Att I -Pre-proposal Network Form RFP 26-87847.docx

This is a Pre-Proposal Network Opportunities Form attachment to 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 encompasses mandatory EQR activities including performance measure validation, performance improvement project validation, MCO compliance reviews, and network adequacy validation, plus seven optional EQR activities. Proposals are due August 26, 2026 at 3:00 PM ET, with a pre-proposal conference scheduled for July 30, 2026 in Indianapolis (available in-person and virtually). Written questions are due August 5, 2026 with responses posted by August 12. Evaluation begins September 1 with potential oral presentations September 7 and award recommendation targeted for September 22. The contract term is four years from execution with two optional one-year renewal periods available for a potential six-year total.

Deliverables include MCO-specific and summary report cards, findings reports with recommendations, data workbooks, quarterly reports, monthly activity and status reports, and an annual technical report due to FSSA by March 1 and to CMS by April 30. 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 (5 base plus 1 bonus). An additional 5 points are available for Indiana businesses qualifying under the Buy Indiana Initiative. The contractor must demonstrate HIPAA compliance under a Business Associate Agreement and comply with Indiana IT security policies and data residency requirements in U.S. data centers with encryption, role-based access, SOC 2 audits, and 24/7 support. Liquidated damages of $1,000 per day apply 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.