Att G Q&A Responses 8.21.26.xlsx
XLSX spreadsheet 61 KB Posted
- Solicitation number
- 26-87847
- Issued by
- Marion County, Indiana
About this file
This file is a Question and Answer responses document for RFP #26-87847, issued by the Indiana Department of Administration on behalf of the Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning, seeking an External Quality Review Organization (EQRO) contractor to evaluate quality, timeliness, and access to healthcare services under Indiana's four Medicaid managed care programs. The RFP addresses comprehensive external quality review activities including performance measure validation, performance improvement project validation, MCO compliance reviews, network adequacy validation, encounter data validation, quality rating system development, case management evaluation, and workshops and training for five managed care organizations (Anthem, CareSource, MHS, United, and Humana across various programs). Proposals were due August 26, 2026, with written questions due August 5, 2026, and responses posted by August 12. A pre-proposal conference was held July 30, 2026. Best and Final Offer submissions are targeted for January 2027, with award recommendation in February 2027 and anticipated contract start date of July 1, 2027. The contract term is four years from execution with two optional one-year renewal periods available for a potential six-year total. The State expects to award the contract to a single prime contractor.
The cost proposal is scored on a 30-point scale using a normalization formula, with all costs captured in a four-year bid amount; the incumbent contractor is Qsource with a previous contract size of $3,260,699.30. An Indiana Veteran Owned Small Business (IVOSB) subcontractor goal of 3% of total bid amount applies, with scoring up to 6 points (5 base plus 1 bonus), and an additional 5 points are available for Indiana businesses qualifying under the Buy Indiana Initiative. Total evaluation is 90 points maximum (91 with bonus), consisting of 50 points for management assessment and quality and 30 points for cost, with liquidated damages of $1,000 per day for late or incomplete deliverables and a 10% payment withhold pending quarterly performance verification. The contractor must be NCQA-certified for HEDIS and CAHPS activities with NCQA-certified HEDIS Compliance Auditors employed from contract start, maintain HIPAA compliance under a Business Associate Agreement, and comply with Indiana IT security policies including U.S. data center residency, encryption, role-based access, SOC 2 audits, and 24/7 support. All respondents must complete the Indiana Economic Impact Form and must not have had a state contract terminated for failure to perform within the last two calendar years.
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Question & Inquiry Form
| Attachment G | |||||||
| Question and Answer Template | |||||||
| RFP #26-87847 | |||||||
| Please submit your questions in the form below (yellow shaded area) per RFP Section 1.24. | |||||||
| Click the dropdown in the RFP Document Column to select topic. | |||||||
| No. | RFP Document | Section Number | Page | Topic | Question | Responsible Party | State Answers |
| 1 | RFP26-87847 Addendum 1 | Summary of Milestones | 2-3 | Non-Technical - Procurement Schedule | Please confirm the complete controlling procurement schedule. In particular, should the Best and Final Offer and Award Recommendation target dates shown as January 2026 and February 2026 be January 2027 and February 2027, respectively? | IDOA [Answered] | The BAFO will be issued in January 2027, followed by the Award Recommendation in February 2027. |
| 2 | RFP Boilerplate Document | 1.14; Addendum 1 | 11; 1-3 | Non-Technical - Contract Start | Please provide the anticipated contract execution, transition commencement, operational start, and first contract-year dates, including the amount of notice the selected Contractor will receive before work begins. | Program Team | The anticipated notice of award date is February 2027. The anticipated contract start date is July 1, 2027. |
| 3 | RFP Boilerplate Document | 1.14 | 11 | Non-Technical - Contract Term | The RFP Boilerplate specifies a four-year initial term plus two one-year options, while the Executive Summary Operational Analysis describes a one-year base term plus four optional renewals. Please confirm the controlling initial term and number of renewal options. | Program Team | Per RFP Section 1.14 Type and Term of Contract, "The term of the contract shall be for a period of four (4) years from the date of contract execution. There may be two (2) one-year optional years for a total of six (6) years at the State’s option." |
| 4 | RFP Boilerplate Document | 1.14 | 11 | Non-Technical - Award Structure | The State states that it may contract with one or more Respondents. Does FSSA anticipate one statewide EQRO award, multiple awards by activity or program, or multiple awards only as a contingency? | Program Team | The State expects to award a contract to a single prime contractor for these services. |
| 5 | RFP Boilerplate Document | 2.1 and 2.4 | 17-18 and 24-25 | Non-Technical - Proposal Submission | Please confirm the required standalone electronic files, file-naming convention, maximum file size, and whether technical appendices must be separate files or included with Attachment F. | Program Team | Please see response to Question 55. |
| 6 | RFP Boilerplate Document | 3.2.2 | 30-31 | Non-Technical - Evaluation Weighting | Please provide the point allocation or relative weighting within the 50-point Management Assessment/Quality score for the Business Proposal, Technical Proposal sections, staffing, implementation, innovations/value, and any oral presentation. | Program Team | This information is not available at this time. |
| 7 | RFP Boilerplate Document | 2.5 and 3.2.3 | 25 and 31 | Non-Technical - Price Evaluation | Please identify the exact contract periods, activities, optional services, renewal years, travel, and pass-through items included in the Total Cost of Proposal used for the 30-point price score. | Program Team | The contract term will begin on July 1, 2027, with a four year term, with the option to add two additional years (see RFP section 1.14). Per RFP Attachment D: Cost Proposal, no other costs other than those listed will be billable. |
| 8 | RFP Boilerplate Document | 3.2, Step 1 | 30 | Non-Technical - Mandatory Attachments | Step 1 lists “Infrastructure Overview and AI Technical Proposal Questions” as mandatory. Please identify the applicable attachment(s), submission format, and whether AI-related responses are required when the proposed solution does not use artificial intelligence. | IDOA [Answered] | No need to submit if the document/content does not apply to the RFP. |
| 9 | RFP Boilerplate Document | 1.13 | 10-11 | Non-Technical - Site Visits | Please clarify whether Respondent site visits, oral presentations, demonstrations, or in-person meetings are expected and whether associated costs must be included in the proposal price. | Program Team | Oral presentations and demonstrations may be part of the solicitation process. Only work in line with RFP Attachment K: SOW should be included in the respondent's proposal price. |
| 10 | RFP Boilerplate Document | 1.20 and 1.22 | 12-15 | Non-Technical - IVOSB Calculation | Please confirm the dollar base used to calculate the 3% IVOSB commitment and scoring, including whether it includes the full initial term, optional years, travel, ad-hoc work, and other pass-through amounts. | Program Team | Please see response to Question 7. The amount used should match the Total 4 Year Bid Amount in Attachment D, tab 5. Cost Proposal Summary. Per RFP Section 1.22 Indiana Veteran Owned Small Business Subcontractor Commitment (IVOSB), the IVOSB subcontractor amount and Subcontractor percentage is based on the initial term of the contract for scoring purposes only. |
| 11 | RFP Boilerplate Document | 1.2 and 1.22 | 5 and 12-15 | Added Value - IVOSB Valuable Scope Contribution | Please provide examples of EQRO-related goods or services that the State would consider a Valuable Scope Contribution, and describe how the State will determine whether an IVOSB subcontractor serves a genuine value-added purpose on this engagement. | Program Team | Subcontractors must provide support to the responsibilities outlined RFP Attachment K: SOW. The State may follow-up with respondents regarding the scope of their subcontractor's work. |
| 12 | Attachment K - Statement of Work | III.a.i; EQR Activity Protocols | 6-7 | Added Value - Desired Outcomes | The SOW directs the Contractor to build on prior EQRO efforts and actively identify improvement opportunities. What types of added value does FSSA most want beyond minimum compliance—for example earlier risk identification, stronger corrective actions, reduced MCO reporting burden, reusable analytics, benchmarking, or faster decision support? | Program Team | The State would be interested to understand what additional value your team may be able to supply. |
| 13 | Attachment K - Statement of Work | III.a.i; EQR Activity Protocols | 6-7 | Added Value - Priority Improvement Areas | Please identify and rank the current areas in greatest need of improvement, such as data quality, timeliness, performance-measure validation, PIP effectiveness, network adequacy, provider-directory accuracy, care management, health equity, MCO comparison, reporting usability, or corrective-action sustainability. | Program Team | This information can be gathered by reviewing the public facing documents on the State website Quality and Outcomes page. |
| 14 | Attachment K - Statement of Work | III.a.i; EQR Activity Protocols | 6-7 | Added Value - Prior Recommendations | Please provide prior EQRO recommendations, open improvement initiatives, unresolved findings, and known process or data gaps that the selected Contractor should build upon rather than duplicate. | Program Team | See Question 13 |
| 15 | Attachment K - Statement of Work | III.a.i and VII.a.iii | 6-7 and 32-34 | Added Value - Measurement | How will FSSA evaluate proposed improvements and innovations during proposal scoring and contract performance? Please identify desired baselines, outcome measures, benefit-realization periods, and any minimum targets for demonstrating value. | Program Team | Respondents must be capable of performing the Statement of Work. The State will evaluate proposed improvements and innovations in the context of the requirements, based on information provided in the response. Contract performance will be evaluated through the quality and timeliness of deliverables and work, as well as adherence to performance measures outlined in RFP Attachment K: SOW Section VII.a.iii. Contractor Performance Measures. |
| 16 | Attachment K - Statement of Work | III.a.i and IV.a | 6-7 and 24-27 | Added Value - Approval and Pricing | What process, decision authority, and turnaround time will FSSA use to approve Contractor-proposed improvement opportunities, and should implementation effort be included in base pricing, separately priced, or authorized as ad-hoc work? | Program Team | Please see response to Question 57. Any subsequent improvement opportunities that are not included in your proposal would require a Contract amendment and full State approval. |
| 17 | Attachment K - Statement of Work | III.a.i; EQR Activity Protocols | 6-8 | Technical - Existing Resources and Data | Please inventory the existing EQR resources, data sets, templates, repositories, analytic code, dashboards, workpapers, and historical artifacts the State expects the Contractor to reuse, including format, completeness, ownership, and availability dates. | Program Team | Publicly-available information may be found in the Bidder's Library and State transparency portal. The State will coordinate with the awarded Respondent to review other related materials after award. |
| 18 | Attachment K - Statement of Work | II and III.a | 3 and 6-8 | Technical - MCO and Program Baseline | Please provide the current and anticipated number of MCOs by Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and PathWays, including planned market entries, exits, mergers, or program changes during the anticipated contract term. | Program Team | There are currently five MCOs, as follows: |
HHW: Anthem, CareSource, MHS HIP: Anthem, CareSource, MHS HCC: Anthem, MHS, United PathWays: Anthem, Humana, United The State is not able to predict future changes.
| 19 | Attachment K - Statement of Work | III.a.i | 6-8 | Technical - Historical Work Volumes | Please provide at least three years of actual volumes by EQR activity, MCO, program, and deliverable, including reviews performed, records sampled, surveys completed, reports produced, corrective actions monitored, and ad-hoc requests. | Program Team | Prior technical reports may be found here: https://www.in.gov/fssa/ompp/quality-and-outcomes-reporting/. |
| 20 | Attachment K - Statement of Work | III.a.i | 6-8 | Technical - Continuous EQR Cycle | Please provide the current annual EQR calendar and define the artifacts, status information, refresh frequency, and access method required to support the continuous year-round cycle and at-least-quarterly State access. | Program Team | This will be determined in cooperation with FSSA during contract transition. These will be developed and maintained by the EQRO and do not currently exist beyond the information available within the technical reports which are available for review on the State transparency portal. |
| 21 | Attachment K - Statement of Work | III.a.ii.1 | 8-9 | Technical - Report Cards and Comparative Reporting | Please provide current templates or samples for the MCO report card, statewide summary report card, three-year findings reports, annual summaries, and data workbooks, and identify required formats, measures, benchmarks, and comparison groups. | Program Team | This will be determined in cooperation with FSSA during contract transition. These will be developed and maintained by the EQRO and do not currently exist beyond the information available within the technical reports which are available for review on the State transparency portal. |
| 22 | Attachment K - Statement of Work | III.a.iii.1 | 9-10 | Technical - Performance Measure Validation | Please provide the current measure inventory by MCO and program, distinguishing HEDIS, State-defined, CMS-defined, self-reported, audited, and Contractor-calculated measures, along with expected annual changes. | Program Team | This may be found within the Bidder's Library which includes the MCO SOWs, and State Quality Strategy Plan. All of these documents may be referenced on the State transparency portal. |
| 23 | Attachment K - Statement of Work | III.a.iii.2 | 10-11 | Technical - PIP Validation | Please provide the number, topic, program, stage, and anticipated review schedule of current and planned Performance Improvement Projects for each MCO, including any PIPs requiring intensified technical assistance. | Program Team | Please see related CFRs and review documents on the State transparency portal. |
| 24 | Attachment K - Statement of Work | III.a.iii.3 | 11-13 | Technical - Compliance Reviews | Please identify the MCOs and standards scheduled for each year of the three-year compliance-review cycle, the scope of quarterly case-management desk reviews, and the historical frequency and subject matter of State-directed targeted reviews. | Program Team | At present, there are 5 MCOs. Standards are outlined in CMS guidance along with case management desk reviews. The State may additional guidance depending on performance standards. This is not something that has been done historically. |
| 25 | Attachment K - Statement of Work | III.a.iii.4 | 13-16 | Technical - Network Adequacy Volumes | Please provide expected quarterly volumes and sampling assumptions for GeoAccess, online provider-directory audits, secret-shopper surveys, provider access telephone surveys, and the related performance-measure calculation, by MCO, program, specialty, geography, and language. | Program Team | This will be per CFR and all Federal and State governing bodies rules and guidance releases. Documents may be referenced on the State transparency portal. |
| 26 | Attachment K - Statement of Work | III.a.iii.4 | 13-16 | Technical - Survey Operations | Please clarify which party supplies provider lists, member or provider contact data, call scripts, translation and accessibility services, call technology, recordings, and escalation protocols for secret-shopper and telephone surveys. | Program Team | This will be produced quarterly by the MCOs and obtained online. All specifications may be found in State contracts, EQR protocols, and CMS Final Rules. |
| 27 | Attachment K - Statement of Work | III.a.iv.1 | 16-17 | Technical - Encounter Data Validation | Please provide encounter-data volumes, claim and file types, submission frequency, historical rejection or quality issues, anticipated medical-record sample sizes, record-retrieval responsibilities, and the systems and formats used to exchange EDV data. | Program Team | This may be found within the technical report located on the State's transparency portal, EQR protocol guidance, etc. FSSA requires a statistically significant sample and result. |
| 28 | Attachment K - Statement of Work | III.a.iv.4-8 | 17-18 | Technical - Additional EQR Activities | Which focused studies, quality-rating activities, quality-strategy evaluations, or other additional EQR activities does FSSA expect during the first contract year, and which are included in base scope versus activated and priced separately? | Program Team | Focus study topics will be determined by FSSA and shared with the EQRO to discuss feasibility at the time of contract execution. Please see questions 16 and 57 for pricing information. |
| 29 | Attachment K - Statement of Work | III.a.v.1 | 18-19 | Technical - ISCA | Please provide the current ISCA schedule, most recent assessments, open findings, MCO remediation status, systems in scope, and expected first-year assessment volume. | Program Team | This is a mandatory activity woven into Protocols. |
| 30 | Attachment K - Statement of Work | III.a.v.2 | 19-20 and 25 | Technical - Workshops and Training | Please reconcile the SOW narrative describing an annual in-person quality forum with the deliverables table listing monthly training and classes. How many events, attendees, locations, virtual sessions, and training products should be included in base pricing? | Program Team | Annual activities and monthly activities are distinct, as described in SOW section III.a.v.2. Please see questions 16 and 57 for pricing information. |
| 31 | Attachment K - Statement of Work | III.a.v.2 | 19-20 | Non-Technical - Event Costs | Please clarify which party pays for venue, catering, audiovisual services, participant travel, accommodations, printing, and accessibility services for workshops and the annual quality forum. | Program Team | The annual quality forum will be technical based. The need for venue, catering, participant travel, accommodations, and printing is not an expected requirement of the EQRO. |
| 32 | Attachment K - Statement of Work | III.a.v.3-6 | 20-21 | Technical - Case Management, Readiness, CAPs and Ad-Hoc Work | Please provide historical and forecast volumes, typical duration, and staffing expectations for case-management evaluations, MCO readiness reviews, corrective-action-plan monitoring, and ad-hoc projects. | Program Team | This has not been a historical requirement. Staffing will be determined by the EQRO and will be reviewed as a part of cost proposal submission. Proposal will need to meet guidelines outlined in CMS protocols for this measure. |
| 33 | Attachment K - Statement of Work | III.a.v.6 and IV.e | 21 and 31 | Technical - Ad-Hoc Turnaround | Please define the expected size and complexity of work subject to the five-business-day ad-hoc response or report requirement and the process for negotiating a different deadline when data access, MCO response, or scope makes five days impracticable. | Program Team | Ad hoc reporting needs will be on an as needed basis determined by FSSA. |
| 34 | Attachment K - Statement of Work | III.b | 21-23 | Technical - Annual Technical Report | Please provide the current annual technical report template and prior reports, and identify required draft cycles, data cutoffs, accessibility testing, graphics, approval milestones, and responsibilities needed to meet the March 1 FSSA and April 30 CMS deadlines. | Program Team | Prior technical reports may be found here: https://www.in.gov/fssa/ompp/quality-and-outcomes-reporting/. |
| 35 | Attachment K - Statement of Work | III.c and IV.f | 23-25 and 31 | Technical - Deliverable Acceptance | Please define deliverable acceptance criteria, State and MCO review periods, comment-resolution cycles, approval authority, version-control requirements, and whether a deliverable is deemed accepted if comments are not returned within a specified period. | Program Team | Any items not defined in the SOW will be determined with the Contractor during the Contract term. The State reserves the right to make the final determination on all deliverable approval. |
| 37 | Attachment K - Statement of Work | II.c and III.c | 3-5 and 23-25 | Technical - Security Requirements | Please identify applicable IOT Information Security Framework controls, required hosting boundary, encryption and key-management standards, background checks, security training, incident-notification timelines, vulnerability testing evidence, and typical State access-provisioning lead times. | IDOA / IOT | The following link introduces the IOT Information Security Framework: https://www.in.gov/iot/iot-vendor-engagement/. Everyone intending to access ISF policies will need to create an Access Indiana account first. Respondents will be required to sign a Non-Disclosure Agreement (NDA) to access the IOT Information Security Framework. |
| 38 | Attachment K - Statement of Work | III.c | 23-25 | Technical - Accessibility | Please identify the required Section 508 and Indiana accessibility standard and version, required test methods and evidence, VPAT or ACR expectations, remediation timelines, and whether FSSA will provide an accessibility testing environment or review service. | IDOA / IOT | There is currently no testing environment available. |
| 36 | Attachment K - Statement of Work | III.c | 23-25 | Technical - Data Warehouse and Real-Time Access | Please define the required data-warehouse capability, including hosting and architecture expectations, State user roles, data domains, update latency meant by “real-time,” interfaces, retention, export capability, availability, disaster recovery, ownership, and costs to include in the proposal. | Program Team | Please see response to Question 160. |
| 39 | Attachment K - Statement of Work | IV.a.ii and Deliverables Table | 25-27 | Technical - Implementation Plan Timing | The narrative requires a proposed implementation plan within 45 days after contract start, while the deliverables table requires the draft 45 days before contract start and the final 15 days before contract start. Please confirm the controlling deadlines and required inputs available before contract execution. | Program Team | Per RFP Attachment K: SOW Section III.b Deliverables and Deadlines., the implementation plan initial draft is due forty-five (45) days before Contract start and the final draft due fifteen (15) days before Contract start. |
| 40 | Attachment K - Statement of Work | IV.a.i-ii | 26-27 | Technical - Transition and First-Year Work Plan | Please identify activities already in progress at contract start, incumbent transition obligations, knowledge-transfer period, first-year deliverables, and the point at which the new Contractor becomes accountable for deadlines and performance measures. | Program Team | Please see the current EQRO contract on the State's transparency portal |
| 41 | Attachment K - Statement of Work | IV.b and IV.b.1 | 28-30 | Technical - Staffing and Key Personnel | Please clarify required full-time or minimum allocation levels for the Project Director, Medical Records Review Staff Coordinator, licensed clinical reviewers, auditors, analysts, and other key roles, and identify any roles that may be shared across activities or subcontracted. | Program Team | The Contractor will propose the suggested allocations for this project in RFP Attachment D: Cost Proposal. These must meet the minimum requirements as outlined in the RFP Attachment K: SOW Section IV.b.i. Staffing. |
| 42 | Attachment K - Statement of Work | IV.b and IV.b.1 | 28-30 | Technical - Medical Record Review Capacity | Please provide anticipated annual medical-record review volumes by activity and required licensure type, including seasonal peaks, record-retrieval assumptions, over-read requirements, inter-rater reliability standards, and State approval expectations for reviewers. | Program Team | This is determined by CMS guidelines, Federal and State Scope of Practice, and other applicable rules and guidelines. |
| 43 | Attachment K - Statement of Work | III.a.i and IV.b | 6-7 and 28-30 | Technical - Independence and Conflicts | Please define the State’s independence and conflict-of-interest review process, including lookback period, affiliates and subcontractors in scope, work for Indiana MCOs or related entities that must be disclosed, required certifications, and options to mitigate a potential conflict. | Program Team | Please reference Indiana State Ethics Code 42 IAC 1-5-6, IC 4-2-6-6, and any other applicable codes. |
| 44 | Attachment K - Statement of Work | III.a.i and IV.c | 6-7 and 30 | Technical - NCQA and HEDIS Qualifications | Must NCQA-certified HEDIS/CAHPS vendor status and HEDIS Compliance Auditor credentials be held by the Prime at proposal submission, or may they be supplied by an approved subcontractor by contract start? Please identify required evidence and ongoing certification obligations. | Program Team | Per RFP Attachment K: SOW Section II.a Introduction/Intent, the Contractor or Subcontractor must hold these credentials from the start of the contract term, on July 1, 2027. |
| 45 | Attachment K - Statement of Work | IV.c-d | 30 | Non-Technical - Subcontractor Approval | Please describe the pre-award and post-award subcontractor approval process, expected review time, required flow-down terms, circumstances in which FSSA may require removal, and how schedule or cost impacts from a State-directed removal will be handled. | Program Team | Please see RFP section 2.6.3. Time lines are not specifically established. Contractors are responsible for the performance of subcontractors. |
| 46 | Attachment K - Statement of Work | IV.d-e | 30-31 | Technical - State Systems and Tools | Please identify the State-provided SharePoint sites, secure file-transfer methods, collaboration tools, identities, environments, licenses, and interfaces the Contractor must use, together with current data structures, access limitations, and anticipated costs. | Program Team | FSSA would like to review the EQRO's proposed systems for these items to satisfy requirements outlined in SOW. All costs for proposed systems must be included in the cost proposal. |
| 47 | Attachment K - Statement of Work | IV.g | 32 | Technical - KPIs and Modified NPS | Please provide proposed KPI definitions, baselines, targets, measurement periods, exclusions, data sources, and cure rules, plus the modified Net Promoter Score survey population, methodology, minimum response threshold, scoring bands, and default threshold. | Program Team | The State will define all KPI and NPS specifications during contracting using a standard framework. |
| 48 | Attachment K - Statement of Work | IV.h | 33-34 | Non-Technical - Performance Withhold | Please clarify how the 10% withhold is calculated and released by billing period and quarter, how partial performance is treated, which measures control release, and whether there is a review or dispute process before amounts are forfeited. | Program Team | Please see RFP Attachment K: SOW Section VII.a.i Payment Withholds. The State will determine within thirty (30) calendar days of the date of invoice receipt, whether or not the Contractor has fully complied with the requirements and responsibilities appropriate for the months invoiced. If any issue has not been resolved by the Contractor to the State’s satisfaction within ten (10) business days of notice provided by the State, the amount withheld may be forfeited by the Contractor. If the State determines all requirements were met, the State will release the withheld amount for payment on a quarterly basis. On a case-by-case basis, the State may allow exceptions to the withhold if it deems that there were circumstances outside of the Contractor’s control. The Contractor must discuss any such instances with the State and submit a written request to FSSA for detailed review. The State reserves the right to make the final decision on all performance measure determinations. |
| 49 | Attachment K - Statement of Work | IV.i | 33-34 | Non-Technical - Liquidated Damages | Please clarify whether the $1,000 per-day liquidated damage applies per deliverable or per event, when accrual begins and ends, applicable caps and cure periods, exclusions for State/MCO/CMS-caused delay, and whether liquidated damages may be imposed simultaneously with withholds and corrective actions. | Program Team | Per RFP Attachment K: SOW VII.a.iii, "If Contractor fails to submit or complete any deliverable listed below, in a timely, complete, and accurate manner, the Contractor must pay liquidated damages of $1,000.00 per day." This refers to each deliverable/service per day of delay/unsatisfactory quality. Exclusions may be discussed as necessary. Liquidated damages may be imposed simultaneously with other remedies. |
| 50 | Attachment K - Statement of Work | V | 40 | Technical - Turnover | Please provide the expected turnover notice period, incumbent cooperation requirements, required data and artifact formats, successor access, staff-transition expectations, and acceptance criteria for the 15-business-day data transfer. Also clarify which transition costs must be included in base pricing. | Program Team | Please see the current EQRO contract on the State's transparency portal. All transition costs must be included in the cost proposal. |
| 51 | Attachment F Technical Proposal | Technical Proposal Components | 1 | Technical - SOW Attachment Reference | Attachment F repeatedly directs Respondents to Attachment L, but the Statement of Work provided with this solicitation is Attachment K. Please confirm that all Attachment L references in Attachment F should be read as Attachment K. | Program Team | RFP Attachment L was renamed Attachment K. For references to the Statement of Work and its sections made in all attachments (including RFP Attachment F: Technical Proposal), the respondent should refer to the Statement of Work. |
| 52 | Attachment F Technical Proposal | Technical Proposal Components; Sections 3, 4 and 6 | 1 and 5-8 | Technical - Section Cross-References | Attachment F cites SOW Sections III.a.vi, III.a.vii, III.a.viii, VI, and VIII, which do not appear to align with the section structure in the provided Attachment K. Please provide a corrected crosswalk from every Attachment F response section to the controlling SOW section. | Program Team | Please see response to Question 51. |
| 53 | Attachment F Technical Proposal | Submission Specifications | 1-2 | Non-Technical - Technical Proposal Page Limit | Technical proposals greater than 100 pages are “discouraged.” Is 100 pages an enforceable maximum, a preference, or an evaluation consideration, and may a proposal exceeding 100 pages be rejected or receive a lower score? | Program Team | Responses longer than 100 pages will not lead to rejection. However, the review team has allocated time to closely review responses of 100 pages or less. Please refer to RFP Attachment F: Technical proposal Template for information on what is excluded from the page count. Unless otherwise indicated, all parts of a response are included in the page count. |
| 54 | Attachment F Technical Proposal | Submission Specifications | 1-2 | Non-Technical - Page Count Inclusions | Please identify what is included in the discouraged 100-page count, including the cover, table of contents, executive summary, resumes, organization chart, work plans, sample reports, certificates, diagrams, and separately submitted exhibits. | Program Team | Please see response to Question 53. |
| 55 | Attachment F Technical Proposal | Submission Specifications | 1-2 | Non-Technical - Response Format | Attachment F permits Respondents to use a format of their choosing if the prescribed order is maintained, while RFP Section 2.4 cautions against altering the Technical Proposal Template. Please confirm whether Respondents should create a new narrative document following Attachment F’s order rather than entering responses directly into the Attachment F file. | Program Team | Respondents may utilize a format of their choosing for the response to RFP Attachment F: Technical Proposal Template, as long as it follows the prescribed structure. Respondents may not alter any prompts or other requirements in the Technical Proposal Template as part of their format of choice. File size, naming, and pagination should follow a logical approach that ensures clarity for the reader. |
| 56 | Attachment F Technical Proposal | Submission Specifications | 1-2 | Non-Technical - Multiple Technical Files | If the Technical Proposal is divided into multiple files because of file size, please provide any maximum number of files, file-size limits, naming convention, required sequence, and method for cross-referencing exhibits. | Program Team | Please see response to Question 55. |
| 57 | Attachment F Technical Proposal | Response Structure; Sections 1-6(a) | 2-8 | Added Value - Inclusion in Price | Attachment F requests value-add elements that are fully included in the proposed price for each technical section. Will separately priced optional innovations be evaluated, or must every value-add element be included at no additional cost to receive technical credit? | Program Team | Any response item included in the Technical Proposal Template should be included in the pricing in the Cost Proposal exhibit. |
| 59 | Attachment F Technical Proposal | Response Structure | 2 | Technical - AI/ML Readiness Assessment | Please provide the State AI Policy, Agency AI Systems Standard, AI Readiness Assessment questionnaire, required artifacts, review criteria, approval authority, and typical approval timeline applicable to any proposed AI or machine-learning capability. | IDOA / IOT | Please see the "Artificial Intelligence" document attached to this RFP. |
| 60 | Attachment F Technical Proposal | Response Structure | 2 | Technical - AI/ML Proposal Requirements | Must AI/ML readiness artifacts be submitted with the proposal or only after award and before implementation? If a Respondent proposes no AI/ML, is one global statement sufficient, or must “no AI/ML proposed” be stated in every relevant response section? | IDOA / IOT | If the vendor's proposal includes AI, it must be submitted with the RFP. If AI is not relevant, no readiness requirements are necessary. |
| 58 | Attachment F Technical Proposal | Response Structure; Sections 1-6(a) | 2-8 | Added Value - Scoring and Presentation | Please explain how value-add responses will be evaluated within the Management Assessment/Quality score and whether Respondents should provide one consolidated value summary in addition to the six section-level summaries. | Program Team | Please see response to Question 15. |
| 61 | Attachment F Technical Proposal | Response Structure | 2 | Non-Technical - Experience Attribution | For requested experience and proven results, may Respondents rely on the experience of approved subcontractors and proposed key personnel, or must each example be corporate experience performed by the Prime Respondent? Please describe how each type of experience will be evaluated. | Program Team | The response to RFP Attachment F: Technical Proposal may include the experience of the prime or subcontractor fulfilling those specific responsibilities. Please make clear which contractor is fulfilling which duties. |
| 62 | Attachment F Technical Proposal | Section 1(e) - Compliance Review | 3-4 | Technical - Medicare Non-Duplication | Please identify the Medicare Advantage audit and Model of Care review materials that FSSA or the MCOs will provide, the periods eligible for non-duplication, the State’s approval criteria for reliance on those materials, and the Indiana Medicaid elements that must always be independently reviewed. | Program Team | The State is not able to share this at this time. |
| 63 | Attachment F Technical Proposal | Section 1(e) - Compliance Review | 3-4 | Technical - Integrated Care Review Volumes | Please provide anticipated annual case-file and record volumes, sampling requirements, and review criteria for Unified Appeals and Grievances, integrated HRAs, Interdisciplinary Care Teams, Care Coordinator caseload ratios, and active delivery of care coordination for PathWays populations. | Program Team | CMS provides the regulatory framework for these functions. Indiana will therefore establish these specifications directly with the EQRO. |
| 64 | Attachment F Technical Proposal | Section 1(e) - Compliance Review | 4 | Technical - Critical Incident Data Mining | Please identify the claims, encounter, critical-incident, case-management, and clinical data sources available for critical-incident data mining; applicable lookback periods; expected algorithms or indicators; historical volumes; and the process for validating and escalating suspected under-reporting. | Program Team | Please see question 175. |
| 65 | Attachment F Technical Proposal | Section 1(f) - Network Adequacy Validation | 4 | Technical - HCBS Network Adequacy Standards | Please provide the Indiana standards, provider categories, geographic units, member-access assumptions, and calculation methodology to be used when validating capacity and adequacy for HCBS providers that travel to members. | Program Team | This is provided through the bidders library. |
| 66 | Attachment F Technical Proposal | Section 1(g) - Secret Shopper Surveys | 4 | Technical - Dual-Eligibility Verification | Please define the required sampling and validation method for confirming that PathWays providers accept both Medicare and Medicaid and are accepting new members, including the authoritative provider data, required survey frequency, and treatment of providers serving only one program. | Program Team | This framework is defined in the EQR protocols and the State is requesting the vendor to propose solutions. The State has not historically had these populations. |
| 67 | Attachment F Technical Proposal | Section 2(b) - Encounter Data Validation | 5 | Technical - Crossover and Lesser-of Logic | Please provide the applicable Indiana crossover-claim layouts, payment rules, test scenarios, known systemic issues, and expected validation criteria for Medicare-primary/Medicaid-secondary encounters and the “lesser-of” payment logic. | Program Team | The State is not able to share this at this time. |
| 68 | Attachment F Technical Proposal | Section 4(b-e) - Reports/Deliverables | 6-7 | Non-Technical - Work Sample Submission | For requested Report Cards, Findings Reports, Summary Reports, Data Workbooks, implementation plans, transition plans, and annual technical reports, may Respondents submit redacted or publicly available examples, hyperlinks, or excerpts? Please identify required file formats and whether these samples count toward the Technical Proposal page limit. | Program Team | Respondents may submit publicly available examples but not hyperlinks. Excerpts are not allowed but redactions of non-public details are allowed. Primary responses to the Technical Proposal Template should stay within the suggested page limit. However, supplementary items in response to a direct Technical Proposal Template request are not included in the suggested page limit. |
| 69 | Attachment F Technical Proposal | Section 4(f-g) - Annual Technical Reports | 7 | Non-Technical - Annual Report Examples | Attachment F requests a list of reports, two annual technical reports, and the most recent annual technical report. May the most recent report also serve as one of the two required reports, and may reports completed by a proposed subcontractor satisfy this requirement? | Program Team | No. |
The annual technical report must be a separate submission.
Subcontractor submitted reports are also not appropriate for this submission.
| 70 | Attachment F Technical Proposal | Section 4(h) - Legislative Summary Report | 7 | Technical - Legislative Summary Report | Please define the legislative summary report’s required content, audience, frequency, data period, format, accessibility standard, review process, and due date, and confirm whether this is a separate base-scope deliverable from the Annual Technical Report. | Program Team | As defined in Attachment F - please describe vendor's ability to compose concise, clear, and useful information for all parties from information gathered through EQR process. |
| 71 | Attachment F Technical Proposal | Section 4(i) - Report Certification | 7 | Technical - Data and Report Certification | Please define what FSSA means by “certifying” submitted data and reports, including who must sign or attest, required quality-control evidence, applicable professional credentials, and whether certification creates obligations beyond standard Contractor quality assurance. | Program Team | Please describe how the vendor certifies that the data is accurate, complete, and valid. |
| 72 | Attachment F Technical Proposal | Section 5(c-e) - Staffing | 7-8 | Technical - Monthly Staffing Plan | Please provide the State’s expected annual workload assumptions for the required month-by-month staffing plan and clarify whether FTE totals must include management, quality assurance, corporate support, surge resources, and subcontractors. Are named personnel commitments binding at the staffing levels proposed? | Program Team | As defined by the SOW, the vendor must maintain staffing levels sufficient to complete the services and meet the requirements specified in this Contract. The Contractor must be prepared at all times to recruit qualified staff, as required to implement all aspects of the services required in this Contract within the stated timeframes. Corporate overhead may be included within the proposed costs. Named personnel commitments are binding unless otherwise approved by the State. |
| 73 | Attachment F Technical Proposal | Section 5(e) - Staffing | 8 | Technical - Required Staff Training | Please identify all State-mandated training, background screening, certifications, system-access training, renewal frequency, estimated hours, and completion deadlines that Respondents should incorporate into the staffing plan and price. | Program Team | Please refer to section II.C Technical Requirements in the SOW. Please see Question 57 regarding pricing. |
| 74 | Attachment F Technical Proposal | Section 6(b) - EQR Activity Workplan | 8 | Technical - Workplan Requirements | Please provide the required planning horizon, template, minimum task detail, dependencies, milestones, resource fields, review cycle, and first-year start and completion dates for the proposed EQR Activity Workplan. | Program Team | The workplan is to be submitted by the EQRO for State review in accordance with the SOW |
| 75 | Attachment F Technical Proposal | Section 6(c-d) - Transition Plans | 8 | Technical - Transition Examples and Inputs | May implementation and outgoing transition-plan examples be redacted, and do they count toward the page limit? Please also identify the incumbent’s required transition support, materials to be provided, knowledge-transfer period, and State acceptance criteria that Respondents should use in preparing the proposed transition approach. | Program Team | Please see Question 68. Please see the current EQRO contract on the State's transparency portal. All necessary support to successfully complete transition is required. Details of the transition process will be agreed upon with the awarded Respondent. |
| 76 | Attachment F Technical Proposal Template | Technical Proposal Components | 1 | Statement of Work | Please confirm that all references to Attachment L Statement of Work are intended to reference Attachment K. | Program Team | Please see response to Question 51. |
| 77 | Attachment F Technical Proposal Template | 3.i. | 6 | Security | Attachment F instructs respondents to "Confirm your compliance with all applicable Indiana Statewide IT Policies, Procedures & Standards, including security requirements listed in SOW Section VI." However, Section VI pertains to Compliance Requirements/CAPs. Please confirm the reference is intended to be SOW Section II.c. Technical Requirements. | Program Team | Yes, compliance must be followed for the requirements listed in Attachment K: SOW Section II.c Technical Requirements. |
| 78 | Attachment H Reference Form | Reference Check Form Due Date | 1 | Reference Check Form Due Date | The due date indicated on the Reference Check Form is August 26, 2026. However, the RFP indicates the form is due by September 17, 2026. Please confirm the due date is September 17, 2026 and that respondents may edit this in Attachment H prior to sending to clients for completion. | Program Team | The due date is September 17. Please see all posted addenda to the RFP. |
| 80 | Attachment E Business Proposal Template | 2.3.14 | 5 | Payment | This section is titled "Payment" and instructs respondents to provide the requested information in RFP Section 2.3.15. However, RFP Section 2.3.15 pertains to Extending Pricing to Other Governmental Bodies. Please confirm this section is intended to reference RFP Section 2.3.14. | IDOA [Request] | Removed at the request of the agency. |
| 81 | Attachment E Business Proposal Template | 2.3.15 | 5 | Extending Pricing to Other Governmental Bodies | This section references RFP Section 2.3.17. However, this section does not exist. Please confirm this section is intended to reference RFP Section 2.3.15 | IDOA [Request] | Removed at the request of the agency. |
| 79 | Attachment E Business Proposal Template | 2.3.7 | 3 | Registration to do Business | Please confirm this section is intended to reference RFP Section 2.3.7. | Program Team | Please refer to RFP Section 2.3.7 when responding to RFP Attachment E: Business Proposal 2.3.7 Registration to do Business |
| 83 | N/A | N/A | Portal Unit Bid Price | In the procurement portal, there is a line item for respondents' unit bid price. What amount should respondents enter here (e.g., first year total, four year total)? | IDOA [Answered] | Total bid amount of the RFP as a whole. | |
| 84 | Attachment J Attestation Form | 2 | 1 | Contract Terms/Clauses | Please confirm that the row for Contract Terms/Clauses is intended to reference RFP Section 2.3.5 | IDOA [Request] | Correct it is tended to reference RFP Section 2.3.5. |
| 82 | 2.2 | 18 | Submission Form | RFP Section 2.2 and other sections reference a "Submission Form." For instance, RFP Section 2.2 states that "The Executive Summary is to be attached to the Submission Form." There is no attachment titled "Submission Form" and there is no section in the portal with this title. Please clarify. | Program Team | Please see response to Question 171. | |
| 85 | 3.2 | 30 | Attachment M Infrastructure Overview | In RFP Section 3.2, the Mandatory Requirements listed in evaluation Step 1 include respondents' Infrastructure Overview. This appears to reference Attachment M. Is Attachment M expected to be completed and submitted with respondents' proposals? If so, where should it be included? | Program Team | Attachment M is not required for this RFP. | |
| 86 | 3.2 | 30 | Artificial Intelligence | In RFP Section 3.2, the Mandatory Requirements listed in evaluation Step 1 include respondents' AI Technical Proposal Questions. Does this reference the solicitation document titled "Artificial Intelligence?" Is this document expected to be completed and submitted with respondents' proposals? If so, where should it be included? | Program Team | The referenced "AI Technical Proposal Questions" are in the document labeled "Artificial Intelligence". | |
| 87 | N/A | N/A | Incumbent Contractor | Who is the incumbent contractor for this work? | Program Team | The incumbent vendor is Qsource. | |
| 88 | N/A | N/A | Current Contract Size | What is the size of the current contract for this work? | Program Team | The contract size of the previous solicitation was $3,260,699.30 | |
| 89 | III.Scope of Work a.ii.1 | 8 | EQR Activity Deliverables | Please clarify the contents of the Summary Report. The third bullet states that the report summarizes the compliance audit but then notes that the report must cover all EQR activities. Is this report specific to the compliance review activity or all EQR activities? | Program Team | Per the SOW section III.a.ii.1, this report must cover all EQR activities and be submitted annually | |
| 90 | III.Scope of Work a.iii.2 | 9 | Validation of PIPs | How many PIPs are subject to validation per year? | Program Team | Per CFR, at minimum 2 PIPS, 1 clinical and 1 non-clinical, per program per MCO per year will be subject to validation (42 CFR § 438.330) | |
| 91 | III.Scope of Work a.iii.3 | 11 | Ongoing MCO Compliance Reviews | In which contract year is the next comprehensive review to be conducted? | Program Team | Per the SOW, a comprehensive review of each MCO’s compliance with federal regulations described in 42 CFR § 438, submitted every three (3) years. The Contractor may be required to conduct partial reviews annually, as determined by FSSA. | |
| 92 | III.Scope of Work a.iii.3 | 11 | Ongoing MCO Compliance Reviews | Please describe the scope of the partial reviews. | Program Team | See Question # 91 | |
| 93 | III.Scope of Work a.iii.3 | 12 | Ongoing MCO Compliance Reviews | Please provide the frequency of targeted reviews for select additional operational topics. | Program Team | Varies by topic and will be discussed during contracting | |
| 94 | III.Scope of Work a.iii.4 | 13 | Network Adequacy and Availability Validation | This section describes collaboration with the State to develop a provider survey. Will the contractor be responsible for conducting the survey? | Program Team | Yes | |
| 95 | III.Scope of Work a.iv.2 | 16 | Additional Required EQR Activities | How many focused studies will the contractor conduct per year? | Program Team | At minimum two focus studies per year | |
| 96 | Attachment D Cost Proposal Template | N/A | N/A | Cost Proposal | Please confirm that the costs for deliverables 1-5 include all mandatory EQR activities and additional required EQR activities (activities 1-3). | Program Team | No, deliverables 1-5 of Attachment D: Cost Proposal are those listed in RFP Attachment K: SOW Section III.a.ii.1 EQR Activity Deliverables. Deliverables listed outside of this section are also necessary for the completion of mandatory and additionally required EQR activities. |
| 97 | Attachment D Cost Proposal Template | N/A | N/A | Cost Proposal | Is deliverable 6 for the provider survey, secret shopper survey or another type of survey? | Program Team | Deliverable 6 in Attachment D: Cost Proposal refers to the surveys listed in RFP Attachment K: SOW III.a.iii.4 Network Adequacy and Availability Validation and its subsections. |
| 98 | Attachment K Scope of Work | III.a.ii | 6 | Consumer Quality of Care Survey | Will survey be administered or is only validation of data required? | Program Team | Only validation of data. |
| 99 | Attachment K Scope of Work | III.a.ii | 6 | Consumer Quality of Care Survey | Which CAHPS surveys are required? | Program Team | See Question 115 |
| 100 | Attachment K Scope of Work | III.a.ii | 6 | Consumer Quality of Care Survey | What is the mode of survey administration? | Program Team | See Question 115 |
| 101 | Attachment K Scope of Work | III.a.ii | 6 | Consumer Quality of Care Survey | What is the sample size? | Program Team | See Question 115 |
| 102 | Attachment K Scope of Work | III.a.ii | 6 | Provider Quality of Care Survey | Will survey be administered or is only validation of data required? | Program Team | Please see section III.a.ii of the SOW. Administration or validation of consumer or provider surveys of quality of care may also be required. |
| 103 | Attachment K Scope of Work | III.a.ii | 6 | Provider Quality of Care Survey | What survey will be utilized? Is there an existing survey instrument? If yes, please provide. | Program Team | Please see question 110 |
| 104 | Attachment K Scope of Work | III.a.ii | 6 | Provider Quality of Care Survey | What is the mode of survey administration? | Program Team | Per RFP Attachment K: SOW section III.a.ii, the "Administration or validation of consumer or provider surveys of quality of care" may be required by the State. The State will work with the Contractor to determine specific requirements. |
| 105 | Attachment K Scope of Work | III.a.ii | 6 | Provider Quality of Care Survey | What is the sample size? | Program Team | Please see question 108 |
| 106 | Attachment K Scope of Work | III.a.ii | 6 | Provider Quality of Care Survey | Which provider specialties will be surveyed? | Program Team | The State will work with the Contractor to determine the specialties to be surveyed. |
| 107 | Attachment K Scope of Work | III.a.iii.4. | 13/14 | Secret Shopper Provider Directory Survey | Which provider specialties will be surveyed? | Program Team | See question 106 |
| 108 | Attachment K Scope of Work | III.a.iii.4. | 13/14 | Secret Shopper Provider Directory Survey | What is the sample size? (quarterly sample size) | Program Team | The State will work with the Contractor to determine sample sizes. |
| 109 | Attachment K Scope of Work | III.a.iii.4 | 13/14 | Secret Shopper Provider Directory Survey | How many call attempts are required? | Program Team | The State will work with the Contractor to determine required number of call attempts. |
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