AHCA ITN 002-2425_Addendum No.1.pdf

RON DESANTIS

GOVERNOR

JASON WEIDA

SECRETARY

Facebook.com /AHCA Flor ida Twit ter .com/AHCA_FL

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

February 12, 2025

Prospective Vendor(s):

Subject: Solicitation Number: AHCA ITN 002-24/25, Addendum No. 1

Title: Enhanced Provider Network Auditing Program

This addendum to the subject solicitation provides the Agency’s responses to written questions, modifies ITN requirements, and modifies the solicitation timeline in Attachment A, Instructions and Special Conditions.

All other terms and conditions of the solicitation remain in effect.

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 Purchasing and Contract Administration

Enclosures:

Addendum No. 1 Questions and Answers

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AHCA ITN 002-24/25

ADDENDUM NO. 1

AHCA ITN 002-24/25, Addendum No. 1, Page 1 of 1

ITEM 1

Attachment A, Instructions and Special Conditions, Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, is hereby deleted in its entirety and replaced with the following:

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

Anticipated Date for Agency Responses to Written

Questions

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

Deadline for Receipt of Responses

March 11, 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

March 11, 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 31, 2025 – May 5, 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

May 15, 2025 Electronically Posted https://vendor.myfloridamarketplace.com/

ITEM 2

Attachment B, Scope of Services, Section XI., Information Technology, Sub-Section D.

Development Requirements, Item 13., is hereby deleted in its entirety and replaced with the following:

13. Chrome, Firefox, Safari, and Edge are the most commonly used browsers. Internet applications must be compatible with all internet browsers recognized by the World Wide Web Consortium, http://www.w3.org/. The Vendor shall deploy the system to be browser agnostic while keeping up with the most current versions of Internet browser releases in coordination with the Agency’s Division of IT standards. Compatibility is required by the Vendor with all supported versions within six (6) months of the browser’s official release.

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https://vendor.myfloridamarketplace.com/ mailto:solicitation.questions@ahca.myflorida.com https://vendor.myfloridamarketplace.com/ http://www.w3.org/

QUESTIONS AND ANSWERS

# VENDOR NAME

ATTACHMENT

IDENTIFIER

SECTION

IDENTIFIER

SUB-SECTION

REFERENCE

ITEM

REFERENCE

ATTACHMENT

EXHIBIT

PAGE

NUMBER

QUESTION ANSWER

1 Accenture Attachment A A.1. Instructions A. Overview 13.b 6

Will the Agency consider a payment methodology that includes payment for other deliverables, such as a project schedule and initial dashboard design and build, to account for the initial work to be completed by the

Vendor?

No.

2 Accenture Attachment A A.1. Instructions A. Overview 13.b 6

Will the Agency confirm that payment methodologies are not required to be based on reimbursement from the Manage Care Plans for penalties they may incur resulting from non-compliance identified through this work?

Correct, payment methodologies will not be based upon plan non-compliance and payment of penalties.

3 Alliant Health Solutions Attachment B II.B.3.a

3. Sampling

Methodology

Plan

Automated

Reviews N/A 6 of 38

What is meant by automated review? Reports generated from a program algorithm through which plan file submissions are automatically processed in the Vendor's system to determine if metrics are met. Also refer back to Attachment B, Section II., Manner of Service(s) Provision, Sub-

Section B., Services Provided by the Vendor, Item 3., Sampling Methodology Plan, Sub-Item a.

4 Alliant Health Solutions Attachment B II.E.5

E.5 CMS

Network

Adequacy

Validation(NAV)

Reporting

Protocol 4

Validation N/A 20 of 38

Protocol 4 calls for validating network adequacy. The ITN states, “The

Vendor shall coordinate and collaborate with the Agency’s External

Quality Review Organization (EQRO) to conduct the required Centers for Medicare and Medicaid Services (CMS) External Quality Review

(EQR) Protocol 4 Validation of Network Adequacy engagements in the timeframes mandated by CMS.”

Will the EQRO validate the Vendor's work from this Scope of Services, or will the Vendor's results satisfy the requirements in Protocol 4?

The EQRO will review the Vendor's processes and systems data including programming language/specs

(i.e., code), with resultant reports to validate level of confidence in determining network adequacy per the federal Protocol 4 with CMS.

5 Alliant Health Solutions Attachment B II.B.6

6. Analytics and

Dashboards

Analytics, reports, and dashboards

N/A 8-9 of 38

For meeting analytic, reporting and dashboard requirements, will the

Vendor be expected to acquire licenses for the same system applications used by AHCA, e.g., Tableau? If so, what are those applications expected of the Vendor?

The Vendor should propose the best application(s) needed to complete the activities.

6 Deloitte B III. B. 2 N/A

On page 21 of the RFP, the Department notes that all travel expenses must be submitted to the Department for approval prior to them being charged to the Department. Is it the Department's expectation that travel expenses related to this project (for example, in-person visits for the secret shopper program) be submitted to the Department during the course of the project and not be included as part of the vendor's cost submission?

As required in Attachment A, Section B., Response

Preparation and Content, Sub-Section 2., Mandatory

Response Content, Item g., Cost Proposal, the Cost

Proposal submitted by the respondent shall identify all costs and fees associated with providing the services detailed in Attachment B, Scope of Services. Travel costs may also be addressed in the respondent's response to SRC# 3, Reimbursement/Payment

Structure.

7 KPMG Attachment A SRC #7 N/A N/A Exhibit A-4 61 of 169

Are there existing communication protocols with Managed Care Plans that we should integrate into our proposed approach for ensuring remediation of deficiencies?

The Vendor should propose the best approach for ensuring remediation of deficiencies.

8 KPMG Attachment A SRC #4 N/A N/A Exhibit A-4 55 of 169

Are there particular security protocols or standards that the web-based system must adhere to for secure data access and storage?

The Agency has multiple standards that could apply to a web-based system which requires secure access and/or storage. References can include NIST SP 800-

53, Revision 5, 45 CFR, and 60GG, F.A.C.

AHCA ITN 002-24/25 Questions and Answers, Page 1 of 4

# VENDOR NAME

ATTACHMENT

IDENTIFIER

SECTION

IDENTIFIER

SUB-SECTION

REFERENCE

ITEM

REFERENCE

ATTACHMENT

EXHIBIT

PAGE

NUMBER

QUESTION ANSWER

9 KPMG Attachment A SRC #4 N/A N/A Exhibit A-4 55 of 169

To ensure secure and efficient access to the system by all appropriate external users, can you provide detailed information regarding:

1. The specific external user roles (e.g., Agency Staff, Managed Care

Plan Staff, Providers, and other stakeholders) and the anticipated number of users for each role.

2. The concurrency requirements for each external user role, including the expected number of users logged in simultaneously during peak hours.

3. The anticipated peak user volume and the typical user volume during off-peak hours for external users.

4. The secure login protocols or mechanisms required for external users

(e.g., Multi-Factor Authentication, Single Sign-On) and whether different access levels are necessary for different user roles to ensure proper data security and access control.

Currently, system access is intended for Agency staff and potentially plan staff (in a limited capacity). At this time, this is not intended for providers or other stakeholders.

10 KPMG Attachment A Exhibit A-4 N/A N/A Exhibit A-4 50 of 169

Are there any preferred or required tools or platforms for managing and tracking progress for the various activities described (e.g., secret shopper, compliance monitoring)?

The Vendor should propose the best tools or platforms for these items.

11 KPMG Attachment A SRC #5 N/A N/A Exhibit A-4 57 of 169

Besides Excel spreadsheets and dashboards, are there any other preferred methods or enabling tools for presenting the analysis results that the Agency uses or recommends? For example, would interactive web-based reports, PDF summaries, or the use of visualization tools like Tableau be preferred?

The Vendor should propose the best methods or tools for presenting the analysis results.

12 KPMG Attachment A SRC #9 N/A N/A Exhibit A-4 65 of 169

SRC #9 requests “capability to work in parallel on multiple projects, with multiple vendors, and maintain timelines.” How many parallel projects does the Agency anticipate running simultaneously? What are the expected interaction points between these projects in terms of data sharing, reporting, and coordination with multiple vendors and stakeholders?

SRC #9 requests the bidder to demonstrate their capability to manage multiple projects; the number, timing, and interaction of future potential parallel projects with the Agency is unknown at this time.

13 KPMG Attachment B Section II A 1 N/A 3 of 38

Can you provide detailed information on the protocols or methods that will be used to access data from HealthTrack, FMMIS, EDW, and FX modules (e.g., API, SFTP, Direct Database Access)? Additionally, how frequently will these data sets be made available (e.g., real-time, daily, weekly), and in what formats and schemas (e.g., JSON, XML, CSV)?

Finally, will historical data be provided, and if so, how far back will it extend?

Historical data will not be provided.

14 KPMG Attachment B Section II A 1 N/A 3 of 38

Besides HealthTrack, MMIS, EDW, and FX, are there any other systems that the solution needs to integrate with? If so, please specify these systems and provide details on the type of integration required

(e.g., real-time, batch processing). What are the expected data exchange formats and standards for integrating with these additional systems?

The Agency is unaware of additional systems and data exchange formats. The expected data exchange format is unknown. The solution should have the capability to integrate with additional systems if directed by the

Agency.

15 KPMG Attachment B Section II B 7 N/A 9 of 38

Could you provide detailed information on any release schedules, critical deadlines, or go-live dates for EPNA program that we need to consider in our response?

These items may be discussed as part of the negotiation process.

16 KPMG General N/A N/A N/A N/A N/A

Could you please clarify whether the agency prefers to host the EPNA program-related systems within your existing environments, or if you prefer the vendor to host the system in the vendor's environment?

The Vendor should host the system in the Vendor's environment.

17 KPMG LLP Attachment B

B. Services

Provided by

Vendor

1. General

Responsibilities J N/A 4 of 38

Is the state open to leveraging / establishing a Patient and Family

Advisory Council (PFAC) to support the goals of this initiative?

Not at this time.

AHCA ITN 002-24/25 Questions and Answers, Page 2 of 4

# VENDOR NAME

ATTACHMENT

IDENTIFIER

SECTION

IDENTIFIER

SUB-SECTION

REFERENCE

ITEM

REFERENCE

ATTACHMENT

EXHIBIT

PAGE

NUMBER

QUESTION ANSWER

18 Myers and Stauffer LC Attachment A

Submission

Requirements and

Evaluation Criteria

Components

(Technical

Response)

SRC# 6 - Secret

Shopper

8. Description of physical onsite secret shopper approach.

Exhibit A-4 p.11

To what extent should enrollee access to services be validated through physical onsite secret shopper activities? Are onsite secret shoppers expected to book and attend appointments to validate that the services they are seeking are in fact being provided by the provider, or are onsite secret shoppers intended to verify in person providers' addresses, hours of operation, bi-lingual signage, handicap access, etc.?

The latter. The intent of onsite secret shoppers is to verify in person providers' addresses, hours of operation, bi-lingual signage, handicap access, etc.

The Vendor should propose the extent to which onsite secret shopper will be utilized.

19 Myers and Stauffer LC Attachment A

Submission

Requirements and

Evaluation Criteria

Components

(Technical

Response)

SRC# 6 - Secret

Shopper

8. Description of physical onsite secret shopper approach.

Exhibit A-4 p.11

If onsite secret shoppers are expected to book and attend appointments, is the expectation that these appointments be booked and attended by actual Medicaid members seeking services in order to avoid secret shopper activities taking away valuable provider time for simulated service needs?

Please see answer to Question 18.

20 Myers and Stauffer LC Attachment A/

Attachment B

Submission

Requirements and

Evaluation Criteria

Components

(Technical

Response)/Scope of Services

SRC# 8 -

Staffing/B.

Services

Provided by the

Vendor

2. Qualifications and experience/10.

Vendor Staffing

Exhibit A-4 p.15

Are resumes and references required to be included for all proposed team members, or only the Contract Manager, Data Analytics Director, and Secret Shopper Manager? Secret Shopper Staff are listed as Key

Staff in Attachment B, Section II.B.10. In addition, how many references are expected for each person identified as Key Personnel?

Only the Contract Manager, Data Analytics Director, and Secret Shopper Manager. At least two references should be provided.

21 Myers and Stauffer LC Attachment A

Submission

Requirements and

Evaluation Criteria

Components

(Technical

Response)

SRC# 4 - Data and Systems Exhibit A-4 p.7

ITN discusses maintaining a system that “tracks secret shopper activities and results, in real-time, whether completed telephonically or physically onsite.” Please clarify the expected level of real-time tracking.

Does this mean we must geographically track on-site staff or does this mean that activities for the day, when reported, will be available in real-time in dashboards and reports?

It is anticipated that Vendor staff would enter online results of their findings while completing their secret shopper activities (or shortly thereafter if completing onsite). Agency staff should have access to see these online results in real-time.

22 Myers and Stauffer LC Attachment B Scope of Services XI. Information

Technology

D. 13

Development

Requirements

N/A p.31

The scope of work indicates that systems must be compatible with

Internet Explorer, however Internet Explorer has been retired by

Microsoft since June of 2022. Is the vendor expectedt o support the

Agency's use of Internet Explorer or has it been replaced with Microsoft

Edge as the current modern browser?

Please see Addendum No. 1, Item 2.

23 Myers and Stauffer LC Attachment A

Submission

Requirements and

Evaluation Criteria

Components

(Technical

Response)

SRC# 8 -

Staffing 3 Staff Ratio Exhibit A-4 p.15

Please clarify the functional areas of the Enhanced Provider Network

Auditing Program. Are there other functional areas to include in the staff ratio section other than the Data and Systems; Network Analysis and

Reporting; and Secret Shopper?

Refer to Attachment B, Scope of Services. In addition, the Vendor should propose any additional functional areas needed to complete activities.

24 Myers and Stauffer LC Attachment A Instructions A.1

Table 1:

Solicitation timeline

N/A p.3

Due to the complexity and size of this contract and to allow thoughtful comprehesive incorporations of questions/answers, would the State be willing to allow 4 weeks between answers to questions and the submission date?

Please see Addendum No. 1, Item 1.

25 RADcube Attachment B Scope of Services

Provider Network

Auditing

Requirements

Deliverables and

Performance

Standards

Exhibit B-2

Can the Agency elaborate on specific challenges faced with current auditing processes that this program aims to resolve?

Volume of activities and requirements. Lack of staff to perform secret shopper activities. Inability to focus on larger scale targeted review of specific provider specialties.

26 RADcube Attachment A Instructions and

Special Conditions

Response

Preparation

Mandatory

Response

Content –

Technical

Response

Exhibit A-4

Are there any specific tools or platforms currently in use for network auditing that the Agency expects the vendor to integrate with or replace?

Outside of the systems mentioned in Attachment B, Section II, Manner of Service(s) Provisions, Section A., Services provided by the Agency, Sub-Section 1., the

Vendor should propose the best tools or platforms to fulfill the requirements.

AHCA ITN 002-24/25 Questions and Answers, Page 3 of 4

# VENDOR NAME

ATTACHMENT

IDENTIFIER

SECTION

IDENTIFIER

SUB-SECTION

REFERENCE

ITEM

REFERENCE

ATTACHMENT

EXHIBIT

PAGE

NUMBER

QUESTION ANSWER

27 RADcube Attachment B Scope of Services Secret Shopper

Assignments

Requirements for

Simulated

Patient Activities

Exhibit B-1

What historical data on secret shopper activities is available, and are there any gaps in data that have hindered performance evaluation?

Historical data will not be provided. This is a new program, therefore, there are no gaps in data that have hindered performance evaluation.

28 RADcube Attachment A

Response

Evaluation and

Contract Award

Negotiation

Process

Best Value

Determination

What criteria or challenges specific to Florida’s Medicaid program will weigh most heavily in determining “best value” during negotiations?

In accordance with Attachment A, Section A.1, Instructions, Sub-section D., Response Evaluation, Negotiations and Contract Award, Item 7., Selection

Criteria for Determining Best Value, the negotiation team shall establish the selection criteria for determining best value. Criteria weight may be determined by the negotiation team during the negotiation phase.

29 RADcube Attachment B Scope of Services Deliverables Performance

Standards Exhibit B-2

Are there existing bottlenecks or compliance risks in achieving the performance standards outlined in Exhibit B-2?

This is a new program, therefore there are no known bottlenecks or compliance risks in achieving the performance standards.

30 RADcube Attachment B Scope of Services Reporting

Requirements

Data and System

Requirements Exhibit B-1

Are there preferred data visualization or reporting formats the Agency intends vendors to use, and what are the primary pain points in the current reporting process?

The Agency expects that the Vendor will propose the best data visualization and reporting formats. This is a new program.

31 RADcube Attachment A Special Terms and

Conditions

General

Definitions

Disaster

Recovery Plan

What disaster recovery challenges have been encountered in the past, and how should vendors address these in their proposals?

This is a new program, therefore, there have been no disaster recovery challenges in the past.

32 RADcube Attachment B Scope of Services

Data

Management

Requirements

Systems

Integration Exhibit B-1

What are the specific integration challenges the Agency has faced when aligning data from multiple provider networks?

This is a new program, therefore, there have been no integration challenges in the past.

33 RADcube Attachment B Scope of Services IT Infrastructure Security

Standards Exhibit B-1

Does the Agency have a preference for specific security certifications or frameworks, such as SOC 2 Type II or ISO 27001, for vendor systems?

No, so long as it conforms to the contract requirements.

34 RADcube Attachment B Scope of Services

Technical

Integration

Requirements

Legacy System

Compatibility Exhibit B-1

Are there any legacy systems or platforms that must be integrated with the proposed solution, and what are their current limitations?

Please see answer to Question 18.

35 RADcube Attachment B Scope of Services Provider Network

Auditing

Technology

Tools Exhibit B-1

Are there any mandated or preferred technology tools or platforms the

Agency requires for conducting audits, or is the vendor free to propose?

The Agency expects that the Vendor will propose the best tools and platforms for the program.

36 RADcube Attachment B Scope of Services Performance

Standards

SLA

Expectations Exhibit B-2

Are there any historical difficulties in meeting the SLAs outlined, and how does the Agency expect the vendor to mitigate those challenges?

This is a new program, therefore there is no historical data in this area.

37 RADcube Attachment B Scope of Services Deliverables and

Reporting

Compliance and

Risk Monitoring Exhibit B-2

Can the Agency provide details on any recurring compliance risks or violations that should be prioritized in the proposed solution?

This information will not be provided.

AHCA ITN 002-24/25 Questions and Answers, Page 4 of 4