RFP 27-88284

ATTACHMENT K

STATEMENT OF WORK

I. EXECUTIVE SUMMARY

This Statement of Work defines the services required by the Contractor to support the Bureau of Better Aging, part of the Indiana Family and Social Services Administration’s Division of Disability, Aging and Rehabilitative Services in modernizing, implementing, operating, and transitioning Medicaid Administrative Claiming (MAC) processes. The Contractor will update the MAC framework, develop and pilot new tools, conduct operational activities for an initial two-year period, and ensure the State is prepared for long-term operational sustainability. The State may, at its discretion, extend the Contract beyond the initial two-year term if continuation of services is determined to be the most appropriate course of action. The term will be two years.

II. BACKGROUND AND CURRENT STATE

The Bureau of Better Aging oversees MAC activities performed by the Area Agencies on Aging (AAAs), the State Long Term Care Ombudsman, and other participating partners. MAC supports federally allowable administrative activities that promote proper and efficient Medicaid program administration.

To improve accuracy, compliance, transparency, and statewide consistency, the State is modernizing the MAC infrastructure. The Contractor will support redesign and deployment of updated processes, pilot new tools, operate MAC functions for the two-year base period, and may be required to continue such activities should the State elect to extend the Contract.

III. SCOPE OF WORK

a. Objectives of the Engagement

1. Modernize the MAC administrative and operational framework.

2. Implement and pilot revised time study tools and methodologies.

3. Develop standardized cost reporting and cost pooling processes.

4. Strengthen AAA monitoring and quality improvement through MAC data.

5. Operate MAC functions for the initial two years term, with the potential for continued operations during any State approved extension.

6. Onboard additional agencies upon FSSA direction.

7. Prepare the State for long-term sustainability.

b. Deliverables and Deadlines

1. Updated activity catalog

2. Time study methodology and tool

3. Training materials

4. Cost reporting templates and guidance

5. Monthly and quarterly operational reports

6. Evaluation summaries

7. Recommendations

8. Transition documentation

9. Knowledge transfer materials

10. Specific due dates for the deliverables will be established in the approved project management plan and will apply during the initial two-year term and any approved extensions.

c. Payment Milestones Payments will be tied to acceptance of Contract deliverables. If IV&V is employed, IV&V approval will be required before payment is issued. This requirement applies to deliverables produced during the initial term and any Contract extensions.

IV. PROJECT MANAGEMENT

a. Project Management Plan The Contractor will prepare a detailed project management plan outlining timelines, deliverables, staffing resources, communication protocols, and risk-mitigation activities applicable to the two-year period and any State-approved extension. The plan shall acknowledge the State’s right and responsibility to review, propose revisions, and formally approve the project plan before implementation.

b. Key Persons The Contractor and the State will each designate key roles responsible for the oversight and execution of the Contract throughout the initial two years term and any State authorized extensions.

c. Document Management All documentation will be maintained in accordance with State requirements and made accessible throughout the full duration of the Contract, including during any extensions.

d. Status Updates and Reporting The Contractor will provide required updates and participate in all meetings scheduled for the initial year and any period of extension.

V. INDEPENDENT VALIDATION AND VERIFICATION

If the State elects to include IV&V services, the Contractor will copy the IDOA IV&V Team on all project communications and provide access to all project documents, deliverables, and tools throughout the two-year term and any extensions the State elects to exercise.

VI. COMPLIANCE REQUIREMENTS

The Contractor shall comply with all applicable federal and State laws, regulations, and policies governing Medicaid Administrative Claiming throughout the initial term and any extended term of the Contract.

VII. KEY PERFORMANCE INDICATORS

The State will establish Key Performance Indicators (KPIs) to assess the Contractor’s delivery of MAC modernization and operational services. These KPIs will be finalized collaboratively during the initial stages of the Contract as project artifacts and operational processes are defined. At a minimum, KPIs will include:

a. Timeliness of Deliverables, including submission of modernization deliverables, operational reports, and implementation materials according to the approved project plan. Submission will be 95% on time as compared to the approved project management plan.

b. Quality and Federal Compliance of Deliverables, including accuracy of the updated time study tool, guidance documents, cost‑reporting instructions, and training materials.

c. Operational Reliability, including execution of MAC claiming cycles within federally recognized timeframes, delivery of error‑free claims files, and adequate documentation of operational decisions.

d. Stakeholder Support, including technical assistance provided to AAAs and other MAC participants within federally recognized timeframes and to adequate standards.

e. Budget and Resource Stewardship, including adherence to approved budget parameters and efficient use of resources under the Contract.

f. Remedies for Non-Performance If KPIs are not met, a Corrective Active Plan (CAP) may be required or for significant under performance, payment delay may be instituted.

I. END OF CONTRACT TRANSITION AND TURNOVER

At the conclusion of the initial two-year term or any State-approved extension, the Contractor shall complete a full transition of MAC responsibilities to the State. Transition and turnover activities shall include:

a. Transfer of all tools, templates, training materials, documentation, methodologies, reports, and any artifacts developed or used during the Contract term, including during any extension.

b. Conducting structured knowledge‑transfer sessions with FSSA staff covering all MAC processes, including updates developed during any extension.

c. Supporting operational handover to ensure uninterrupted MAC functions as the State assumes full responsibility at the end of the Contract, whether after two years or following an approved extension.

d. Providing written recommendations to support the State’s long‑term MAC operations.

e. Submitting a final transition report summarizing turnover activities, readiness assessments, outstanding items, and confirmation that all transition requirements have been fulfilled.