Addendum 2 - Question & Answers.pdf

PDF 303 KB Posted

Attached to
Program Integrity Case Management (PICM) and Fraud Abuse Detection (FAD) Analytics Solution
Solicitation number
122125 O3
Issued by
Blaine County, Nebraska

About this file

This document is a Solicitation Addendum for the Nebraska Department of Health and Human Services (DHHS) seeking a Provider Integrity Case Management (PICM) and Fraud, Abuse, and Detection Solution (FADS). The solicitation is for a comprehensive system to support Medicaid program integrity functions, with proposals due on July 18, 2025, and a targeted go-live date of October 31, 2026. The addendum includes detailed questions and answers from potential bidders, covering technical requirements, data migration, integration specifications, security protocols, and implementation expectations. The project requires vendors to have a current implemented contract for PICM/FADS services with another State Medicaid agency.

The solicitation does not disclose a specific budget, instead encouraging bidders to submit their best pricing. The system will support approximately 25 users, with the State preferring pricing for additional users in 5-user increments up to 40 users. Key technical requirements include migrating approximately 5,680 existing cases with 2,289 associated attachments, supporting bi-directional data exchanges, and meeting CMS Streamlined Modular Certification requirements. The State currently processes around 33.6 million claim lines annually, with a mix of managed care and fee-for-service claims. The solution must provide data mining capabilities, support provider communications, and accommodate various party types involved in investigations, including clients, providers, and guardians.

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122125 O3 Attachment 1 - Minimum Qualifications.docx.docx DOCX document
122125 O3 Attachment 3 - Technical Specifications.docx.docx DOCX document
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122125 O3 Deloitte File 9 of 9 Attachment 3 Technical Specifications (Redacted).pdf PDF
Addendum 1 - Attachment 2 - Functional Specifications [Use This Attachment].docx DOCX document
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122125 O3 Attachment 3 - Technical Specifications.docx.docx DOCX document
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Addendum 1 - Attachment 2 - Functional Specifications [Use This Attachment].docx DOCX document
122125 O3 Attachment 6 - Deviations Form to Section VI.docx.docx DOCX document
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122125 O3 Attachment 5 - CMS Certification Outcomes and Metrics.docx.pdf PDF
122125 O3 PICM RFP Cost Sheet.docx.docx DOCX document
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122125 O3 Attachment 1 - Minimum Qualifications.docx.docx DOCX document
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122125 O3 Attachment 6 - Deviations Form to Section VI.docx.docx DOCX document
122125 O3 PICM RFP Solicitation Evaluation Criteria.docx.pdf PDF
Addendum 2 - Question & Answers.pdf PDF
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122125 O3 Attachment 4 - Data Integration Guidelines.docx.pdf PDF
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122125 O3 Attachment 5 - CMS Certification Outcomes and Metrics.docx.pdf PDF
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122125 O3 Attachment 2 - Functional Specifications.docx.docx DOCX document
122125 O3 Attachment 5 - CMS Certification Outcomes and Metrics.docx.pdf PDF
122125 O3 Attachment 6 - Deviations Form to Section VI.docx.docx DOCX document
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Text version

SOLICITATION ADDENDUM TWO

QUESTIONS AND ANSWERS

Date: 06/25/2025

To: All Bidders

From: Dhinesh Santhakumar Department of Health and Human Services

RE: Addendum for 122125 O3 to be opened July 10, 2025, at 2.00 p.m. CST

Questions and Answers

Following are the questions submitted and answers provided for the above-mentioned solicitation.

The questions and answers are to be considered as part of the solicitation. It is the responsibility of bidders to check the State Purchasing Bureau website for all addenda or amendments.

No. RFP Section

Reference

RFP

Page

Number

Question Response

1 V. PROJECT

INFORMATION

AND ESSENTIAL

QUALIFICATIONS

- C. MINIMUM

REQUIREMENTS

FOR

EVALUATION: "2.

Bidder must have current implemented contract for providing PICM /

FADS services to a

State Medicaid agency. This must be supported by demonstrating an active contract with another State

Medicaid agency for the PICM / FADS solution."

Page 28 Would the State of

Nebraska consider expanding the minimum qualifications to include vendors that have successfully implemented comparable services to

Medicaid Managed Care

Organizations (MCO's) under State Medicaid programs?

No, the vendors must have a current implemented contract for providing

PICM / FADS with another State

Medicaid agency.

2 N/A N/A To allow vendors adequate time to incorporate the

State’s responses to submitted questions into their proposals, will the

State consider extending the proposal due date beyond July 18th? Given that the normal DDI periods for a PICM/FADS modules are less than 9 months, we do not believe that pushing the deadline for the RFP will affect the desired October 31, 2026, go-live date.

No, the State will not entertain an extension. The current schedule should allow plenty of time for preparation, finalization, and submission of all bids.

3 N/A N/A Can the State share the anticipated budget allocations for both the

DDI phase and the annual

The budget information is not being provided. Bidders are highly encouraged to submit their best pricing.

Maintenance & Operations

(M&O) services?

4 Attachment 2 -

Functional

Specifications

7 Specifications 13 - 16 appear to be identical. Can the State clarify if additional specifications were intended here or if specifications 14-16 can be removed?

Kindly refer to the Addendum 1 -

Attachment 2 – Functional

Specifications. This was corrected in

Addendum 1.

The State can entertain any additional questions to the three revised specifications 14, 15 and 16 until June

30, 2025. The extended timeline for entertaining questions will be limited to only the revised specifications listed above. This will be denoted in a revised

Schedule of Events in the revised RFP posted in the addendum posted on June

25, 2025.

5 Attachment 2 -

Functional

Specifications

14 Specification 50 - Can the

State clarify what is intended by "data mining services"? Is the State performing these services or is the vendor expected to staff this? If the vendor is expected to perform these services, is there an expected level of effort?

Data mining is the process of analyzing large datasets to uncover patterns, trends, or anomalies that support decision-making. In PICM/FADS, it helps identify fraud, waste, abuse, and service utilization patterns.

The vendor solution is expected to provide data analytic tools to enable the

State with data mining services.

6 Attachment 2 -

Functional

Specifications

19 Specification 69 - Are the historical scanned documents - currently stored in a structured way.

I.e. having associated metadata for each scanned file that identifies the corresponding record, or does the State envision additional document tagging and processing work to integrate these historical scanned documents?

Yes, the State stores metadata for touches on the account/audit trail. This includes who uploaded it, who touched it, etc.

7 VI.A.2.a. Project

Environment

31 The integration requirements are, among other things, to integrate with "all applicable external third-party platforms." Can the state please provide a more

Please refer to the Attachment 4 - Data

Integration Guidelines for a detailed list of the data sources, both internal and external.

detailed list of those third-party platforms that are anticipated to require integration. If there are sources anticipated in DDI that require a vendor purchase, should that be reflected in our Total Cost.

8 VI.4.g.v Execute and Evaluate

Testing

39 For the Security section, it asks the vendor to conduct a pre-go live penetration test and security audits. Is it the State's anticipation that the vendor would be responsible for contracting with a Third-Party vendor to perform an independent security audit or should these tasks be handled by the awarded vendor internally and results share with the State?

Yes, the vendor is responsible for contracting a third-party to perform pre-go-live penetration test and security audit.

The State is not responsible for the contract and the cost of this activity.

9 VI.4.h.iii Data/File

Conversion and

Migration

40 Could the State please provide an approximate number of historical cases needed to be migrated to the new PICM? Are attachments that are associated with those cases to be migrated as well? If yes, can the state provide additional details on how these attachments are currently stored and structured? Also, are there data file sizes (in GB or

TB) for these historical cases and associated files?

As of June 2025, there are a total of 5680 cases in the ICM solution. Associated attachments are structured, and metadata is available. The total number of attachments associated with these cases is 2289.

All cases and associated attachments in the current ICM solution must be migrated to the new PICM solution at the time of go-live. Also, this data must be available for UAT, ORR and Pilot of the new PICM solution.

Based on the last four years, the approximate number of new cases as well as attachments is 310-325 per year.

The Case Management tables include the following five types. These five categories of tables collectively contain the data used within ICM.

a) Audit tables

b) Case tables

c) Task tables

d) Assignment table

e) User Role table.

Data file size for all historical cases is

416.3MB. The associated attachments file size is about 30GB. As stated in the

RFP, the new PICM solution shall not have any file size limit on attachments.

10 VI.4.j CMS

Certification

Requirements

43-44 To normalize level of effort and pricing across all vendors, could the state please update the CMS

Certification Requirements in this section to reflect the activities required for ARC-

AMPE? Please see items, i.10, 11; ii.5,6,7,11,12 as examples.

The State does anticipate following all

CMS requirements, including new requirements related to ARC-AMPE.

CMS will, however, ultimately determine what specific requirements will be required for certification of this system and will make those determinations through the certification process.

11 Attachment 2 -

Functional

Specifications

14 To normalize pricing, can the State provide the expected maximum number of unique users? What is the maximum number of concurrent users?

As specified in the RFP, the State anticipates 25 unique as well as concurrent users.

The State prefers vendors to provide pricing for additional users in a tiered format. Please provide pricing in 5 user increments up to 40 users.

If the bidder would like to submit the tiered pricing structure, Please add the information within the “Part IV -

Optional Services Miscellaneous

Enhancements” section of the cost sheet in a tabulated format, as shown below

Total Number of users Additional

Price

30 $

35 $

40 $

12 2. Project

Environment; f.ii.

Configure

Environments

37 The State requests that the

Vendor establish four environments

(development, testing, training, and production).

To comply with and obtain

CMS certification, the State

CMS will ultimately determine what environments are required to comply with requirements for Disaster Recovery.

The State is interested in vendors’ experience achieving CMS certification on their systems, and what environments they use for which purposes.

must have a Disaster

Recovery Environment. We recommend that the State consider revising the total number of environments.

13 VII.A.1.H Summary of Bidder's

Corporate

Experience

59 So that the State can properly evaluate a bidder's historical ability to complete projects on time and on budget and given the State's published roadmap and times associated, we are requesting clarification regarding the requirements for the narrative project descriptions:

- Please confirm that (b) refers to the contract start and end date (i.e. total period of performance including O&M).

- Please confirm that (e) refers to the originally scheduled and actual budget and completion dates are specifically regarding DDI time periods for the referenced projects.

The List of requested information under the Section VII(A)(1)(h)(i) shall be revised as follows and this language will replace the language in the RFP:

a) Start date of the project –

Scheduled (as planned) and actual (the date that vendor started the project)

b) End Date of the project –

Scheduled (as planned) and actual (the date that vendor started the project)

c) The bidder’s responsibilities,

d) For reference purposes, a customer name (including the name of a contact person, a current telephone number, a facsimile number, and e-mail address); and

e) Each project description should identify whether the work was performed as the prime Vendor or as a subcontractor. If a bidder performed as the prime Vendor, the description should provide the originally planned budget and the actual budget to complete the project (or the currently planned budget if it is an ongoing project). The budget information shall be broken down between the DDI and the Maintenance &

Operations

14 V. PROJECT

INFORMATION

AND ESSENTIAL

QUALIFICATIONS

- B.

BACKGROUND

INFORMATION.

"The Medicaid program also adjudicates a smaller number of claims on a Fee-For-

Service (FFS) basis in addition to the

Managed Care services, including both Home and

Community Based

(HCBS) Waivers and Nursing Facility

(NF) services."

Page 27 Is the State of Nebraska interested in pre-payment analytics for the "smaller number of claims" adjudicated by the State? If so, can the State advise how many claims it adjudicated in 2024?

No, the State is not interested in pre-payment analytics for the "smaller number of claims".

15 h. SUMMARY OF

BIDDER’S

CORPORATE

EXPERIENCE - "ii.

Bidder and

Subcontractor(s) experience should be listed separately.

Narrative descriptions submitted for

Subcontractors should be specifically identified as subcontractor projects"

Page 59 For requirements that reference subcontractors, we have relationships for our technological infrastructure, such as:

Microsoft, Geocodio, Salesforce, etc. Can the

State confirm these day-to-day types of suppliers are outside the scope of these requirements?

Yes, these types of suppliers are outside the scope of these requirements. A subcontractor is defined as an entity that carries out work for a company as part of a larger project. The subcontractor requirement only applies to those companies performing specialized tasks that are hired by the bidder. See page xi of the RFP for subcontractor definition.

16 Attachment 2 -

Functional

Specifications:

requirement "76.

Must conduct a final review of every investigation and ensure a State accepted outcome has been executed

Page 20 For the scope of this question, is the State expecting the vendor to supply an FTE to conduct additional manual interventions to review cases prior to closure; or is the State seeking a case lifecycle workflow to automate the monitoring of

No, the state does not expect the vendor to supply an FTE for the review of cases prior to closure; however, in the end what the bidder chooses to propose is a business decision that is up to the bidder.

The vendor shall propose how their business or lifecycle workflows can direct cases to the appropriate reviewer after the required steps have been before the case is closed."

the completion of the steps required by the State to close a case?

completed and when all the necessary information is available.

17 Schedule of Events 2 Given the complexity of this RFP, would the State consider extending the proposal submission deadline by 45 calendar days to allow sufficient time for vendors to finalize partnerships, and prepare a comprehensive response aligned with the RFP requirements?

Please see response to question 2 within this Q&A attachment.

18 V.B. Project

Information and

Essential

Qualifications

27 What percentage of the project will be for Fee-For-

Service (FFS)?

In terms of claim lines, typically around

50% - 60% of claim lines are managed care and the remaining 40% - 50% are

FFS, with FFS including capitation lines.

Without capitation lines, the percentages are around 90% - 95% managed care and

5% - 10% FFS claim lines.

In terms of billing providers, typically around 40% have billed at least one FFS claim and 60% have billed at least one

MCO claim.

19 Functional

Specifications

Row 3

4 Provided data is automatically populated to fill fields, must it be via an

API?

The State assumes the question is for

“Provider” data instead of “Provided” data.

While the State recommends and prefers the API method for its efficiency and alignment with modern standards, the

State is open to vendor-proposed alternatives if they support a standards-based, modern approach to data exchange.

20 Data Integration

Guidelines

3.4 Data Sources

Landscape

7 The data table references

EVV data as a source, but the document also notes that the State does not currently store EVV data.

Can the State clarify whether EVV data is expected to be included in this project, or whether it is listed only for future consideration?

It is listed only for future consideration.

Also, the State would like to gather vendor’s expertise on how to use data like EVV for Fraud, Waste, Abuse work in the future.

21 n/a n/a Is the State anticipating that the selected vendor’s solution will support access for the Medicaid Fraud

Control Unit (MFCU)? If so, does the State prefer vendors with prior experience supporting

MFCUs?

Yes, the State anticipates giving access for MFCU, at minimum read-only. The

State doesn’t have a preference on prior

MFCU experience.

22 n/a n/a Has the State conducted any recent market research, system demos, or vendor discovery sessions related to program integrity, case management, or fraud analytics? If so, can the

State confirm which, if any vendors have provided demonstrations to date for this procurement?

State released a Request for Information

(RFI). All information related to the RFI can found on this page - here. The State has also conducted additional market research for this project that includes attending conferences and demonstrations to gather information for this project. The State will not release individual vendor information.

23 n/a n/a Has the State established or appropriated a budget range for this project? If so, can the State please disclose the budget ceiling or targeted investment level to ensure vendors tailor their cost proposals appropriately?

Please see response to question 3 within this Q&A attachment.

24 4. Project

Requirements

Page 32 Is the state able to share the anticipated budget amount for the implementation?

Please see response to question 3 within this Q&A attachment.

25 B. Background

Information

Page 28 What are the different security groups or permission levels that will require access?

Yes, the State expects configurable permission levels available for the new

PICM solution.

The State also expects vendors to demonstrate their expertise in making the best use of the security groups / permission levels.

https://das.nebraska.gov/materiel/purchasing/RFI%20MLTC%20Data%20Management/RFIMLTCDATAMANAGEMENT.html

26 2. Project

Environment

Page 31 How many external systems require a bi-directional integration other than MMIS/N-FOCUS?

Bi-directional integration is not anticipated for just the PICM solution.

27 Attachment 2 Page 6 Functional Requirement 13 through 16 appear to be duplicates. Are these intended to be unique

Requirements?

Please refer to response to question 4 within this Q&A attachment.

28 Section J; ii; 14 45 When mentioning compliance with FedRAMP regulations, does DHHS mean the software application is FedRAMP compliant or the hosted environment (cloud infrastructure) complies with FedRAMP solutions?

The State doesn’t need the actual software application to be FedRamp compliant but expect the Cloud Service provider to be FedRamp compliant and have implemented the necessary security controls.

29 Section J; ii; 14 45 When mentioning compliance with SOC 1 and SOC 2 does DHHS mean the software application has undergone

SOC2 auditing and attestation or the hosted environment (cloud infrastructure)?

SOC 2 (System and Organization

Controls 2) assesses a service organization’s controls relevant to data security, availability, processing integrity, confidentiality, and privacy.

As it pertains to the software application

It can cover how the application handles data, operational processes like deployment, change management and logging and monitoring.

The state will accept other third-party assessments and certifications that demonstrate that the software application/system (entire stack) meets the NIST SP 800 requirements in lieu of

SOC 2 Type 2 Certification.

30 Section A; 1 30 When stating its preference for customization of a COTS product, will the customizations provided for

DHHS become Nebraska property under work for hire, or are the

The State intends to utilize federal funding through the APD process. As such, 45 CFR § 95.617 would apply, and therefore the State is required to retain ownership of any software or modifications designed, developed, or installed with Federal financial participation.

customizations owned by the vendor?

31 Section VI; A; 1 30 Will DHHS further elaborate on what is meant by “implement, maintain, operate” a configurable PI solution meeting CMS certification?

The State means that the vendor will be responsible for implementing their solution, maintaining their solution, and operating such functions of their solution not operated directly by the State. Such vendor activities must also meet all requirements of CMS Streamlined

Modular Certification for Medicaid

Information Technology Systems.

Please refer to pages 43 through 47 of the RFP.

32 Attachment 2 –

Functional

Specifications

18 In Line 65 it states: “Must maintain, track, log...all provider communications.”

Will providers login and communicate with the

PICM solution, or send communications through other means? Further, will provider communications be hand entered or loaded from provider specific communications systems?

The State requires vendors to present their solution’s ability to handle communication from outside entities, at minimum. The State prefers the ability to upload Provider communications to the

PICM solution.

33 Section E; 1 –

Deliverables

56 Among the deliverables to be provided DHHS is requesting that CMS certification, training, security assessment, and penetration testing are completed. Does DHHS expect all of those activities to be completed before the six-month preferred UAT milestone?

No, DHHS does not expect all the activities to be completed before the six-month UAT milestone.

34 General Question N/A Who is the current RAC vendor? Will they use the system, or will it just be a data transfer to the vendor when requested?

The State currently has a waiver until

December 2026; it can be found here. In case the State no longer has the waiver, the State would like the PICM vendors to inform us about the possible options to work with a RAC vendor in their proposal.

https://dhhs.ne.gov/Pages/Medicaid-Recovery-Audit-Contractors.aspx

35 General Question N/A Will DHHS want us to calculate the FFP on their recoveries and what if any involvement will we be expected to have with the

RAC vendor?

Yes, the State would want the ability to calculate FFP on recoveries. The State would like vendors to tell us how they can help us with these calculations, regardless of whether it is for RAC or not.

36 Attachments N/A Are vendors allowed to add a header and/or footer to

Attachments with corporate logos, etc.?

Yes, the vendors are allowed to add a header and/or footer to their RFP

Solicitation Response with corporate logos.

37 RFP: Section V.B 43 Please confirm that the number of user licenses will remain at the current volume of 25 internal users.

Please refer to response to question 11 within this Q&A attachment.

38 Cost Sheet 3 Per the RFP, the

PICM/FADS solution must go into production by

10/31/26 and there is a 90-day warranty. Does the warranty go into effect

11/1/26 and any costs associated for those 3 months would be included in the post-implementation section of the cost sheet?

It is a business decision how the vendor wants to charge for the 90-day warranty period. The State does not have any preference on where the cost of the 90-

Day warranty period should be included within the cost sheet, provided the cost is within the category percentage breakdown.

39 RFP: Section V.B 43 Due to licensing requirements, would the

Attorney General's office be willing to enter a

Memorandum of

Understanding or similar agreement regarding the

Attorney General's system access?

Nebraska Medicaid has a memo of understanding with the Medicaid Fraud and Patient Abuse Unit of the Attorney

General’s office that includes access to

Medicaid data and case information.

The vendor’s proposal should clearly indicate their licensing requirements for consideration.

40 General General Would the State envision a need for procedure episode grouping and/or evidence-based care measures?

No, the state does not need a procedure for episode grouping and/or evidence-based care measures.

41 RFP: Section V.B 43 Will Attorney General users require separate workflows and segregation of case details from DHHS staff to necessitate a separate instance/tenant?

No, case information does not require segregation. The vendor should describe how workflows can include users with the Attorney General’s office for law enforcement referrals and the information sharing.

42 Attachment 4 Page 5 3.2.1 mentions "PICM system will publish its data and metadata in a standard format for downstream systems." Will the State please provide additional details and data layout(s) for these extracts?

Vendors are encouraged to provide their industry standard metadata extract layouts.

43 RFP: Section H.1 20 The RFP states, "The

“Contractual Agreement

Form” must be signed manually in ink or by

DocuSign and returned by the opening date and time along with the bidder’s solicitation response and any other requirements as stated in this solicitation in order for the bidder’s solicitation response to be evaluated." Will the State accept an electronic signature?

All documents must be signed using the approved companies found in Nebraska

Administrative Code (NAC) title 437 –

Digital Signatures Act and the Nebraska

Rev. Statute 86-611. Also, see attached

Approved List of Certification

Authorities for acceptable signature authorities.

44 RFP 1 Would the State consider granting a two-week extension to the proposal due date to allow offerors adequate time to develop thorough and responsive submissions post answers to questions, particularly given the upcoming holiday and the need to ensure key staff have appropriate time away?

Please refer to the response to question 2 within this Q&A attachment.

45 RFP (VI)(A)(1) 30 Please provide the estimated number of historical case files, associated HIA tables, and historical file attachments.

Please refer to the response to question 9 within this Q&A attachment.

46 RFP (VI)(A)(1) 30 Will Deloitte HIA provide access to documentation and/or subject matter experts familiar with the

HIA table structure to assists with the historical case mapping?

Yes, where available, documentation or subject matter experts in the existing structure will be provided.

https://regulations.justia.com/states/nebraska/secretary-of-state/title-437/ https://regulations.justia.com/states/nebraska/secretary-of-state/title-437/ https://regulations.justia.com/states/nebraska/secretary-of-state/title-437/ https://nebraskalegislature.gov/laws/statutes.php?statute=86-611 https://nebraskalegislature.gov/laws/statutes.php?statute=86-611

47 RFP (VI)(A)(1) 30 Please provide the average number of claim lines per year for each of the 10 years of historical data to be imported (to include pharmacy, dental, encounters, etc.).

The average number of claim lines was

33.6 million from 2014 through 2024.

This count includes denied, voided, replacement, and adjusted claim lines, as well as capitation payment lines. This count is trending upwards with 2023 being the current maximum number of claim lines at 53.7 million.

48 Attachment 2, requirement 64

18 Is the provider data referenced in requirement

64 from one source system or multiple systems?

Multiple systems, examples include

Provider Screening and Enrollment

System, MMIS, etc.

49 Attachment 2, requirement 64

18 Do the historical communications referenced in requirement 64 include both documents as well as free-form text notes entered by call center staff?

The current ICM solution has free form notes available for cases and documents in formats like .txt, .pdf, etc.

50 Attachment 2, requirement 76

20 Are the parties referenced in requirement 76 considered subjects of the investigation, or would this encompass other types of parties? Would the State provide a list of party types?

Parties are mentioned in requirement 75, not requirement 76.

The parties may be subjects of the investigation or other parties involved in the allegation or issue under review. The parties include clients, billing or service rendering providers, owners or managing employees or other provider staff, citizens, or guardians of clients.

The vendor shall describe how their system will accommodate the known categorization of parties and allow for the addition of new parties.

51 Schedule of Events 2 This is a substantial RFP.

Will the State consider extending the proposal submission deadline by at least 45 calendar days to allow sufficient time for vendors to finalize partnerships and prepare a comprehensive response.

Please refer to the response to question 2 within this Q&A attachment.

52 Att. 4 Data

Integration

Guidelines

5 Attachment 2 - Req 4:

references a list of agency databases, with one of those being Electronic Health

Records (EHR). Within

Att.4 Data Integration

Guidelines there wasn’t a clear labeling for EHR.

Does DHHS currently leverage an EHR interface that the vendor would access or does DHHS have an alternative approach?

No, currently the State doesn’t have an interface with EHR. The State would like vendors to inform us on how the EHR data can be used by their PICM solution and explain the integrations for the same.

53 2.Liquidated

Damages – Table 1

15 If there are dependencies outside of the vendor which are delayed during the implementation phase resulting in the UAT not being deployed within 6 months from kick off.

Would DHHS consider the impact when reflecting the prospective liquidated damages associated?

The state will consider all relevant factors while assessing the need to apply liquidated damages. All issues will be reviewed for responsibility, Force

Majure application, etc. and the state will make a case-by-case ruling if required.

54 PICM RFP –

1.Scope of Work

55 The vendor is responsible for migrating all case data.

Would DHHS provide details on how many cases are expected to be migrated and the potential volume of documentation to be included.

Please refer to the response to question 9 within this Q&A attachment.

55 Att.2 Functional

Specifications

4 Requirement 17: Is DHHS seeking the history audit trails to account for time by the hours and minutes to reflect time tracking from an audit trail perspective?

The audit trail timestamp needs to include industry standard format. The time-tracking should be part of a proposed workflow management. The

State is interested in what vendor solutions can do for time tracking.

56 Att. 2 Functional

Specifications

7 Requirements 13 – 16:

These requirements appear to be duplicative, please advise if these should be revised or condensed down to 1 requirement?

Yes, this was a typo and has been corrected in Addendum 1 to the solicitation.

57 Att. 2 Functional

Specifications

10 Requirement 28: Would

DHHS advise the estimated volume of reports and letters to be included by

UAT or Production Go-

Live?

The State does not have an estimate currently. The State requires vendors to come with their own proposed library of reports and letter templates.

58 PCIM RFP –

VII.A.1.b

73 For Requirement VII.A.1.b

- Financial statements – For a private company where alternative/additional documentation suffices, would our Dunns &

Bradstreet report suffice in supporting stability and financial strength?

Yes, a Dunns & Bradstreet (D&B) report, aka D&B Business Credit Report, is acceptable as a Financial statement if it conforms with the RFP requirements under the Section VII(A)(1)(b).

59 PICM RFP - SSP

Requirements

60 SSP SOC 1 Type 2 requirement is typically associated with financial controls. We have successfully assisted state

Medicaid agencies with completing CMS

Certification exercises without the need to include a SOC 1 Type 2.

Would DHHS consider removing this certification requirement considering the scope is associated with a

PICM SaaS solution?

The State does not need the vendor to have SOC 1 Type 2 for this implementation.

60 Att. 4 Data

Ingestion Guidelines

8 Section 4. Standards and the subsection 4.3 Data

Formats, please confirm if these data formats listed are the options available for data outbound to the vendor only?

No, the data formats listed are not limited to outbound data only. These formats are applicable for both inbound and outbound data exchanges between the vendor system and other systems.

They support bidirectional data flows, ensuring consistent formatting for data sent to the vendor as well as data received from the vendor.

61 Att. 4 Data

Ingestion Guidelines

7 Section 3.5 Initial Data

Mapping for PICM within the table, #7 EVV Data.

Please clarify if the EVV

Data has been aggregated and available to meet the timelines listed for UAT and Production Go-Live?

The vendors shall tell us how they can use EVV data in future.

62 Att. 4 Data

Ingestion Guidelines

7 Section 3.5 Initial Data

Mapping for PICM within the table, #8 Waiver

Authorizations and Claims.

Please clarify if this data is structured or unstructured data.

The claims data is structured. The vendors shall tell the State how they can use waiver authorization data, which can be either structured or unstructured.

63 PICM RFP – Project

Requirements

47 L. Pre-Implementation and

Pilot: Would the Pilot be synonymous with the ORR demonstration, if not, please elaborate further on the distinction between the

UAT, Pilot, and Go-Live.

The UAT, Pilot, CMS ORR, and Go-

Live are separate DDI activities as detailed in the RFP.

File details come from the government source that posted it. Updated .