Opportunity Detail

Questions and Answers

Ohio Medicaid Enterprise System (OMES), Financial Intermediary (FI) RFP
Document #:  0A1286


Question:   Template F – Cost Proposal Workbook 5. Software Maintenance and Ops Support Tier 1 represents the current or expected volume of services or records. Tier 2 represents potential future volumes of services or records Question: Since the Tier 1 volumes represent the current and expected volumes and in order to more fairly evaluate the vendors, will the State consider evaluating only Tier 1 prices for MCO, FFS, Encounters and PA?

Answer:   No, all vendors are required to provide pricing for both Tier 1 and Tier 2 levels and will be scored accordingly.

Date: 5/4/2020

Inquiry: 75988


Question:   30 - Scope of Work Amendment One Overview Q&A #74548, #74954 SOW “Help Desk Services The selected Contractor must provide Help Desk support for external users related to the functions and services provider by the Contractor (e.g., providers regarding claim and PA processing, MCPs regarding PA or encounter processing).” Answer to Inquiry 74954 - “FI will take calls from providers and escalate back to ODM staff when necessary to resolve any issues.” Answer to Inquiry 74548 – “the contractor solution may need to take phone calls related to payments or prior authorizations. Determination will be made based on the offerors proposal. There have been 6000 incoming calls on average for the last 12 months.” Question: We wish to confirm the effort of work associated with the Help Desk. The SOW and the two inquiries appear to be related to the same service which requires the contractor to manage calls however it is unclear if these calls are just providers or if it includes MCPs or other internal users such as ODM. ODM also noted in Inquiry #74548 an average of 6000 calls but it is not clear if these are monthly or annual figures. Additionally, no volumes were provided for internal user help desk inquiries. Please provide the following or estimated number in order to properly size the solution and staffing. Provider inquiries - Average number (monthly or weekly) of calls the contractor will handle, and average duration of these calls. MCP inquiries - Average number (monthly or weekly) of calls the contractor will handle, and average duration of these calls. Internal Users Inquiries - Average number (monthly or weekly) of inquiries the contractor will handle, and average duration of these inquiries

Answer:   The language added to the SOW for help desk defines the expectations for help desk support and does include providers and MCPs. The average call volume number provided is current monthly and for all calls.

Date: 5/4/2020

Inquiry: 75989


Question:   Template E Assumptions and Template F – Cost Proposal Workbook Template E Assumptions states “The offeror must list all the assumptions the offeror made in preparing the Proposal.” and the instructions for Template F Cost Proposal Workbook states “All assumptions regarding the offeror’s cost proposal must be included in tab 8 Assumptions in Template F – Cost Proposal Workbook.” Question: Please clarify whether the State would like the cost assumptions in both Template E Assumptions and Template F Cost Proposal Workbook or just in Template F Cost Proposal Workbook.

Answer:   The tab in the cost workbook is for assumptions pertaining to the cost workbook only. Template E is for all other RFP assumptions.

Date: 5/4/2020

Inquiry: 75991


Question:   Supplement One – Scope of Work – Amendment One 4.3- Prior Authorization Page 32 Removal of Requirement FI-030-030-020 Does the State’s removal of Prior Authorization scope via Amendment One mean that the State will be issuing a future RFP for this Scope?

Answer:   No decision has been made at this time in regards to issuing a future RFP for Prior Authorization

Date: 5/4/2020

Inquiry: 75992


Question:   Inquiry: 74515 and Inquiry: 74514 Questions and Answers The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times. Question: Will the State consider using the same process for the electronic submission of proposals for this RFP as was used for the EDI RFP? If so, considering it can take several days to print, produce, and deliver 16 copies (1 original and 15 copies) of the hard copy proposal, will the State consider notifying Offerors by May 15th of the process for electronic submission?

Answer:   The electronic submission solution used for the EDI RFP has not yet been approved for this RFP. If it is approved, an amendment to this RFP will be posted.

Date: 5/4/2020

Inquiry: 75990


Question:   RFP Document Name: Supplement 1 RFP Section: Supplement 1, Section 1 Page Number: 7 Question: Were any of the volumes provided in the RFP or prior questions and answers affected by any of the changes in Amendment One?

Answer:   No.

Date: 4/30/2020

Inquiry: 74953


Question:   RFP Document Name: Supplement 1 RFP Section: FI-052.020.010 Page Number: 47 Question: “The contractors solution must calculate, process, and track payables to Medicare for Medicare Buy-In enrolled individuals (e.g., Part A, Part B, Part D).” Is the fiscal intermediary responsible for creating enrollment requests for Medicare Buy-In?

Answer:   No- Buy-in processing was not part of the this RFP FI will need to process claim based on Medicare co-pays and deductibles.

Date: 4/30/2020

Inquiry: 74952


Question:   RFP Document Name Supplement 1 RFP Section: Supplement 1, Section 1 Page Number: 7 Question: In answer to question 74592 previously, the State indicated that help desk capabilities will include primarily SME work, as well as resolving IT issues. In Amendment One, you reference handling inquiries from providers. Please confirm that another entity is responsible for taking provider phone calls and we are simply handling escalations from that call center that require the expertise of a SME.

Answer:   FI will take calls from providers and escalate back to ODM staff when necessary to resolve any issues.

Date: 4/30/2020

Inquiry: 74954


Question:   RFP Document Name Supplement 1 RFP Section: Supplement 1, Section 4.3 Page Number: 35 Question: Do you have any existing prior authorization rules that you have implemented currently? If so, can you provide the details in the bidders’ library?

Answer:   Existing Prior Authorization rules will be provided to the awarded vendor.

Date: 4/30/2020

Inquiry: 74955


Question:   RFP Document Name: Supplement One RFP Section: 2.5 Proposed Work Plan and Schedule Page Number: 19 Question: The RFP requests a Gantt Chart showing all tasks and subtasks. Due to the extensive length of such a document, would the State consider a Gantt Chart of summary-level tasks plus a detailed-level work plan of all tasks without a Gantt Chart?

Answer:   Yes the State would accept Gantt Chart of summary-level tasks plus a detailed-level work plan of all tasks without a Gantt Chart. Also, project schedules can be just be included electronically and not count against the page limit of the response.

Date: 4/20/2020

Inquiry: 74515


Question:   RFP Document Name: Supplement One RFP Section: 2.5 Proposed Work Plan and Schedule Page Number: 19 Question: The RFP requests a Network Diagram showing all tasks and subtasks. A typical Microsoft Project network diagram for a project of this size and complexity would average 500-1000 pages in length (printed). Would the State consider a Network Diagram of critical path tasks only instead? We estimate this would be still in the range of 50-150 pages in length.

Answer:   Yes the State would accept Gantt Chart of summary-level tasks plus a detailed-level work plan of all tasks without a Gantt Chart. Also, project schedules can be just be included electronically and not count against the page limit of the response.

Date: 4/20/2020

Inquiry: 74514


Question:   RFP Document Name: Supplement One RFP Section: 5.3 Data Management Page Number: 71 Question: FI-130.030.050 “The contractors solution must have functionality to maintain time period based metadata and information related to all state-approved payment methodologies (e.g., DRG, HCPCS, RUG, APG, capitation payments).” States often obtain no cost license agreements to groupers. What groupers do you have in place today and are they licensed by the State and available for use by the contractor for no charge?

Answer:   Ohio currently utilizes 3M Health Information Systems’ All Patient Refined Diagnosis Related Groups (APR-DRG) for inpatient hospital services and the Enhanced Ambulatory Patient Groups (EAPG) for outpatient services. The groupers are licensed by the State from 3M HIS and approved third-party users to sign a Software Access and Confidentiality Agreement with 3M HIS.

Date: 4/17/2020

Inquiry: 74560


Question:   RFP Document Name (Supplement Three, Section 2.1.): RFP Section: Supplement Three Section 2.1 Contractor Requirements Page Number: 15 Question: Can you please provide us a copy of policy information for the two below. 2.1.7. Criminal Justice Information Systems Policy. 2.1.4. Corresponding Ohio Administrative Code Rules and Updates.

Answer:   These policies are available online by searching Ohio.gov.

Date: 4/17/2020

Inquiry: 74668


Question:   RFP Document Name: Inquiry 74468 Cost Proposal Workbook RFP Section: Revised Template to be published as an Amendment Page Number: Inquiry 74468 Question: When will the state release the amended cost proposal?

Answer:   This document is available on the website.

Date: 4/17/2020

Inquiry: 74667


Question:   FI RFP Base Part Two Work and Contract Administation Background Checks - Page 58 Requirement - All Contractor and subcontractor personnel, including any Replacement Personnel, assigned to this project who have access to sensitive or confidential information or to sensitive State systems must have a current fingerprint search and background check performed by the Federal Bureau of Investigation or other Federal investigative authority. The fingerprint search and background checks must be completed before any such Contractor or subcontractor personnel gain access to State facilities, sensitive and/or confidential information or systems. Question: Can the state identify what vendor they use for conducting their FBI and Fingerprinting checks?

Answer:   The Contractor will be responsible for this process. The State uses the Department of Public Safety for its internal staff.

Date: 4/17/2020

Inquiry: 74674


Question:   RFP Section: Inquiry: 74382 Page: N/A Question: Has the State made a final decision on the ability of Offerors to submit proposals electronically in lieu of hardcopies?

Answer:   No. The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 4/17/2020

Inquiry: 74682


Question:   FI Base RFP 3.4 Proposal Submittal Requirement - Each Offeror must submit a technical section and a cost section as part of its total Proposal before the opening time on the Proposal due date. The Offeror must submit the technical section as a separate package from the cost section of its Proposal, and each section must be submitted in its own separate, opaque package. The package with the technical section of the Proposal must be sealed and contain one (1) originally signed technical section and fifteen (15) additional copies of the technical section, and the package with the cost section also must be sealed and contain three (3) complete copies of the cost section of the Proposal. The Offeror must mark the outside of each package with either: “RFP #0A1286 – Fiscal Intermediary – Technical Proposal” or “RFP #0A1286 – Fiscal Intermediary RFP – Cost Proposal,” as appropriate. Included in each sealed package, the Offeror also must provide an electronic “searchable” copy of everything contained within the package on a flash drive (portable storage device) in Microsoft Office (native format), Microsoft Word (native format), Microsoft Project (native format), Microsoft Excel (native format) and Adobe Acrobat format, as appropriate. If there is a discrepancy between the hard copy and the electronic copy of the Proposal, the hard copy will control, and the State will base its evaluation of the Offeror’s Proposal on the hard copy. Question: Will the State confirm that the offeror will be allow to submit only an electronic version of the proposal? If so, will the State confirm the procedure for submission of the electronic version of the proposal?

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 4/17/2020

Inquiry: 74705


Question:   RFP Document Name: Supplement 2 and Base RFP and Attachments e.g. Table 1 – State of Ohio IT Policies, Standards, IT Bulletins and DAS Polices Questions: i) The State of Ohio IT Policies, Standards, IT Bulletins and DAS Policies and Bulletins referenced in this section are expansive and dynamic and many do not appear to be relevant to the work that will be performed under this Contract. Would the State please provide a hard copy of those policies it considers relevant and which will govern the Contractor’s performance of the eventual Contract? ii) Will the State please confirm that any change to those Ohio IT Policies, Standards, IT Bulletins and DAS Polices after the proposal due date will be managed through the Change Management process and shall be subject to mutual agreement on cost, schedule, scope, resource, and/or any other impacts?

Answer:   The offeror may make this request as part of their proposal but the State will not provide this documentation in hard copy prior to proposal submission nor will it agree to the inquiry requirement prior to an evaluation and negotiation process.

Date: 4/17/2020

Inquiry: 74697


Question:   Supplement One - Scope of Work - OMES-130.020.050 The contractor must convert all required data from existing data sources into the contractors solution in a format that supports all state-defined business processes. Question: How many years of claim and financial data will the State require to be converted?

Answer:   At a minimum of 10 years of claim and financial data will need to be converted.

Date: 4/17/2020

Inquiry: 74672


Question:   Supplement One - Scope of Work - OMES-130.020.050 The contractor must convert all required data from existing data sources into the contractors solution in a format that supports all state-defined business processes. Question: Does the State intend for the FI contractor to convert Image data? If so, how many years?

Answer:   Yes, financial documents will need to be stored in the contractor's solution and a minimum of 10 years of data needs to be converted.

Date: 4/17/2020

Inquiry: 74673


Question:   FI-055.010.010 Supplement One Page 54 Requirement - The contractors solution must have functionality to establish facility rates using state-identified data (e.g., cost report data, case mix scores, bed counts, quality score), based on state-defined business rules. Question - Will the contractor be required to use the detailed cost report data to establish facility rates or will ODM provide the facility rates for claims adjudication? If the contractor is required to use the detailed cost report data then how many rates per year will the contractor be required to calculate?

Answer:    Yes, cost report data must be used to establish facility rates based on the facility type and rate update schedule.

Date: 4/17/2020

Inquiry: 74675


Question:   FI-055.010.020 Supplement One Page 54 Requirement - The contractors solution must have functionality to analyze MDS data to categorize individual residents into Resource Utilization Groups (RUGs), based on state-defined business rules. Does ODM currently have a contractor that performs this requirement? If so can ODM provide the name of the contractor?

Answer:   The solution is an internal proprietary system.

Date: 4/17/2020

Inquiry: 74676


Question:   FI-055.010.030 Supplement One Page 54 Requirement - The contractors solution must have functionality to calculate each facilitys case mix score(s) using the associated weight of each RUG group and other supporting data, based on state-defined business rules. Question - Will the contractor also be required to develop resident rosters and distribute to nursing facility providers? If so what is the frequency of these reports and respective distribution?

Answer:   FI will not be responsible to develop resident rosters or distribute to nursing facilities.

Date: 4/17/2020

Inquiry: 74677


Question:   RFP Document Name: Base RFP 6.2. Attachment Two: Special Provisions & Interval Deliverable Agreement, Submittal of Deliverables (4th paragraph), page 33 Question: Will the State please define the phrase “Deliverable is not in compliance”? For example, can a detailed design document (“DSD”) detailing specific system functional requirements drafted by the Contractor and approved by the State be used as the basis for compliance/non-compliance of functional requirements in addition to the Deliverable Expectations Document (DED)?

Answer:   ODM reserves the right to reject any deliverable document if it does not meet their expectations. Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/17/2020

Inquiry: 74678


Question:   FI-060.000.010 Supplement One Page 55 Requirement - The contractors solution must capture and maintain cost data and supporting documentation received from providers (e.g., MSP, NF, hospitals, FQHC, LTSS) submitted for cost reports (i.e., Medicare, Medicaid) and calculate settlements as directed by the State. Question: Approximately how many cost reports, by provider type, should the contractor expect to receive on an annual basis? Approximately how many settlement calculations does ODM anticipate the contractor to determine on an annual basis?

Answer:   Approximately 2,700 cost reports are received annually from various provider types; quarterly or annually. Additional details for program and provider types will be provided to the awarded contractor.

Date: 4/17/2020

Inquiry: 74679


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part One: Performance And Payment, Compensation, 1st paragraph, proper invoice, page 45 Question: Will the State please define or otherwise clarify the term “proper invoice”?

Answer:   There are rules in OAC 125.01 and information in OAKS as well. OAC and OAKS- 1.An itemized listing showing delivery of the supplies or performance of the services described in the order; and 2.The date of the purchase or rendering of the service, or an itemization of the things done, material supplied, or labor furnished;and 3.The sum due pursuant to the contract or obligation. The awarded contractor will receive further instructions for details that need to be included in the invoice based on the mutually agreed upon contract.

Date: 4/17/2020

Inquiry: 74680


Question:   4.9 Cost Reports Supplement One Page 55 General Cost Report Functions Question - Does ODM currently have a contractor that performs the Cost Report requirements? If so can ODM provide the name of the contractor?

Answer:   The solution is an internal proprietary system.

Date: 4/17/2020

Inquiry: 74681


Question:   RFP Document Name: Supplement One RFP Section: 4.6 Accounts Payable Page Number: 45 Question: FI-052.000.030 “The contractors solution must have functionality to capture and maintain all financial transaction information for non-claim related payments in a format specified by the State. Non-claim related payments made on behalf of the State must be detailed in the contractors invoice. The contractor must work with the OME to develop processes and protocols for invoices. Any related documentation associated with a non-claim payment must be maintained.” This requirement appears to discuss contractor creating an invoice for a payment the contractor is also making on the State’s behalf – as opposed to the contractor receiving an invoice and making a payment. Please confirm. Is this invoice intended to show the detail of payment the contractor is making to the entity receiving the payment?

Answer:   In order for the Contractor to be reimbursed by the State for non-claim related payments, the Contractor must reflect these payments in their (the Contractor's) invoice or the payment mechanism the State and Contractor agree to.

Date: 4/17/2020

Inquiry: 74559


Question:   RFP Document Name: Supplement One RFP Section: 4.3 Prior Authorization Page Number: 36 Question: Please confirm the answer to question 74591 which states, “Durable Medical Equipment to include at a minimum of medical, dental, and transportation types of prior authorizations.” Most commonly Durable Medical Equipment is defined as medical equipment and supplies. Please clarify how medical, dental and transportation PA’s fit into this definition and confirm alignment with the answers to questions 74518 and 74519, which state, “Manual reviews for medical necessity will be performed by the contractor. Current Durable Medical Equipment Prior Authorization request volumes are about 5,000 per month. At this time, these are the only PA requests that the FI vendor are being asked to review.”

Answer:   Some CPT/HCPCS codes require prior authorization other procedures codes have limit based edits in place PA review is needed to either approve a procedure or service can be done or that exceeding the limits is medically necessary.

Date: 4/17/2020

Inquiry: 74671


Question:   RFP Document Name: Supplement One RFP Section: 4.2 Claims Adjudication Page Number: 34 Question: FI-020.080.010 “The contractor’s solution must have the functionality to suspend claims for manual review. The contractor must work with the State to define the routing processes for suspended claims to be worked until final resolution.” Is the contractor responsible for processing all suspended claims? Or is that performed by someone else like the State? Are there any claims resolution scenarios worked by someone other than the contractor? If so, please explain. Please provide projected claim suspense volumes by type and number.

Answer:   The awarded contractor may be required to work some suspended claims to resolution. The final list will be provided upon award. These numbers have been provided already.

Date: 4/17/2020

Inquiry: 74557


Question:   RFP Document Name: Base RFP Software Warranty, p. 63 Question: Will the State please modify the “Software Warranty” clause as follows: Software Warranty. If this Contract involves software as a Deliverable, then, on go-live and for 3 months after the date of go-live of any Deliverable that includes software, the Contractor warrants as to all software developed under this Contract that: (a) the software will operate on the computer(s) for which the software is intended in the manner described in the relevant software documentation, the Contractors Proposal, and the RFP Documents (b) the software will be free of any material defects (c) the Contractor will deliver and maintain relevant and complete software documentation, commentary, and source code and (d) the source code language used to code the software is readily available in the commercial market, widely used and accepted for the type of programming involved, and support programming in the language is reasonably available in the open market and (e) the software and all maintenance will be provided in a professional, timely, and efficient manner.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74704


Question:   RFP Document Name: Template B Sections 4.2 (Implementation Standards) and 4.3 (Ongoing Performance Standards) Question: Would the State please consider reducing the “Fee at Risk” and “Retainage” from 10% to 5%?

Answer:   No, but the vendor should document this in Template B Section 8 of the Terms and Conditions if they wish to make these exception

Date: 4/15/2020

Inquiry: 74703


Question:   RFP Document Name: Base RFP and all attachments Indemnification/Indemnify Question: Will the State please confirm the obligation to indemnify is limited to third party claims and indemnification of the Contractor’s negligence or willful misconduct?

Answer:   No, the obligation to indemnify is not limited to third party claims and indemnification of the Contractor's negligence or willful misconduct. Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74702


Question:   RFP Document Name: Supplement 5 Section 3.1 (Competitive Pricing and Services) Question: Will the State please modify this clause as follows: 3.1. Competitive Pricing and Services For the purposes of maintaining pricing and Service competitiveness, the Contractor agrees to a six-month review after the proposal submission date of its pricing and Service offerings. The six-month review will include a like-customer review wherein the Contractor must provide an analysis that includes both retail and wholesale prices of substantially similar services and terms it provides to other customers similar to the State to ensure the State and the Subscribers are receiving cost-competitive and technologically competitive Services. Written amendments to the Service Attachments to reduce fees and introduce technological Service improvements may be submitted.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74701


Question:   RFP Document Name: Base RFP General Warranties, 3rd paragraph, p. 63 Question: Will the State please modify the “Warranties” clause, 3rd paragraph, as follows: The warranties regarding material defects, merchantability, and fitness are 90 day warranties from the go-live date. All other warranties will be continuing warranties. If any portion of the Project fails to comply with these warranties within the 90 day warranty period, and the Contractor is so notified in writing, the Contractor must correct such failure with all due speed or must refund the amount of the compensation paid for such portion of the Project. The Contractor also must indemnify the State for any direct damages and claims by third parties based on a breach of these warranties. This obligation of indemnification will not apply where the State has modified or misused the Deliverable and the claim is based on the modification or misuse. The State will give the Contractor notice of any such claim as soon as reasonably practicable. If a successful claim of infringement is made, or if the Contractor reasonably believes that an infringement claim that is pending may actually succeed, the Contractor must do one of the following things: (1) modify the Deliverable so that it is no longer infringing (2) replace the Deliverable with an equivalent or better item (3) acquire the right for the State to use the infringing Deliverable as it was intended for the State to use under this Contract or (4) remove the Deliverable and refund the amount the State paid for the Deliverable and the amount of any other Deliverable or item that requires the availability of the infringing Deliverable for it to be useful to the State.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74700


Question:   RFP Document Name: Supplement 3 Section 2.2.3 (Inspection) Question: Will the State please consider modifying this “Inspection” clause as follows: The IRS and the Agency, with five (5) days’ notice to Contractor, shall have the right to send its inspectors into the offices and plants of the Contractor for inspection of the facilities and operations performing any Project-related work under this contract for compliance with requirements defined in IRS Publication 1075. The IRS’ right of inspection shall include the use of manual, and/or automated scanning tools to perform compliance and vulnerability assessment of information technology (IT) assets that access, store, process or transmit FTI. On the basis of such inspection, corrective actions may be required in cases where the Contractor is found to be noncompliant with contract safeguards. If corrective actions are required, Contractor shall have thirty (30) days’, or longer if mutually agreed upon, to correct noncompliant contract safeguards 2.2.3. Inspection The IRS and the Agency, with 24 hour notice, shall have the right to send its inspectors into the offices and plants of the Contractor for inspection of the facilities and operations performing any work under this contract for compliance with requirements defined in IRS Publication 1075. The IRS’ right of inspection shall include the use of manual, and/or automated scanning tools to perform compliance and vulnerability assessment of information technology (IT) assets that access, store, process or transmit FTI. On the basis of such inspection, corrective actions may be required in cases where the Contractor is found to be noncompliant with contract safeguards.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74699


Question:   RFP Document Name: Supplement 3 2.1 Contractor Requirements The Contractor specifically agrees to comply with state and federal confidentiality and information disclosure laws, rules and regulations applicable to the work associated with this Contract including but not limited to: Question: Will the State please confirm that any change in state and federal confidentiality and information disclosure laws, rules and regulations after the proposal due date applicable to the work will be managed through the Change Management process and shall be subject to mutual agreement on cost, schedule, scope, resource, and/or any other impacts?

Answer:   Any enhancements after implementation will be managed through the Change Management process but that excludes any changes that are required for federal compliance.

Date: 4/15/2020

Inquiry: 74698


Question:   RFP Document Name: Base RFP Part Two: Work And Contract Administration, Fee at Risk, page 59 Question: Will the State please explain how the fee at risk process works with the MBE set-aside?

Answer:   The fee at risk is associated with an SLA to the payment milestones. It does not have any connection with the MBE set-aside percentage.

Date: 4/15/2020

Inquiry: 74696


Question:   RFP Document Name: Base RFP and throughout all attachments Question: Will the State please define or otherwise clarify the distinction between “subcontractor” and “vendor”? Does the definition of subcontractor apply to a third party entity that receives and passes data via internet connections?

Answer:   Generally, when the State refers to "Vendor", it is referring to the prime contractor. Generally, when the State refers to "Subcontractor", it is referring to any vendor that is subcontracted through the prime contractor.

Date: 4/15/2020

Inquiry: 74695


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, Article II (Confidentiality of Information)(I), page 81 Question: Will the State please modify this sub-section as follows: I. Contractor shall permit onsite inspection to Project-related documents by the State of Ohio (including but not limited to ODM, the Auditor of the State of Ohio, the Inspector General of Ohio, the Ohio Attorney General or any duly authorized law enforcement officials) and, to the extent required by law, by agencies of the United States government.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74694


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, ARTICLE IX - LIMITATION OF LIABILITY, page 83 Question: Will the State please modify the “Limitation of Liability” clause as follows: ARTICLE IX - LIMITATION OF LIABILITY To the extent allowable by law, Contractor agrees to defend, indemnify and hold ODM, its officials, employees and agents harmless from and against any and all third party liability, loss and expense (including reasonable attorneys’ fees) or claims for personal injury, property damage, patent and copyright infringement, or for any liability or claims under ARTICLE X, Business Associate Requirements Under HIPAA, below, and/or any other type of third party claim that arises from Contractor’s negligent acts or willful misconduct under this Agreement. Contractor’s sole and exclusive remedy for any ODM failure to perform under this Agreement will be an action in the Ohio Court of Claims pursuant to ORC Chapter 2743 that will be subject to the limitations set forth in this Article. Neither party will be liable for any indirect or consequential damages, including loss of profits, of the other party even if ODM knew or should have known of the possibility of such damages. To the extent that ODM is a party to any litigation arising out of or relating in any way to this Agreement or the performance thereunder, such an action shall be brought only in a court of competent jurisdiction in Franklin County, Ohio. Subject to ORC 109.02, Contractor agrees to defend ODM against any such claims or legal actions if called upon by ODM to do so.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74693


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, ARTICLE VIII - INDEPENDENT CONTRACTOR, last sentence, page 83 Question: Will the State please modify this sentence as follows: If at any time during the contractual period Contractor becomes disqualified from conducting business in Ohio, for whatever reason, Contractor will promptly notify ODM of the disqualification and will immediately cease performance of its obligations hereunder.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74692


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, ARTICLE VIII - INDEPENDENT CONTRACTOR, last sentence, page 83 Question: Will the State please modify this sentence as follows: If at any time during the contractual period Contractor becomes disqualified from conducting business in Ohio, for whatever reason, Contractor will promptly notify ODM of the disqualification and will immediately cease performance of its obligations hereunder.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74691


Question:   RFP Document Name (example Base RFP, Supplement One, Template C): Base RFP 6.10. Attachment Ten: Business Associate Agreement, Article II (Confidentiality of Information) (K), page 82 Question: Will the State please modify this sub-section as follows: K. Contractor shall comply with Ohio Administrative Policy IT-04, Use of Internet, E-mail and Other IT Resources, prior to gaining access to statewide and ODM IT resources.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74690


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, Article II (Confidentiality of Information), page 80 Question: Will the State please modify the following paragraph as follows: ARTICLE II - CONFIDENTIALITY OF INFORMATION A. Contractor agrees that it shall not use any information, systems, or records made available to it for any purpose other than to fulfill the obligations specified herein. Contractor specifically agrees to comply with state and federal confidentiality and information disclosure laws, rules, and regulations applicable to programs under which this Agreement exists, as set forth in the following:

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74689


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, Article X - Business Associate Requirements Under HIPPA (B)(12), page 85 Question: Will the State please modify the “Material Breach” clause as follows: 11. Material Breach. In the event of material breach, attributable solely to Contractor, of Contractors obligations under this Article, ODM may immediately terminate this Agreement as set forth in ARTICLE V, Section B. Termination of this Agreement will not affect any provision of this Agreement, which, by its wording or its nature, is intended to remain effective and to continue to operate after termination.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74688


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, Article X - Business Associate Requirements Under HIPPA (B)(12), page 85 Question: Will the State please modify the “Material Breach” clause as follows: 11. Material Breach. In the event of material breach, attributable solely to Contractor, of Contractors obligations under this Article, ODM may immediately terminate this Agreement as set forth in ARTICLE V, Section B. Termination of this Agreement will not affect any provision of this Agreement, which, by its wording or its nature, is intended to remain effective and to continue to operate after termination.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74687


Question:   RFP Document Name: Base RFP 6.10. Attachment Ten: Business Associate Agreement, Article X - Business Associate Requirements Under HIPPA (B)(11), page 85 Question: Will the State please modify the “Access to Books and Records” clause as follows: 11. Access to Books and Records. Contractor shall make available to ODM and, as requested, to the Secretary of the U.S. Department of Health and Human Services, internal practices, documentation, books, and records directly related to the Contractor’s use and disclosure of PHI received from ODM, or created or received on behalf of ODM. Such access shall be granted and such information shall be reviewed solely for the purposes of determining compliance with the HIPAA Rules.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74686


Question:   RFP Document Name: Base RFP Part Two: Work And Contract Administration, Replacement Personnel, two resumes, 4th paragraph, last sentence, page 52 Questions: i) To allow sufficient time to find qualified replacement personnel meeting the requirements, will the State please modify the last sentence of the fourth paragraph as follows: The Contractor must submit the two resumes, along with such other information as the State may reasonably request, within 15 business days after the decision to remove a person is made or the unavailability of a listed person becomes known to the Contractor. ii) Will the State waive the liquidated damages associated with not timely providing two replacement candidates, if Contractor provides a temporary replacement candidate with equal or greater qualifications than the prior resource, until two replacement candidates can be provided?

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74685


Question:   RFP Document Name: Base RFP Part Two: Work And Contract Administration, Fee at Risk, page 59 Question: Will the State please modify “Fee at Risk” as follows: Fee at Risk. Compliance with Contractor’s cost MBE set-aside percentage is a term of this contract. Contractor agrees to place ten percent (10%) of its annual payment at risk for failure to attain the cost MBE set-aside percentage each year, if failure to attain cost MBE set-aside percentage is solely attributable to Contractor.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74684


Question:   RFP Document Name: Base RFP Part Two: Work And Contract Administration, Record Keeping, page 48 Question: Will the State please modify “Record Keeping” as follows: Record Keeping. The Contractor must keep all financial records in accordance with generally accepted accounting principles or equivalent consistently applied. The Contractor also must file Project-related documentation to support each action under this Contract in a manner allowing the documentation to be readily located. Additionally, the Contractor must keep all Project-related records and documents at its principal place of business or at its office where the work was performed. “Project-related” documents are defined as those directly related to the Contractor’s work under this Contract.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74683


Question:   RFP Document Name: Template F RFP Section: 5. Software Maint & Ops Support Page Number: Tab 5 Question: In the monthly cost columns per year, is the state expecting to see a fixed fee for each tier range? Or a per claim/record/ request fee?

Answer:   The State expects to see total costs for each category and tier level per month.

Date: 4/15/2020

Inquiry: 74670


Question:   RFP Document Name: Inquiry 74590 RFP Section: N/A Page Number: N/A Question: Is the FI expected to provide the pharmacy point of sale processing?

Answer:   The FI will process FFS POS claims received from the PBM via EDI in NCPCP post-adjudicated format, and pay the providers

Date: 4/15/2020

Inquiry: 74669


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part Two: Work And Contract Administration, Insurance Page: 47-58 Question: Will the State please modify the “Insurance” clause as follows: Insurance Contractor shall procure and maintain for the duration of the contract insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by the Contractor, its agents, representatives, or employees. Contractor shall procure and maintain for the duration of the contract insurance for claims arising out of their services and including, but not limited to loss, damage, theft or other misuse of data, infringement of intellectual property, invasion of privacy and breach of data. MINIMUM SCOPE AND LIMIT OF INSURANCE Coverage shall be at least as broad as: 1. Commercial General Liability (CGL): written on an "occurrence" basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 2. Automobile Liability: covering Code 1 (any auto), or if Contractor has no owned autos, Code 8 (hired) and 9 (non-owned), with a limit no less than $1,000,000 per accident for bodily injury and property damage. 3. Workers Compensation insurance as required by the State of Ohio, or the state in which the work will be performed, with Statutory Limits, and Employers Liability Insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease. If Contractor is a sole proprietor, partnership or has no statutory requirement for workers’ compensation, Contractor must provide a letter stating that it is exempt and agreeing to hold Entity harmless from loss or liability for such. 4. Technology Professional Liability (Errors and Omissions) Insurance appropriate to the Contractor’s profession, with limits not less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. Coverage shall be sufficiently broad to respond to the duties and obligations as is undertaken by Contractor in this agreement and shall cover all applicable Contractor personnel or subcontractors who perform professional services related to this agreement. 5. Cyber liability (first and third party) with limits not less than $5,000,000 per claim, $10,000,000 aggregate. Coverage shall be sufficiently broad to respond to the duties and obligations as is undertaken by Pre-Qualified Contractor in this agreement and shall include, but not be limited to, claims involving infringement of intellectual property, including but not limited to infringement of copyright, trademark, trade dress, invasion of privacy violations, information theft, damage to or destruction of electronic information, release of private information, alteration of electronic information, extortion and network security. The coverage shall provide for breach response costs as well as regulatory fines and penalties and credit monitoring expenses with limits sufficient to respond to these obligations. The Insurance obligations under this agreement shall be the minimum Insurance coverage requirements and/or limits shown in this agreement. Any insurance proceeds in excess of or broader than the minimum required coverage and/or minimum required limits, which are applicable to a given loss, shall be available to the State of Ohio. No representation is made that the minimum Insurance requirements of this agreement are sufficient to cover the obligations of the Contractor under this agreement. The insurance policies are to contain, or be endorsed to contain, the following provisions: Additional Insured Status Except for Workers’ Compensation, Cyber and Professional Li

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74634


Question:   RFP Document Name: Base RFP §6.4 (ATTACHMENT FOUR: GENERAL TERMS AND CONDITIONS), PART TWO: WORK AND CONTRACT ADMINISTRATION, Suspension Page: 47-58 Question: The Contractor respectfully submits i) reasonable compensation during periods of suspension, in order to keep staff/subcontractor(s) and any other requirement(s) available, and ii) a reasonable time limit to such periods. Will the State please modify this Section as follows: The State will have the option of suspending, with thirty (30) days prior written notice to Contractor, this Contract in full or in part rather than terminating the Project, if the State believes that doing so would better serve its interests. In the event of a suspension for the convenience of the State, the Contractor will be entitled to receive payment for the work performed before and during the suspension. In the case of suspension of the Project for cause rather than termination for cause, the Contractor will be entitled to compensation. If the State reinstates the Project after suspension for cause, rather than terminating this Contract after the suspension, the Contractor will be entitled to compensation for work performed before and during the suspension, less any damage to the State resulting from the Contractor’s breach of this Contract or other fault. Any amount due for work before or after the suspension for cause will be offset by any damage to the State from the default or other event giving rise to the suspension. No such suspension shall last longer than thirty (30) days, during which time the State shall cover all unrecoverable fixed and variable costs incurred and after which time the Contractor may terminate for convenience.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74633


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part Two: Work And Contract Administration, Audits and throughout the RFP and its Attachments Page: 47-59 Question: Will the State please modify the “Audits” clause as follows: Audits. During the term of this Contract and for three years after the payment of the Contractor’s Fee, on reasonable notice, not less than five (5) business days, and during customary business hours, the State may audit the Contractor’s records and other materials that directly relate to the Project. This audit right also applies to the State’s duly authorized representatives and any person or organization providing financial support for the Project. Any non-State employee will execute Contractor’s Non-Disclosure Agreement to protect Contractor’s proprietary and confidential information prior to performing any audit. State audit rights will apply to those Contractor materials that directly relate to the contract, and that are required to verify the accuracy of a Contractor invoice to the State inclusive of: Contractor personnel timesheets Contractor purchased or provided equipment for benefit of the State that will remain in the State’s possession State deliverable acceptance documentation any required State written approvals as required herein final Work products and deliverables any partial or incomplete Work products or deliverables that the Contractor submit for partial compensation from the State as a result of termination of this contract.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74632


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part Four: Representations, Warranties, And Liabilities, Indemnity for Property Damage, Bodily Injury, and Data Breach, Page: 64 Question: Will the State please modify the “Indemnity for Property Damage, Bodily Injury, and Data Breach” clause as follows: Indemnity for Property Damage, Bodily Injury, and Data Breach. Subject to the Limitation of Liability clause, the Contractor must indemnify the State from third party claims for all liability and expense resulting from bodily injury to any person (including injury resulting in death), damage to tangible or real property, or disclosure/breach of State Data including personally identifiable information and State sensitive information arising out of the performance of this Contract, provided that such bodily injury, property damage, or disclosure/breach is due to the negligence or willful misconduct of the Contractor, its employees, agents, or subcontractors. The Contractor will not be responsible for any damages or liability to the extent caused by the negligence or willful misconduct of the State, its employees, other contractors, or agents. The Contractor’s obligations with respect to any legal action are contingent upon the State giving the Contractor (1) written notice of any action or threatened action, (2) the opportunity to take over and settle or defend any such action at Contractor’s sole expense, and (3) reasonable assistance in defending the action. The Contractor shall not be liable for any cost, expense, or compromise incurred or made by the State in any legal action without the Contractor’s prior written consent, which shall not be unreasonably withheld.

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74631


Question:   RFP Document Name: Base RFP §6.4 (ATTACHMENT FOUR: GENERAL TERMS AND CONDITIONS), PART TWO: WORK AND CONTRACT ADMINISTRATION, Termination for Convenience Page: 47 - 58 Questions: Will the State please confirm the Contractor will be provided a thirty (30) days’ prior written notice before exercising a “Termination for Convenience”? For items not specifically priced, does the price owed to Contractor include i) a price to commensurate with the actual cost of performance for partially completed deliverables, ii) unamortized costs and iii) reasonable wind-down costs?

Answer:   The State will attempt to provide a reasonable notice of termination for convenience. If the termination is for the convenience of the State, the Contractor will be entitled to the Contract price as prorated by the State Contract price for deliverables, products or services accepted by the State and not previously paid for provided in that in no event will total payments exceed the amount payable to the Contractor if the Contract had been fully performed. For items not specifically priced, the State will use fair market value to determine the price owed. The Contractor will use generally accepted accounting principles or equivalent and sound business practices in determining all costs claimed, agreed to, or determined under this clause. Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74629


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part One: Performance And Payment, Appropriations Pages: 44-47 Question: Regarding the availability of lawful appropriations by the Ohio General Assembly. Can the State please confirm that if funds become unavailable: i) State shall notify the Contractor as soon as it has knowledge that funds may not be available for the continuation of this Contract for each succeeding fiscal period beyond the first, and ii) Contractor shall be reimbursed for the reasonable value of any nonrecurring costs incurred but not amortized in the price of the Contract, the Contract price(s) for completed deliverables delivered to and accepted by the State (including unpaid invoices), a price to commensurate with the actual cost of performance for partially completed deliverables, the recovery of allowable costs incurred or obligated but unbilled as of the date of termination, unamortized costs, costs incurred in the performance of the work terminated, including, but not limited to start-up costs and preparatory expense allocable thereto, the cost of settling and paying termination settlements under terminated subcontracts and leases, accounting, legal, clerical, and other expenses reasonably necessary for the preparation and negotiation of termination settlement proposals and the termination claim and a fair and reasonable profit on the foregoing costs?

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74628


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part One: Performance And Payment, Compensation Page: 45 Question: Will the State please confirm that payment terms for an undisputed Contractor’s invoice is net thirty (30) days from Contractor’s invoice date?

Answer:   Yes, payment terms for an undisputed Contractor's invoice is net thirty (30) days from the date of receipt of Contractor's invoice.

Date: 4/15/2020

Inquiry: 74627


Question:   RFP Document Name: Template B RFP Section: 4.1 Performance Standards, Fee at Risk, Retainage, and Service Credits Page: 5 Question: Will the State please consider i) limiting the cumulative service level agreement (SLA(s)) service credits to a percentage of the monthly invoice or consider some other monthly limit and ii) should one SLA failure trigger one or more different SLA failure(s), the State will only assess a service credit for one SLA after Contractor’s failure to cure?

Answer:   Mandatory contractual terms noted in Section 4: Mandatory Terms and Documents are non-negotiable.

Date: 4/15/2020

Inquiry: 74626


Question:   RFP Document Name: General Question Section: General Question Page: N/A Question: Will the State please consider including a non-solicitation provision, as negotiated with the awarded vendor, in the final agreement?

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B, section 8.

Date: 4/15/2020

Inquiry: 74625


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part One: Performance And Payment, Scope of Work, satisfactory performance, Page 44 Questions: Will the State please outline what constitutes satisfactory performance?

Answer:   Satisfaction would be the compliance with requirements, deliverables, SLAs, and KPIs as outlined in the RFP.

Date: 4/15/2020

Inquiry: 74624


Question:   RFP Document Name: Base RFP 6.4. Attachment Four: General Terms And Conditions, Part Four: Representations, Warranties, And Liabilities, Limitation of Liability, Page 64 Question: In order to offer competitive pricing, the Contractor respectfully requests a cap on liability consistent with industry standards and reasonable apportionment of risk on programs of similar size and complexity. Will the State please consider changing “excess of two times the fixed price of this Contract” to “excess of two times the annual amount of this Contract paid by State to Contractor”?

Answer:   The State will not consider this request

Date: 4/15/2020

Inquiry: 74622


Question:   RFP Document Name: Base RFP 6.4 (Attachment Four General Terms and Conditions), Part Three (Ownership and Handling of Intellectual Property and Confidential Information), Page 59 and throughout the RFP and its Attachments Question: Intellectual Property (IP) terms must be applicable to and appropriate for the Offeror’s proposed solution, so Offeror requires the IP terms throughout the RFP and its Attachments be replaced and superseded in their entirety with the IP terms below, which are applicable to and appropriate for Offeror’s proposed solution. Will the State please confirm its acceptance of the following: Intellectual Property (IP) Ownership: State Ownership. State and Contractor agree that State shall be the exclusive owner of all right, title, and interest in and to modifications to CMdS Core Claims & Financial reports, data, and materials that are created specifically for State by Contractor and paid for by State as an output of the Services or other performance by Contractor under this Agreement or any SOW (collectively, the “State Work Product”). Such State Work Product shall be deemed a work-made-for-hire under the Copyright Act and that State shall have the exclusive right to protect the State Work Product by patent, copyright, or any other means. In the event that, by operation of law or otherwise, Contractor is deemed to be the owner of all or any portion of the Intellectual Property Rights in the State Work Product, Contractor hereby assigns all such Intellectual Property Rights to State and agrees to cooperate with State in confirming State’s sole and exclusive ownership of the State Work Product, without further consideration to Contractor. For the avoidance of doubt, any development or configuration of Contractor Work Product used internally by Contractor to provide Services that results in State-specific versions of the Contractor Work Product, shall not be considered State Work Product. Contractor Ownership. State and Contractor agree that Contractor shall be the exclusive owner of all right, title, and interest in and to all pre-existing software, programming, tools, documentation, materials, and other intellectual property, or materials developed independently from this agreement that is not State Work Product (collectively, the “Contractor Work Product”) of any kind, used, developed, or delivered by Contractor to State in connection with providing the Applications, Documentation, and Services or other performance by Contractor under this Agreement that such Contractor Work Product shall not constitute a work-made-for-hire under the Copyright Act and that Contractor shall have the exclusive right to protect the Contractor Work Product by patent, copyright, or any other means. In the event that, by operation of law or otherwise, State is deemed to be the owner of all or any portion of the Intellectual Property Rights in the Contractor Work Product, State hereby assigns all such Intellectual Property Rights to Contractor and agrees to cooperate with Contractor in confirming Contractor’s sole and exclusive ownership of the Contractor Work Product, without further consideration to State. IP Licenses: Fixed Term License. Contractor grants to State a renewable, limited, non-exclusive, non-sublicensable, non-transferable right to use, to access, and to permit the state staff users identified in Exhibit ___ (“Users”) to use and access the portions of the CMdS Core Claims & Financial necessary for State to use the State Work Product for the purpose of ___ during the period starting on the date this Agreement is signed by the last party to sign it (as indicated by the date associated with that party’s signature) (the “Effective Date”) and ending ten (10) years later PROVIDED THAT this license does not apply to third party commercial off the shelf (COTS) software, programming, tools, documentation, materials, and other intellectual property, or materials, for which Contractor will

Answer:   Any exceptions to the RFP terms and conditions must be provided in Template B.

Date: 4/15/2020

Inquiry: 74621


Question:   RFP Document Name: Base RFP Part Four - Section 4.14. (Contract Negotiations), Page 23 Question: Can the State please provide information on which proposal aspect(s) the State will and will not negotiate or how that determination may be made?

Answer:   Mandatory contractual terms noted in Section 4: Mandatory Terms and Documents are non-negotiable. Any other exceptions will be considered on a case by case basis. ODM has full discretion to accept or reject any proposed exceptions.

Date: 4/15/2020

Inquiry: 74620


Question:   RFP Document Name: Response to Q&A RFP Section: Inquiry 74548 Page Number: N/A Question: In your response to inquiry 74548 you indicated that there have been 6000 incoming calls on average over the last 12 months. Is this a monthly average?

Answer:   Yes

Date: 4/15/2020

Inquiry: 74618


Question:   RFP Document Name: Base RFP RFP Section: 1.3 Page Number: 9 Question: RFP Text: “Once awarded, the term of the Contract will be from the award date until the Project is completed to the satisfaction of the State and the Contractor is paid or June 30, 2031, whichever is sooner and, subject to and contingent on the discretionary decision of the Ohio General Assembly to appropriate funds for this Contract in each new biennium for the maximum contract term expiring June 30, 2031. Question: Will the State please define “satisfaction”?

Answer:   Satisfaction would be the compliance with requirements, deliverables, SLAs, and KPIs as outlined in the RFP.

Date: 4/15/2020

Inquiry: 74617


Question:   RFP Document Name: Base RFP and Supplement Five RFP Section: Base RFP (Section 1.3) Supplement Five (Sections 1.4-1.6) Page Number: Base RFP (page 9) Supplement Five (page 3) Question: The go-live date is estimated to be October 2021. Does the initial contract term expire at the end of the current biennium (6/30/21)? If during implementation the contract expires (not renewed) or is terminated for convenience, in addition to paying for completed work, will the State pay for partially completed work based on a proration of the contract price?

Answer:   In the event that the State elects not to renew the contract or terminate it for convenience, State will consider paying for partially completed deliverables on a prorated basis.

Date: 4/15/2020

Inquiry: 74616


Question:   RFP Document Name: Base RFP and Template A RFP Section: Technical Proposal Instructions – Table Entry “Template A – Cover Letter, Executive Summary, and Subcontractor Letters” Page Number: 40 (Base RFP) and Pages 4 through 5 (Template A) Question: Page 40 of Base RFP has an entry for “Subcontractor Letters for each proposed subcontractor. The offeror must attach a letter from the subcontractor, signed by an individual authorized to legally bind the subcontractor, and having the same content as that listed above.” Does the phrase “same content as that listed above” refer to the following bullets? ➢ The offeror’s legal notice address ➢ The offeror’s payment address ➢ The offeror’s legal structure ➢ Individuals responsible for development of the offeror’s proposal We ask this because these bullets relate to the requirements in Template A for Section 2 Offeror Information, Subsection 2.1 Payment Address, (Table 1), Subsection 2.2 Legal Notice Address (Table 2), Subsection 2.3 Offeror Legal Structure (Table 3), and Subsection 2.4, Proposal Preparation (Table 4). Please confirm that Subcontractor Letters should contain only the information requested in Template C, Section 4. Subcontractor Letters.

Answer:   Subcontractor Letters, per the RFP Base, must contain the information stated in all nine of the bullets listed in the Technical Proposal Intructions table.

Date: 4/15/2020

Inquiry: 74614


Question:   RFP Document Name: Template B RFP Section: Section 3. State Customary Terms and Conditions and Section 4. Mandatory Terms and Documents Page Number: 4 - 5 Question: Section 3. State Customary Terms and Conditions specifically lists Performance Standards, Fee at Risk, Retainage, and Service Credits (Section 4) as one of the bulleted documents allowed to have exceptions. However, in Section 4. Mandatory Terms and Documents, which includes sub-sections 4.1 - 4.4 (Performance Standards, Fee at Risk, Retainage, and Service Credits), the RFP does not allow exceptions. Please confirm the Offeror is allowed to make exceptions to the language in Sections 4.1 - 4.4, Performance Standards, Fee at Risk, Retainage, and Service Credits as detailed in Section 3, State Customary Terms and Conditions.

Answer:   Mandatory contractual terms noted in Section 4: Mandatory Terms and Documents are non-negotiable.

Date: 4/15/2020

Inquiry: 74613


Question:   RFP Document Name: Base RFP RFP Section: 4.12 Reference Checks Page Number: 22 Question: Page 22, Section 4.12 Reference Checks of the Base RFP states: ‘…the State may conduct reference checks to verify and validate the Offeror’s and its proposed candidates’ and subcontractors’ past performance. Reference checks that indicate poor or failed performance by the Offeror or a proposed candidate or subcontractor may be cause for rejection of the Offeror’s Proposal.” While we understand that Offerors must provide past performance references for the prime and individual references for proposed candidates, page 22 of the Base RFP suggests that we must also include references for subcontractors’ past performance. Must Offerors provide references for proposed subcontractors? If so, how many references are required and where in the proposal such references should be provided?

Answer:   Template C, Section 2.4 states that if the offeror uses subcontractors, they must also complete the information requested in Table 5.

Date: 4/15/2020

Inquiry: 74612


Question:   RFP Document Name: Template C RFP Section: 4.1 Subcontractor Contact Information Page Number: 7 Question: Table 5 – Subcontractor Contact Information asks for Company Size. Does this requirement refer to total number of employees or dollar value of the company?

Answer:   Template A, Table 5- Company Size refers to the number of employees.

Date: 4/15/2020

Inquiry: 74611


Question:   RFP Document Name: Supplement One RFP Section: 8.0, Summary of Deliverables, Table 32 Page Number: 123 Question: The Program Integrated Master Schedule Management Guide includes a Solution Configuration Build phase, which we assume would cover any configuration and development work for the project. Is it the States intent to include a phase like this in the 12-month DDI, and if so, would the state consider adding it to Table 32?

Answer:   Solution Configuration Design is a phase listed in Table 32 and further described in Table 33, page 127.

Date: 4/15/2020

Inquiry: 74610


Question:   RFP Document Name: Supplement One RFP Section: 7.3 Compliance Page Number: 125 Question: Will the FI be responsible for overall security and integrity of the solution environment? A. Who will Own the Security Operations (i.e. all the operational controls for monitoring and compliance - patches, AV updates, IDS/IPS implementation, MFAs)? B. Who will manage SIEM?

Answer:   A. The vendor will be responsible for managing the security operations related to their solution. B. The selected vendor will be required to have their own SIEM solution and ship relevant logs to the state.

Date: 4/15/2020

Inquiry: 74594


Question:   RFP Document Name: Base RFP, 03 Supplement One Scope of Work and throughout the RFP and its Attachments 6.4. Attachment Four: General Terms And Conditions, Part Seven: Law And Courts, Compliance with Law Page 68, Supplement One (compliance) and throughout the RFP and its Attachments Question: Will the State please confirm that any changes, including but not limited to, changes in laws, rules, regulations, policies, requirements, standards, etc. after the proposal due date will be managed through the Change Management process and shall be subject to mutual agreement on cost, schedule, scope, resource, and/or any other impacts?

Answer:   Any enhancements after implementation will be managed through the Change Management process but that excludes any changes that are required for federal compliance.

Date: 4/15/2020

Inquiry: 74623


Question:   RFP Document Name: Supplement One RFP Section: 7.3 Compliance Page Number: 125 Question: Assuming that the vendor is required to use state’s hosted solution environment, will the State leverage its own tools for the below functions or should the vendor propose its own set of tools? • Log Management • Vulnerability Management • Patch Management • Anti-Virus • Change Detection Services • Domain Name Services (DNS) • Authentication Services • Intrusion Detection Services (IDS)/Intrusion Prevention Services (IPS) • NTP Services • Backup and Tape Management • Change Management • Virtual Data Center including Storage Area Networks • Disaster Recovery and Data Replication Services • Incident Response (IR) • Web Proxy Services • Remote Access/VPN Services

Answer:   If the vendor leverages the State's environment, there will be likely a mix of the State's tools and the vendor tools for the functions in question.

Date: 4/13/2020

Inquiry: 74595


Question:   RFP Document Name: Supplement One RFP Section: 7.3 Compliance Page Number: 125 Question: OMES-320.010.050 captures risk based assessment requirement by a third party. What would be the frequency of “NIST 800-53 Rev4 Moderate Baseline and HIPAA requirements” audit stated under this section?

Answer:   The audits needs to be done annually.

Date: 4/13/2020

Inquiry: 74593


Question:   RFP Document Name: Supplement One RFP Section: 2.3 Key Roles Page Number: 14 Question: Based on the description of the Help Desk / Training Coordinator, it appears that you are expecting more of functional/SME capability in the Help Desk such as the usage of our solution to process claims rather than technical/IT issues such as login issues, reporting errors, or web browser issues. Please confirm.

Answer:   The helpdesk capabilities will include primarily SME work as well as resolving IT issues.

Date: 4/13/2020

Inquiry: 74592


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 3 Question: The RFP has identified that the fiscal intermediary is responsible for processing 50,000 prior authorizations a year. Currently we have no further information about the types of authorizations (i.e. medical, dental, waiver, transportation) and we cannot forecast the types of judgements, including clinical, required to process those prior authorizations. Can more information be provided about the types of prior authorizations to be processed?

Answer:   Durable Medical Equipment to include at a minimum of medical, dental, and transportation types of prior authorizations.

Date: 4/13/2020

Inquiry: 74591


Question:   RFP Document Name: Supplement One RFP Section: Responses to questions Page Number: N/A Question: Based on the responses to questions, we would like to clarify the role of the fiscal intermediary in processing pharmacy claims. It is it the intent that the separate PBM FFS contractor will receive and price all pharmacy claims, including requests for adjustments, and then pass the adjudicated original claim or adjustment to the fiscal intermediary for a claims payment cycle to calculate payments or recoveries due to or from the provider.

Answer:   The FFS PBM will process the claim up to pricing and pass to the FI. The FI will price and pay the claim.

Date: 4/13/2020

Inquiry: 74590


Question:   RFP Document Name: Supplement One RFP Section: 4.3 Prior Authorization Page Number: 36 Question: FI-030.040.010 “The contractor must provide multi-lingual FFS prior authorization correspondence to support the required languages pursuant to 45 Code of Federal Regulations (CFR) Section 80.3(b)(2) for member-facing correspondence.” Often prior authorization requests are requested by the provider and correspondence occurs between the payer and provider. Could you please clarify what member related prior authorization correspondence the fiscal intermediary would be responsible for delivering?

Answer:   The member related prior authorization correspondence will include denial notices as well as potentially any other member related notices.

Date: 4/13/2020

Inquiry: 74589


Question:   RFP Document Name: Supplement One RFP Section: 4.12 OAKS Integration Page Number: 61 Question: FI-090.000.010 “The contractors solution must integrate with the Ohio Administrative Knowledge System (OAKS).” We have reviewed the information in the bidder library, and we are finding limited information and no specifications about any existing integrations between MITS and OAKS. Could you please provide or direct to us to this information so that we may respond about OAKS integration?

Answer:   ODM will provider the contractor with all INF files that will be used for FI since the existing file may no longer be utilized. The OAKS integration would include at minimum, information from INF02 (provider payment), INF30 (billing), and INF31 (customer) processes. Further information will be provided to the awarded vendor.

Date: 4/13/2020

Inquiry: 74588


Question:   RFP Document Name: Supplement One RFP Section: 7.3 Compliance Page Number: 121 Question: OMES-320.010.050 “The contractor must possess a recent risk-based security assessment performed by an independent third party, in accordance with a relevant common security framework (CSF) or widely recognized set of cybersecurity controls which adhere to either a) the NIST 800-53 Rev4 Moderate Baseline and HIPAA requirements, b) HITRUST, c) the FedRAMP Moderate Impact Baseline, or d) as specified by CMS.” With the use of the word “recent” here, is this a requirement looking backwards rather than an ongoing requirement? If so, will the third party FedRAMP assessment of the cloud infrastructure provider be sufficient to meet this requirement.

Answer:   No, if the offeror is presenting an existing platform then the State wants to see the existing audits. Going forward, the selected vendor will be required to obtain annual third party audits demonstrating compliance with a relevant common security framework.

Date: 4/13/2020

Inquiry: 74587


Question:   RFP Document Name: Supplement One RFP Section: 4.5 Financial Management Page Number: 43 Question: FI-050.010.050 “The contractors solution must generate electronic 1099s to appropriate providers and service contractors prior to January 31 for the previous year. The contractors solution must have functionality to distribute 1099s to each provider via a method of their choosing (e.g., provider portal, email).” Will the Provider Network Management Module provide the information on each provider’s communication preferences? If not, what is the source of this information?

Answer:   Yes, the data will be available in the Provider Network Management module.

Date: 4/13/2020

Inquiry: 74586


Question:   RFP Document Name: Supplement One RFP Section: 4.5 Financial Management Page Number: 41 Question: FI-050.000.070 “The contractor must establish and maintain state-identified accounting periods (e.g., monthly, quarterly, fiscal year) applied to financial processes.” Do you use non-calendar-based monthly or quarterly periods? i.e. the accounting month ends after the 4th Friday instead of the last day of the calendar month. While we have experience with differing state and federal fiscal year schedules, we would like to understand the use case better for monthly and quarterly so we can respond with our capabilities to meet your requirement.

Answer:   The State uses both non-calendar based periods as well standard calendar periods.

Date: 4/13/2020

Inquiry: 74585


Question:   RFP Document Name: Supplement One RFP Section: 4.5 Financial Management Page Number: 42 Question: FI-050.000.110 “The contractors solution must have functionality to perform mass adjustments to previously processed transactions (e.g., claims payments, capitation payments, performance-based payments) based on changes to data used for previous calculations (e.g., annual adjustment in rates, negotiated rate change, changes in program services, court settlements).” If this task can be accomplished for certain kinds of payments (i.e. capitations or performance-based payments) in a way that is different from a mass adjustment but has the same outcome, is that okay?

Answer:   Yes it is okay, as long as the individual transactions accurately reflect what happened through the mass adjustment process.

Date: 4/13/2020

Inquiry: 74584


Question:   RFP Document Name: Supplement One RFP Section: 2.3 Key Roles Page Number: 14 Question: Please modify the requirements to allow representative resumes for key role staff positions for RFP to be submitted with the understanding that the State has the right to review and approve all key staff proposed after contract award and prior to contract execution.

Answer:   ODM expects that the key staff resources submitted in the bidder's proposal will be available and assigned to this project upon contract award. If the specific key resources are not available at the time of contract execution, the awarded vendor is required to follow the process outlined in the section 6.4 Attachment Four- General Terms and Conditions, page 51, Replacement Personnel.

Date: 4/13/2020

Inquiry: 74583


Question:   RFP Document Name: Supplement One RFP Section: 2.3 Key Roles Page Number: 14 Question: Please modify the requirements to allow representative resumes for key role staff positions for RFP to be submitted with the understanding that the State has the right to review and approve all key staff proposed after contract award and prior to contract execution.

Answer:   ODM expects that the key staff resources submitted in the bidder's proposal will be available and assigned to this project upon contract award. If the specific key resources are not available at the time of contract execution, the awarded vendor is required to follow the process outlined in the section 6.4 Attachment Four- General Terms and Conditions, page 51, Replacement Personnel.

Date: 4/13/2020

Inquiry: 74582


Question:   RFP Document Name: Supplement One RFP Section: 2.3 Key Roles Page Number: 14 Question: Help Desk/Training Coordinator Responsibilities – Please confirm the following responsibility is appropriately listed for this role: “Executes quality review of resolution staff to ensure adjudication rules are understood and followed.”

Answer:   Yes, this is confirmed

Date: 4/13/2020

Inquiry: 74581


Question:   RFP Document Name: Supplement One RFP Section: 4.2 Claims Adjudication Page Number: 33 Question: FI-020.060.050 "The contractors solution must have functionality to disposition pharmacy claims for enrolled individuals that are eligible for Medicare Part D Dual and Medicare Low Income Subsidy and adjudicate in accordance with State policy." Is this a requirement to deny encounters paid by the MCO where the member is eligible for Medicare? Our understanding is there is a separate PBM contractor who would be processing FFS pharmacy claims.

Answer:   No, this requirement is not to deny encounters paid by the MCO where the member is eligible for Medicare.

Date: 4/13/2020

Inquiry: 74564


Question:   RFP Document Name: Supplement One RFP Section: 4.2 Claims Adjudication Page Number: 29 Question: FI-020.000.030 “The contractors solution must have functionality to apply a specified set of edits and audits to managed care claims, and route approved claims with the Medicaid ICN, to the appropriate Managed Care Plan for adjudication and payment. Managed care claims failing edits and audits will be denied and returned to the submitter.” If the managed care claim is rejected by the fiscal intermediarys solution before going to the MCP, should be rejected back to the submitter via EDI or just denied on an FFS 835?

Answer:   The intent is not for the FI module vendor to reject any claims, but to do minimal edits/audits and if those are not met to deny the claim.  The denial would go back to the provider in the same format in which they came into FI, whether that is Portal or EDI. 

Date: 4/13/2020

Inquiry: 74544


Question:   RFP Document: Template C Section: 2.1.1 Mandatory Qualification #1 – Experience Page Number: page 5 Question: The instructions for providing references refers to “the offeror’s (or proposed subcontractor’s) experience.” The first column in Table 3 “Experience” in section 2.1.1 is titled “Offeror/Subcontractor Information.” Please clarify: are offerors required to submit references for the subcontractors?

Answer:   2.1.1 refers to the ""prime contractor"" meaning the Offeror. All of section 2 requires information for the Offeror unless it is stated to provide subcontractor information as in Section 2.4: ""If offeror uses subcontractors, associated companies or consultants that will be involved in any phase of this project, each of these entities must submit this information as part of the response.""

Date: 4/9/2020

Inquiry: 74597


Question:   RFP Document Name: Supplement One RFP Section: 4.10 Third Party Liability Page Number: 57 Question: FI-070.000.020 "The contractors solution must have functionality to accumulate claims up to a specified threshold amount and notify state recovery units to initiate recovery activities when the threshold is reached, in accordance with State policy." Is this a requirement for cost avoidance/recovery for commercial insurance and/or is it a subrogation requirement? Please help us further understand the types of recoveries for this requirement.

Answer:   Yes, this is a requirement for cost avoidance/recovery for commercial insurance and subrogation. FI will be the source of truth for TPL data; There will be rules, processes to verify the recovery.

Date: 4/9/2020

Inquiry: 74565


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 4 Question: "The Contractor’s solution must validate all claims received (both FFS and MC), route managed care claims to the appropriate MCP for adjudication and payment, and continue processing the FFS claims internally by the FI module." How do we determine which MCP to route claims to? Will we be using member enrollment information or based on receiver information received in the 837 that identifies the MCP?

Answer:   Route to the MCP based on information received in the 837.

Date: 4/9/2020

Inquiry: 74563


Question:   RFP Document Name: Template B RFP Section: 4.2 Implementation Standards Page Number: 6 Question: “The Contractor hereby agrees that ten (10) percent or 10% of each payment milestone (see tab 4 of Template F Cost Proposal Workbook) will be at risk (“Fee at Risk”) for SLA deficiencies.” There only appears to be one Implementation Performance Standard and it does not seem to have any specific penalties associated (like the Ongoing Performance Standards have a ‘Contractor Assessment of Service Credits’ column). It also doesn’t seem to apply to all phases – i.e. DDI Initiating and Planning wouldn’t typically have any test case execution. Please help us understand what events would cause what portions of the 10% hold back for each phase to not be recoverable by the contractor.

Answer:   During DDI/Implementation the Vendor will be subject to a "Fee at Risk" for the deliverables identified on Tab 4 of the Cost Workbook. The "Fee at Risk" is calculated for each identified payment milestone. Any liquidated damages for "Fee at Risk" can not be recovered. During M&O, each monthly invoice will be subject to a 10% holdback which is used to satisfied any liquidated damages accrued for Service Level Agreements not achieved. Holdbacks/Retainage can be recovered by the Vendor.

Date: 4/9/2020

Inquiry: 74562


Question:   RFP Document Name: Supplement One RFP Section: 4.6 Accounts Payable Page Number: 47 Question: FI-052.010.070 “The contractors solution must capture, maintain, and transmit data supporting capitation payment to MCPs in compliance with standard EDI transactions (e.g., X12 820, X12 834 transactions).” Usually 834 transactions are used for notifying the MCP of enrollment changes or for enrollment reconciliation. Is the fiscal intermediary responsible for either of those tasks? If not, please explain the use case for 834 transactions between the fiscal intermediary and a MCP.

Answer:   The Offeror is not responsible for enrollment changes or for enrollment reconciliation. The 834 transaction will be the source of knowledge for Care Plan enrollment used to route claims to the correct Care Plan.

Date: 4/9/2020

Inquiry: 74561


Question:   RFP Document Name: Supplement One RFP Section: 4.3 Prior Authorization Page Number: 36 Question: FI-030.030.020 – Please provide anticipated volumes for prior authorization that require manual review?

Answer:   Manual reviews for medical necessity will be performed by the contractor. Current Durable Medical Equipment Prior Authorization request volumes are about 5,000 per month. At this time, these are the only PA requests that the FI vendor are being asked to review.

Date: 4/9/2020

Inquiry: 74519


Question:   RFP Document Name: Supplement One RFP Section: 4.3 Prior Authorization Page Number: 36 Question: Requirement ID FI-030.030.020 – Does the State require the FI contractor to determine medical necessity for prior authorizations which require manual review? If so, please identify prior authorization types and associated volumes for medical necessity determinations?

Answer:   Manual reviews for medical necessity will be performed by the contractor. Current Durable Medical Equipment Prior Authorization request volumes are about 5,000 per month. At this time, these are the only PA requests that the FI vendor are being asked to review.

Date: 4/9/2020

Inquiry: 74518


Question:   RFP Document Name: Supplement One RFP Section: 4.2 Claims Adjudication Page Number: 32 Question:FI-020.050.030 - Does the State require the FI Contractor to manually price out-of-state claims? If so, please provide anticipated claim types and associated volumes for out-of-state claims that require manual pricing

Answer:   Yes. The average volume based on the last 10 months is 120.4 per month. This includes out of state claims.

Date: 4/9/2020

Inquiry: 74517


Question:   RFP Document Name: Supplement One RFP Section: 4.2 Claims Adjudication Page Number: 34 Question: FI-020.080.020 – Does the State require the FI contractor to apply manual pricing rules to suspended claims? If so, please provide claim types and associated volumes that require manual pricing.

Answer:   Yes. The average volume based on the last 10 months is 120.4 per month. This includes out of state claims.

Date: 4/9/2020

Inquiry: 74516


Question:   RFP Document Name: Supplement One, Section 7.2 Business Continuity-Disaster Recovery, OMES-310-000-030 Page: 115 Question: The requirement states: “The contractor must provide a Business Continuity Plan and a Disaster Recovery Plan which adhere to applicable State and federal laws, rules, regulations, and guidelines.” Can you specify the State of Ohio laws, rules, regulations, and guidelines that Conduent must adhere to regarding our Disaster Recovery/Business Continuity plans and testing? (OMES-310-000-030)

Answer:   Please refer to Section 7.2 Supplement One Scope of Work.

Date: 4/9/2020

Inquiry: 74500


Question:   RFP Document Name: SUPPLEMENT ONE: SCOPE OF WORK, requirement ID OMES-310.020.020 RFP Section: Business Continuity / Disaster Recovery Page Number: 117 Question: The requirement OMES-310.020.020 states that “[t]he contractor must align their disaster recovery testing schedule with the overall OMES disaster recovery schedule, as defined by the State.” What is the overall OMES disaster recovery schedule defined by the State?

Answer:   The OMES disaster recovery schedule is being currently defined by the State and will be negotiated with the selected vendor. At minimum, an annual schedule will be developed.

Date: 4/9/2020

Inquiry: 74499


Question:   RFP Document Name: Supplement Two RFP Section: 3.3.1.1 Digital Identity Products Page Number: 6 Question: Does the IAM (Identity Access Management) from the state’s Digital Identity Products support standard secure protocols, such as SAML or OAuth for Single sign-on (SSO)? Do they support federated SSO where 3rd party Service Provider can integrate with the IdP (Identity Provider/Authentication Server) from the state’s Digital Identity Products?

Answer:   Yes, SAML 2.0 and OAuth, to include OIDC 2.0. Yes, federated SSO integration is supported.

Date: 4/9/2020

Inquiry: 74487


Question:   RFP Document Name: Supplement One RFP Section: 4.2 Claims Adjudication Page Number: 30 Question: FI-020.020.040 “The contractors solution must have functionality to identify enrollment exception or pre-enrollment periods and emergency circumstances, and assign statuses (e.g., hold, deny, pay), in accordance with State specifications.” Is this pre-enrollment/emergency enrolment of members or is it providers?

Answer:   Yes, for members only.

Date: 4/8/2020

Inquiry: 74545


Question:   RFP Document Name: Template B RFP Section: 4.3 Ongoing Performance Standards Page Number: 7 Question: Is it the States intent that monthly M&O invoices are to reflect a 10% retainage reduction as well as service level credits (if service levels are missed)?

Answer:   No. The retainage from the M&O invoices is to offset any liquidated damages accrued by not achieving the identified Service Level Agreements.

Date: 4/8/2020

Inquiry: 74555


Question:   RFP Document Name: Template B RFP Section: 4.3 Ongoing Performance Standards Page Number: 7 Question: Please confirm that a vendor won’t be penalized by multiple SLA’s for a single event, i.e. downtime in excess of 99.9% where there are High priority helpdesk tickets that take more than an hour.

Answer:   It would depend on the event.

Date: 4/8/2020

Inquiry: 74554


Question:   RFP Document Name: Supplement Two RFP Section: 3.3.9 Telephony Services Page Number: 18-20 Question: Are there any costs to use shared services such as your VoIP?

Answer:   Any shared service that is provided by the State to the offeror will be at no cost to the offeror.

Date: 4/8/2020

Inquiry: 74553


Question:   RFP Document Name: Supplement One RFP Section: 5.9 OMES Integration Page Number: 100 Question: FI-110.020.070 “The contractors solution must have functionality to integrate with MITS to access and update information necessary to perform supported business functions.” Since MITS is scheduled to be decommissioned as part of this project, please indicate what types of integrations will be required. Is MITS going to continue to stay running after go-live? If so, what tasks will it be performing in the OMES?

Answer:   The FI is not replacing all of the functions provided by MITS. MITS will remain operational until all functionality it currently provides has been transitioned to new components. At the time the FI goes live, there will likely be a need to utilize data from MITS for functions provided by the FI.

Date: 4/8/2020

Inquiry: 74552


Question:   RFP Document Name: Supplement One RFP Section: 5.4 Security Page Number: 78 Question: OMES-140.020.120 “The contractor must perform security compliance testing on a quarterly basis and report the results of the testing along with any recommended remediation to the State after the end of the calendar year.” Please explain what is included within the scope of security compliance testing.

Answer:   Please refer to Supplement Two for details of security requirements including compliance testing.

Date: 4/8/2020

Inquiry: 74551


Question:   RFP Document Name: Supplement One RFP Section: 4.7 Accounts Payable Page Number: 51 Question: FI-053.040.030 “The contractors solution must accept, record, and apply online payments.” Is this requirement related to payments that would be received through the ePayment solution?

Answer:   Section 4.7 is Accounts Receivable. The FI will receive payment data, record it, and apply it to the appropriate accounts. The FI is not required to bring an ePayment solution.

Date: 4/8/2020

Inquiry: 74550


Question:   RFP Document Name: Supplement One RFP Section: 4.5 Finance Management Page Number: 43 Question: FI-050.020.040 “The contractors solution must track and audit incentive payments, based on state-defined business rules.” Please clarify what audit means within the context of this requirement.

Answer:   The FI must track incentive payments and perform audits specified in business rules.

Date: 4/8/2020

Inquiry: 74549


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 3 Question: “Table 1 – Key volumes related to the Fiscal Intermediary module” The are no phone call volumes listed. Is the fiscal intermediary expected to have an inbound call capability other than the required Helpdesk that would serve internal users and State users? For example, will we need to take phone calls related to payments or prior authorizations? If yes, please provide anticipated call volumes.

Answer:   Yes, the contractor solution may need to take phone calls related to payments or prior authorizations. Determination will be made based on the offeror's proposal. There have been 6000 incoming calls on average for the last 12 months.

Date: 4/8/2020

Inquiry: 74548


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 3 Question: “Table 1 – Key volumes related to the Fiscal Intermediary module” Please identify any volumes of paper the fiscal intermediary is expected to receive in a mailroom. For example – paper claims, paper prior authorizations. Are we expected to perform OCR/data entry on any incoming paper volumes?

Answer:   ODM does not accept paper claims or paper PAs.

Date: 4/8/2020

Inquiry: 74547


Question:   RFP Document Name: Supplement One RFP Section: 4.7 Accounts Receivable Page Number: 50 Question: “Receivables due to the agency are collected in the form of cash, check, online payments, electronic funds transfer, and recoupments against payments.” Does the fiscal intermediary directly process inbound payments (i.e. receive checks) or is that performed by another party and we receive payment information via interface?

Answer:   The FI will not receive inbound payments; the information will be conveyed to the FI to apply to the appropriate accounts.

Date: 4/8/2020

Inquiry: 74546


Question:   RFP Document Name: Supplement One RFP Section: 4.1 Claims Processing Page Number: 33 Question: FI-020.050.050 “The contractors solution must have functionality to price pharmacy claims at the lesser of approved pharmacy reimbursement methods, in accordance with State policy.” Please clarify the scope of this requirement. Does this contract include PBM services? If not, please clarify what types of claims these would be. Is there an interface with the PBM contractor to provide pricing?

Answer:   This applies to FFS pharmacy claims that are currently processed and paid by ODM. ODM will provide the list of interfaces to the awarded vendor.

Date: 4/8/2020

Inquiry: 74543


Question:   RFP Document Name: Supplement One RFP Section: 4.1 Claims Processing Page Number: 26 Question: FI-010.040.040 “The contractors solution must process adjustments on paid claims submitted through the Pharmacy POS system.” Please clarify if this is an adjudication requirement or a payment requirement. Given you have a PBM contractor, it’s not clear what “process” means in this case.

Answer:   This is an adjustment process. FFS pharmacy claims must be paid by the FI. If an adjustment must be made due to over or underpayment, the FI must process the adjustment and pay, or offset a future payment to recover any amounts due back to Medicaid.

Date: 4/8/2020

Inquiry: 74542


Question:   RFP Document Name: Supplement One RFP Section: 4.5 Finance Management Page Number: 40 Question: “Finance Management is a collection of business processes necessary to support provider and MCP payments and the management of other healthcare delivery expenditures and revenues.” Does the fiscal intermediary make payments for pharmacy claims or is that handled by the pharmacy contractor?

Answer:   FFS pharmacy claims will be paid by the FI.

Date: 4/8/2020

Inquiry: 74541


Question:   RFP Document Name: Supplement One RFP Section: 2.5 Proposed Work Plan and Schedule Page Number: 19 Question: “ODM desires to implement all functionality and services within twelve (12) months of award. If the solution must be implemented in phases, the order of services implemented must be:” Are you anticipating a phased implementation to last more than 12 months, or do you expect all phases of a phased implementation to be completed within 12 months?

Answer:   ODM anticipates a 12 month implementation for all functionality requested in the RFP. If the contractor cannot accommodate a 12 month implementation a phased in approach may be considered.

Date: 4/8/2020

Inquiry: 74540


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 3 Question: “Table 1 – Key volumes related to the Fiscal intermediary module” Please confirm that the only prior authorizations processed by the staff of the fiscal intermediary are the 50,000 FFS prior authorizations. Please confirm that for the 1.8 million per year Managed Care and the 425,000 a year MyCare the fiscal intermediary is not responsible for any reviews by staff.

Answer:   Yes to both.

Date: 4/8/2020

Inquiry: 74539


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 6 Question: “Sister State Agencies – Claims for some services provided under programs operated by other State agencies are submitted to OMES by those agencies on behalf of the providers. The agencies provide these claims to OMES in the Notes Storage Facility (NSF) 2.0 format. It is the goal of the OME to transition these claims to be submitted directly by providers to OMES via either EDI or the portal however, the existing operations must be supported until a future date when the Sister State Agencies and their providers can make the transition.” Should all bidders include the cost of processing NSF in their cost proposals? Or is this considered to be an unlikely need for the new fiscal intermediary contract and this would be dealt with through an amendment?

Answer:   Yes, the FI contractor must accept and process claims submitted in NSF format and include in their cost proposals.

Date: 4/8/2020

Inquiry: 74538


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 5 Question: “A component of the OMES Provider Network Management module, the Provider Portal provides a self-service interface for providers to conduct OME business, including the submission of claims, status inquiries, and prior authorization requests.” Are there any external portal functions for provider or members that would be expected to be provided using a portal provided by the fiscal intermediary?

Answer:   No, the FI will not provide a portal for members or providers.

Date: 4/8/2020

Inquiry: 74537


Question:   RFP Document Name: Supplement One RFP Section: 1. Overview of Fiscal Intermediary Module Page Number: 5 Question: “A component of the OMES Provider Network Management module, the Provider Portal provides a self-service interface for providers to conduct OME business, including the submission of claims, status inquiries, and prior authorization requests.” Are there any external portal functions for provider or members that would be expected to be provided using a portal provided by the fiscal intermediary?

Answer:   No, the FI will not provide a portal for members or providers.

Date: 4/8/2020

Inquiry: 74536


Question:   RFP Document Name: Supplement One RFP Section: 5.9 OMES Integration Page Number: 100 Question: FI-110.020.020 “The contractors solution must have functionality to integrate with the States EDI contractor solution to access information necessary to perform supported business functions.” Is trading partner enrollment handled by either the EDI contractor or the Provider Network Management module? If not, who is responsible for trading partner enrollment?

Answer:   The FI contractor will not provide trading partner management. The final approach is still being considered.

Date: 4/8/2020

Inquiry: 74535


Question:   RFP Document Name: Supplement One RFP Section: 6.1 Project Management Page Number: 104 Question: OMES-200.020.010 “The contractor must provide a detailed staffing plan for the Project, including all contractor and subcontractor positions identified for all phases of the project.” Could you please provide the staffing information for the incumbent contractor(s) and any State staff that currently perform this scope of work?

Answer:   The incumbent contractor is not an FI and does not provide a similar scope of work. The offeror should propose staffing levels deemed necessary to meet the requirements in the RFP.

Date: 4/8/2020

Inquiry: 74534


Question:   RFP Document Name: Supplement One RFP Section: 2.6 Prior Authorization Shared-Services Model Page Number: 19 Question: Could you provide an organization chart of the current State staff supporting the prior authorization function? While we are not asking for the names, we would appreciate titles, numbers of staff, and any clinical credentials.

Answer:   The offeror should submit how their model will support prior authorization function.

Date: 4/8/2020

Inquiry: 74533


Question:   RFP Document Name: Supplement One RFP Section: 4.1 Claims Processing Page Number: 27 Question: FI-010.080.010. “The contractors solution must have functionality to implement state-approved internal controls in support of OME oversight activities, including MCP oversight, for processing accuracy, timeliness, and performance measures.” By implementing state-approved internal controls do you mean that the contractor must be able to calculate performance measures on behalf of the state to help identify issues and determine whether accuracy and timeliness criteria are being met? If this is not the scope, please help understand the types of activities the contractor is expected to perform in support of this requirement.

Answer:   Yes that is the intent.

Date: 4/8/2020

Inquiry: 74532


Question:   RFP Document Name: Supplement One RFP Section: 4.1 Claims Processing Page Number: 27 Question: FI-010.080.010. “The contractors solution must have functionality to implement state-approved internal controls in support of OME oversight activities, including MCP oversight, for processing accuracy, timeliness, and performance measures.” By implementing state-approved internal controls do you mean that the contractor must be able to calculate performance measures on behalf of the state to help identify issues and determine whether accuracy and timeliness criteria are being met? If this is not the scope, please help understand the types of activities the contractor is expected to perform in support of this requirement.

Answer:   Yes this is the intent.

Date: 4/8/2020

Inquiry: 74531


Question:   RFP Document Name: Supplement One RFP Section: 4.1 Claims Processing Page Number: 27 Question: FI-010.070.010. The contractors solution must process and update fee-for-service (FFS) claims and managed care records with results data.” What does results data mean in this requirement? Do you mean saving claim statuses, posted edits, and other fields normally determined during adjudication?

Answer:   Yes that is the intent.

Date: 4/8/2020

Inquiry: 74530


Question:   RFP Document Name: Supplement One RFP Section: 6.1 Project Management Page Number: 102 Question: Requirement ID OMES-200.000.010 – Does the State require any dedicated space in the FI facility required by this requirement during the Implementation and/or Operations/Maintenance phase(s) of the project? How many office and/or cube spaces is required for State staff? Does the State require co-location with the FI vendor for any State-designated space?

Answer:   The contractor does not need to provide dedicated space. Work spaces and meeting spaces should be provided to accommodate meetings with the State when the State staff comes onsite.

Date: 4/8/2020

Inquiry: 74524


Question:   RFP Document Name: Supplement One RFP Section: 2.3 Key Roles Page Number: 11 Question: Please confirm ALL of the roles identified in Table 2 Required Key Roles are mandatory and must be included in the vendor’s response to be compliant. If there is a designation between a role that is mandatory and a role that is optional, please identify.

Answer:   The table provides examples of key roles. The offeror is expected to add or modify key roles as deemed appropriate and is expected to explain why the key roles in their response will best support a successful implementation of the solution and ongoing operations.

Date: 4/8/2020

Inquiry: 74523


Question:   RFP Document Name: Base RFP 0A1286 RFP Section: 6.4 Attachment Four, General Terms and conditions, part one. 6.2 Attachment Two Page Number: 46 and 34 Question: In page 46 the RFP indicates the state will pay for reimbursable expenses on Section 126.31 of Revise Code not included in the RFP documents, and then in page 34 it mentions there are none reimbursable expenses, will the state please provide clarification in regards to the reimbursable expenses and if there are any additional expenses considered passthrough from the State´s perspective.

Answer:   Page 46 states: Reimbursable Expenses. The State will pay all reimbursable expenses identified in the RFP Documents, if any, in accordance with the terms in the RFP Documents and, where applicable, Section 126.31 of the Revised Code. The Contractor must assume all expenses that it incurs in the performance of this Contract that are not identified as reimbursable in the RFP Documents. As there are no expenses called out in this RFP as reimbursable, all expenses are the responsibility of the Contractor.

Date: 4/8/2020

Inquiry: 74504


Question:   RFP Section: Supplement Two RFP Section: 1.1. Solution Architecture Requirements Page: 5 Question: Cloud-based solutions must utilize as many platform services as possible and comply with State requirements to run in the State of Ohio Enterprise brokered public cloud service. Currently, Microsoft Azure and Amazon Web Services are hosted by DAS OIT for the State of Ohio. 1. Can you please elaborate on the term “utilize”? Will the State sponsor all regions including development & test on Microsoft Azure to the capacity and infrastructure design provided by us? 2. Is it the Bidder or State’s responsibility to procure licenses for dependent COTS software like Oracle for Database?

Answer:   The vendor should bring in a full packaged solution suite (Software as a Service) that is managed and supported by the vendor. If the vendor can utilize State resources without impacting their business and delivery model, they may be required to do so. If the vendor only offers its software in its own cloud-hosted solution as a package, only reference the full package, not the infrastructure components supporting it. The awarded offeror will be expected to leverage some State resources such as the Identity and Access Management platform.

Date: 4/8/2020

Inquiry: 74522


Question:   RFP Document Name: Bidder Library - OMES Program Integrated Master Schedule Management Guide RFP Section: 3.2.4 Standard Project Phases Page Number: 14 Question: Requirement ID OMES-230.000.080 – The guide indicates that each schedule uses a standard set of project phases. For contractors using an agile/iterative system development life cycle, is it acceptable to combine two or more phases in the work plan? If so, do you have a recommendation for a naming convention that will work with the combined master schedule?

Answer:   Yes, it is acceptable to combine phases and no, there is no recommended naming convention. At a high level, the tasks mentioned under phases should resemble the tasks mentioned in the Integrated Master Schedule Guide.

Date: 4/8/2020

Inquiry: 74521


Question:   RFP Document Name Supplement One RFP Section: 6.3 Training Page Number: 109 Question: Requirement ID OMES-230.000.080 – Does the State require the FI Contractor to provide or secure facilities needed for in-person training? If so, how many and what frequency is in person training required. How many attendees is projected to need in person training? Will in-person training be required outside of Columbus, OH? If so, what locations will in-person training be required? Please define user groups, format and number of trainees.

Answer:   Space will be provided by State for in-person training of State staff. The training may need to be provided for 300 attendees. The trainings need to be recorded and provided to State. In-person training is not required outside of Columbus, OH.

Date: 4/8/2020

Inquiry: 74520


Question:   RFP Document Name: Supplement One RFP Section: 2.5 Proposed Work Plan and Schedule Page Number: 19 Question: RFP requests that the proposed work plan include “assigned persons,” but later in the sentence it seems to be clarified as Contractor versus State efforts. Is it sufficient to identify each task as either a contractor responsibility, a State responsibility, or a joint responsibility? If not, please clarify the terminology “assigned persons.”

Answer:   "Assigned persons" means resources assigned to each task. Yes, it is acceptable to indicate Contractor, State Staff, or indicate joint responsibility for each task.

Date: 4/8/2020

Inquiry: 74513


Question:   RFP Document Name: Supplement One RFP Section: 2.1 Project Staffing Page Number: 10 Question: The RFP requests that Offerors propose an initial staffing plan that meets all the requirements for staffing in the RFP Base and Supplement One. Is this a full draft, narrative-based, standalone project management plan? Or rather, a description of the staffing approach in the body of the response to the requirement?

Answer:   Provide the response where indicated. The staffing plan must provide details of how the offeror will staff the FI services, including hours, numbers and types of personnel, and anticipated use of State project resources.

Date: 4/8/2020

Inquiry: 74512


Question:   RFP Document Name: Template F RFP Section: Tab 5. 5. Software Maint & Ops Support Page Number: N/A Question: Are the M&O volume tiers monthly or annual volumes? Is M&O to be billed on a layered basis such that only the specific volumes exceeding Tier 1 are billed at the Tier 2 rate? For example, for MCP Clearinghouse, would the first 10,000,000 claims be billed at the Tier 1 rate and then the next 5,000,000 claims billed at the Tier 2 rate?

Answer:   The volumes in Column B are Volumes per Month. When calculating the cost for the tiers, only include the amounts included in that tier. Tier 1 is up to 10,000,000; any amounts over 10,000,000 would fall into Tier 2 pricing.

Date: 4/8/2020

Inquiry: 74511


Question:   RFP Document Name: Template B RFP Section: 4.2 Implementation Standards Page Number: 6 Question: Please confirm that implementation invoices are only subject to reduction ("Fee at Risk") for SLA deficiencies and that the 10% retainage does not also apply.

Answer:   During the implementation phase of the project, the set of deliverables in each payment milestone are subject to the Fee at Risk if there is a delay in them being produced. Retainage only applies during the M&O phase, not Implementation phase.

Date: 4/8/2020

Inquiry: 74510


Question:   RFP Document Name: Bidder Library RFP Section: OMES Business Volume Estimates Page Number: 1 Question: Volumes provided by the state are based on the historical information of 2017, can the state confirm if offerors will be provided with updated volumes information of 2019 year.

Answer:   Information in the Bidder Library is informational. Representative volumes are provided in Supplement One- Scope of Work.

Date: 4/8/2020

Inquiry: 74509


Question:   RFP Document Name: Template F RFP Section: 3. Labor Rates Page Number: 3 Question: Can the state confirm the hourly rates requested on the labor rate tab will be for informational purposes in case the state requires additional work hours from the offerors personnel. Also in the instructions tab it indicates offeror can’t modify the cost proposal workbook, and on this tab it indicates the offeror is responsible for the calculations to be correct, does this means on this specific tab we are allowed to do changes in calculations?

Answer:   The State requests hourly labor rates. The instruction Tab states the offeror cannot alter the Cost Summary Tab of the workbook, which is Tab 2.

Date: 4/8/2020

Inquiry: 74508


Question:   RFP Document Name: Template F RFP Section: 1. Instructions Page Number: 5. All tabs Question: Can the state confirm the first year will be partial due that the ongoing start date will probably not be July, and therefore not in line with the state fiscal year.

Answer:   The State Fiscal Year is 7/1-6/30. The start date of the project will be determined once the contract is awarded. However, the purchase order will always end on the last day of each fiscal year.  You are permitted to indicate assumptions regarding the partial first fiscal year on the Assumption tab of the Cost Workbook.

Date: 4/8/2020

Inquiry: 74507


Question:   RFP Document Name: Template B RFP Section: 4.3 Ongoing Performance Standards Page Number: 7 Question: Concerning the Ongoing Performance Standards will the state perform the 10% retainage every month and the at the end of month 6 the release will be effective after acceptance of SLAs performance? Or will the state retain the 10% and 6 months after its due every invoice will be released separately?

Answer:   The 10% retainage will be withheld for each monthly invoice and will be released every six months, after all liquidated damages have been satisfied.

Date: 4/8/2020

Inquiry: 74506


Question:   RFP Document Name: Template B RFP Section: 4.3 Ongoing Performance Standards Page Number: 7 Question: Concerning the Ongoing Performance Standards will the state perform the 10% retainage every month and the at the end of month 6 the release will be effective after acceptance of SLAs performance? Or will the state retain the 10% and 6 months after its due every invoice will be released separately?

Answer:   The 10% retainage will be withheld for each monthly invoice and will be released every six months, after all liquidated damages have been satisfied.

Date: 4/8/2020

Inquiry: 74505


Question:   RFP Document Name: Base RFP 0A1286 RFP Section: 1.3 RFP Process and 1.5 Calendar of Events Page Number: 9 and 11 Question: On page 9 the RFP wording indicates a maximum contract term expiring on June 2031, and on page 11 the estimated Go Live date is October 2021 which will result in a 116 months of ongoing operations, can the state please clarify the expected ongoing term?

Answer:   The contract can span a total of ten years, which would end at the end of the State Fiscal Year (June 30, 2031). The number of months of operations would depend on the month that the system goes into production.

Date: 4/8/2020

Inquiry: 74503


Question:   RFP Document Name: Template F – Cost Proposal RFP Section: Tab 5. Software Maint & Ops /Notes Page Number: 5 Question: State wording indicates that on this tab of the cost proposal offerors need to complete monthly cost columns from Year 1 to 5, and other cells must not be altered, however the price sheet is created for 10 years, will the state release an updated version that includes a formula to annualize years 6 to 10, or the offerors need to complete the pricing for those years regardless of the wording on the notes section? Also, price sheet is set for monthly costs, can the state confirm the expectation to complete these columns is to assume volumes to price for each month and provide the total monthly fees for each category?

Answer:   Complete for all years; 1-10. Formulas are included for all years. Yes, the volumes provided in Column B to determine monthly cost for each category. Tab 5a provides additional information.

Date: 4/8/2020

Inquiry: 74502


Question:   RFP Document Name: Supplement One, Section 7.2 Business Continuity-Disaster Recovery Page: N/A – General Question Question: Does the Ohio Fiscal Intermediary use “native” data replication?

Answer:   The State does not currently have a Fiscal Intermediary solution.

Date: 4/8/2020

Inquiry: 74501


Question:   RFP Document Name Supplement One RFP Section: 4.1 Claims Processing Page Number: 26 Question: The first two paragraphs in this section state “…. The selected Contractor must provide services that support the intake and processing of fee-for-service (FFS) claims…” and “The Contractor must be engaged to provide end-to-end FFS claims processing activities including accurately capturing, adjudicating, and pricing all submitted claims and adjustments…” Is the contractor’s solution expected to process FFS pharmacy claims directly or just receive data from the PBM contractor(s) and MCPs?

Answer:   The contractor solution will receive data from the PBM contractor(s) and MCPs.

Date: 4/8/2020

Inquiry: 74489


Question:   RFP Document Name: Base RFP - 0A1286 RFP Section: 1.2 Background Page Number: p. 5 Question: “Currently, ODM maintains and administers a Fee-for-Service (FFS) program for services carved out of managed care and individuals not required to enroll with MCPs. The FFS membership consists primarily of individuals dually eligible for Medicaid and Medicare, children enrolled in the ODH Bureau for Children with Medical Handicaps, individuals in Home and Community Based Services (HCBS) and other waiver programs, and individuals living in institutionalized settings. ODM plans to continue transitioning FFS individuals to managed care, further relying on the MCPs while reducing the FFS populations.” Is the contractor expected to process the FFS medical and pharmacy claims of this membership?

Answer:   Yes.

Date: 4/8/2020

Inquiry: 74493


Question:   RFP Document Name: Base RFP OA1286 RFP Section: PART FIVE: ACCEPTANCE AND MAINTENANCE Page Number: 65-66 Question: Is the 90-day performance testing period part of the implementation phase (prior to Go-Live) or is it the start of Go-Live during which the M&O fees are billable? Text from RFP: “There will be a period for performance testing of the completed Project. During the performance period, the State, with the assistance of the Contractor, will perform acceptance testing. The performance period will last up to 90 business days, during which time the Project must meet the standard of performance required by the RFP Documents for 30 consecutive business days............The Project will not be accepted until the performance period is complete.”

Answer:   The 90-day performance testing period is before go-live.

Date: 4/8/2020

Inquiry: 74494


Question:   RFP Document Name: Base RFP 0A1286 RFP Section: 4.13. FINANCIAL ABILITY Page Number: 23 Question: Please confirm that this RFP does not require an Offeror to submit audited financial statements with its bid.

Answer:   Yes.

Date: 4/8/2020

Inquiry: 74495


Question:   RFP Document Name: Base RFP 0A1286 RFP Section: 6.3. ATTACHMENT THREE: REQUIREMENTS FOR PROPOSALS PROPOSAL Subsection REQUIREMENTS AND FORMAT Page Number: 38 Question: Please confirm that the reference to Section 3.5 in the following sentence “Proposals must meet all requirements of Section 3.5 Proposal Submittal of this RFP Base document.” should say 3.4 rather than 3.5.

Answer:   Yes, 3.4 is the correct section.

Date: 4/8/2020

Inquiry: 74496


Question:   RFP Document Name: Base RFP 0A1286 RFP Section: PROPOSAL REQUIREMENTS AND FORMAT Page Number: 36 Question: We understand we are required to submit the State’s original RFP documents. Are Bidders allowed to add the bidder’s company name to the footer of the RFP documents?

Answer:   Yes

Date: 4/8/2020

Inquiry: 74497


Question:   RFP Document Name: Template C RFP Section: 2.1 Mandatory Qualifications (Attachment Seven) and Section 2.1.1 Mandatory Qualification #1 – Experience Page Number: Pages 4 and 5 Question: Please confirm that the Offeror should place its response to 2.1 Mandatory Qualifications (Attachment Seven) in Table 3 provided in Section 2.1.1 Mandatory Qualification #1 – Experience. If confirmed, should the Offeror include the response to the following two bullets in the last row of Table 3 called “Describe work performed and completed through production deployment.”? * Description of the Related Service Provided. The State will not assume that, since the experience requirement is provided at the top of the page, all descriptions on that page relate to that requirement. The offeror must reiterate the experience being described, including the capacity in which the work was performed and the role of the offeror on the Project. It is the offeror’s responsibility to customize the description to clearly substantiate the qualification. * Description of how the related service shows the offeror’s (or proposed subcontractor’s) experience, capability, and capacity to develop the Deliverables and to achieve the milestones within the scope of work of this RFP.

Answer:   Yes- Table 3 is provided to respond to Mandatory Requirement #1- Experience. Use a separate Table 3 for each project referenced to meet the requirement. Yes- complete all sections in Table 3 for each project.

Date: 4/8/2020

Inquiry: 74498


Question:   FI-030.040.010 Supplement One- Page 36 Requirement - The contractor must provide multi-lingual FFS prior authorization correspondence to support the required languages pursuant to 45 Code of Federal Regulations (CFR) Section 80.3(b)(2) for member-facing correspondence. Question: What languages are to be included in the correspondence? What organization is performing the translation of the content to go into the correspondence? Is there an existing/centralized letter generator solution or is each vendor the one that creates correspondence delivering one specific to their business domain?

Answer:   Currently there are 13 Core Languages identified in Ohio and they are: Arabic, Bengali, French (European), Fulani, Mandarin, Nepali , Somali, Serbian, Spanish (Latin), Spanish (European), Swahili, Vietnamese, Russian. Vocalink is the organization performing the translation.

Date: 4/8/2020

Inquiry: 74471


Question:   Supplement One - FI-055.010.010 - Page 54 Requirement: The contractors solution must have functionality to establish facility rates using state-identified data (e.g., cost report data, case mix scores, bed counts, quality score), based on state-defined business rules. Question: Will the contractor receive a file with determined rates for each facility type or is the contractor expected to calculate the rates?

Answer:   The necessary data will be provided to the contractor to calculate facility rates based on applicable rules. 

Date: 4/6/2020

Inquiry: 74481


Question:   Supplement One - OMES-230.030.050 - Page 109 Requirement: The contractor must provide training support for all user groups, in accessible locations and formats, as defined by the State. Question: Can the State please clarify what it defines as “accessible locations and formats”?

Answer:   Locations- Website and Portal; Formats- PDF and Word.

Date: 4/6/2020

Inquiry: 74480


Question:   FI-020.050.050 Supplement One - Page 33 Requirement - The contractors solution must have functionality to price pharmacy claims at the lesser of approved pharmacy reimbursement methods, in accordance with State policy. Question - Is it the States intent that the FI vendor be able to price and adjudicate pharmacy claims?

Answer:   The FFS PBM will send a file on a regular basis, the FI will need to price, adjudicate and pay providers directly.

Date: 4/6/2020

Inquiry: 74473


Question:   FI-030.020.010 Supplement One - Page 36 Requirement - The contractors solution must receive and maintain electronic attachments related to prior authorization requests. Question - Are electronic attachments related to prior authorizations coming into the system through a standard X12 transaction format? How will these attachments be passed to the FI ?

Answer:   The attachments can come in to the FI solution through X12, or a centralized EDMS solution.

Date: 4/6/2020

Inquiry: 74472


Question:   FI-010.030.01 Supplement One - Page 25 Requirement - The contractors solution must have functionality to retrieve, upload, and associate claim-related attachments to the appropriate claim. Question: Does the State intend for the contractor to retrieve attachments from a common/centralized document managements system? If so, please identify where the EDMS is located, what COTS is used and what vendor is performing the work today?

Answer:   The vendor's solution must have its own EDMS component. Vendors are required to bring in their own EDMS solution to manage attachments within their own module. There will be a centralized EDMS solution that will be used to share documents across modules.

Date: 4/6/2020

Inquiry: 74470


Question:   FI-010.000.040 Supplement One - Page 25 Requirement -The contractors solution must assign a unique identifier (i.e., internal control number (ICN)) for each claim accepted for processing. The contractors solution must provide logic needed for region codes identifiers. Question: The State uses the term region codes. If the solution achieves the same functionality but doesn’t use the term Region Code is that still acceptable?

Answer:   Yes.

Date: 4/6/2020

Inquiry: 74469


Question:   Template F – Cost Proposal Workbook 2. Cost Summary Cell M11 is referencing Cell “6. Disaster Recovery!P11”. Please confirm this is correct or modify and republish Template F as necessary.

Answer:   There was an issue with the Cost Proposal Workbook. A revised template will be published as an amendment.

Date: 4/6/2020

Inquiry: 74468


Question:   Template F – Cost Proposal Workbook 2. Cost Summary Cell L11 is referencing Cell “6. Disaster Recovery!O11”. Please confirm this is correct or modify and republish Template F as necessary.

Answer:   There was an issue with the Cost Proposal Workbook. A revised template will be published as an amendment.

Date: 4/6/2020

Inquiry: 74467


Question:   Template F – Cost Proposal Workbook 2. Cost Summary Cell k11 is referencing Cell “6. Disaster Recovery!N11”. Please confirm this is correct or modify and republish Template F as necessary.

Answer:   There was an issue with the Cost Proposal Workbook. A revised template will be published as an amendment.

Date: 4/6/2020

Inquiry: 74466


Question:   Template F – Cost Proposal Workbook 2. Cost Summary Cell J11 is referencing Cell “6. Disaster Recovery!M11”. Please confirm this is correct or modify and republish Template F as necessary.

Answer:   There was an issue with the Cost Proposal Workbook. A revised template will be published as an amendment.

Date: 4/6/2020

Inquiry: 74465


Question:   Template F – Cost Proposal Workbook 2. Cost Summary Cell I11 is referencing Cell “6. Disaster Recovery!L11”. Please confirm this is correct or modify and republish Template F as necessary. Will the State republish the templates with the correct links?

Answer:   There was an issue with the Cost Proposal Workbook. A revised template will be published as an amendment.

Date: 4/6/2020

Inquiry: 74464


Question:   In light of the COVID pandemic, please revise the response requirements to forego hardcopies and USBs and replace them with an electronic delivery format, such as: Email or upload to a site. This would limit staff’s potential exposure given we must work in close proximity to provide such items.

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 3/30/2020

Inquiry: 74382


Question:   3.4 PROPOSAL SUBMITTAL Each Offeror must submit a technical section and a cost section as part of its total Proposal before the opening time on the Proposal due date. The Offeror must submit the technical section as a separate package from the cost section of its Proposal, and each section must be submitted in its own separate, opaque package. The package with the technical section of the Proposal must be sealed and contain one (1) originally signed technical section and fifteen (15) additional copies of the technical section, and the package with the cost section also must be sealed and contain three (3) complete copies of the cost section of the Proposal. The Offeror must mark the outside of each package with either: “RFP #0A1286 – Fiscal Intermediary – Technical Proposal” or “RFP #0A1286 – Fiscal Intermediary RFP – Cost Proposal,” as appropriate. Included in each sealed package, the Offeror also must provide an electronic “searchable” copy of everything contained within the package on a flash drive (portable storage device) in Microsoft Office (native format), Microsoft Word (native format), Microsoft Project (native format), Microsoft Excel (native format) and Adobe Acrobat format, as appropriate. If there is a discrepancy between the hard copy and the electronic copy of the Proposal, the hard copy will control, and the State will base its evaluation of the Offeror’s Proposal on the hard copy. – RFP Page 15 Question: Given the national health crisis resulting from the Coronavirus, most vendors are in the process of having as many people work from home as possible. The manual effort to print and prepare paper copies of the proposal will require a number of our employees to travel to and work from a company office during the production process. Due to the current crisis, will the State consider eliminating the requirement to submit paper copies of the proposal, and allow the vendors to submit electronic versions only?

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 3/30/2020

Inquiry: 74374


Question:   Supplement 1 – SOW: Figure 2, page 7 Q: Can additional clarification be provided on the role of the SI as the OMES Real-time Interface?

Answer:   Please resubmit inquiry clarifying which RFP it is referencing. This question appears to be combining two RFPs currently on-the-street but must be directed specifically at one or the other, without combining.

Date: 3/27/2020

Inquiry: 74420


Question:   Given the COVID-19 pandemic and the impact across the country, Conduent respectfully requests the state of Ohio extend the due date to July 31, 2020, for the Ohio Medicaid Enterprise System (OMES), Fiscal Intermediary proposal response (RFP #0A1286).

Answer:   At this time ODM is not going to change the opening date. If the agency determines at a later date that it will provide additional response time, an RFP amendment will be posted to this website to update the opening date.

Date: 3/27/2020

Inquiry: 74381


Question:   Reference Point in RFP- supplement 1 EDI objectives. Page 1 Q: Can OMES provide an estimated number of Trading Partners that will access the system from the Sister agencies?

Answer:   Please resubmit inquiry clarifying which RFP it is referencing. This question appears to be combining two RFPs currently on-the-street but must be directed specifically at one or the other, without combining.

Date: 3/25/2020

Inquiry: 74421


Question:   Supplement 1 – SOW: Figure 1, page 6 Q: For Outbound batch transactions, what is the expected input to EDI solution (e.g. X12, XML, other)?

Answer:   Please resubmit inquiry clarifying which RFP it is referencing. This question appears to be combining two RFPs currently on-the-street but must be directed specifically at one or the other, without combining.

Date: 3/25/2020

Inquiry: 74419


Question:   Supplement 1 – SOW: Figure 1, page 6 Q: For Inbound batch transactions, what is the expected output format from the EDI solution (e.g. X12, XML, other)?

Answer:   Please resubmit inquiry clarifying which RFP it is referencing. This question appears to be combining two RFPs currently on-the-street but must be directed specifically at one or the other, without combining.

Date: 3/25/2020

Inquiry: 74418


Question:   Supplement 1 – SOW: Figure 1, page 6 Q: For Inbound batch transactions, is the intent that the transactions will 1st be deposited in the EDI solution mailboxes and then flow into the System Integrator (SI)?

Answer:   Please resubmit inquiry clarifying which RFP it is referencing. This question appears to be combining two RFPs currently on-the-street but must be directed specifically at one or the other, without combining.

Date: 3/25/2020

Inquiry: 74417


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Inquiry period ended:  5/1/2020 8:00:00 AM