STATE OF IDAHO

DIVISION OF PURCHASING

FOR

Idaho Division of Veterans Services

Request For Proposal

Medicare Billing Services

RFP Number: #1338

Table of Contents

Section 1 Administrative Information and Overview

1.1 Purpose

The State of Idaho’s (“State”) Division of Purchasing (“DOP”), on behalf of Idaho Division of Veterans Services (“IDVS”) is issuing this Request For Proposal (“RFP”) to solicit Proposals from qualified and experienced firms (“Offerors”), that can provide Medicare Billing Services. Background information is provided in Exhibit 2. General requirements are set forth in Exhibit 3. The complete scope of work is provided in Exhibit 4.

1.2 Procurement Schedule

Pre-Proposal Meeting:

Deadline to submit questions:

Closing Date (deadline to submit Proposal):

Public Opening Date:

Bid Opening Link:

The State will make every effort to adhere to the schedule below, but reserves the right, at its sole discretion, to adjust the schedule.

9/16/2026 @ 11:00 am MT 9/23/2026 @ 11:59 pm MT See IPRO Event Main Page for current closing date and time.

10/13/2026 @ 10:30 am MT Join the meeting now

1.3 RFP Lead

Name:

Title & Agency:

Email:

The individual listed below (referred to as “RFP Lead”) is responsible for the conduct of this procurement. From the issue date of this RFP, until a contract is awarded, or the RFP is cancelled, Offerors are prohibited from communicating with any State employee, Official, or Evaluators regarding this RFP or procurement.

Erik Schmidt Purchasing Officer, Division of Purchasing Erik.Schmidt@adm.idaho.gov

1.4 Pre-Proposal Conference

Link:

A non-mandatory pre-proposal conference will be held to provide an overview of the RFP process, the scope of work, and submission requirements. While attendance is highly encouraged, it is not mandatory. The meeting will be conducted virtually, with the access link provided below. To inform the State of your planned interest and attendance, please complete and submit Exhibit 6.

Join the meeting now

1.5 IPRO eProcurement System

This Solicitation is issued by the State via the State’s eProcurement system, IPRO. It is the Offeror’s responsibility to monitor IPRO for any updates or amendments.

Link: IPRO POWERED BY LUMA

1.7 Questions

The Offeror must review this entire RFP solicitation, including associated documents. All questions, requests for clarification, or other correspondence must be submitted in writing via email to the RFP Lead. See Exhibit 7 for additional instructions. Questions must be submitted using the table provided within Exhibit 7.

1.8 Modifications and Exceptions to Requirements, Terms, and Conditions

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7. Vendors are strongly encouraged to submit any proposed modifications to the requirements, terms, or conditions of the RFP on Exhibit 8 – Contract Modifications and Exceptions prior to the deadline to submit questions. Questions regarding these requirements must contain the following:

0. The rationale for the specific requirement being unacceptable to the party submitting the question (define the deficiency).

0. Recommended verbiage for the State’s consideration that is consistent in content, context, and form with the State’s requirement that is being questioned.

0. Explanation of how the State’s acceptance of the recommended verbiage is fair and equitable to both the State and to the party submitting the question.

7. In the event that a Proposal contains modifications or exceptions to any Solicitation requirements, terms, or conditions which are not addressed during the question and answer period, they must be identified and submitted on Exhibit 8 - Modification and Exception Form and must contain the same information outlined in Section 1.8, above. The State will not consider any modifications or exceptions that are not identified specifically on Exhibit 8.

7. The State has sole discretion to determine if the modifications or exceptions submitted by an Offeror would result in a material change or otherwise threaten the integrity of the procurement process. See Idaho Terms and Conditions Background and Limitations. Pursuant to IDAPA 38.05.01.084.e, the State may only negotiate non-material modifications or exceptions. Modifications or exceptions which the State determines to be material, or which otherwise threaten the integrity of the procurement process, will not be accepted or negotiated. If the Offeror has conditioned its Proposal on the State’s acceptance or negotiation of its proposed modifications or exceptions, and the modifications or exceptions are deemed material, the Offeror will be given the opportunity to retract the proposed modifications or exceptions from its Proposal. Failure to do so will result in the Offeror’s Proposal being found non-responsive, after which it will receive no further consideration.

7. Non-material modifications or exceptions may be discussed with the apparent successful Offeror, at the discretion of the State; however, the State shall have the right to reject any and all such modifications and/or exceptions, or to call an end to such discussions, and to instruct the Offeror to amend its Proposal and remove the modifications and/or exceptions. Failure to do so may result in the State finding the Proposal non-responsive.

7. Except as otherwise provided within the Solicitation, the State will not consider modifications or exceptions to the requirements, terms, or conditions which are proposed after the RFP Closing Date.

1.9 Amendments

The State may issue amendments to make changes to the RFP, or to respond to any questions. Amendments will be posted on IPRO. Offerors are responsible for monitoring IPRO for updates and amendments. All published amendments must become part of this RFP, and must be considered by the Offeror in its Proposal. Oral interpretations or clarifications of this RFP are not binding and should not be relied upon. Any verbal responses or informal communications from the State regarding this RFP are considered unofficial and will not be binding.

1.10 Authority

This procurement is conducted in accordance with IDAPA 38.05.01 and pursuant to Title 67, Chapter 92 of the Idaho Code.

Section 2 Format & Submission Requirements

2.1 Adherence to Requirements

The Proposal must be submitted in accordance with the requirements set forth in this document. Any Proposal that does not adhere to the requirements may be deemed non-responsive and rejected. The State reserves the right, in its sole discretion, to waive any minor informalities or immaterial non-compliance.

2.2 Deadline to Submit

All Proposals are due at the date and time specified in the Procurement Schedule (Section 1.2). Late Proposals must not be accepted or considered. The State will not be responsible for any technical issues, difficulties, or delays. Offerors are strongly encouraged to begin the process of submitting the Proposal response far enough in advance of the Closing Date/Time to allow for resolution of any technical difficulties.

2.3 Submittal Form Templates

The Offeror must ensure that their response meets all requirements detailed within this RFP. This RFP contains Submittal Forms, which must be used by the Offeror to submit their Proposal. Offerors must not re-create these Submittal Forms, create their own Submittal Forms, or edit the format structure of the Submittal Forms. An electronic copy of each Submittal Form is posted along with this RFP. The Offeror must download, complete, and submit each Submittal Form in their response.

2.4 General Format Requirements

The Proposal response must meet the following requirements:

2.4.1 The Offeror must not embed information, embed files, or embed any links within the Submittals.

2.4.2 Be formatted to fit on standard 8.5” x 11” paper size.

2.4.3 Use a minimum font size of ten (10) (images, figures, graphs, charts, are excluded from this font size).

2.4.4 Use a font style such as: Calibri, Arial, Times New Roman, or similar.

2.4.5 The Offeror must not attach additional information to any Submittal Form (unless it has been explicitly requested). Any additional attachments submitted will not be considered in the evaluation process.

2.4.6 Cost information must only be contained within Submittal Form C – Cost Proposal. No other document or Submittal Form may contain cost or pricing information.

2.5 Page Limits

The Submittal Forms have maximum page limit requirements, as shown in the table below. The Offeror must ensure that their Proposal meets these page limit requirements. Offerors must not exceed the maximum page limits. Please note that the page limit applies exclusively to the front side of a page only (i.e. a ‘1 Page’ implies that the Offeror can only provide a response on one side of a piece of paper). Additional text will be removed or redacted before being provided to evaluators; only the text within the page limit will be evaluated. Offerors may add a cover page and table of contents which will not affect the Maximum Page Limits and this information will not be used for evaluating Offerors Proposal. Any substantive content added to the cover page or table of contents will be removed or redacted before being provided to evaluators.

Approach

Obstacles, Challenges, & Risks

2.6 Electronic Submission Instructions

The Offeror must submit the Proposal as follows:

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2.6.

2.6.1. The Proposal must be submitted electronically through IPRO POWERED BY LUMA. The State will not accept Proposals in any other manner (i.e. facsimile, email, or hardcopy submissions). All Offerors participating in this Solicitation must establish an account in the IPRO system, as it is necessary in order to process and/or award the resulting Contract(s). Establishing an account is free.

Link: IPRO POWERED BY LUMA

Please make sure that the entity profile under which the Proposal is submitted in IPRO, is the same legal entity presented in the uploaded response materials. If there are any discrepancies, the entity information provided within Submittal Form A prevails.

2.6.2. The Proposal must be submitted in the following forms:

* If applicable. Applies to Proposals with trade secrets as discussed below.

2.6.3. All files must be in Adobe PDF, Microsoft Word, or Microsoft Excel format as noted in the table above.

2.6.4. The Proposal file(s) must not be password protected or locked in any way.

2.6.5. All submission materials must be submitted at the same time. If multiple submissions are received, only the latest timely submission will be considered.

2.6.6. Alternate Proposals are not allowed.

2.6.7. Note: When submitting through IPRO, enter your Cost in IPRO as “$0.01”.

2.6.8. If your Proposal contains trade secrets (see Section 2.7), submit an additional redacted version. This submittal must have 'Redacted' in the file name.

2.7 Trade Secrets and Non-Public Information

The Idaho Public Records Act, Idaho Code title 74, chapter 1 (the “Act”) defines trade secrets to “include a formula, pattern, compilation, program, computer program, device, method, technique or process that derives economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by other persons and is subject to the efforts that are reasonable under the circumstances to maintain its secrecy.” The Act also defines other records that may be exempt from public disclosure.

In addition to marking each page of the document with a trade secret or other exemption notation (as applicable; and as provided in Paragraph 28 of the Solicitation Instructions to Vendors), Offerors must also:

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2.7.1. Identify with particularity the precise text, illustration, or other information contained within each page marked “trade secret” or “exempt from disclosure” (it is not sufficient to simply mark the entire page). The specific information you deem “trade secret” or “exempt” within each noted page must be highlighted, italicized, identified by asterisks, contained within a text border, or otherwise clearly delineated from other text/information and specifically identified as a “trade secret” or “exempt from disclosure.”

2.7.2. Provide a separate document entitled “List of Redacted Trade Secret and Exempt Information” which provides a succinct list of all trade secret and exempt information noted in your Proposal; listed in the order it appears in your submittal documents, identified by Page #, Section #/Paragraph #, Title of Section/Paragraph, specific portions of text/illustrations; or in a manner otherwise sufficient to allow the State’s procurement personnel to determine the precise text/material subject to the notation. Additionally, this list must identify with each notation the specific basis for your position that the material be treated as exempt from disclosure and how the exempting the material complies with the Act.

2.7.3. Submit a redacted copy of any Proposal response document (e.g. Scope of Work Response) with all trade secret and exempt information removed or blacked out. The redacted copy must be submitted electronically in the Supplier Attachments section of IPRO, with the word “redacted” in the file name.

Section 3 Proposal Contents

3.1 Background, Declarations, and Certifications (Submittal Form A) The Offeror must complete and submit all information requested in this Submittal Form. An Offerors failure to complete and submit Submittal Form A may result in their Proposal being found non-responsive and given no further consideration.

3.2 Technical Proposal (Submittal Form B)

The Offeror must complete and submit all information requested in Submittal Form B. An Offerors failure to complete and submit Submittal Form B may result in their Proposal being found non-responsive and given no further consideration. The Technical Proposal consists of three (3) parts, as described below:

3.2.1 Part 1 - Qualifications and Experience: The Offeror must respond to each subsection below. The Offeror's Part 1 response is evaluated as a single Qualifications and Experience score.

3.2.1.1 Firm Qualifications and Experience: The Offeror must summarize its experience and qualifications as they relate to the scope of work requested in this RFP, including its experience providing Medicare Part A and Part B billing services for skilled long-term nursing care. The Offeror must highlight any unique attributes that make the team especially qualified for the scope of services.

3.2.1.2 Key Personnel: The Offeror must outline the experience and qualifications of the key personnel who will be assigned to this Contract and provide their resumes. For any key position not yet filled, the Offeror must provide a position description with the required qualifications and experience.

3.2.1.3 References: The Offeror must provide up to three (3) references from individuals, companies, or agencies with knowledge of the Offeror's experience that is similar in nature and scope to the services requested in this RFP, obtained within the last five (5) years from the date this RFP was posted to IPRO. The Idaho Division of Veterans Services (IDVS) may not be used as a reference, and only one (1) reference will be accepted per company or agency. For each reference, the Offeror must provide:

3.2.1.3.1 The reference organization's name; and

3.2.1.3.2 A description of the work the Offeror performed for that reference and the approximate dates, including the services provided and their similarity in nature and scope to the services in this RFP, and the reference's experience with the Offeror's billing accuracy, claim volume and turnaround, responsiveness, reliability, and the length of the working relationship.

3.2.1.4 The RFP Lead may contact any reference for clarification. The RFP Lead will redact reference contact information before providing the Technical Proposals to the evaluation committee. The evaluation committee scores the content of the Offeror's Part 1 response, including the references, and does not contact references or Offerors.

3.2.2 Part 2 - Approach: The Offeror must provide a brief overview of the approach that will be taken to successfully deliver these services including any necessary transition plan. This must include a brief roadmap describing the general approach to successfully deliver the Services and meet the Agency's expectations (cost, time, quality, etc.), including the Offeror's approach to billing accuracy and pre-billing review, timely claims submission, denial management and follow-up, reporting, and a no-gap transition at the start and end of the Contract. This must also include a high-level schedule of major activities or tasks.

3.2.3 Part 3 - Obstacles, Challenges, & Risks: The Offeror must identify and address issues, concerns, challenges, obstacles, or risks that may impact the successful delivery of this project or service. This includes areas that may cause the project to not be completed on time, not finished within budget, generate any change orders, or may be a source of dissatisfaction for the Agency. The Offeror must rely on and use their past experience and knowledge of completing similar projects to identify these potential risks, issues, or challenges.

Each item should contain enough information to describe to a reader why the item is a valid risk/concern. The Offeror should also explain how it will avoid or minimize the risks from occurring. The Offeror should consider:

3.2.3.1 Controllable Items: This includes risks, activities, or tasks that are controllable by the Offeror, or by entities/individuals that are contracted to by the Offeror. This includes things that are part of the technical scope of what the Offeror is being hired to do. This may also include risks that have already been minimized before the project begins due to the Offeror’s expertise (i.e. risks that are no longer risks due to the Offeror’s expertise in delivering this type of project). All controllable risks and strategies to mitigate them MUST be included in the Offeror’s base Proposal cost and schedule (if there are any impacts at all).

3.2.3.2 Non-Controllable Items: This includes risks, activities, or tasks that are not controllable by the Offeror. This may include risks, issues, challenges, or obstacles attributed by the Agency, Agency personnel, parties hired by Agency, risks that are caused by other agencies, or completely uncontrollable risks. These can also be areas/risks that can contribute to contingency. Although these risks may not be controlled by the Offeror, the Offeror must identify a strategy that can be followed or used to mitigate these risks. All non-controllable risks and strategies to mitigate them must not be included in the Offeror’s base Proposal cost or schedule.

Provide a brief description of each item (background of how the concern/issue may impact the project or service if it occurs), and a strategy to prevent/minimize the issue/concern from occurring, or strategy to minimize the impact of the risk if it does occur.

3.3 Cost Proposal (Submittal Form C)

The Offeror must complete and submit all information requested in Submittal Form C. The Offeror is not permitted to adjust or modify this form, and may not include additional rates, amounts, costs, information, exceptions, or limitations to their cost proposal. An Offerors failure to meet these requirements may result in their Proposal being found non-responsive and given no further consideration.

Section 4 Evaluation & Award Procedures

4.1 Mandatory Submission Requirements

All Proposals will be reviewed on a "pass" or "fail" basis to ensure compliance with all mandatory submission requirements. Proposals determined by the State, at its sole discretion, to be responsive in this regard will proceed to the evaluation process outlined in this Section. Proposals that do not meet the mandatory submission requirements will be deemed non-responsive. Mandatory submission requirements include, but are not limited to, the following:

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4.1.1. The Proposal was submitted prior to the specified Closing Date and Time.

4.1.2. The Proposal complies with the submission instructions detailed in Section 2.6.

4.1.3. The Proposal includes a fully completed and signed Submittal Form A.

4.1.4. The Proposal includes all required Submittal Forms listed in Section 3.

4.2 Evaluation Criteria

The objective of the State in soliciting and evaluating Proposals is to ensure the selection of a firm or individual that will produce the best possible results for the funds expended. Responsive Proposals will be evaluated as described in the table below.

4.3 Evaluation Committee

The Technical Proposal will be evaluated and scored utilizing one (1) or more Technical Proposal Evaluation Committee(s). The scores for the Technical Proposal will be normalized as described in Section 4.4.

4.4 Calculations

The following approach will be used to normalize and calculate scores:

Written Proposal Calculations

For each document that is evaluated and scored by the evaluation committee, the RFP Lead will:

4.4.1 Average evaluator scores for each evaluated criteria of each Proposal.

4.4.2 Apply criteria weighting for each evaluated criteria of each Proposal.

4.4.3 Sum all weighted criteria for each Proposal.

4.4.4 Identify the highest weighted average score among all Proposals.

4.4.5 Assign normalized points as follows:

4.4.5.1 The Proposal with the highest weighted score will receive the maximum available points for Submittal B.

4.4.5.2 All other Proposals will receive a proportional share of the available points using the formula:

Interviews Calculations (if conducted)

The RFP Lead will average all evaluator scores for each Interview, Presentation, or Demonstration element. The averaged score will then be normalized as follows:

4.4.6 The Offeror receiving the highest raw average score for an element will be awarded the maximum available points for that element.

4.4.7 All remaining Offerors will receive a proportional share of the available points using the following formula:

Cost Calculations

Points for the Cost Proposal will be normalized as follows:

4.4.8 The Proposal with the lowest total evaluated cost will receive the maximum available points.

4.4.9 All remaining Proposals will receive a proportional share of the available points using the following formula:

4.5 Exhibition Candidate Selection

The RFP Lead may select Offerors to participate in oral presentations, key personnel interviews, or product demonstrations, as necessary.

4.6 Cost Proposal Evaluation

The State intends to evaluate Cost Proposals only for those Offerors selected to participate in oral presentations, key personnel interviews, or product demonstrations, if conducted.

4.7 Key Personnel Interviews (if conducted)

The RFP Lead may invite selected Offerors to participate in key personnel interviews, which will be scored by the evaluation committee.

The Offeror is responsible for assigning key personnel (individuals) to this Contract. These individuals must be assigned to this role for the duration of the contract and shall not be permitted to be removed or replaced during the first twelve (12) months of this Contract, unless requested and approved by the State (with the exception of uncontrollable events such as: retirement, medical emergency/injury/sickness, or resignation). Any changes made after the first twelve months must be approved by the State.

The following key personnel may be interviewed:

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4.7.1. Project Manager: Individual that will serve as the daily point of contact for this contract and responsible for managing this overall effort.

The State anticipates that the interviews may be performed virtually or in-person. Interviews are expected to last approximately 30 minutes per individual. The State will interview each proposed team member separately. Interview questions may address the individual’s experience, understanding of the scope of work, anticipated challenges, proposed strategies, and overall approach.

Only the interviewee may attend; no other representatives from the Offeror’s organization may participate, or observe. Interviewees are prohibited from making any reference to the Offeror’s cost or fee Proposal. Substitutes or proxies will not be permitted. Any individual who fail to attend their scheduled interview will receive a score of zero “0”, which may affect the Offeror’s competitiveness.

4.8 Clarification Discussions

The RFP Lead may, in the State’s sole discretion, perform clarification discussions with the Offeror(s) to verify and validate that the Proposal will meet the needs of the Agency. At any time during this period, if it is discovered that the Offeror has not met a mandatory requirement, or has failed to adequately respond to an item below, the State may find the Offeror non-responsive.

4.9.1 The Offeror may be required to provide documentation to demonstrate its responsibility. Failure to provide the requested documentation may result in the Offeror being deemed non-responsible. IDAPA 38.05.01.81.

4.9.2 If requested, provide any additional documentation that may be requested, which may include a detailed project/work plan, testing and commissioning plan, training, change management plan, safety plan, staffing plan, operational plan, maintenance plans, warranties, bonding and insurance, background checks, etc.

4.9.3 The clarification discussion cannot materially alter the Proposal. The State does not expect to negotiate any terms or conditions requested by the Offeror, unless they were submitted by the Offeror prior to the deadline for submitting questions (see Section 1.8), or they provide the State an opportunity to secure more advantageous terms or pricing.

4.9 Best-And-Final-Offer (BAFO)

The State reserves the right to request Best and Final Offers (BAFOs) from Offerors. If BAFOs are requested, the State will issue written instructions to the selected Offerors identifying the scope of the BAFO request and the deadline for submission. Offerors must not modify any aspect of their Proposal except as specifically requested by the State. BAFO responses must be submitted in accordance with the instructions provided. Failure to submit a BAFO, if requested, may result in the Offeror’s original Proposal being considered as its final offer.

4.10 Award

Award of Contract will be made to the responsive, responsible Offeror whose Proposal receives the highest number of total normalized points.

4.11 Resulting Contract

If the State awards Contract(s) from this solicitation, it will do so by issuing a Contract Purchase Order (CPO) Contract document(s) from Luma, the State’s ERP system. The State anticipates issuing a single contract from this solicitation, incorporating the Terms and Conditions, Insurance Requirements, General Requirements, Scope of Work, Definitions, Cost Proposal, some or all of the Offeror’s Technical Proposal, and other selected Exhibits in this RFP.

EXHIBIT 1

Definitions This Exhibit defines terms and spells out acronyms used throughout this RFP and, where applicable, the resulting Contract. Where a term derives from federal statute, regulation, or CMS guidance, that source is noted. Terms not defined below carry their ordinary meaning. Because all terms are defined here, they may be used elsewhere in the RFP without further definition.

EXHIBIT 2

Background Information

1. About The Department / Agency The Idaho Division of Veterans Services (IDVS) serves Idaho’s veterans and their families and operates the State’s four (4) State Veterans Homes, which provide skilled long-term nursing care to eligible resident veterans. The Homes are located in Boise, Lewiston, Pocatello, and Post Falls.

2. Background Information IDVS is soliciting Medicare Part A and Part B Consolidated Billing services, including third-party insurance billing, for the skilled long-term nursing care provided at its four State Veterans Homes. The objective is to bill Medicare and third-party insurers accurately and on time for resident care, to meet all applicable federal and state requirements, and to secure the appropriate revenue based on adjudicated claims.

Because the Homes receive federal funds, regulatory compliance and the integrity of every claim are essential. IDVS has contracted for these services under prior agreements and seeks to continue uninterrupted billing operations under a new contract, with an anticipated start date of November 1, 2026, coinciding with the expiration of the current contract.

3. Existing Data / Current Conditions The following summarizes the current conditions relevant to this solicitation:

4. Current Challenges and Priorities The nature of this work creates several priorities that shape this solicitation:

4.1. Accuracy and timeliness: Errors or late submissions can result in denied claims, lost revenue, and potential fines or penalties to IDVS.

4.2. Specialized expertise: Medicare billing for State Veterans Homes differs from hospital, hospice, or behavioral-health billing, particularly in the handling of skilled long term nursing care and veterans-home payer types including VA Service Connected status.

4.3. Continuity: IDVS requires a smooth transition with no gap in billing or in resident-related payments.

4.4. Compliance: the Contractor must keep current with evolving CMS Consolidated Billing regulations and support the Homes’ annual Medicare cost reports.

5. Reference Documents The detailed requirements for this solicitation are set out in the exhibits to this RFP, principally the Scope of Work and the reports specified therein. Offerors should also be familiar with the CMS Consolidated Billing requirements (available at cms.gov).

EXHIBIT 3

General Requirements

1. Contract Term The initial term of the Contract is two (2) years. Upon mutual written agreement, the Contract may be renewed for up to two (2) additional two-year terms, for an anticipated total term of six (6) years. The anticipated start date is November 1, 2026.

2. Compliance with Laws, Policies, and Facility Surveys The Contractor must comply with all applicable federal and state laws, regulations, and program guidance throughout the term of the Contract, including the False Claims Act, the federal Anti-Kickback Statute, the CMS Consolidated Billing requirements applicable to skilled long-term nursing care, the procedures and policies of the Homes, and the rules of any licensing or certification agency issuing licenses or certifications held by the Homes. The Contractor must:

2.1. Keep current on Consolidated Billing regulations and notify the Homes of the requirements of, and changes to, such regulations;

2.2. Advise IDVS and the management of the Homes regarding policy and regulatory changes concerning Medicare reimbursement;

2.3. Develop, implement, and maintain procedural checks and balances sufficient to withstand all applicable state and federal audits, and provide these procedures to IDVS for review and approval within ten (10) business days of award;

2.4. Take immediate action to correct any deficiencies identified during facility surveys conducted by state or federal licensing or certification agencies that arise from or relate to the Contractor’s services.

2.5. Report and return any identified overpayment to IDVS within sixty (60) calendar days after the overpayment is identified, consistent with 42 U.S.C. § 1320a-7k(d).

2.6. Comply with Section 6032 of the Deficit Reduction Act of 2005, including adopting IDVS's policies on the federal False Claims Act, the Program Fraud Civil Remedies Act, applicable state false-claims laws, and the related whistleblower protections, and informing the Contractor's staff who have contact with IDVS of those policies. IDVS will provide the applicable policy to the Contractor on request.

2.7. The Contractor must perform all billing, accounts receivable, collections, uncollectible-account write-off, and record-retention activities in accordance with the IDVS Fiscal Policy (Exhibit 5) and the applicable IDVS fiscal procedures it references, including Billing, Accounts Receivable, and Collections (FIS-PR-25-02); Write-Off of Uncollectible Accounts (FIS-PR-25-03); and Record Retention (FIS-PR-25-14). IDVS will make the applicable procedures available to the Contractor.

3. Contractor Eligibility Because the Homes receive federal funds, the Contractor must not be debarred by the federal government and must not appear on the Idaho Medicaid Exclusion List at any time during the term of the Contract. If the Contractor becomes debarred, suspended, or excluded at any time during the term, the Contractor must notify IDVS within five (5) business days, and such status is grounds for termination of the Contract.

4. Subcontractors The Contractor must not enter into any subcontract relating to the performance of this Contract without the State’s prior written approval, and remains fully responsible for the performance of any subcontractor. The State may require the removal of any subcontractor found unacceptable. Subcontracting is otherwise governed by the Subcontracting and Reassignment of Contractor Employees provisions of the Contract Terms and Conditions.

5. Key Personnel and Availability

5.1. The Contractor must designate a Contractor POC and a backup Contractor POC who are available Monday through Friday, 8:00 a.m. to 5:00 p.m. Mountain Time excluding state holidays.

5.2. The Contractor must provide backup staff sufficient to complete the services without interruption.

5.3. The Contractor must ensure that staff selection conforms to all requirements and regulations governing the provision of billing services in long-term-care facilities, and that its staff hold any licenses or certifications required by law to perform their assigned services.

5.4. The Contractor must require its staff to conduct themselves professionally. The reassignment or removal of any Contractor employee or subcontractor found unacceptable to a Home, and the background-check and security-awareness requirements for Contractor personnel, are governed by the Reassignment of Contractor Employees and the Background Checks and Security Awareness provisions of the Contract Terms and Conditions.

6. Equipment and Resources

6.1. The Contractor must provide, at its sole expense, all equipment and resources necessary to perform the services, including telephones, fax machines, copiers, computers, internet access, and secure email.

6.2. IDVS is not obligated to provide office space, work areas, or equipment to the Contractor. The Contractor may perform services on-site at a Home only with IDVS's prior written approval and subject to the Home's space availability, security, access, and privacy requirements.