5-Attachment C - Intro Background Mandatory Minimum Requirements.docx

Attachment C

Oxygen Concentrator Request Proposals

Introduction/Background/Minimum Mandatory Requirements

Introduction

The purpose of this Request for Proposal (RFP) is to enter into a contract with a qualified Offeror for the rental of oxygen concentrators, associated equipment, supplies, and maintenance for Utah Medicaid Members.

The State will award a contract to a single Offeror who must provide Concentrators and associated equipment for all eligible, enrolled Medicaid Members (as defined in Attachment B: Scope of work, Section 1.1, Definitions) statewide.

Furthermore, the Offeror must render any other equipment or supplies ordered by a treating Practitioner to meet the respiratory needs of the Member when a Concentrator has been ordered. These items are separately reportable by the Offeror with reimbursement based on the Medicaid fee schedule (e.g. ventilators, CPAP, BiPAP, pulse oximeters, and sufficient backup and portable oxygen to meet the member’s medical needs).

Background

Services will be provided, when medically necessary, for all Medicaid Members who are eligible for Concentrators. Average total utilization for this service over four recent service years is approximately 955 rental units per month (representing a 6.65% decline compared to the 2017-2020 assessment period) . In the table below, the locations of members receiving this service are broken down by county with rounded average monthly usage within each county:

Note: the data in the table above is based on utilization of E1390 across Utah’s counties over a recent four year period. The four years of usage data spans from January 2022 – December 2025.

Note: Counties with an average of 1-10 concentrators in use per month are listed as an aggregate <11 due to DHHS Data Suppression Guidelines

Minimum Mandatory Requirements

1. Provide Equipment Statewide

The Offeror has the capacity to supply Medicaid Members, throughout the state of Utah, prescribed Concentrators and any other equipment or supplies ordered by a treating Practitioner to meet the respiratory needs of the Member as outlined in the Attachment B: Scope of Work, Article 3. (Yes/No)

2. Specifications for Oxygen Concentrators

The Offeror has the capacity and processes in place to furnish, install, and service all oxygen equipment needed to dispense oxygen as ordered by a Practitioner to Medicaid Members, as outlined in the Attachment B: Scope of Work, Article 3. All equipment used must, at a minimum, meet the specifications as outlined in the Attachment B: Scope of Work, Article 3. (Yes/No)

3. Urgent Services

The Offeror has a well-established communication system, providing 24-hour a day services and the ability to provide education, maintenance, replacement, and/or repair services at the Member’s place of residence within a maximum of 6-hours from time of notification by fax, email, or phone for newly ordered or malfunctioning equipment.

The Offeror has a telephone service available 24 hours per day; 7 days a week (including holidays and weekends) and shall have staff available to answer member calls, or an answering service outside of normal business hours. If an answering service is used, the answering service will inform the member that the Offeror will call the member within 15-minutes. The Offeror will respond to the member by telephone within 15-minutes of the initial member call. An answering machine may not be used.

(Yes/No)

4. Certified Respiratory Therapy Technician (CRTT) and Registered Respiratory Therapist (RRT)

The Offeror shall employ a Utah licensed CRTT or RRT level respiratory therapist or technician for every 200 concentrators in use to perform an initial home assessment/plan of care and follow-up home respiratory therapy visits. The Offeror RRTs shall provide education, as outlined in the Attachment B: Scope of Work Article 11, to each Member at the time of set-up and each RRTs home visit.

The Offeror shall maintain qualified staff 24 hours a day/365 days a year for support throughout the State of Utah. The staff shall be available for Concentrator placement, maintenance, and repair. The staff shall also be available to answer Member questions, respond to urgent medical needs related to Concentrators, and Member non-emergent respiratory care. (Yes/No)

5. Provide Backup Oxygen

The Offeror shall provide an appropriate backup system consisting of an oxygen source and regulator with stand, humidifiers, and cannulas/masks for use during the event of a power failure or mechanical problem necessitating the use of the backup oxygen. The back-up oxygen system must be maintained to provide sufficient oxygen to meet the member’s medical needs for, at minimum, three-times the Contractor’s response time. The Offeror must provide a written emergency management plan to DHHS with an affidavit of training/resources received that effectively manages Concentrator function and backup system supply to meet member medical needs in the event of a natural disaster as defined by the county in which the Member resides or other emergency situations that would interfere with the delivery, maintenance, and/or replacement of the Concentrator or backup system. (Yes/No)

6. Qualifications

The Offeror has, at minimum, 2 years of recent experience providing Concentrators, related respiratory equipment, and services. (Yes/No)

7. Licensure

The Offeror and any subcontract organizations hold, or have a complete and verifiable plan to obtain by the beginning date of contract operations, all required current licenses and credentials to perform the services described in Attachment B: Scope of Work, Article 22. (Yes/No)