Amendment 1 Questions and Answers-RFP 27054 Amendment 1 Questions and Answers MAC 7.28.26.pdf

State of Hawaii

Department of Health

Executive Office on Aging

Request for Proposals

Solicitation #RFP-27-054

Medicaid Administrative Claiming Support

Amendment 1 – Questions and Answers

1. Does the State of Hawaii have an approved Medicaid Administrative Claiming guide with federal CMS?

Yes, Hawaii has an approved Cost Allocation Plan (CAP).

2. If so, can you please provide the approved guide, or the location for the approved guide for review?

The State will not be providing its internal MAC Operations Manual as part of this procurement. The awarded contractor will receive the CAP after award. See Section

2.4.F.

3. If not, can you please provide the currently used guidance for the administration of the MAC program?

These materials are not being released as part of this procurement. Offerors should base their proposals on the requirements contained within this RFP.

4. What is the first quarter of MAC claiming that the awarded vendor will be responsible for?

The awarded Contractor is expected to be responsible for the October 1, 2026 through

December 31, 2026 Medicaid Administrative Claiming quarter. See Section 2.4.F.

5. Is there a vendor currently performing the scope of work and if so, who is the vendor?

No. There is not a current contractor performing these services.

6. (Ref. 2.1.A) For the twice daily stratified RMS, does the agency have a preference on how the stratification occurs? Moments sent at the same time each day to a randomly selected group, or moments sent during two time periods (i.e., morning and afternoon) but the times themselves are random?

The State's preference is that each participant receive one randomly generated moment during the morning portion of their workday and one randomly generated moment during the afternoon portion of their workday. The specific times should be randomly generated within those two periods.

7. What is the variable currently used to determine the different stratified samples?

The current methodology stratifies the sample by time of day (morning and afternoon) within each participating agency's operating hours.

8. How are a participant's moments determined to occur twice within a day?

Each participating staff member receives one randomly generated moment during the morning portion of the workday and one randomly generated moment during the afternoon portion of the workday.

9. What information is currently collected for an individual participant's work schedule?

The Contractor will receive work schedule information necessary to administer the

Random Moment Sampling process, including each participant's scheduled workdays and normal working hours.

10. (Ref. 2.3) Modern RMTS systems can generate samples at any designation and interval (i.e., stratified, fully random, bi-weekly, etc.). Please confirm the State's priority is Medicaid administrative claiming and time study administration expertise when evaluating vendors.

Yes. The State's primary objective is implementation and administration of a federally compliant Medicaid Administrative Claiming program. Proposals will be evaluated in accordance with the evaluation criteria set forth in Section 4 of the RFP. See Section 2.3 for minimum requirements.

11. In the Orientation call, you mentioned a 5% oversight responsibility by the State.

Can you please explain what that 5% oversight is regarding?

The reference pertains to review of approximately five percent of Random Moment

Sampling responses as part of the quality assurance process conducted by EOA and participating agencies. The Contractor is expected to support this review process.

12. (Ref. 2.4.B.8) This item requires the vendor to "Support a monthly five percent quality assurance review process conducted by participating agencies and EOA." Is this a 5% QA review of moment responses or is this related to the Medicaid

Administrative Claim calculation?

The five percent quality assurance review refers to a review of Random Moment

Sampling responses and associated documentation. It does not refer to review of the quarterly Medicaid Administrative Claim calculation.

13. (Ref. 2.4.A.9) This item requires the vendor to "Develop and implement enhancements to the RMS or cost allocation system." What cost allocation system is the agency referring to?

The reference to the cost allocation system refers to the processes and tools used to develop the quarterly MAC cost pool and claim calculation.

14. (Ref. 2.4.B.6) This item requires the vendor to "Submit draft quarterly claim packages to EOA in accordance with timelines established by EOA." Can the agency please provide the anticipated timelines following each quarter-end for submission of draft claim packages to EOA?

Timelines will be established by EOA in coordination with the Contractor. Draft quarterly claim packages shall be submitted in accordance with timelines established by EOA after receipt of all required time study and cost pool data. See Section 2.4.F.

15. Will EOA provide participant payroll/expenditure data in a standardized format, or does the Contractor need to collect and normalize cost data from each participating agency?

EOA and participating agencies will provide expenditure information. The Contractor will be responsible for collecting, validating, and utilizing the information necessary to develop the quarterly claim in accordance with the Scope of Work. The format of expenditure information may vary among participating agencies.

16. Does the State currently use any RMS or MAC platform, and if so, will historical

RMS data or claim documentation need to be migrated into the new solution?

EOA does not currently utilize an RMS or MAC platform. As a result, historical RMS data migration is not anticipated under this procurement.

17. What specific security standards (e.g., FedRAMP Moderate, SOC 2, HIPAA/HITECH) must the hosted RMS application meet for State approval?

The hosted solution must comply with all applicable federal and State laws, regulations, and security requirements applicable to the services being provided, as well as the requirements identified in the RFP. The State has not prescribed a specific security certification (e.g., FedRAMP or SOC 2). See Sections 2.4.A.2 and 2.4.A.7

18. Please confirm the expected number of participating agencies and individual RMS participants at go-live, as well as any anticipated growth over the initial two-year contract term, so we can appropriately size licensing and infrastructure.

At implementation, EOA anticipates approximately 6 participating agencies and approximately 40 Random Moment Sampling (RMS) participants. During the contract term, participation is expected to increase to approximately 8–12 participating agencies and 50–80 RMS participants. These values are estimates only and may change during the contract term. See Section 2.1.A.

19. Can the agency provide information on how the budget amount was determined?

Are all expected scope items and deliverables outlined in the RFP?

The budget represents the State's independent estimate of the anticipated cost to perform the complete Scope of Work over the contract term, including implementation activities.

Offerors should propose the costs necessary to perform the required services. All expected deliverables are identified in the RFP.

20. May recurring SaaS licensing and cloud hosting expenses be invoiced as direct contract costs under the cost-reimbursement model, or should they be embedded within indirect or fixed-price line items?

Allowable costs may be reimbursed in accordance with the cost-reimbursement provisions of the resulting contract and applicable State cost principles. Offerors should include all proposed costs in their Cost Proposal and Budget Narrative in accordance with

Section 3.10 of the RFP. Exact invoicing procedures will be determined at contract commencement.