40DHHS-S3926-Scope of Work_AVS.docx

Scope of Work

1. Scope of Work-Asset Verification System (AVS)

1.1 Supplemental Appropriation Act of 2008 (P.L. 110-252) section 1940 of the Social Security Act, requires all states to implement a system for verifying the assets of the aged, blind, and disabled applicants for and recipients of Medicaid.

1.1.1 The system used must be “consistent with the approach taken by SSA in their SSI asset verification pilot project”.

1.1.2 To be consistent with the approach taken by SSA in its SSI asset verification pilot, a State’s AVS must meet the following requirements:

A. The request and response system must be electronic:

1. The verification inquiries must be sent electronically via the internet or similar means from the State to the financial institution (FI);

2. The system cannot be based on a mailing paper-based request; and

3. The system must have the capability to accept responses electronically.

B. The system must be secure, based on a recognized industry standard of security (e.g. as defined by the U.S. Commerce Department’s National Institute of Standards and Technology, or NIST)

C. The system must establish and maintain a database of FI’s that participate in the State’s AVS.

D. Verification requests also must be sent to FI’s other than those identified by applicants and recipients, based on some logic such as geographic proximity to the applicant’s home address, or other reasonable factors whenever the State determines that such requests are needed to determine or re-determine the individual’s eligibility.

1.1.3 The verification request must include a request for information on both open and closed accounts, going back for a period of up to five (5) years, as determined by the State.

1.1.4 The State must be able to generate reports on verification activity, including information such as:

A. The number of requests; and

B. Number of responses; and

C. Amounts of undisclosed assets found, etc.

2. BAFO Scope of Work

2.1 Please provide a written presentation that may include screen shots, detailed diagrams, and any supporting information you believe will help clarify how the agency, its programs and technical staff access and use the vendor’s best solution.

2.1.1 Provide an example and clear description of what a return of information provides.

2.1.2 Provide an example or detailed description of what analytics are possible to provide to the State with the vendors solution for the Asset Verification System.

2.1.3 The State would like confirmation as to the immediate access of the information within the provided solution.

2.1.4 Provide an example of what a return of information produces for the State.

3. General Requirements

3.1 The Vendor shall maintain an AVS that complies with the requirements of:

3.1.1 Public Law 110-252, Section 7001(d), Asset Verification Through Access to Information Held by Financial Institutions; and

3.1.2 the Gramm-Leach-Bliley Act, Pub.L. 106-102, 113 Stat. 1338 (November 12, 1999), and the regulations promulgated there under;

3.2 The Vendor shall participate in periodic meetings with the Division at a location identified and agreed upon by the Division, or by conference call, as requested by the Division.

3.3 The Vendor must give the Division written notice within one hundred and twenty (120) days of any decision by the Vendor or by any of the Vendor’s subcontractors to relocate the performance of any work under the contract from a location within the United States to a location outside the United States. Movement of services offshore will cause termination of contract.

4. Post-Award Activities

4.1 During project startup to begin upon contract execution, the Vendor shall provide a full time day-to-day Project Manager dedicated 100% to the start up. The Project Manager shall coordinate activities and allocate Vendor resources. This person is expected to be available in person or remotely on a daily basis until the electronic inquiry function go live date. The Project Manager shall be the Vendor’s “Key Personnel.”

4.2 Within 14 calendar days following contract execution, the Vendor shall organize and lead a kick-off meeting in person at a location identified and agreed upon by the Division. The purpose of the meeting is to discuss the Vendor’s work and finalize the development of the work plan and schedule for the Vendor to provide the Division a secure internet service between the State’s Medicaid eligibility system and the Vendor’s AVS.

5. Financial Institution Network

5.1 Within 14 days following contract execution, the Vendor shall identify those Financial Institutions in the State of Nevada that are not members of the Vendor’s Financial Institution Network and devise and implement a campaign to add those Financial Institutions to its network.

5.2 The Vendor shall continuously recruit Financial Institutions in the State of Nevada and across the United States to join and expand its network and provide the Division documentation of such activities.

5.3 The Vendor shall notify the Division in writing of any Nevada institutions that are removed from the Vendor’s Financial Institution Network within 10 business days of removal.

6. AVS

6.1 The Vendor shall give Division staff unlimited, 24x7 secure internet access to the Vendor’s AVS.

6.2 The AVS must list all Financial Instruments (excluding life insurance policies) held or managed by all Financial Institutions in the Vendor’s Financial Institution Network.

6.3 The AVS must list the monthly balance of each Financial Instrument for each of the immediate past 60 months. If the Financial Instrument has not been in existence for 60 months, the AVS must list the monthly balance for each month of the Financial Instrument’s existence. The monthly balance of a Financial Instrument is the balance that existed as of 12:01 a.m. on the first day of the month in question.

6.4 When Division staff query the AVS regarding the assets of a Medicaid applicant or beneficiary, the AVS must respond by providing the monthly balances described in the preceding paragraph for each Financial Instrument that belonged to the applicant or beneficiary at any time during the immediate past 60 months, whether the Financial Instrument belonged to the applicant or beneficiary as a single account holder or as a joint account holder.

6.5 The AVS must allow verification requests to be sent by the Vendor to all Financial Institutions in Vendor’s Financial Institution Network, not just those Financial Institutions located within the State of Nevada and not just those Financial Institutions identified by the applicant or recipient.

6.6 Within twenty-four (24) hours after each search is completed, the AVS must deliver via the internet written confirmation that the search has been completed, a list of the balances of the Financial Instruments found by the search, or a statement that no Financial Instruments were found.

6.7 The AVS must be scalable and flexible so it can be adapted as needed in response to program or enrollment changes. The Vendor shall incur and bear all costs related to updates in scalability and/or flexibility of the Vendor-provided components of the AVS.

6.8 The AVS must be capable of accepting individual queries and batch queries without any limitation on query volume or frequency.

6.9 Section 1940(b)(2) of the Social Security Act specifies that an asset verification program must be “consistent with the approach used by the Commissioner of Social Security under section 1631(e)(1)(B)(ii).” This requirement is explained in the CMS memo attached to this RFP as Attachment 1.

6.9.1 Currently, procurement of values for life insurance policies and real/personal property are not required. However, this information may be used in the future to determine eligibility. Vendors who wish to provide these services to the Division, should they become necessary, may outline service fees in the cost proposal.

7. Help Desk Services

7.1 The Vendor shall make at least one Vendor Help Desk information technology representative available to designated Division Help Desk personnel via toll-free telephone number and email from 6:00 am to 8:00 pm PT, Monday through Friday, except for State holidays, beginning immediately upon contract execution.

7.2 The Vendor’s Help Desk representative shall: (1) answer questions regarding access to the AVS; (2) receive and respond to error reports; and (3) initiate corrective action when problems are identified.

7.3 The Vendor Help Desk shall promptly notify the Division Help Desk when the Vendor identifies problems that will interrupt or delay online inquiries or data transfers. The Vendor shall use reasonable efforts to correct such problems within 24 hours of discovery.

8. Reporting

8.1 The Vendor shall generate standard monthly reports as described in its proposal, and ad hoc reports as requested by the Division and CMS at no additional cost to the Division. The Division and CMS will specify the format and data ranges of these reports.

8.2 The Vendor shall submit each report within five (5) business days following its receipt of the subject request, unless given additional processing time by the Division.

9. Data Protection

9.1 The Vendor shall adhere to all data protection, privacy, security, and breach notification requirements established in the Cloud Service & Web Service Requirements and Data Use Agreement for the Division of Social Services (DSS). The Cloud Service & Web Service Requirements and Data Use Agreement for the Division of Social Services (DSS) governs all handling of Division data and is incorporated by reference as an attachment to the RFP package.