41NHA-S3627-Request-for-Proposals~2.docx

Nevada State Purchasing Division Department of Administration 515 E Musser St Ste 300 Carson City, NV 89701 purchasing.nv.gov nevadaepro.com

Request for Proposals 41NHA-S3627

Release Date 01/07/2026

Solicitation number 41NHA-S3627

Single point of contact name Heather Moon

Single point of contact email hmoon@admin.nv.gov

Single point of contact phone 775-531-3309

Soliciting agency Nevada State Purchasing Division

Contracting agency Nevada Health Authority

Solicitation title Coordination Only Dual Eligible Special Needs Plans (CO D-SNP) Program

Deadline for submissions 02/17/2026 @ 2:00 P.M.

For deaf and hard of hearing, call 711 and ask the relay agency to dial the single point of contact phone number above.

This request for proposals is available at nevadaepro.com as a bid solicitation.

Table of Contents

Applicable regulations governing procurement

Statute and code. All applicable Nevada Revised Statutes (NRS) and Nevada Administrative Code (NAC) documentation can be found at: www.leg.state.nv.us/law1.html

Single point of contact. Vendors and their representatives shall only contact the single point of contract or use the electronic procurement system regarding this solicitation until after a notice of award (NOA) has been issued. Failure to observe this restriction may result in disqualification of a response per NAC 333.155(3).

Ethics. Prospective vendors are advised to review Nevada’s ethical standards requirements, including but not limited to NRS 281A, NRS 333.800, and NAC 333.155.

Project overview

The Nevada State Purchasing Division, on behalf of the Nevada Health Authority (NVHA) is seeking proposals from qualified vendors to provide a Coordination Only Dual Eligible Special Needs Plan for certain Medicare and Medicaid eligible recipients as described below and in the scope of work and attachments.

The State intends to award at least one contract in conjunction with this request for proposals (RFP). The State reserves the right, at its sole discretion, to award multiple contracts if it is determined in the best interests of the State to do so. The State is under no obligation to award any contract(s) as a result of this RFP. The Nevada Health Authority, Medicaid Division (Nevada Medicaid) shall administer the contract(s) resulting from this solicitation. The resulting contract(s) are expected to be for a contract term of four years, with two one-year options for renewal, subject to Board of Examiners approval.

Contracting agency background

Nevada Health Authority (NVHA) is the single State agency for the Medicaid program in Nevada. The Medicaid program is administered through the Medicaid Division of NVHA, known as “Nevada Medicaid.” As of November 2025, Nevada Medicaid serves approximately 88,700 members through a Fee-For-Service (FFS) delivery model who are both Medicaid and Medicare eligible, known as “Dual Eligibles.” A Coordination Only Dual Eligible Special Needs Plan (CO D-SNP) is a type of Medicare Advantage Plan designed for Dual Eligibles. These plans are specifically created to coordinate care between the two programs, aiming to improve the quality of care and reduce costs for Dual Eligibles. CO D-SNPs can offer additional benefits not typically available under Medicare, such as transportation and over-the-counter products, while also ensuring that both Medicare and Medicaid benefits work together seamlessly. A contract to provide CO D-SNP services resulting from this solicitation is known as a State Agency Medicaid Contract (SMAC).

Goals and objectives

NVHA’s goal is to contract with at least one qualified Vendor to offer a statewide CO D-SNP to Nevada Medicaid’s Dual Eligible population with the goal to better coordinate care for these beneficiaries, improve the quality of care and increase access to services while also lowering costs. NVHA prefers to contract with Vendor(s) who have a demonstrated track record of providing care coordination activities for Dual Eligibles, including ensuring beneficiaries receive quality services, enhanced coordination of services, and reduced confusion between the Medicare and Medicaid program benefits and offerings.

By offering a CO D-SNP in Nevada, NVHA additionally aims for Dual Eligibles to have access to supplemental benefits not typically available under Medicare but often offered through Medicaid programs when applicable.

NVHA intends for a CO D-SNP operating in Nevada to have two separate Plan Benefit Packages (PBP) with differing eligibility criteria for Full Benefit Dual Eligible (FBDE) individuals and Partial Dual eligibility (Qualified Medicare Beneficiary enrollees). One PBP shall enroll FBDE and the second PBP shall be limited to enrollment of Partial Dual eligibles.

Vendor(s) awarded a Contract pursuant to this solicitation to provide CO D-SNP services to Nevada Medicaid’s Dual Eligible population are required to submit bid documentation to the Centers for Medicare and Medicaid Services (CMS) annually to operate as a CO D-SNP under a SMAC for each year of the Contract term.

Scope of work

See Scope of Work in ‘Attachments’ tab of NEVADAePRO.

Attachments

Attachments incorporated by reference. To be read and not returned.

Terms and conditions for services

Attachments for review. To be read and not returned (unless redlining).

Standard form contract Insurance schedule Business Associate Addendum – no redlining of document Business Continuity Agreement – no redlining of document

Attachments for response. To be completed and returned.

Reference questionnaire Vendor information response Certification regarding lobbying

Timeline

Questions. All questions regarding this solicitation shall be submitted using the bid Q&A feature at nevadaepro.com.

Timeline. The following represents the proposed timeline for this project.

All times stated are Pacific Time (PT).

These dates represent a tentative schedule of events.

The State reserves the right to modify these dates at any time.

The deadline for submissions is the nevadaepro.com bid opening date and time. Late quotes will not be accepted.

Evaluation

Evaluation and scoring are conducted in accordance with NRS 333.335 and NAC 333.160-333.165.

Responses shall be kept confidential until a contract is awarded.

In the event the solicitation is withdrawn prior to award, responses remain confidential.

The evaluation committee is an independent committee established to evaluate and score qualitative evaluation factors for the solicitation.

Financial stability shall be scored on a pass or fail basis.

Responses shall be consistently evaluated and scored based upon the following factors and relative weights.

Technical factor #1 – Centers for Medicare and Medicaid (CMS) Aggregate Star Rating – The vendor shall provide their most recent CMS Aggregate Star Rating for one H contract that includes at least one D-SNP plan benefit package. Bidders must attest to accuracy in Attachment B 25 Technical factor #2 – National Committee for Quality Assurance (NCQA) Model of Care Score – The vendor must provide their most recent overall NCQA MOC score and attest to the accuracy in Attachment B. 25

Presentations. The State may require vendors to make a presentation. The State reserves the right to add additional criteria for presentations. The State reserves the right to forego presentations and select vendor(s) based on written responses submitted.

Best and final offers. Pursuant to NAC 333.165, the State reserves the right to permit revised responses or add criteria to obtain the best offers. Vendors are encouraged to submit their best offer at time of initial response.

Nevada-based business preference

The State awards a five percent (5%) preference to Nevada-based businesses pursuant to NRS 333.3351 to 333.3356, inclusive.

Nevada-based business is defined in NRS 333.3352(1).

The term ‘principal place of business’ has the meaning outlined by the United States Supreme Court in Hertz Corp v. Friend, 559 U.S. 77 (2010), typically meaning a business’s corporate headquarters.

To claim this preference a vendor must indicate it on their vendor account and submitted quote in nevadaepro.com.

This preference cannot be combined with any other preference, granted for the award of a contract using federal funds, or granted for the award of a contract procured on a multi-state basis.

Inverse preference

The State applies an inverse preference to vendors that have a principal place of business in a state other than Nevada and that state applies an in-state preference not afforded to Nevada based vendors, pursuant to NRS 333.33695.

The amount of the inverse preference is correlated to the amount of preference applied in the other state.

Vendors who meet this criterion must indicated it on their submitted quote in nevadaepro.com.

This preference cannot be combined with any other preference, granted for the award of a contract using federal funds, or granted for the award of a contract procured on a multi-state basis.

Mandatory minimum requirements

Pursuant to NRS 333.311 a contract cannot be awarded to a response that does not comply with the requirements listed in this section. Response shall include confirmation of compliance with all mandatory minimum requirements.

Nevada Law and State indemnity. Pursuant to NRS 333.339, any contract that is entered into may not: (1) require the filing of any action or the arbitration of any dispute that arises from the contract to be instituted or heard in another state or nation; or (2) require the State to indemnify another party against liability for damages.

No Boycott of Israel. Pursuant to NRS 333.338, the State of Nevada cannot enter a contract with a company unless that company agrees for the duration of the contract not to engage in a boycott of Israel. By submitting a response, vendor agrees that if it is awarded a contract, it will not engage in a boycott of Israel as defined in NRS 333.338(3)(a).

nevadaepro.com vendor registration. Pursuant to NRS 333.313, vendor must be registered at nevadaepro.com to respond to the solicitation. Vendor information must match Nevada business license and sam.gov entity registration. Vendor information in nevadaepro.com will be used for contract formation. Email address(es) associated with general mailing address or default bid mailing address (if different from general mailing address) in nevadaepro.com will be used for formal notifications. If a vendor has a different contact name and email for negotiations, that should be indicated on the title page(s) of their response.

Nevada business license. Pursuant to NRS 353.007, prior to contract execution awarded vendor must hold a state business license pursuant to NRS chapter 76 unless exempted by NRS 76.100(7)(b). Business license must match nevadaepro.com vendor registration.

System for Award Management (sam.gov) Prior to contract award vendor must hold an active entity registration in sam.gov. Entity registration must match nevadaepro.com vendor registration.

Contract responsibility. Awarded vendor shall be the sole point of contract responsibility. The State shall look solely to the awarded vendor for the performance of all contractual obligations which may result from an award based on this solicitation, and the awarded vendor shall not be relieved for the non-performance of any or all subcontractors.

Data encryption and stateside data. State IT requires that data be encrypted in transit and in rest. State IT requires that State data assets must be maintained in the United States and data will not be held offshore.

Confidentiality and certification of indemnification

Submitted responses, which are marked confidential in their entirety, or those in which a significant portion of the submitted response is marked confidential may not be accepted. Pursuant to NRS 333.333, only proprietary information may be labeled a trade secret as defined in NRS 600A.030(5). All proposals are confidential until the contract is awarded; at which time, both successful and unsuccessful vendor proposals become public information.

Vendors shall submit proprietary information and confidential business information in separate files, flagged as confidential in nevadaepro.com. The State is not responsible for any information contained within a response; responses shall be released as submitted.

By submitting a response vendor acknowledges its responsibility to act in protection of labeled information and agrees to defend and indemnify the State of Nevada for honoring such designation. Failure to so act shall constitute a complete waiver, and all submitted information shall become public information; additionally, failure to label any information that is released by the State shall constitute a complete waiver of any and all claims for damages caused by the release of the information.

Vendor certifications

Vendor understands and acknowledges that the representations within their response are material and important and are relied on by the State in evaluation of the response. Any vendor misrepresentations can be treated as fraudulent concealment from the State of the true facts relating to the response.

Any and all prices that may be charged under the terms of the contract do not and shall not violate any existing federal, State, or municipal laws or regulations concerning discrimination or price fixing. Vendor agrees to indemnify, defend, and hold the State harmless from liability for any such violation.

All response terms, including prices, shall remain in effect for a minimum of 180 days after the response due date. In the case of the awarded vendor, all response terms, including prices, shall remain in effect throughout the contract term.

The price(s) and amount of this response have been arrived at independently and without consultation, communication, agreement or disclosure with or to any other contractor, vendor, or potential vendor. No attempt has been made at any time to induce any firm or person to refrain from proposing or to submit a response higher than this response, or to submit any intentionally high or noncompetitive response. All responses shall be made in good faith and without collusion.

The information included in this response has been arrived at independently and without non-public information obtained from State officials, staff, or their agents.

All employees and contractors assigned to the project are authorized to work in this country.

Vendor has a written equal opportunity policy that does not discriminate in employment practices with regard to race, color, national origin, physical condition, creed, religion, age, sex, marital status, sexual orientation, developmental disability or disability of another nature.

Vendor has a written policy regarding compliance for maintaining a drug-free workplace.

Critical items

In addition to the scope of work and attachments, the items listed in this section are critical to the success of the project. These items will be used in evaluating and scoring responses. Vendor response should address items in this section in enough detail to provide evaluators an accurate understanding of vendor capabilities. Responses that fail to sufficiently respond to these items may be considered non-responsive.

Standard form contract. The State strongly prefers vendors agree to the terms of the attached standard form contract as is. Ability to agree to contract terms is a high priority to the State. Vendors who cannot agree to the contract as is must include a redlined Word version of the attached standard form contract with their response, with comments justifying the benefit to the State for each requested change. To the extent a vendor has prior contractual dealings with the State, no assumption should be made that terms outside those provided herein have any influence on this project.

Indemnification. Required contract terms on Indemnification: "To the fullest extent permitted by law, Contractor shall indemnify, hold harmless and defend, not excluding the State’s right to participate, the State from and against all liability, claims, actions, damages, losses, and expenses, including, without limitation, reasonable attorneys’ fees and costs, arising out of any breach of the obligations of Contractor under this contract, or any alleged negligent or willful acts or omissions of Contractor, its officers, employees and agents. Contractor’s obligation to indemnify the State shall apply in all cases except for claims arising solely from the State’s own negligence or willful misconduct. Contractor waives any rights of subrogation against the State. Contractor’s duty to defend begins when the State requests defense of any claim arising from this Contract."

Limited liability. Required contract terms on Limited Liability: "The State will not waive and intends to assert available NRS Chapter 41 liability limitations in all cases. Contract liability of both parties shall not be subject to punitive damages. Damages for any State breach shall never exceed the amount of funds appropriated for payment under this Contract, but not yet paid to Contractor, for the Fiscal Year budget in existence at the time of the breach. Contractor’s tort liability shall not be limited."

Insurance schedule. The State strongly prefers vendors agree to the terms of the attached insurance schedule as is. Vendors who cannot agree must explain which areas are causing non-compliance and attach a redline if necessary. Awarded vendor shall maintain, for the duration of the contract, insurance coverages as set forth in the fully executed contract. Work on the contract shall not begin until after the awarded vendor has submitted acceptable evidence of required insurance. Failure to maintain any required insurance coverage or acceptable alternative method of insurance shall be deemed a breach of contract.

Vendor background

Provide a background, history, and why vendor is qualified to provide the services described in this solicitation. Background should include, at a minimum, the location(s) of the office(s) that would perform the work and the number of employees locally and in total. History should include, at a minimum, the number of years in business and company headquarters location. Provide a brief description of the length of time vendor has been providing services described in this solicitation to the public or private sector. If your company has worked with the State previously, include information about those engagements.

No marketing material desired. Unnecessarily elaborate brochures or other presentations beyond those requested and sufficient to present a complete response are not desired.

Key personnel. Provide a resume free of photos or overly stylized formatting for proposed key personnel, whether employed directly or through a subcontractor.

Current or former employees. If you employ (a) any person who is a current employee of an agency of the State of Nevada, or (b) any person who has been an employee of an agency of the State of Nevada within the past two (2) years, and if such person is performing or producing the services which you shall be contracted to provide under this contract, you must disclose the identity of each such person in your response, and specify the services that each person shall be expected to perform.

Exclusions. All conditions and provisions of this solicitation are deemed to be accepted by the vendor and incorporated by reference in the response, except such conditions and provisions that the vendor expressly excludes in the response. Any exclusion shall be in writing and included in the response at the time of submission.

Subcontractors

Subcontractors are defined as a third party, not directly employed by the contractor, who shall provide services identified in this solicitation. This does not include third parties who provide support or incidental services to the contractor.

Vendor shall disclose all proposed subcontractors. Response should include a vendor information response form for each proposed subcontractor.

Vendor shall not allow any subcontractor to commence work until all insurance required of the subcontractor is provided to the vendor.

Vendor shall certify that subcontractors comply with mandatory minimum requirements except contract responsibility.

Vendor response shall identify specific requirements of the project for which each subcontractor shall perform services.

How the work of any subcontractor(s) shall be supervised How channels of communication shall be maintained How compliance with contracts terms and conditions will be assured Previous experience with subcontractor(s)

Confidential business information

The information requested in this section is designated as confidential business information by the Administrator pursuant to NRS 333.020(5)(b) and is not public information pursuant to NRS 333.333.

This information should be submitted as a separate attachment, flagged as confidential in nevadaepro.com.

Dun and Bradstreet number. Vendor shall provide their Dun and Bradstreet Number.

Financial information. Vendor shall provide the last two full years and current year interim (a) profit and loss statements and (b) balance statements.

Disclosure. Vendor shall provide complete disclosure of any alleged significant prior or ongoing contract failures, contract breaches, any civil or criminal litigation or investigations pending which involves the vendor or in which the vendor has been judged guilty or liable.

Conflict of interest. Vendor shall disclose any existing or potential conflict of interest relative to the performance of the contractual services resulting from this solicitation. Any such relationship that might be perceived or represented as a conflict shall be disclosed. By submitting a response in response to this solicitation, vendors affirm that they have not given, nor intend to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant or any employee or representative of same, in connection with this procurement. Any attempt to intentionally or unintentionally conceal or obfuscate a conflict of interest shall result in disqualification of a vendor response. An award shall not be made where a conflict of interest exists. The State shall determine whether a conflict of interest exists and whether it may reflect negatively on State vendor selection. The State reserves the right to disqualify any vendor on the grounds of actual or apparent conflict of interest.

Client references

Vendor may be asked to provide reference questionnaire attachment to client references from similar projects performed for private or public sector clients within the last five years.

The single point of contact may receive up to three complete reference questionnaire documents directly from the client references via email, if determined to be required for evaluation of the work solicited.

The purpose of these references is to document relevant experience and aid in the evaluation process.

Reference questionnaire will not be accepted directly from proposing vendors.

Client references are not to be requested from the contracting agency.

The State will not disclose client references, but may confirm the quantity of reference questionnaires received.

The State reserves the right to contact client references during evaluation or negotiations.

Submission checklist

This section identifies documents that vendors can submit to be considered responsive. Vendors are encouraged to review all requirements to ensure all requested information is included in their response.

This is a general request for most solicitations. There may be additional instructions within the body of the solicitation that require scope specific response documents. Vendors are encouraged to thoroughly review all requirements.

Responses must be submitted as a quote through nevadaepro.com.

Vendors are encouraged to submit a single file attachment per section where possible.

Technical proposal information is not to be included in the same attachment.

Additional attachments may be included, but are discouraged and should be kept to a minimum.

Technical proposal

Title page Table of contents Signed certification regarding lobbying Response to mandatory minimum requirements Response to critical items Response to scope of work Other informational material

Proprietary information. If necessary. Attachment should be flagged confidential in nevadaepro.com.

Title page Table of contents Trade secret information, cross referenced to the technical proposal (alternatively, a redacted technical proposal and a full confidential technical proposal can be submitted)

Confidential business information. Attachment should be flagged confidential in nevadaepro.com.

Other attachments. If necessary, not recommended.

Client references. Not submitted directly by vendor. To be sent to sole point of contact on RFP.

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