Att_I_-_Pre-proposal_Network_Form_IPRO.docx

This is a Pre-Proposal Network Opportunities Form submission for Request for Proposal 26-87847, issued by the State of Indiana Department of Administration on behalf of the Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning. The RFP seeks an External Quality Review Organization (EQRO) to evaluate quality, timeliness, and access to healthcare services under Indiana's four Medicaid managed care programs: Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging Program. The contractor must be NCQA-certified for HEDIS and CAHPS activities and employ NCQA-certified HEDIS Compliance Auditors. The scope includes mandatory EQR activities—performance measure validation, performance improvement project validation, MCO compliance reviews, and network adequacy validation—plus seven optional EQR activities as directed by FSSA. A pre-proposal conference was scheduled for July 30, 2026 in Indianapolis (in-person and virtual), with written questions due August 5, 2026 and responses posted by August 12. Proposals were due August 26, 2026 at 3:00 PM ET. The contract term is four years from execution with two optional one-year renewal periods available for a potential six-year total. Evaluation was scheduled to begin September 1, with potential oral presentations on September 7 and award recommendation targeted for September 22.

The cost proposal is scored on a 30-point scale using a normalization formula favoring the lowest cost, with all costs captured in a four-year bid amount including position titles and hourly billable rates. An Indiana Veteran Owned Small Business (IVOSB) subcontractor goal of 3 percent of total bid amount is scored up to 6 points, and an additional 5 points are available for Indiana businesses qualifying under the Buy Indiana Initiative. Evaluation criteria total 90 points maximum (91 with bonus), with 50 points for management assessment and quality and 30 for cost. Deliverables include MCO-specific and summary report cards, findings reports with recommendations, data workbooks, quarterly reports, monthly activity/status reports, and an annual technical report due to FSSA by March 1 and to CMS by April 30. The contract includes liquidated damages of $1,000 per day for late or incomplete deliverables with a 10 percent payment withhold pending quarterly performance verification. 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. IPRO, an IVOSB-qualified firm located in Jericho, New York, submitted this optional pre-proposal network form with Edison Machado, MD, MBA, Chief Strategy Officer, as the contact.