 79 Can ODM clarify the number of quarterly reviews it expects the contractor to perform in SFY 2014 if the anticipated implementation date is October 28, 2013?

Answer:   ODM expects the contractor to perform at least two quarterly reviews from October 2013 – June 2014, and anticipates that there will be no more than three quarterly reviews performed during SFY 2014.

Date: 7/18/2013

Inquiry: 28977


Question:   Attachment D--Cost Proposal Form Attachment D--Cost Proposal Form indicates that Activity H3-Technical Assistance is included in H1 and H2. Should the Vendor leave the cost blank for H3?

Answer:   Yes.

Date: 7/18/2013

Inquiry: 28971


Question:   Attachment D--Cost Proposal Form Attachment D--Cost Proposal Form includes columns for Cost per Unit(s) and the total cost per activity for each SFY. May the Vendor include a separate schedule with the budgeted number of units for each activity and SFY?

Answer:   No.

Date: 7/18/2013

Inquiry: 28970


Question:   Section 5.1, B. Cost Proposal and Ohio Department of Medicaid Contract for Services, Article III. Compensation, C.4., page 67 of 79 Can ODM clarify its intent for the project as a fixed-price contract vs. a cost-reimbursement contract? The RFP indicates that the offeror should submit a flat, all-inclusive fee for performing each activity however, the Ohio Department of Medicaid Contract for Services, page 3 of 12, C.4. indicates that the contractor will provide monthly, quarterly, and annual detailed invoices that should include hourly rates and number of hours (if applicable), amount of monthly fee (if applicable), and itemized travel and other expenses if permitted by this Contract.

Answer:   ODM’s intent for this project is a fixed-price contract. However, the selected vendor may be required by the ODM contract manager to submit documentation at any time that delineates hourly rates, number of hours and itemized costs.

Date: 7/18/2013

Inquiry: 28957


Question:   Section 4.4, Specification of Deliverables, page 16 of 79 For the work plan for each activity/deliverable, should the offeror include a work plan that covers the SFY 2014, 2015, and potential contract renewals for SFY 2016, 2017, 2018, and 2019?

Answer:   Yes.

Date: 7/18/2013

Inquiry: 28950


Question:   Section 4.6, Selected Vendor Compensation Structure, page 63 of 79 If the offeror agrees with the terms set forth in this section, is a response required in the offeror’s proposal?

Answer:   No, because the vendor compensation structure is non-negotiable and will be incorporated into the resulting contract.

Date: 7/18/2013

Inquiry: 28955


Question:   Section 5.2, format for Organization of the Proposal, item A. Proposal Organization, page 66 of 79 For the sub-tabs for Section 4.4, can ODM confirm that each sub-tab should encompass all activities and sub-activities (e.g., Sub-Tab 4c. Deliverable C includes Activity C1 and Activity C2).

Answer:   Yes. In the example you provided, Sub-Tab 4c will include Activity C1 and C2.

Date: 7/18/2013

Inquiry: 28956


Question:   Section 4.4, Specifications of Deliverables, Activity G2: Quality of Life Surveys, page 26 of 79 How does ODM anticipate being able to assess quality of life for the child population?

Answer:   ODM plans to administer two surveys to the parents or caretakers of children enrolled in the Ohio Medicaid Managed Care Program who belong to the ABD Medicaid category of assistance. A baseline study will be conducted in the Spring of 2014 and a second, potentially repeat, study will be conducted in the Spring of 2016. The studies will assess the impact of health on quality of life for these members.

Date: 7/18/2013

Inquiry: 28954


Question:   Section 4.4, Specifications of Deliverables, Activity A: Assessment of Compliance with federal Medicaid Managed Care regulations and state requirements, page 16 of 79 Frequency: With the ICDS plans beginning enrollment in March of 2014, can ODM clarify its expectation for targeted quarterly reviews beginning in SFY 2014?

Answer:   The first set of quarterly reviews can be performed between April and June 2014.

Date: 7/18/2013

Inquiry: 28953


Question:   Section 4.4, Specifications of Deliverables, Activity A: Assessment of Compliance with federal Medicaid Managed Care regulations and state requirements, page 16 of 79 Can ODM clarify whether the MCP comprehensive reviews in SFY 2014 satisfy the comprehensive reviews for the four MCPs participating as ICDS plans in SFY 2015, or does ODM expect a comprehensive review of all MCPs in SFY 2014 and all five ICDS plans in SFY 2015?

Answer:   ODM anticipates that comprehensive reviews will be performed for 5 MCPs in CY 2014 and for 5 ICDS plans in CY 2015.

Date: 7/18/2013

Inquiry: 28952


Question:   Section 4.4, Specifications of Deliverables, Activity A: Assessment of Compliance with federal Medicaid Managed Care regulations and state requirements, page 16 of 79 Can ODM clarify its timeline expectation for conducting a comprehensive review of the MCPs during CY 2013 if the anticipated implementation contract date is October 28, 2013?

Answer:   This is an error. The anticipated completion timeframe is between January and June 2014. VENDOR PROPOSALS MUST TAKE THIS INTO CONSIDERATION.

Date: 7/18/2013

Inquiry: 28951


Question:   Section 4.3, Administrative Structures, item B. For the table described in item B., should the offeror include the FTEs for the entire term of the contract, or just the first year?

Answer:   Please include the FTEs for the entire term of the contract.

Date: 7/18/2013

Inquiry: 28949


Question:   Section 8.8, Minority Business Enterprise, page 74 of 79 The RFP states that if the vendor is not an Ohio-certified MBE, they may subcontract a minimum of 15% of the total contract price to an Ohio-certified MBE. Although ODJFS encourages the use of an MBE subcontractor, it will have no effect on the vendor’s technical scores. Will Prime vendors receive the additional points in Phase II if using an MBE subcontractor?

Answer:   In regards to a possible MBE subcontractor, the Prime Contractor (not the subcontractor) must be an Ohio MBE with a current and valid certification (as well as necessary documentation) in order for the prime vendor to receive additional points. Please refer to Section 8.8 for more detailed information and submission requirements.

Date: 7/16/2013

Inquiry: 28959


Question:   Attachment C, Technical Proposal Score Sheet, Phase II B.—Additional Consideration Will the vendor receive the 500 extra points if the vendor does not have an Ohio presence and is not an MBE, but elects to use a subcontractor that does have an Ohio presence and is an Ohio-certified MBE?

Answer:   Per Section 8.23 of the RFP, the selected (prime) vendor will be required to have an Ohio presence under the resulting contract. Please refer to Section 8.23 for more detailed information and requirements. In regards to a possible MBE subcontractor, the Prime Contractor (not the subcontractor) must be an Ohio MBE with a current and valid certification (as well as necessary documentation) in order for the prime vendor to receive additional points. Please refer to Section 8.8 for more detailed information and submission requirements.

Date: 7/16/2013

Inquiry: 28958


Question:   Section 6.1, Scoring of Proposals, page 68 of 79 Can ODM please provide further clarification or examples of “unnecessary use of self-promotional claims”?

Answer:   Vendor proposals should be free of "self-promotional claims". These are platitudes (bragging) or trite statements ("fluff") that only serve to boast about an organization's performance and experience rather than demonstrating it.

Date: 7/15/2013

Inquiry: 28986


Question:   General Does ODM have a preference in terms of whether offerors’ proposals should be printed single-sided or double-sided?

Answer:   ODM prefers proposal pages to be single-sided.

Date: 7/15/2013

Inquiry: 28948


Question:   Section 4.4, Specifications of Deliverables, Activity I: Validation of Performance Improvement Projects, page 33 of 79 The RFP states that each MCP will be required to conduct no more than three (3) PIPs as outlined in the MCP Provider Agreement. Appendix K, Section 3a of the MCP Provider Agreement states that the initiation of the PIPs will begin in the second year of participation in the Medicaid managed care program. Please confirm the year for the first submission of PIPs for validation.

Answer:   SFY 2014

Date: 7/15/2013

Inquiry: 28931


Question:   Section 4.4, Specifications of Deliverables, Activity I: Validation of Performance Improvement Projects, page 33 of 79 The RFP states that each MCP will be required to conduct no more than three (3) PIPs. Will the MCPs submit all three PIPs annually to the vendor for validation? If not, please confirm the number of PIPs that will be submitted for validation by MCPs annually.

Answer:   The vendor should assume that all three PIPs will be submitted annually.

Date: 7/15/2013

Inquiry: 28930


Question:   Section 1.2, Background, and Section 4.4, Specifications of Deliverables, Activity I: Validation of Performance Improvement Projects, page 3 of 79 and page 33 of 79 Page 3 of the RFP states that ICDS plans will begin in March 2014. Page 33 states that ICDS plans will conduct two PIPs during each contract year. Will the ICDS plans be required to submit PIPs for validation in SFY 2014? Or, will SFY 2015 be the first submission year for PIPs for the ICDS plans?

Answer:   SFY 2015

Date: 7/15/2013

Inquiry: 28929


Question:   Section 4.4, Specifications of Deliverables, page 16 of 79. Do the timeline and work plan for each activity/deliverable count toward the 10-page limit per activity, or is it permissible for the vendor to provide a rolled-up timeline and work plan for all activities/deliverables at the end of the activities section?

Answer:   The timeline and work plan for each activity/deliverable do not count toward the 10-page limit. ODM prefers that the vendor include the timeline and work plan at the end of each activity’s response as opposed to the end of the entire section as the question suggests.

Date: 7/15/2013

Inquiry: 28926


Question:   Section 4.3, Administrative Structures, item A., page 15 of 79. For the table of organization, is it permissible to provide an organizational chart to illustrate the structure of the organization and reporting structures, along with a table listing positions located in Ohio and the corporate office?

Answer:   Yes.

Date: 7/15/2013

Inquiry: 28925


Question:   Section 3.2, Organizational Experience and Capabilities, page 10 of 79. For section 3.2 D, subsections for activities a. through r., please confirm that vendors should address components 1 through 6 for one state Medicaid agency only per activity.

Answer:   Yes. The vendor should address components 1 through 6 for one state Medicaid agency only per activity.

Date: 7/15/2013

Inquiry: 28924


Question:   Section 3.2, Organizational Experience and Capabilities, page 10 of 79. Does ODJFS require/expect vendors to provide references, and if so, how many?

Answer:   References are not required for this RFP. In regard to Section 3.2.D, the vendor is required to provide contact information for a state contact who can validate responses for components 1 through 6 for Activities a. through r. of Section 3.2,D.

Date: 7/15/2013

Inquiry: 28923


Question:   Section 3.2, Organizational Experience and Capabilities, page 10 of 79. For section 3.2 D., subsections for activities a. through r., please confirm that each activity has a two-page limit.

Answer:   The response for each Activity (a. through r.)has a two-page limit.

Date: 7/15/2013

Inquiry: 28922


Question:   Section 3.2, Organizational Experience and Capabilities, pages 9 and 10 of 79. For the response to Section 3.2, items A. through D., is the two-page limit for the entire response (A. through D.), or only for item A.?

Answer:   For Item A. only

Date: 7/15/2013

Inquiry: 28921


Question:   Dear Sir/Mam, We would like the opportunity to submit a bid for this project. Thank you! Tony Manzo Triad Agency Group

Answer:   Please follow the submission instructions as provided in the RFP. Thank you.

Date: 7/15/2013

Inquiry: 28889


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Inquiry period ended:  7/10/2013 8:00:00 AM