Addendum 1.pdf
PDF 399 KB Posted
- Attached to
- MEDICAID MANAGED CARE RATE SETTING/PROGRAM ADMIN
- Solicitation number
- CRFP 0511 BMS2700000001 3
- Issued by
- Kanawha County, West Virginia
About this file
This Addendum 1 document, issued by the West Virginia Department of Administration Purchasing Division on behalf of the Bureau for Medical Services (BMS), provides responses to vendor questions regarding a Centralized Request for Proposals (CRFP) for Medicaid Managed Care Rate Setting, Program Administration, and Actuarial Services. The solicitation, numbered CRFP 0511 BMS2700000001, seeks comprehensive services including lead actuary services (5,000 hours annually), staff actuary services (20,000 hours annually), technical support staff (5,000 hours annually), clerical support staff (5,000 hours annually), managed care program oversight services, managed care oversight ad hoc services, actuarial services ad hoc services, financial services, and optional provider rate setting services. The vendor question deadline was July 30, 2026, with the solicitation closing on August 25, 2026, at 1:30 p.m. The contract structure includes a base year followed by five optional renewal years, with all services to be delivered to the Health and Human Resources Bureau for Medical Services located at 350 Capitol Street, Room 251, Charleston, West Virginia. Responses must be submitted in hard copy format, and online submissions are prohibited.
The State clarified that Sections 4.2.1 (Goals and Objectives) and 4.3.1 are non-mandatory specifications evaluated through technical scoring with point deductions for deficiencies, while Sections 4.2.2 and 4.3.2 (Mandatory Project Requirements) are evaluated on a pass/fail basis with proposals deemed non-responsive and disqualified for non-compliance. The State confirmed that subcontracting is permitted only for actuarial services, with all other functions requiring direct performance by the prime contractor, and that no formal market analysis was conducted regarding subcontracting restrictions or mandatory corporate experience requirements. The RFP requires offerors to submit a conflict mitigation plan addressing potential organizational conflicts of interest arising from the same contractor performing both MLR audits and rate-setting functions, which the State does not consider a self-review conflict but instead places responsibility on each offeror to disclose and mitigate conflicts. Service level agreement penalties of $500 per day apply for failure to deliver required services within specified timeframes, and medicaid managed care rate certifications must be submitted to the State ninety days prior to the effective date of rates.
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Text version
Date Printed: Aug 14, 2026 Page: 1 FORM ID: WV-PRC-CRFP-002 2020\05
Department of Administration Purchasing Division 2019 Washington Street East Post Office Box 50130 Charleston, WV 25305-0130
State of West Virginia Centralized Request for Proposals
Service - Misc
Proc Folder: 1945653 Reason for Modification:
Doc Description: MEDICAID MANAGED CARE RATE SETTING/PROGRAM ADMIN ADDENDUM 1
TO PROVIDE ANSWERS TO
VENDOR QUESTIONS
Proc Type: Central Master Agreement
Date Issued Solicitation Closes Solicitation No Version
2026-08-14 2026-08-25 13:30 CRFP 0511 BMS2700000001 2
BID RECEIVING LOCATION
BID CLERK
DEPARTMENT OF ADMINISTRATION
PURCHASING DIVISION
2019 WASHINGTON ST E
CHARLESTON WV 25305
US
VENDOR
Vendor Customer Code:
Vendor Name :
Address :
Street :
City :
State : Country : Zip :
Principal Contact :
Vendor Contact Phone: Extension:
FOR INFORMATION CONTACT THE BUYER
Crystal G Hustead
(304) 558-2402 crystal.g.hustead@wv.gov
Vendor Signature X FEIN# DATE All offers subject to all terms and conditions contained in this solicitation
Date Printed: Aug 14, 2026 Page: 2 FORM ID: WV-PRC-CRFP-002 2020\05
ADDITIONAL INFORMATION
THE STATE OF WEST VIRGINIA PURCHASING DIVISION FOR THE AGENCY, WEST VIRGINIA DEPARTMENT OF HUMAN SERVICES (DOHS), BUREAU FOR MEDICAL SERVICES (BMS), IS SOLICITING PROPOSALS TO ESTABLISH A CONTRACT FOR MEDICAID MANAGED CARE RATE SETTING, PROGRAM ADMINISTRATION, AND ACTUARIAL SERVICES PER THE
ATTACHED DOCUMENTS.
***ONLINE RESPONSES ARE PROHIBITED FOR THIS SOLICITATION***
***QUESTIONS REGARDING THE SOLICITATION MUST BE SUBMITTED IN WRITING TO CRYSTAL.G.HUSTEAD@WV.GOV PRIOR TO THE QUESTION PERIOD DEADLINE CONTAINED IN THE INSTRUCTIONS TO VENDORS SUBMITTING BIDS***
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 1 Lead Actuary Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Lead Actuary Services
$_____Per Hour X 5,000 Hours Annually
Date Printed: Aug 14, 2026 Page: 3 FORM ID: WV-PRC-CRFP-002 2020\05
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 2 Staff Actuary Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Staff Actuary Services
$_____Per Hour X 20,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 3 Technical Support Staff (non-actuary)
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Technical Support Staff (non-actuary)
Date Printed: Aug 14, 2026 Page: 4 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 4 Clerical Support Staff
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Clerical Support Staff
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 5 Managed Care Program Oversight Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Managed Care Program Oversight Services Annual Cost
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
Date Printed: Aug 14, 2026 Page: 5 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 6 Managed Care Oversight Ad Hoc Serv
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Managed Care Oversight Ad Hoc Services
$____ per hour X 5,000 hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 7 Actuarial Services Ad Hoc Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Actuarial Services Ad Hoc Services
$____ per hour X 5,000 hours Annually
Date Printed: Aug 14, 2026 Page: 6 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 8 Financial Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Financial Services Annual Cost
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 9 Rate Setting Services (Optional)
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Rate Setting Services (Optional)
Date Printed: Aug 14, 2026 Page: 7 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 10 Optional Renewal Year 1 Lead Actuary
Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Lead Actuary Services
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 11 Optional Renewal Year 1 Staff Actuary
Extended Description:
Staff Actuary Services
$_____Per Hour X 20,000 Hours Annually
Date Printed: Aug 14, 2026 Page: 8 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 12 Optional Renewal Year 1 Technical Support
Staff (non-actuary
Extended Description:
Technical Support Staff (non-actuary)
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 13 Optional Renewal Year 1 Clerical Support Staff
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Clerical Support Staff
Date Printed: Aug 14, 2026 Page: 9 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 14 Optional Renewal Year 1 Managed Care
Program Oversight Servi
Extended Description:
Managed Care Program Oversight Services Annual Cost
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 15 Optional Renewal Year 1 Managed Care
Oversight Ad Hoc Ser
Extended Description:
Managed Care Oversight Ad Hoc Services
Date Printed: Aug 14, 2026 Page: 10 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 16 Optional Renewal Year 1 Actuarial Services
Ad Hoc Services
Extended Description:
Actuarial Services Ad Hoc Services
$____ per hour X 5,000 hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 17 Optional Renewal Year 1 Financial Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Financial Services Annual Cost
Date Printed: Aug 14, 2026 Page: 11 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 18 Optional Renewal Year 1 Rate Setting
Services (Optional)
Extended Description:
Rate Setting Services (Optional)
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 19 Optional Renewal Year 2 Lead Actuary
Extended Description:
Date Printed: Aug 14, 2026 Page: 12 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 20 Optional Renewal Year 2 Staff Actuary
Extended Description:
Staff Actuary Services
$_____Per Hour X 20,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 21 Optional Renewal Year 2 Technical Support
Extended Description:
Date Printed: Aug 14, 2026 Page: 13 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 22 Optional Renewal Year 2 Clerical Support Staff
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Clerical Support Staff
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 23 Optional Renewal Year 2 Managed Care
Program Oversight Serv
Extended Description:
Date Printed: Aug 14, 2026 Page: 14 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 24 Optional Renewal Year 2 Managed Care
Extended Description:
Managed Care Oversight Ad Hoc Services
$____ per hour X 5,000 hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 25 Optional Renewal Year 2 Actuarial Services
Extended Description:
Date Printed: Aug 14, 2026 Page: 15 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 26 Optional Renewal Year 2 Financial Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Financial Services Annual Cost
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 27 Optional Renewal Year 2 Rate Setting
Extended Description:
Date Printed: Aug 14, 2026 Page: 16 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 28 Optional Renewal Year 3 Lead Actuary
Extended Description:
Lead Actuary Services
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 29 Optional Renewal Year 3 Staff Actuary
Extended Description:
Date Printed: Aug 14, 2026 Page: 17 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 30 Optional Renewal Year 3 Technical Support
Extended Description:
Technical Support Staff (non-actuary)
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 31 Optional Renewal Year 3 Clerical Support Staff
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Date Printed: Aug 14, 2026 Page: 18 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 32 Optional Renewal Year 3 Managed Care
Extended Description:
Managed Care Program Oversight Services Annual Cost
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 33 Optional Renewal Year 3 Managed Care
Extended Description:
Date Printed: Aug 14, 2026 Page: 19 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 34 Optional Renewal Year 3 Actuarial Services
Extended Description:
Actuarial Services Ad Hoc Services
$____ per hour X 5,000 hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 35 Optional Renewal Year 3 Financial Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Date Printed: Aug 14, 2026 Page: 20 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 36 Optional Renewal Year 3 Rate Setting
Extended Description:
Rate Setting Services (Optional)
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 37 Optional Renewal Year 4 Lead Actuary
Extended Description:
Date Printed: Aug 14, 2026 Page: 21 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 38 Optional Renewal Year 4 Staff Actuary
Extended Description:
Staff Actuary Services
$_____Per Hour X 20,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 39 Optional Renewal Year 4 Technical Support
Extended Description:
Date Printed: Aug 14, 2026 Page: 22 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 40 Optional Renewal Year 4 Clerical Support Staff
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Clerical Support Staff
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 41 Optional Renewal Year 4 Managed Care
Extended Description:
Date Printed: Aug 14, 2026 Page: 23 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 42 Optional Renewal Year 4 Managed Care
Extended Description:
Managed Care Oversight Ad Hoc Services
$____ per hour X 5,000 hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 43 Optional Renewal Year 4 Actuarial Services
Extended Description:
Date Printed: Aug 14, 2026 Page: 24 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 44 Optional Renewal Year 4 Financial Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Financial Services Annual Cost
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 45 Optional Renewal Year 4 Rate Setting
Extended Description:
Date Printed: Aug 14, 2026 Page: 25 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 46 Optional Renewal Year 5 Lead Actuary
Extended Description:
Lead Actuary Services
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 47 Optional Renewal Year 5 Staff Actuary
Extended Description:
Date Printed: Aug 14, 2026 Page: 26 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 48 Optional Renewal Year 5 Technical Support
Extended Description:
Technical Support Staff (non-actuary)
$_____Per Hour X 5,000 Hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 49 Optional Renewal Year 5 Clerical Support Staff
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Date Printed: Aug 14, 2026 Page: 27 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 50 Optional Renewal Year 5 Managed Care
Extended Description:
Managed Care Program Oversight Services Annual Cost
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 51 Optional Renewal Year 5 Managed Care
Extended Description:
Date Printed: Aug 14, 2026 Page: 28 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 52 Optional Renewal Year 5 Actuarial Services
Extended Description:
Actuarial Services Ad Hoc Services
$____ per hour X 5,000 hours Annually
INVOICE TO SHIP TO
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 53 Optional Renewal Year 5 Financial Services
Comm Code Manufacturer Specification Model # 93151507
Extended Description:
Date Printed: Aug 14, 2026 Page: 29 FORM ID: WV-PRC-CRFP-002 2020\05
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
HEALTH AND HUMAN RESOURCES
BUREAU FOR MEDICAL SERVICES
350 CAPITOL ST, RM 251
CHARLESTON WV 25301-3709
US
Line Comm Ln Desc Qty Unit of Measure Unit Price Total Price 54 Optional Renewal Year 5 Rate Setting
Extended Description:
Rate Setting Services (Optional)
All-Inclusive Fixed Annual Amount (Inclusive of 12 Months)
SCHEDULE OF EVENTS
Line Event Event Date
1 VENDOR QUESTION DEADLINE 2026-07-30
Revised 6/8/2012
SOLICITATION NUMBER: [Insert RFQ, RFP No.]
Addendum Number: [Insert Number]
The purpose of this addendum is to modify the solicitation identified as [insert RFQ, RFP No.]
(“Solicitation”) to reflect the change(s) identified and described below.
Applicable Addendum Category:
[ ] Modify bid opening date and time
[ ] Modify specifications of product or service being sought
[ ] Attachment of vendor questions and responses
[ ] Attachment of pre-bid sign-in sheet
[ ] Correction of error
[ ] Other
Description of Modification to Solicitation:
Additional Documentation: Documentation related to this Addendum (if any) has been included herewith as Attachment A and is specifically incorporated herein by reference.
Terms and Conditions:
1. All provisions of the Solicitation and other addenda not modified herein shall remain in full force and effect.
2. Vendor should acknowledge receipt of all addenda issued for this Solicitation by completing an Addendum Acknowledgment, a copy of which is included herewith.
Failure to acknowledge addenda may result in bid disqualification. The addendum acknowledgement should be submitted with the bid to expedite document processing.
CRFP BMS270000000
1. To provide answers to vendor questions
No other changes
Revised 6/8/2012
ATTACHMENT A
Specific Reference Question Answers
Additional Information/ Bid
Submission
Can the State please clarify what is meant by “ONLINE RESPONSES ARE PROHIBITED FOR THIS SOLICITATION***” in the RFP’s Additional Information section. Specifically, does this prohibit submitting the proposal (and any required attachments/forms) through any online portal or electronic method (e.g., e-procurement system upload, email submission, or web-based bid submission), and if so, what is the required submission method for responses?
The required submission response is hard copy.
2 General
The West Virginia Purchasing Division Procedures Handbook states:
“Agencies should avoid writing RFPs that contain an excessive number of mandatory specifications…” and further states that “The presence of a large number of mandatory specifications in an RFP suggests that the Agency can adequately describe what it needs and should instead use the RFQ method of procurement.”
Please identify every provision of this solicitation that the State considers to be non-mandatory specification for purposes of proposal responsiveness.
Section 4.2.1 Goals and Objectives and Section 4.3.1 are non-mandatory.
3 General
Pass/Fail versus Technical Scoring: The Purchasing Division Procedures Handbook states that proposals are first evaluated for compliance with mandatory requirements before technical scoring is applied. Please clarify which portions of this RFP are evaluated on a pass/fail basis and which portions are evaluated through technical scoring.
Section 4.2.2 Mandatory Project Requirements and Section 4.3.2 Mandatory Project Requirements are Pass/Fail.
4 General
The Purchasing Division Procedures Handbook states that before making a specification mandatory, the Agency should determine whether it is willing to disqualify vendors for failing to meet that specification. Did the State make that determination for each mandatory specification included in this solicitation?
Yes.
5 General For each mandatory specification contained in this solicitation, did the State determine that it would be willing to disqualify all offerors if no proposal satisfied that specification, consistent with the Purchasing Division Procedures Handbook?
Yes.
6 General
The Purchasing Division Procedures Handbook states that the presence of a large number of mandatory specifications in an RFP suggests that the procurement should instead utilize the RFQ procurement method.
Please explain how the State determined that this procurement is more appropriately conducted as an RFP rather than an RFQ, given that it contains nearly identical specifications to the previously canceled RFQ.
The State determined that this procurement is more appropriately conducted as an RFP because the intent is to obtain the best‑value solution rather than simply the lowest‑priced technically acceptable offer. While the specifications may appear similar to those in the previously canceled RFQ, the State is seeking proposals that can offer innovative approaches, enhanced performance, or additional value beyond meeting mandatory requirements—elements that can only be evaluated through the RFP process.
CRFP BMS2700000001 Managed Care Addendum #1
7 General
Alignment with the West Virginia Purchasing Division Procedures Handbook: The West Virginia Purchasing Division Procedures Handbook states that:
“Agencies should avoid writing RFPs that contain an excessive number of mandatory specifications…” and that “The presence of a large number of mandatory specifications in an RFP suggests that the agency can adequately describe what it needs and should instead use the RFQ method of procurement.”
The Handbook further states that RFPs should focus on the desired outcome and allow vendors to describe how they will achieve those outcomes. In light of this guidance, will the State consider canceling and reissuing, or amending, this solicitation to reduce the number of mandatory, process-oriented specifications and instead place greater emphasis on evaluation criteria that distinguish offerors based on overall qualifications and responsibility, such as national organizational experience, financial capacity, Medicaid related litigation or regulatory history, prior Medicaid contract performance, Medicaid contract terminations, and other best-value factors, rather than requiring detailed methodologies for numerous mandatory tasks?
No.
8 General
The State’s correspondence regarding the cancellation of the prior 2025 CRFQ procurement states that Milliman engaged in prohibited ex parte communications with Bureau for Medical Services (BMS) personnel during the 2025 Milliman Client Health Forum. Please confirm whether any BMS employees who attended the Milliman Client Health Forum in 2026 are serving on the evaluation committee for this RFP.
Confirmed.
9 General How many evaluation committee members attended the Milliman Client Health Forum during this 2026 procurement?
10 General If any evaluation committee members attended the 2026 Milliman Client Health Forum, were those individuals screened for potential conflicts or procurement integrity concerns before being appointed to the evaluation committee?
Yes.
11 General Has the State conducted any review or inquiry to determine whether any prospective offeror engaged in prohibited ex parte communications with BMS personnel during the current procurement?
No.
12 General If prohibited ex parte communications are identified during the current procurement, will the State disqualify the offeror that engaged in those communications?
The state will examine the situation and reach a fact-based decision.
13 General If prohibited ex parte communications are identified, would the State cancel the procurement and reissue the solicitation, consistent with its handling of the prior 2025 procurement?
The state will examine the situation and reach a fact-based decision.
14 General
Procurement Review: In light of the cumulative issues identified through the bidder question process, including questions regarding mandatory qualifications, subcontracting restrictions, competition, and procurement integrity, will the State consider canceling and reissuing this solicitation with appropriate revisions to promote full and open competition, align the mandatory requirements with the Scope of Work, and ensure the integrity of the procurement process?
No.
15 General
If the State considers that requiring the same contractor to perform both Medicaid managed care rate setting and MLR audits presents an actual or potential organizational conflict of interest, self-review 16.threat, or auditor independence concern, will the State consider amending the RFP to:
•Require offerors to submit a Conflict Mitigation Plan specifically addressing those risks?
•Describe how the proposed approach maintains auditor independence and the objectivity of both the MLR review and actuarial rate-setting functions?
•Describe how any material findings from the MLR review that affect the financial data relied upon for rate development would be evaluated for their impact on actuarial soundness?
•Permit subcontracting of independent audit or financial review services, while maintaining the prime contractor’s overall contractual responsibility, to preserve organizational independence between the audit and actuarial functions?
A conflict mitigation plan is required. Refer to Section 4.2.1.4.5 for details.
A conflict mitigation plan is required. Refer to Section 4.2.1.4.5 for details.
The impact on actuarial soundness depends on the findings.
No.
16 General
Proposal Due Date: The solicitation provides approximately 38 days between issuance and the proposal due date, with bidder questions due approximately 25 days before proposals are due. Given the number of mandatory requirements, technical proposal requirements, and potential clarifications that may result from the bidder question process, please clarify:
If the State issues amendments or clarifications that materially modify the solicitation or affect proposal preparation, will the State extend the proposal due date to provide offerors with at least 30 additional calendar days to revise and prepare responsive proposals, or, if the amendments are substantial, consider canceling and reissuing the solicitation to incorporate those revisions into a single revised RFP?
Based on certain circumstances, the solicitation could be extended.
17 General
Evaluation Committee: The Purchasing Division Procedures Handbook provides that the agency procurement officer normally serves as a voting member and chair or co-chair of the RFP evaluation committee. Please confirm whether the agency procurement officer will serve as a voting member of the evaluation committee for this procurement.
Confirmed.
18 General
Previous Procurement Interpretation: During the previous 2025 RFQ procurement, the State clarified that the ninety (90)-day requirement referred to the submission of materials by the actuarial contractor to the State, not CMS.
Please confirm whether that interpretation remains applicable to this procurement. If not, please explain the intended new interpretation of this previous requirement.
Confirmed 90-days to the State.
19 General
Future Contract Requirement: Will the resulting contract from this procurement require the successful vendor to submit Medicaid managed care rate certifications to CMS at least ninety
(90) days prior to the effective date of the rates? If so, please identify the contractual provision establishing this requirement and any corresponding non-performance damages.
Per Section 4.1, the submission is due 90 days prior to March 31
Per Exhibit B Service Level Agreements Failure to provide any deliverable under this procurement within the defined timeframes, unless an extension is mutually agreed upon between parties, shall result in a $500 per day service level agreement deduction/penalty until the satisfactory fulfillment of the deliverable.
1.1. Introduction (first
paragraph, last sentence)
Subcontracting Restrictions: The RFP permits subcontracting of actuarial services but otherwise requires the prime contractor to perform the remaining required services. Based on the State’s current contract, it is our understanding that the incumbent contractor utilizes subcontractors for actuarial services as well as certain other specialized functions via 1099 subcontractors (CHIP contract review, for example).
Per Section 1.1 of the RFP: The Vendor may subcontract for Actuarial Services only.
1.1. Introduction (first
paragraph, last sentence) Please clarify: Why does the current RFP limit subcontracting solely to actuarial services while restricting subcontracting for other non-actuarial services?
The current RFP limits subcontracting to actuarial services because BMS has determined that direct oversight of all non‑actuarial functions must remain with the prime contractor. This approach aligns with BMS’s position on maintaining comprehensive program oversight.
1.1. Introduction (first
paragraph, last sentence)
Did the State evaluate whether allowing subcontracting for additional specialized services (for example, accounting, provider reimbursement, financial review, compliance, or other technical services) would increase competition while maintaining contract accountability?
Yes.
1.1. Introduction (first
paragraph, last sentence)
Did the State perform a market analysis to determine whether the subcontracting restrictions, when considered together with the other mandatory corporate experience specifications, reduce the number of firms capable of submitting responsive proposals?
No. The State did not conduct a formal market analysis regarding the subcontracting restrictions or the mandatory corporate experience requirements. While these specifications may limit the number of firms capable of submitting responsive proposals, they reflect essential State requirements that are necessary to ensure successful contract performance.
1.1. Introduction (first
paragraph, last sentence)
Will the State consider revising the solicitation to permit subcontracting of additional specialized services, provided that the prime contractor remains fully responsible for contract performance?
No.
1.1. Introduction (first
paragraph, last sentence)
Would the State permit offerors to utilize qualified small businesses, disadvantaged businesses, or specialized subcontractors to satisfy portions of the technical specifications, provided the prime contractor retains overall contractual responsibility?
Per section 1.1 the Vendor may subcontract for Actuarial Services only.
4.2.1. Goals and
Objectives
Can the State please confirm that the list of project goals and objectives set forth in RFP Section 4.2.1. are mandatory specifications? If a vendor does not meet these specifications, will the proposal be deemed non-responsive and disqualified in accordance with Section 6?
If the proposal is not disqualified, would failure to meet this specification make the proposal ineligible to receive the 500 evaluation points?
Section 4.2.1 is not mandatory. A offeror will not be deemed non‑responsive or disqualified for not meeting this section.
Deficiencies identified in Section 4.2.1 will result in point deductions.
27 4.2.1.
The Scope of Work appears to require the same contractor to rely on MLR financial information for actuarial rate development and later audit that same MLR financial information.
Does the State consider this a potential self-review conflict of interest?
Because the RFP contemplates the same contractor performing both MLR audits by CPA professionals and Medicaid managed care rate setting while limiting subcontracting of non-actuarial services (e.g., subcontracting independent auditors), did the State evaluate whether this structure creates an auditor independence concern? If not, why not?
No. The State does not consider this a self‑review conflict of interest.
As outlined in Section 4.2.1.4.5, the RFP requires each offeror to submit a conflict mitigation plan that identifies any potential conflicts and describes how the offeror will ensure independence and objectivity in performing all required functions, including both MLR‑related work and rate setting.
For the same reason, the State did not conduct a separate evaluation regarding auditor independence concerns arising from the RFP’s subcontracting structure. The responsibility rests with each offeror to disclose any potential conflicts and provide a sufficient mitigation plan demonstrating how independence will be maintained throughout contract performance.
4.2.1.1. Managed Care
Program Administration
Can the State please confirm that the list of project goals and objectives set forth in RFP Section 4.2.1.1. is a mandatory specification? If a vendor does not meet these specifications, will the proposal be deemed non-responsive and disqualified in accordance with Section 6?
Section 4.2.1.1 is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions.
29 4.2.1.1.1.
Vendor Control Over CMS Submission Timing: CMS submission dates are generally influenced by multiple factors outside the actuarial contractor’s control, including State budget development, legislative actions, procurement schedules, MCO and stakeholder review, data availability, and internal State approval timelines.
Please clarify how the State intends to evaluate an offeror’s capacity based upon a submission timeline that is never controlled solely by the actuarial contractor.
All response will be evaluated individually and any defeciencies will be noted.
30 4.2.1.1.1.
Can the State please confirm whether RFP Section 4.2.1.1.1. (requiring the vendor to develop and submit an Operations Plan and implement oversight) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non‑responsive and disqualified in accordance with Section 6? Is this specification WV-specific?
Section 4.2.1.1.1. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
31 4.2.1.1.2.
Can the State please confirm whether RFP Section 4.2.1.1.2. (requiring the vendor to describe their approach and methodology to develop and maintain the MCO contracts) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
Section 4.2.1.1.2. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
32 4.2.1.1.3.
Can the State please confirm whether RFP Section 4.2.1.1.3. (requiring the vendor to describe their approach and methodology to conduct annual network adequacy assessments) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
Section 4.2.1.1.3. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
33 4.2.1.1.4.
Can the Sate please confirm whether RFP Section 4.2.1.1.4 (requiring the vendor to describe their plan to develop an annual report on MCO performance and compliance) is a mandatory specification? If a vendor does not meet this r specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
Section 4.2.1.1.4 is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
34 4.2.1.1.5.
Can the State please confirm whether RFP Section 4.2.1.1.5 (requiring the vendor to describe its approach for providing an analysis dashboard) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non‑responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
Section 4.2.1.1.5 is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
35 4.2.1.1.5.1.
Can the State please confirm whether RFP Section 4.2.1.1.5.1. (requiring the vendor to describe its approach for providing an analysis dashboard that tracks all deliverables submitted by the MCOs) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
Section 4.2.1.1.5.1. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
36 4.2.1.1.5.2.
Can the State please confirm whether RFP Section 4.2.1.1.5.2. (requiring the vendor to describe its approach for providing an analysis dashboard that tracks MCO policies and procedures) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
4.2.1.1.5.2. is not mandatory. A offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
37 4.2.1.1.5.3.
Can the State please confirm whether RFP Section 4.2.1.1.5.3. (requiring the vendor to describe its approach for providing an analysis dashboard that tracks contract and amendment language) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
Section 4.2.1.1.5.3. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
38 4.2.1.1.5.4.
Can the State please confirm whether RFP Section 4.2.1.1.5.4. (requiring the vendor to describe its approach for providing an analysis dashboard that tracks MCO quality metrics) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6.? Is this specification WV-specific?
Section 4.2.1.1.5.4. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
39 4.2.1.1.5.5.
Can the State please confirm whether RFP Section 4.2.1.1.5.5. (requiring the vendor to describe its approach for providing an analysis dashboard that tracks network adequacy and readiness review materials) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6? Is this specification WV-specific?
Section 4.2.1.1.5.5. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
40 4.2.1.1.5.6.
Can the State please confirm whether RFP Section 4.2.1.1.5.6. (requiring the vendor to describe its approach for providing an analysis dashboard that tracks grievances and appeals) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6? Is this specification WV-specific?
Section 4.2.1.1.5.6. is not mandatory. A offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
41 4.2.1.1.6
Can the State please confirm whether RFP Section 4.2.1.1.6. (requiring the vendor to describe their plan to provide MCO-related training) is a mandatory specification? If a vendor does not meet this specification, will the proposal be deemed non-responsive and disqualified in accordance with Section 6? Is this specification WV-specific?
RFP Section 4.2.1.1.6. is not mandatory. An offeror will not be deemed non‑responsive or disqualified for not meeting this section. Deficiencies identified will result in point deductions. Yes, this is a specification specific to WV.
42 4.2.1.1.7.
Can the State please confirm whether RFP Section 4.2.1.1.7 (requiring the vendor to describe its approach for providing support for MLR audits, IBNR, and risk adjustment activities and describe their approach and methodology to ensure oversight of current and new programs developed and operating under managed care waivers) is a mandatory specification?
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