Opportunity Detail

Questions and Answers

Actuarial Services for Medicaid Managed care
Document #:  JFSR1213078006


Question:   •Pease provide the following: a.Name of current consultant b.Length of time the current consultant has provided these services c.Total fees for each of the past three years separated between base costs and ad hoc services, as appropriate d.Hourly professional fees by staff level e.A copy of the current contract •Please describe the role Department staff will have in the rate development and other activities, including project organization, data analysis, and other, as appropriate. •Do you anticipate any changes in the number or make-up of managed care plans participating in your programs? •Please provide additional information with regard to the encounter data: a.Is encounter the data provided to the Contractor by ODJFS or the MCOs? b.What has been the recent experience with MCO encounter data quality? c.How are the encounter data currently validated? d.Do MCOs provide their actual provider payment amounts in the encounter data? Are corresponding Medicaid FFS payment amounts provided in this data? e.What format is the data in (e.g., text files, ASCII, SAS format)? f.What data elements are available in the encounter and eligibility file? •Please provide the expected number of onsite meetings and location of meetings with ODJFS staff or other parties. •On page 4 of the RFP, the Incentive Program is described. Who is responsible for establishing the performance standards, and how is that accomplished? •On pages 13 and of the RFP, Section 3.3 Staff Experience and Capabilities, it states that a Data Manager and a Project Manager must be assigned. May the same person perform both roles? •Can you confirm that the Contractor will not be the sub-recipient of any Federal funds derived from a grant? If Federal grant funds will not be used, can that clarification be added to the Contract? •What will be the process for agreeing to fees to accommodate work that may be out of scope or result from new federal or state requirements?

Answer:   Pease provide the following: a. Milliman,Inc. b. Since SFY 2007 c.SFY 08....$793,140 SFY 09....816,634.20 SFY 10....$797,068.76 All Payments included for each year. d. $265 per hour e. Such requests are NOT requests for clarification of this RFP but are requests for public record (PRRs)/public info that are to be handled as such. The Q&A time line does not necessarily apply to our ability to respond to PRRs. • Appropriate staff from the department are involved in the rate setting process from the beginning. There is an internal team of about 20 people who are considered policy and fiscal experts who provide information to the actuary and review the actuary's work on an ongoing basis. The rate setting process is very interactive. The MCPs are also involved in providing comments on rate methodology, data book and draft rates. • Yes. The program is expected to grow and new population groups might be included in managed care. Other services that are currently excluded might be included under the managed care program. The budget might bring more changes to the program. It is quite likely that there will be changes in the make-up of managed care plans participating in our program. • b. Ohio's data is high quality in comparison to other state's encounters (we have been told by national vendors). c. ODJFS uses a series of data quality measures to ensure accuracy, completeness, and timeliness. Please note that a biennial claims payment validation study is conducted for which the MCP's are held accountable to ensure accuracy of payment information. d. Yes, for claims on which MCPs pay. The MCPs currently submit capitation indicators for claims that are part of a capitated arrangement. However, moving forward with EDI data, ODJFS will require MCPs to place calculated payment information on even the capitated encounters. • No. e. SAS f. Please refer to the documents posted in the Program Resource library (follow the link in the RFP). •Three face to face meetings are expected to take place in Columbus. • ODJFS establishes performance measures and standards for the P4P system. ODJFS determines performance measures that are appropriate for the populations based on ODJFS' expectations for key areas of quality and access to care for the managed care program. The performance standards are set based on national benchmarks (when applicable) as well as historical performance of MCPs in Ohio's managed care program. • ODHFS preference is to have two separate managers. • The contract funding is not based on federal grant funds. • It would be through negotiations between the contractor and JFS and the fees would be comparable to the fees negotiated for the entire contract.

Date: 4/1/2011

Inquiry: 22124


Question:   Section 3.3 – Staff Experience and Capabilities – Page 14 • Please verify whether “B. Assign a project manager” referenced in paragraph 4 should be “C. Assign a project manager” Section 4.1 – Scope of Work – Page 14 • Please verify whether “Section 4.4” referenced in paragraph 4 should be “Section 4.3" Section 5.2 A – Overall Proposal Organization – Page 23 • The RFP states that all pages beyond Tab 1 shall be sequentially numbered. Please clarify whether the attachments that vendors provide in Tab 5, such as work samples and resumes, need to be sequentially numbered or if they also are excluded from this requirement. Section 5.2 B.1 – Tab 1 Required Vendor Information & Certifications – Page 25 • Please verify where the W-9 form is located. Paragraph 2 suggests that it is Attachment B, but Attachment B appears to be the model contract. • Please verify whether “Attachment C, Declaration Regarding Material Assistance/Non-Assistance to a Terrorist Organization” referenced in paragraph 3 should be “Attachment A, Section 3 Declaration Regarding Material Assistance/Non-Assistance to a Terrorist Organization”. • Please verify whether “Attachments A., B., C.” referenced in paragraph 4 should be “Attachments A., B., C.”. • Please clarify each distinct item that should be included in Tab 1 based on the discrepancies identified above. Attachment E – Technical Proposal Score Sheet • Please clarify whether Section 3.2 G will be included in the evaluation as it does not appear on the score sheet. If included, please provide the weighting that will be assigned.

Answer:   Please review the revised posted RFP on the web. We apologize for any inconvenience. Thank you. Text: Section 3.3 - Staff Experience and Capabilities - Page 14 • Please verify whether “B. Assign a project manager” referenced in paragraph 4 should be “C. Assign a project manager” Yes, this is correct. Section 4.1 - Scope of Work - Page 14 • Please verify whether “Section 4.4” referenced in paragraph 4 should be “Section 4.3" Yes, this is correct. Section 5.2 A - Overall Proposal Organization - Page 23 • The RFP states that all pages beyond Tab 1 shall be sequentially numbered. Please clarify whether the attachments that vendors provide in Tab 5, such as work samples and resumes, need to be sequentially numbered or if they also are excluded from this requirement. No, the attachments do not have to sequentially numbered. Section 5.2 B.1 - Tab 1 Required Vendor Information & Certifications - Page 25 • Please verify where the W-9 form is located. Paragraph 2 suggests that it is Attachment B, but Attachment B appears to be the model contract. Attachment A • Please verify whether “Attachment C, Declaration Regarding Material Assistance/Non-Assistance to a Terrorist Organization” referenced in paragraph 3 should be “Attachment A, Section 3 Declaration Regarding Material Assistance/Non-Assistance to a Terrorist Organization”. Yes • Please verify whether “Attachments A., B., C.” referenced in paragraph 4 should be “Attachments A., B., C.”. Attachment A only • Please clarify each distinct item that should be included in Tab 1 based on the discrepancies identified above. Attachment A: Required information and certifications of eligibility of state contract awards, Request for Taxpayer Identification Number (W-9) Form, Declaration regarding Material Assistance/Non-Assistance to a Terrorist Organization Attachment E - Technical Proposal Score Sheet • Please clarify whether Section 3.2 G will be included in the evaluation as it does not appear on the score sheet. If included, please provide the weighting that will be assigned. It is included in the evaluation as #11; 3.2 F and G are covered under #11.

Date: 4/1/2011

Inquiry: 22131


Question:   In Attachment A, 10. Location of Business Declaration and the Location of Business Form, vendors are asked to certify that no public funds shall be spent on services provided offshore. Please clarify whether administrative services such as billing and document production are included in the prohibition.

Answer:   Yes those activities are included in the prohibition.

Date: 4/1/2011

Inquiry: 22136


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Inquiry period ended:  3/31/2011 8:00:00 AM