AHCA ITN 002-24.25.pdf

RON DESANTIS

GOVERNOR

JASON WEIDA

SECRETARY

Facebook .com/AHCAFlo r ida Youtube.com/AHCAFlor i da

Twi t ter .com/AHCA_FL S l ideShare.net /AHCAFlo r ida

2727 Mahan Dr ive • Mai l S top #15 Ta l lahassee, FL 32308 AHCA.MyFlor i da.com

January 2, 2025

Prospective Vendor(s):

Subject: Solicitation Number: AHCA ITN 002-24/25

Title: Enhanced Provider Network Auditing Program

This solicitation is being issued by the State of Florida, Agency for Health Care Administration, hereinafter referred to as “AHCA” or “Agency”, to select a vendor to provide Enhanced Provider Network Auditing Program services. The solicitation package consists of this transmittal letter and the following attachments and exhibits:

Attachment A Instructions and Special Conditions Exhibit A-1 Questions Template Exhibit A-2 Transmittal Letter Exhibit A-3 Required Certifications and Statements Exhibit A-3-a Vendor Certification Form (PUR 7801) Exhibit A-4 Submission Requirements and Evaluation Criteria Components

(Technical Response) Exhibit A-4-a Unique Count of Providers Exhibit A-4-b Compliance History Template Exhibit A-5 Summary of Respondent Commitments Exhibit A-6 Certification of Drug-Free Workplace Program Exhibit A-7 Standard Contract Attachment B Scope of Services Exhibit B-1 Provider Network Standards Exhibit B-2 Deliverables and Performance Standards

Your response must comply fully with the instructions that stipulate what is to be included in the response. Respondents shall identify the solicitation number, date and time of opening on the package transmitting their response. This information is used only to put the Agency mailroom on notice that the package received is a response to an Agency solicitation and therefore should not be opened, but delivered directly to the Procurement Officer.

AHCA ITN 002-24/25

The designated Agency Procurement Officer for this solicitation is the undersigned. All communications from respondents shall be made in writing and directed to my attention at the address provided in Attachment A, Instructions and Special Conditions, Section A.1., Instructions, Sub-Section A., Overview, Item 5., Procurement Officer unless otherwise instructed in this solicitation.

The term “Proposal”, “Response” or “Reply” may be used interchangeably and mean the respondent’s submission to this solicitation.

Section 120.57(3)(b), Florida Statutes and Section 28-110.003, Florida Administrative Code require that a Notice of Protest of the solicitation documents shall be made within seventy-two hours after the posting of the solicitation. Failure to file a protest within the time prescribed in section 120.57(3), Florida Statutes, or failure to post the bond or other security required by law within the time allowed for filing a bond shall constitute a waiver of proceedings under chapter 120, Florida Statutes.

Sincerely, Weston McKain Procurement Officer Bureau of Support Services

ATTACHMENT A

INSTRUCTIONS AND SPECIAL CONDITIONS

AHCA ITN 002-24/25, Attachment A, Page 1 of 26

Table of Contents

A.1. Instructions

A. Overview

1. Solicitation Number

2. Solicitation Type

3. Solicitation Title

4. Date of Issuance

5. Procurement Officer

6. Solicitation Timeline

7. PUR 1000, General Contract Conditions

8. PUR 1001, General Instructions to Respondents

9. Restriction on Communications

10. Respondent Questions

11. Solicitation Addenda

12. Public Opening of Responses

13. Type and Amount of Contract Contemplated

14. Term of Contract

B. Response Preparation and Content

1. General Instructions

2. Mandatory Response Content

a. Exhibit A-2, Transmittal Letter

b. Exhibit A-3, Required Certifications and Statements

c. Exhibit A-3-a, Vendor Certification Form (PUR 7801)

d. Original Proposal Guarantee

e. Financial Information

f. Exhibit A-4, Submission Requirements and Evaluation Criteria (Technical Response)

g. Cost Proposal

h. Exhibit A-5, Summary of Respondent Commitments

3. Additional Response Content

a. Exhibit A-6, Certification of Drug-Free Workplace Program

C. Response Submission Requirements

1. Hardcopy and Electronic Submission Requirements

AHCA ITN 002-24/25, Attachment A, Page 2 of 26

a. General Provision

b. Hardcopies of the Response

c. Electronic Copy of the Response

2. Confidential or Exempt Information

D. Response Evaluation, Negotiations and Contract Award

1. Response Clarification

2. Responsive Reply Determination

3. Non-Scored Requirements

a. Transmittal (Cover) Letter

b. Required Certifications and Statements

c. Vendor Certification Form (PUR 7801)

d. Original Proposal Guarantee

e. Financial Information

f. Unscored Submission Requirements and Evaluation Criteria

g. Summary of Respondent Commitments

4. Scored Requirements – Evaluation Criteria

a. Technical Response Evaluation

5. Ranking of Responses

6. Negotiation Process

7. Selection Criteria for Determining Best Value

8. Number of Awards

9. Posting of Notice of Intent to Award

10. Performance Bond

11. Contract Execution

A.2 Special Terms and Conditions

A. Venue

B. General Definitions

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

AHCA ITN 002-24/25, Attachment A, Page 3 of 26

A.1. Instructions

A. Overview

1. Solicitation Number

AHCA ITN 002-24/25

2. Solicitation Type

Invitation to Negotiate

3. Solicitation Title

Enhanced Provider Network Auditing Program

4. Date of Issuance

5. Procurement Officer

Weston McKain Agency for Health Care Administration 2727 Mahan Drive Mail Stop #15 Tallahassee, FL 32308-5403 Email: solicitation.questions@ahca.myflorida.com

6. Solicitation Timeline

The projected solicitation timeline is shown in Table 1, Solicitation Timeline, below (all times are Eastern Time). The Agency for Health Care Administration (Agency) reserves the right to amend the timeline in the State’s best interest. If the Agency finds it necessary to change any of the activities/dates/times listed, all interested parties will be notified by addenda to the original solicitation document posted on the Vendor Information Portal (VIP) (https://vendor.myfloridamarketplace.com/).

TABLE 1

SOLICITATION TIMELINE

ACTIVITY DATE/TIME LOCATION

Solicitation Issued by Agency

January 2, 2025 Electronically Posted https://vendor.myfloridamarketplace.com/

Deadline for Receipt of Written Questions

January 20, 2025 2:00 p.m.

solicitation.questions@ahca.myflorida.com mailto:solicitation.questions@ahca.myflorida.com https://vendor.myfloridamarketplace.com/ https://vendor.myfloridamarketplace.com/ mailto:solicitation.questions@ahca.myflorida.com

AHCA ITN 002-24/25, Attachment A, Page 4 of 26

TABLE 1

SOLICITATION TIMELINE

ACTIVITY DATE/TIME LOCATION

Anticipated Date for Agency Responses to Written

Questions

February 11, 2025 Electronically Posted https://vendor.myfloridamarketplace.com/

Deadline for Receipt of Responses

February 28, 2025 2:00 p.m.

Attention: Weston McKain Agency for Health Care Administration

2729 Fort Knox Boulevard Mailroom, Building 2 Tallahassee, FL 32308-5403

Public Opening of Responses

February 28, 2025 3:00 p.m.

2727 Mahan Drive, Building 2 Operations Conference Room, 2nd Floor, Room 200

Tallahassee, FL 32308-5403

Anticipated Dates for Negotiations

March 17, 2025 – April 21, 2025

2727 Mahan Drive, Building 2 Operations Conference Room, 2nd Floor, Room 200

Tallahassee, FL 32308-5403

Anticipated Posting of Notice of Intent to Award

April 30, 2025 Electronically Posted https://vendor.myfloridamarketplace.com/

7. PUR 1000, General Contract Conditions

PUR 1000, General Contract Conditions, is incorporated by reference and is available for prospective respondents to download at:

https://www.dms.myflorida.com/content/download/2933/11777/PUR_1000 _General_Contract_Conditions.pdf

8. PUR 1001, General Instructions to Respondents

PUR 1001, General Instructions to Respondents, is incorporated by reference and is available for prospective respondents to download at:

https://www.dms.myflorida.com/content/download/2934/11780/PUR_1001 _General_Instructions_to_Respondents.pdf

Unless otherwise noted, instructions in this Attachment A shall take precedence over the PUR 1001, General Instructions to Respondents.

9. Restriction on Communications

Respondents to this solicitation or persons acting on their behalf may not contact, between the release of the solicitation and the end of the seventy-two (72) hour period following the Agency posting the notice of intended award, excluding Saturdays, Sundays, and State holidays, any employee or officer of the executive or legislative branch concerning any aspect of this solicitation, except in writing to the Procurement Officer or as provided in the solicitation documents. Violation of this provision may be grounds for rejecting a response. See Section 287.057(25), Florida Statutes (F.S.).

https://vendor.myfloridamarketplace.com/ https://vendor.myfloridamarketplace.com/ https://www.dms.myflorida.com/content/download/2933/11777/PUR_1000_General_Contract_Conditions.pdf https://www.dms.myflorida.com/content/download/2933/11777/PUR_1000_General_Contract_Conditions.pdf https://www.dms.myflorida.com/content/download/2934/11780/PUR_1001_General_Instructions_to_Respondents.pdf https://www.dms.myflorida.com/content/download/2934/11780/PUR_1001_General_Instructions_to_Respondents.pdf

AHCA ITN 002-24/25, Attachment A, Page 5 of 26

10. Respondent Questions

a. The Agency will receive all questions pertaining to this solicitation no later than the date and time specified for written questions in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline.

b. Prospective respondents must submit all questions by email at solicitation.questions@ahca.myflorida.com, utilizing Exhibit A-1, Questions Template.

c. The Agency will not accept questions by telephone, postal mail, hand delivery or fax.

d. The Agency’s response to questions received will be posted as an addendum to this solicitation as specified in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, and may be grouped as to not repeat the same answer multiple times.

e. The Agency reserves the right to post an addendum to this solicitation in order to address questions received after the written question submission deadline. It is the sole discretion of the Agency to consider questions received after the written questions submission deadline.

11. Solicitation Addenda

If the Agency finds it necessary to supplement, modify, or interpret any portion of this solicitation during this solicitation period, a written addendum will be posted on the VIP as addenda to this solicitation. It is the respondent’s responsibility to check the VIP periodically for any information or updates to this solicitation. The Agency bears no responsibility for any resulting impacts associated with a prospective respondent’s failure to obtain the information made available through the VIP.

12. Public Opening of Responses

Responses shall be opened on the date, time and at the location indicated in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline. Respondents may, but are not required to, attend. The Agency will only announce the respondent(s) name at the public opening. Pursuant to Section 119.071(1)(b), F.S., no other materials will be released. Any person requiring a special accommodation because of a disability should contact the Procurement Officer at least five (5) business days prior to this solicitation opening. If you are hearing or speech impaired, please contact the Agency by using the Florida Relay Service at (800) 955-8771 (TDD).

AHCA ITN 002-24/25, Attachment A, Page 6 of 26

13. Type and Amount of Contract Contemplated

a. The Agency anticipates negotiating the pricing structure, although the contract resulting from this solicitation will result in no more than $5,000,000 to $10,000,000 reimbursement made per year for a total contract price of $15,000,000 to $30,000,000. The Agency will be open to different reimbursement mechanisms proposed during negotiations. The Respondent shall utilize Exhibit A-4-a, Unique Count of Providers, along with proposed responses in other SRCs concerning workload and deliverables, to develop a proposed payment structure and reimbursement methodology.

b. The Agency shall pay the vendor upon completion and acceptance of deliverables in accordance with the deliverable schedule specified in Attachment B, Scope of Services, Exhibit B-2, Deliverables and Performance Standards. The Agency also reserves the right to modify the Contract amount based on secret shopper monitoring assignments described in Attachment B, Scope of Services. The Agency in its sole discretion shall make this determination.

c. Pursuant to the Agency’s Statewide Medicaid Managed Care Program Core Contract Provisions, the Agency’s expenses for this Contract shall be reimbursed by the managed care plans:

“The Managed Care Plan shall pay to the Agency the expenses of the Agency’s network review vendor at the rates established by the Agency proportionate to the Managed Care Plan’s enrolled population. Payments shall include compensation of the vendor and necessary attendant administrative costs of the Agency directly related to the audit activities. The Managed Care Plan shall pay the Agency within twenty-one (21) days after presentation by the Agency of the detailed account of the charges and expenses.”

d. The Agency shall pay the Vendor, in arrears, upon satisfactory completion and Agency approval of deliverables identified in Attachment B, Scope of Services, Exhibit B-2, Deliverables and Performance Standards, and agreed upon during negotiations.

14. Term of Contract

a. The anticipated term of the resulting Contract is April 1, 2025, through March 31, 2028. The term of the resulting Contract is subject to change based on the actual execution date of the resulting Contract.

b. In accordance with Section 287.057(14), F.S., the Contract resulting from this solicitation may be renewed for a period that may not exceed three (3) years or the term of the resulting original

AHCA ITN 002-24/25, Attachment A, Page 7 of 26

Contract period, whichever is longer. Renewal of the resulting Contract shall be in writing and subject to the same terms and conditions set forth in the resulting original Contract. A renewal Contract may not include any compensation for costs associated with the renewal. Renewals are contingent upon satisfactory performance evaluations by the Agency, are subject to the availability of funds, and are optional to the Agency.

B. Response Preparation and Content

1. General Instructions

a. The instructions for this solicitation have been designed to help ensure that all responses are reviewed and evaluated in a consistent manner, as well as to minimize costs and response time.

Information submitted in variance with these instructions may not be reviewed or evaluated.

b. The Agency has established certain requirements with respect to responses submitted to competitive solicitations. The use of “shall”, “must”, or “will” (except to indicate futurity) in this solicitation, indicates a requirement or condition from which a material deviation may not be waived by the Agency. A deviation is material if, in the Agency’s sole discretion, the deficient response is not in substantial accord with this solicitation’s requirements, provides a significant advantage to one respondent over another, or has a potentially significant effect on the quality of the response or on the cost to the Agency. Material deviations cannot be waived. The words “should” or “may” in this solicitation indicate desirable attributes or conditions but are permissive in nature. Deviation from, or omission of, such desirable features will not in and of itself cause rejection of a response.

c. Respondents shall not retype and/or modify required forms and must submit required forms in the original format.

FAILURE TO SUBMIT EACH REQUIRED FORM IN ITS

ORIGINAL FORMAT MAY RESULT IN REJECTION OF THE

RESPONSE.

d. A respondent shall not, directly or indirectly, collude, consult, communicate or agree with any other respondent as to any matter related to the response each is submitting. Additionally, a respondent shall not induce any other respondent to submit or not to submit a response.

e. The costs related to the development and submission of a response to this solicitation is the full responsibility of the respondent and is not chargeable to the Agency.

AHCA ITN 002-24/25, Attachment A, Page 8 of 26

f. Joint ventures and legal partnerships shall be viewed as one (1) respondent. However, all parties to the joint venture/legal partnership shall submit all mandatory attachments and documentation required by this solicitation from respondents, unless otherwise stated. Failure to submit all required documentation from all parties included in a joint venture/legal partnership, signed by an authorized official, if applicable, may result in the rejection of a prospective vendor’s response.

g. Pursuant to Section 287.133(2)(a), F.S., a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Bid, Proposal, or Reply on a contract to provide any goods or services to a public entity;

may not submit a Bid, Proposal, or Reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit Bids, Proposals, or Replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, F.S. for category two for a period of thirty-six (36) months following the date of being placed on the convicted Vendor list.

2. Mandatory Response Content

The respondent shall include the documents listed in this Item with the submission of the Original Response. Violation of this provision may result in the rejection of a response.

a. Exhibit A-2, Transmittal Letter

The respondent shall complete and submit Exhibit A-2, Transmittal Letter, as part of its response in accordance with the instructions contained therein.

b. Exhibit A-3, Required Certifications and Statements

The respondent shall complete and submit Exhibit A-3, Required Certifications and Statements, as part of its response in accordance with the instructions contained therein.

c. Exhibit A-3-a, Vendor Certification Form (PUR 7801)

The respondent shall complete, sign and submit Exhibit A-3-a, Vendor Certification Form, as part of its response in accordance

d. Original Proposal Guarantee

AHCA ITN 002-24/25, Attachment A, Page 9 of 26

1) The respondent’s Original Response must be accompanied by an Original Proposal Guarantee payable to the State of Florida in the amount of $500,000.00. The proposal guarantee is a firm commitment that the respondent shall, upon the Agency’s acceptance of its response, execute such contractual documents as may be required within the time specified.

2) The respondent must be the guarantor. If responding as a joint venture/legal partnership, at least one party of the joint venture/legal partnership shall be the guarantor.

3) The proposal guarantee shall be in the form of a bond, cashier’s check, treasurer’s check, bank draft or certified check. The Agency will not accept a letter of credit in lieu of the Proposal Guarantee.

4) The Agency will not accept a copy of the Proposal Guarantee.

5) Proposal Guarantees will be returned, at the expense of the

Respondent, upon execution of the legal Contract with the successful respondent and receipt of the performance bond required under this solicitation (See Section A.1., Instructions, Sub-Section D., Response Evaluation, Negotiations and Contract Award, Item 10., Performance Bond).

6) Proposal Guarantees may be returned to respondents not considered responsive and responsible prior to execution of the legal Contract if the respondent is not participating in an administrative challenge regarding this solicitation.

7) Proposal Guarantees will be returned to the Official Contact Person at the address listed in Exhibit A-2, Transmittal Letter.

8) If the successful respondent fails to execute a contract within ten (10) consecutive calendar days after a contract has been presented to the successful respondent for signature, the proposal guarantee shall be forfeited to the State.

9) The proposal guarantee must not contain any provisions that reduce the amount of the proposal guarantee based on the amount of any contract awarded to a replacement awardee or shorten the time from bringing an action to a time less than that provided by the applicable Florida Statute of Limitations (see Section 95.03, F.S.). Proposal guarantees submitted using The American Institute of

AHCA ITN 002-24/25, Attachment A, Page 10 of 26

Architects AIA Document 310 or any document based upon that form will not be accepted by the Agency.

e. Financial Information

In order to demonstrate financial stability, the respondent shall submit its two (2) most recent audited financial statements or its most recent Dun & Bradstreet (D&B) Report.

1) Audited Financial Statements

If the respondent is a subsidiary of a parent organization, the respondent may submit the two (2) most recent audited financial statements of its parent entity. Audited financial statements of the parent organization in lieu of the respondent must include an organizational chart representing the relationship between the respondent and the parent entity.

Respondents submitting audited financial statements shall submit the following:

a) A copy of the respondent’s two (2) most recent audited financial statements (or parent organization’s audited financial statements with organizational chart). If the most recent audit contains columns for the current and previous year on the balance sheet, income statement, and statement of cash flows, then only the most recent year’s audit is required.

b) Audited financial statements must be current. The period covered by the most recent audit cannot be more than one (1) fiscal year and one hundred twenty (120) calendar days old from the solicitation advertisement date.

c) The audit must contain a signed audit statement

(Audit Opinion) from a Certified Public Accountant (CPA) and the statement cannot contain an Adverse Opinion or a Disclaimer of Opinion from the CPA.

2) Dun & Bradstreet (D&B) Report

Respondents may submit a complete D&B report, which at a minimum, shall include the Business and Executive Summaries, Credit Class Score, Financial Stress Score, and Paydex Score portions of the report. The D&B report cannot be more than twelve (12) months old at the time of response to this solicitation.

AHCA ITN 002-24/25, Attachment A, Page 11 of 26

f. Exhibit A-4, Submission Requirements and Evaluation Criteria

(Technical Response)

1) Respondents shall complete and submit Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), and applicable attachments/exhibits as part of its response.

2) Respondents shall comply with the instructions for completing Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), which are contained therein.

g. Cost Proposal

The respondent shall submit a Cost Proposal as part of its response. The Cost Proposal shall identify all costs and fees associated with providing the services detailed in Attachment B, Scope of Services.

During negotiations, the Agency reserves the right to require respondents to submit a detailed budget to identify the individual cost components used by the respondent to develop its Cost Proposal.

h. Exhibit A-5, Summary of Respondent Commitments

The respondent shall complete and submit Exhibit A-5, Summary of Respondent Commitments, as part of its response in accordance

3. Additional Response Content

a. Exhibit A-6, Certification of Drug-Free Workplace Program

The State supports and encourages initiatives to keep the workplace of Florida’s suppliers and contractors drug free. Section 287.087, F.S. provides that, where identical tie Proposals are received, preference shall be given to a Proposal received from a respondent that certifies it has implemented a drug-free workplace program. If applicable, the respondent shall sign and submit Exhibit A-6, Certification of Drug-Free Workplace Program, to certify that the respondent has a drug-free workplace program.

C. Response Submission Requirements

1. Hardcopy and Electronic Submission Requirements

AHCA ITN 002-24/25, Attachment A, Page 12 of 26

a. General Provision

Electronic submissions via MyFloridaMarketPlace will not be accepted for this solicitation.

b. Hardcopies of the Response

1) Original Response

The respondent shall submit one (1) Original Response.

The Original Response shall be marked as the “Original” and contain the Transmittal Letter (Exhibit A-2) that bears the original signature of the binding authority. The box that contains the Original Response shall be marked “Contains Original”. All forms requiring signature shall bear an original signature with the original response.

2) Duplicate Copy of the Original Response

The respondent shall submit one (1) duplicate copy of the Original Response.

3) Packaging and Delivery

a) Hard copy responses shall be bound individually and submitted in three-ring binders or secured in a similar fashion to contain pages that turn easily for review.

b) Each component of the hard copy response shall be clearly labeled and tabbed in the order specified below:

(1) Exhibit A-2, Transmittal Letter;

(2) Exhibit A-3, Required Certifications and

Statements;

(3) Exhibit A-3-a, Vendor Certification Form

(PUR 7801);

(4) Original Proposal Guarantee Note: The

Original Proposal Guarantee must be provided in the Original Response;

(5) Financial Information;

(6) Exhibit A-4, Submission Requirements and

Evaluation Criteria Components (Technical Response);

(7) Cost Proposal;

(8) Exhibit A-5, Summary of Respondent

Commitments; and

(9) Exhibit A-6, Certification of Drug-Free

Workplace Program (if applicable).

AHCA ITN 002-24/25, Attachment A, Page 13 of 26

c) Hard copy responses shall be double sided.

d) Hard copy responses must be submitted in a sealed package (i.e., outer boxes must be sealed, individual binders within the box do not require individual sealing), to the Procurement Officer identified in Section A.1., Instructions, Sub-Section A., Overview, Item 5., Procurement Officer, no later than the time indicated in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline.

e) Hard copy responses shall be submitted via United

States (U.S.) mail, courier, or hand delivery.

Responses sent by fax or email will not be accepted.

f) The Agency will not consider responses received after the date and time specified in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, and any such responses will be returned to the respondent unopened.

c. Electronic Copy of the Response

1) The respondent shall submit one (1) electronic copy of the entire response on a USB flash drive.

2) The electronic copy of the response, including all attachments, shall be submitted as Portable Document Format (PDF) documents. The PDF documents must be searchable, allow printing and must not be password protected (unlocked).

3) The electronic copy of the PDF documents shall be saved on the USB flash drive, with each component listed below saved separately in individual file folders:

(a) Exhibit A-2, Transmittal Letter;

(b) Exhibit A-3, Required Certifications and

Statements;

(c) Exhibit A-3-a, Vendor Certification Form (PUR

7801);

(d) Financial Information;

(e) Exhibit A-4, Submission Requirements and

Evaluation Criteria Components (Technical Response) and applicable attachments/exhibits;

(f) Cost Proposal;

(g) Exhibit A-5, Summary of Respondent

Commitments; and

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(h) Exhibit A-6, Certification of Drug-Free Workplace Program (if applicable).

4) In addition to the PDF submission, the following exhibit shall also be submitted in Microsoft Excel 2016, utilizing the Agency templates, where provided, and shall be saved on the USB flash drive:

(a) Exhibit A-5, Summary of Respondent

Commitments.

5) Electronic Redacted Copies

(a) The respondent shall submit an electronic redacted copy of the response suitable for release to the public in one (1) PDF document on the USB flash drive. The electronic copy shall be saved in a separate file folder on the USB flash drive from the rest of the response. The file folder shall be identified as “Redacted Version Suitable for Public Release”.

(b) The PDF document must be searchable, allow printing, and must not be password protected (unlocked).

(c) Any confidential or trade secret information covered under Section 812.081, F.S., should be redacted as described below. The redacted response shall be marked as the “redacted” copy.

2. Confidential or Exempt Information

a. All submittals received by the date and time specified in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, become the property of the State of Florida and are public records subject to the provisions of Chapter 119, F.S. The State of Florida shall have the right to use all ideas, or adaptations of the ideas, contained in any response received in relation to this solicitation. Selection or rejection of the response shall not affect this right.

b. A respondent that asserts that any portion of the response is confidential or exempt from disclosure under Chapter 119, F.S., shall clearly mark each page of such portion as follows:

1) Pages containing trade secret shall be marked “Trade secret as defined in Section 812.081, Florida Statutes”.

Respondents who fail to identify trade secret as directed herein acknowledge and agree that they waive any right or

AHCA ITN 002-24/25, Attachment A, Page 15 of 26 cause of action, civil or criminal, against the Agency, its employees, and its representatives, for the release or disclosure of trade secret information not so identified.

Respondents shall not mark their entire response as trade secret. The Agency may reject a response that is so marked.

2) Pages that do not contain trade secrets but are otherwise exempt or confidential shall be marked “exempt” or “confidential,” followed by the statutory basis for such claim.

For example: “The information on this page is exempt from disclosure pursuant to Section 119.071(3)(b), Florida Statutes.”

3) Failure to identify and mark such portions as directed above shall constitute a waiver of any claimed exemption and the Agency will provide any unmarked records in response to public records requests for those records without notifying the respondent. Designating material simply as “proprietary” will not necessarily protect it from disclosure under Chapter 119, F.S.

c. All information included in the response (including, without limitation, technical and cost information) and any resulting Contract that incorporates the successful response (fully, in part, or by reference) shall be a matter of public record regardless of copyright status. Submission of a response to this solicitation that contains material for which the respondent holds a copyright shall constitute permission for the Agency to reproduce and disclose such material for the Agency’s internal use, and to make such material available for inspection pursuant to a public records request.

d. If a public records request is submitted to the Agency for responses submitted to this solicitation, the respondent agrees that the Agency may release the redacted response without conducting any pre-release review of the redacted response.

e. Unless otherwise prohibited by law, the Agency will notify the respondent if a requestor contests the respondent’s determination that information is confidential or exempt and asserts a right to the information under Chapter 119, F.S. or other law. The respondent bears sole responsibility for supporting and defending its determination. If an action is brought against the Agency in any appropriate judicial forum contesting the respondent’s determination of confidentiality or the redactions made by the respondent to its response, the respondent agrees that the Agency has no duty to defend against such claims and may elect not to do so, and may elect to release an un-redacted version of the response. By submitting a response, the respondent agrees to

AHCA ITN 002-24/25, Attachment A, Page 16 of 26 protect, defend, hold harmless and indemnify the Agency for any and all claims arising from or relating to the respondent’s determinations of confidentiality or redaction, including the payment of any attorneys’ fees or costs assessed against the Agency.

D. Response Evaluation, Negotiations and Contract Award

1. Response Clarification

The Agency reserves the right to seek written clarification from a respondent of any information contained in the response or to request missing items from a response. However, it is a respondent’s obligation to submit an adequately written reply for the Agency to evaluate. The Agency shall have no duty to conduct discussions or attempt to clarify ambiguities in the respondent’s reply if the respondent is not in the competitive range of respondents selected for negotiations.

2. Responsive Reply Determination

A “responsive reply” means a reply submitted by a responsive and responsible vendor, which conforms in all material aspects to the solicitation [Section 287.012(26), F.S.]. A “responsible vendor” means a vendor who has the capacity in all respects to fully perform the Contract requirements and the integrity and reliability that will assure good faith performance [287.012(25), F.S.]. The Procurement Officer may rely on any facts available to make a determination at any time prior to award as to whether a vendor is a responsible vendor. The Agency reserves the right to contact sources outside the reply to obtain information regarding past performance or other matters relevant to responsibility.

3. Non-Scored Requirements

a. Transmittal (Cover) Letter

The Agency will review responses to this solicitation to determine if the respondent included in its response, Exhibit A-2, Transmittal Letter, from each required party.

b. Required Certifications and Statements the respondent included in its response Exhibit A-3, Required Certifications and Statements.

c. Vendor Certification Form (PUR 7801) the respondent included in its response Exhibit A-3-a, Vendor Certification Form.

AHCA ITN 002-24/25, Attachment A, Page 17 of 26

d. Original Proposal Guarantee

The Agency will review responses to this solicitation to determine if the respondent included in its response, an original proposal guarantee in the appropriate amount, as specified in Section B., Response Preparation and Content, Sub-Section 2., Mandatory

Response Content, Item d.

e. Financial Information

During negotiations, the Agency will utilize the Financial Information submitted by the respondent to determine financial stability. Any questions or concerns regarding financial stability may be addressed by the Agency’s negotiation team with the respondent during negotiations. Furthermore, the Agency reserves the right to request additional or clarifying information to determine financial stability. Financial Information and subsequent information obtained during negotiations may be utilized by the Agency’s negotiation team as a component of its best value determination.

f. Unscored Submission Requirements and Evaluation Criteria

Unscored responses within Exhibit A-4, Submission Requirements and Evaluation Criteria Template will be provided to the Agency negotiators for use in negotiations. Respondents shall submit responses and materials for each of the unscored SRCs identified in Table 2, Summary of Unscored Submission Requirements and Evaluation Criteria, below:

TABLE 2

SUMMARY OF UNSCORED SUBMISSION REQUIREMENTS

AND EVALUATION CRITERIA

SRC #1 Organizational Structure and History

SRC #2 Proposed Subcontractors

SRC #3 Reimbursement/Payment Structure

SRC #11 Additional Dashboards

g. Summary of Respondent Commitments the respondent included in its response, Exhibit A-5, Summary of Respondent Commitments. Exhibit A-5, Summary of Respondent Commitments, will be provided to the Agency negotiators for use in negotiations.

AHCA ITN 002-24/25, Attachment A, Page 18 of 26

4. Scored Requirements – Evaluation Criteria

a. Technical Response Evaluation

1) Each evaluator will evaluate responses independently of the other evaluators and award points based on the criteria and points scale indicated in Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), for the detailed evaluation criteria components.

2) Each response will be individually scored by at least three

(3) evaluators, who collectively have experience and knowledge in the program areas and service requirements for which contractual services are sought by this solicitation.

The Agency reserves the right to have specific Submission Requirement Components (SRC) of the responses evaluated by fewer than three (3) individuals.

3) The scores of independent evaluators will be computed to determine a total score based on the detailed evaluation criteria components indicated in Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), and the weight factor specified in Table 3 Summary Score Sheet, below.

TABLE 3

SUMMARY SCORE SHEET

Maximum Raw

Score Possible

Weight Factor

Maximum

Points Possible

A. Technical Response

SRC# 4 – Data and Systems 25 X 1 = 25

SRC# 5 – Network Analysis and Reporting 20 X 1.2 = 24

SRC# 6 – Secret Shopper 25 X 1 = 25

SRC# 7 – Compliance/Remedies 30 X 0.65 = 19.5

SRC# 8 – Staffing 25 X 0.85 = 21.25

SRC# 9 – Respondent Qualifications 20 X 1 = 20

SRC# 10 – Compliance History 20 X 1 = 20

TOTAL: 154.75

AHCA ITN 002-24/25, Attachment A, Page 19 of 26

5. Ranking of Responses

a. A total score will be calculated for each response based on the total maximum points available as included in Table 3, Summary Score Sheet, above.

b. The total point scores will be used to rank the responses.

6. Negotiation Process

a. The scores from the evaluation process shall be used to determine the respondents with whom the negotiation team will negotiate. The negotiation team shall not utilize the evaluation scores in determining best value.

b. The Agency will negotiate with the three (3) highest ranked respondents (competitive range). However, the Agency may choose not to negotiate with a respondent whose score is lower than seventy percent (70%) of the highest score earned by any respondent to this solicitation.

c. The Agency may review any and all data available to the Agency including but not limited to Agency held data and respondents’ performance-based information for use in negotiations.

d. The Agency’s negotiation team will conduct negotiation strategy sessions pursuant to Section 286.0113, F.S. Negotiation strategy includes determining best value criteria and developing award recommendation(s). During its strategy sessions, the Agency’s negotiation team will develop a recommendation as to the award that will provide the best value (as defined in Section 287.012(4), F.S.) to the State.

e. Negotiation sessions will include discussions of the scope of services to be provided by the respondent until acceptable terms and conditions are agreed upon, or it is determined that an acceptable agreement cannot be reached. The Agency will negotiate the terms and conditions determined to be the best value to the State according to Section 287.012(4) F.S., including, but not limited to price/cost, quality, design, and service delivery. Any terms to be negotiated must be addressed during negotiation sessions, prior to award.

f. At least one (1) authorized official who has the authority to bind the respondent to a contract must be present at each negotiation session. The authorized official(s) must be the Official Contact Person or Alternate Contact Person named in Exhibit A-2, Transmittal Letter.

AHCA ITN 002-24/25, Attachment A, Page 20 of 26

g. The Agency reserves the right at any time during the negotiation process to:

1) Negotiate concurrently or sequentially with competing respondents.

2) Schedule additional negotiation sessions with any or all responsive respondents.

3) Require any or all responsive respondents to provide additional, revised, or final written replies addressing specific topics, including modifications to the solicitation specifications, terms or conditions, or business references.

4) Require any or all responsive respondents to provide a written best and final offer or offers.

5) Require any or all responsive respondents to address services, prices, or conditions offered by any other respondents.

6) Decline to conduct further negotiations with any respondent.

7) Re-open negotiations with any responsive respondent.

8) Take any additional administrative steps deemed necessary in determining the final award, including additional fact-finding, evaluation or negotiations where necessary and consistent with the terms of this solicitation.

9) Review and rely on relevant information contained in the responses.

10) Request pricing options or models different from the initial Cost Proposal submission. This information may be used in negotiations to determine the best pricing solution to be used in the Contract.

h. The Agency has sole discretion in deciding whether and when to take any of the foregoing actions, the scope and manner of such actions, the responsive respondent or respondents affected and whether to provide concurrent public notice of such decision.

i. In the event the Agency cannot reach agreement with a respondent who has been invited to negotiation and/or a respondent withdraws its response during the negotiation phase, the Agency reserves the right to invite the next top-ranking respondent to negotiations to ensure that the Agency can enter into a contract.

AHCA ITN 002-24/25, Attachment A, Page 21 of 26

7. Selection Criteria for Determining Best Value

To adapt the definition of “best value” provided in section 287.012(4), F.S., to the needs of the Enhanced Provider Network Auditing Program, as specified in the ITN, the negotiation team shall establish the selection criteria for determining best value.

In addition to the selection criteria determined by the negotiation team, the following selection criterion will be considered:

The extent to which a respondent maintains a staff in Florida who can conduct onsite, on the ground monitoring of provider networks, in addition to conducting secret shopper activities by phone or electronically.

8. Number of Awards

The Agency anticipates the issuance of one (1) contract as a result of this solicitation for all services included within the Scope of Services. The Agency, at its sole discretion, shall make this determination.

9. Posting of Notice of Intent to Award

Tabulation of Results, with the recommended Contract award, will be posted to the Vendor Information Portal and will be available for review by interested parties at the time and location specified in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, and will remain posted for a period of seventy-two (72) hours, not including weekends or State observed holidays.

Any respondent desiring to protest the recommended Contract award must file a notice of intent to protest to the Procurement Officer identified in Section A.1., Instructions, Sub-Section A., Overview, Item 5., Procurement Officer, within the time prescribed in Section 120.57(3) F.S.

and Rule 28-110, F.A.C.

Any notice of intent to protest must be filed electronically or via United States (U.S.) mail, courier, or hand delivery at the following address:

Weston McKain Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #15 Tallahassee, Florida 32308-5403 Email: solicitation.questions@ahca.myflorida.com

Any formal protest must be filed within the time prescribed in Section 120.57(3) F.S. and Rule 28-110, F.A.C. Failure to file a protest within the time prescribed in Section 120.57(3), F.S., or failure to post the bond or

AHCA ITN 002-24/25, Attachment A, Page 22 of 26 other security required by law, shall constitute a waiver of proceedings under Chapter 120, F.S.

Any formal protest must be filed with the Agency Clerk, at the address below, or electronically at http://apps.ahca.myflorida.com/Efile/, a link to which can be found on the Agency’s public website.

Agency for Health Care Administration C/O Agency Clerk 2727 Mahan Drive, Mail Stop #3 Building 3, Room 3407C Tallahassee, Florida 32308-5403

After submittal of the Notice of Intent to Protest, all communication regarding the solicitation must be submitted to the Agency’s General Counsel’s Office.

10. Performance Bond

a. A performance bond in the amount of ten percent (10%) of the total annual amount of the resulting Contract shall be furnished to the Agency by the successful respondent within thirty (30) calendar days after execution of the resulting Contract and prior to commencement of any work under the resulting Contract.

b. The bond shall be furnished to the Agency’s Bureau of Purchasing and Contract Administration at:

Bureau of Purchasing and Contract Administration

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop #15

Tallahassee, Florida 32308-5403

c. Thereafter, the performance bond shall be furnished on an annual basis, thirty (30) calendar days prior to the new Contract year and be in the amount of ten percent (10%) of the current annual Contract amount.

d. A copy of all performance bonds shall be submitted to the Agency’s Contract Manager.

e. The performance bond must not contain any provisions that shorten the time for bringing an action to a time less than that provided by the applicable Florida Statute of Limitations. (See Section 95.03, F.S.)

f. No payments will be made to the successful respondent until an acceptable performance bond is furnished to the Agency. The performance bond shall remain in effect for the full term of the http://apps.ahca.myflorida.com/Efile/

AHCA ITN 002-24/25, Attachment A, Page 23 of 26 resulting Contract, including any renewal period. The Agency shall be named as the beneficiary of the successful respondent’s bond.

The bond shall provide that the insurer or bonding company(s) pay losses suffered by the Agency directly to the Agency.

g. The cost of the performance bond will be borne by the successful respondent.

h. Should the successful respondent terminate the resulting Contract prior to the end of the resulting Contract period, an assessment against the bond will be made by the Agency to cover the costs of issuing a new solicitation and selecting a new Vendor. The successful respondent agrees that the Agency’s damages in the event of termination by the successful respondent shall be considered to be for the full amount of the bond. The Agency need not prove the damage amount in exercising its right of recourse against the bond.

11. Contract Execution

a. This solicitation, including all its addenda, the Agency’s written response to written questions, and the successful respondent’s response, including information provided through negotiations, shall be incorporated by reference in the final Contract document.

b. The successful respondent shall perform its contracted duties in accordance with the resulting Contract, this solicitation, including all addenda, the successful respondent’s response to this solicitation, and information provided through negotiations. In the event of conflict among resulting contract documents, any identified inconsistency in the resulting Contract shall be resolved by giving precedence in the following order:

1) The resulting Contract, including all attachments, exhibits and any subsequent amendments;

2) This solicitation, including all addenda; and

3) The successful respondent’s response to this solicitation, including information provided through negotiations.

c. The successful respondent shall be registered with the Florida

Department of State as an entity authorized to transact business in the State of Florida by the effective date of the resulting Contract.

d. The Agency reserves the right to amend the resulting Contract within the scope set forth in this solicitation (to include the original Contract and all attachments) in order to clarify requirements.

AHCA ITN 002-24/25, Attachment A, Page 24 of 26

A.2 Special Terms and Conditions

A. Venue

1. By responding to this solicitation, in the event of any legal challenges to this procurement, respondents agree and will consent that hearings and depositions for any administrative or other litigation related to this procurement shall be held in Leon County, Florida. The Agency, in its sole discretion, may waive this venue for depositions.

2. Respondents (and their successors, including but not limited to their parent(s), affiliates, subsidiaries, subcontractors, assigns, heirs, administrators, representatives and trustees) acknowledge that this solicitation (including but not limited to the resulting Contract, exhibits, attachments, or amendments) is not a rule nor subject to rulemaking under Chapter 120 (or its successor) of the Florida Statutes and is not subject to challenge as a rule or non-rule policy under any provision of Chapter 120, F.S.

3. The exclusive venue and jurisdiction for any action in law or in equity to adjudicate rights or obligations arising pursuant to or out of this procurement for which there is no administrative remedy shall be the Second Judicial Circuit Court in and for Leon County, Florida, or, on appeal, the First District Court of Appeal (and, if applicable, the Florida Supreme Court). Any administrative hearings hereon or in connection herewith shall be held in Leon County, Florida.

4. Attorney’s Fees

In the event of a dispute arising under this solicitation, each party shall be responsible for its own attorneys’ fees, except…