Attachment A - Model Contract - Amended.docx

COMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

ONE ASHBURTON PLACE

BOSTON, MA 02108

ATTACHMENT A

MODEL CONTRACT-AMENDED

between

THE EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

and

[CONTRACTOR]

For

MEMBER EXPERIENCE SURVEY ADMINISTRATION, ANALYSIS AND REPORTING

[Date]

This Contract is by and between the Massachusetts Executive Office of Health and Human Services (EOHHS) and [CONTRACTOR].

WHEREAS, EOHHS is the single state agency responsible for the administration of the Medicaid program and the State Children’s Health Insurance Program within Massachusetts (collectively, MassHealth) and other health and human services programs designed to pay for medical services for eligible individuals pursuant to M.G.L. c. 118E, Title XIX of the Social Security Act (42 U.S.C. sec. 1396 et seq.), Title XXI of the Social Security Act (42 U.S.C. sec. 1397aa et seq.), and other applicable laws and waivers;

WHEREAS, EOHHS desires to contract with an entity to administer surveys to MassHealth members about their health care experience and analyze and report on the results of such surveys to EOHHS;

WHEREAS, EOHHS issued a Request for Responses on [DATE] to procure an entity to perform such services;

WHEREAS, on [DATE], EOHHS selected the Contractor, based on the Contractor’s response to the RFR, submitted on [DATE]; and WHEREAS, the Contractor appears qualified and is willing to perform its duties as set forth herein subject to the terms and conditions thereof;

NOW THEREFORE, in consideration of the mutual covenants and agreements contained herein, EOHHS and the Contractor agree as follows:

TABLE OF CONTENTS

Member Experience Surveys Amended and Restated Contract APPENDIX 1: Budget

DEFINITIONS

The following terms appearing capitalized throughout this Contract and appendices have the following meanings unless the context clearly indicates otherwise.

Accountable Care Organizations (ACOs) – Entities that have contracted with EOHHS to enter into population-based payment models with payers, wherein the entities are held financially accountable for the cost and quality of care for an attributed Member population. MassHealth has two different ACO models.

· Accountable Care Partnership Plan (ACPP): A network of primary care providers who have exclusively partnered with a single managed care organization to use the managed care organization’s provider network to provide integrated and coordinated care for members.

· Primary Care ACO (PCACO): A network of primary care providers who contract directly with MassHealth, using MassHealth’s provider network, to provide integrated and coordinated care for members. Members who enroll in a Primary Care ACO receive behavioral health services through MassHealth’s behavioral health carve-out vendor.

Behavioral Health Services – Services provided to persons in an ambulatory, home, school, hospital, community health center, practitioner’s office, or other setting that focus primarily on mental health and substance use disorders.

Centers for Medicare and Medicaid Services (CMS) – The federal agency under the U.S. Department of Health and Human Services responsible for administering the Medicare and Medicaid programs under Titles XVIII and XIX of the Social Security Act.

Children’s Health Insurance Program (CHIP) – A program under which a state receives federal funding to provide child health assistance to uninsured, low-income children that meets the requirements of Section 2103 of the Social Security Act. In Massachusetts, Medicaid and CHIP are combined into one program known as MassHealth.

Children with Chronic Conditions (CCC) Supplemental Items – survey questions for the population of children with chronic conditions that are included in a version of the CAHPS child survey.

Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) – A CAHPS survey of Adults and Children that assesses experience with health care providers and staff in doctors’ offices.

CMS Manuals – CMS guidance and requirements provided to States regarding Adult and Child Core Set CAHPS results. For purposes of this Contract, there are two CMS Manuals: 1) Core Set of Adult Health Care Quality Measures for Medicaid (Adult Core Set): Technical Specifications and Resource Manual, and 2) Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP (Child Core Set): Technical Specifications and Resource Manual. The CMS Manuals that shall apply for purposes of this Contract are those corresponding to the applicable reporting period.

Commonwealth Data – All data used or owned by EOHHS or the Commonwealth to which the Contractor gains access through a contract resulting from this RFR.

Complete and Eligible Survey – A Core Set Survey interview that is eligible for inclusion in final survey data, pursuant to CMS Manuals.

Consumer Assessment of Healthcare Providers and Systems (CAHPS) – A series of standard surveys completed by individuals receiving health care services assessing quality of care provided to those individuals in various ambulatory and institutional settings. (Reference: CAHPS Patient Experience Surveys and Guidance | Agency for Healthcare Research and Quality) Consumer Assessment of Healthcare Providers and Systems (CAHPS) for CMS Core Measure Set Reporting – All activity associated with administration of the CAHPS (Medicaid) Adult survey and CAHPS (Medicaid) Child survey, including Children with Chronic Conditions, (CCC) Supplemental Items to a sample of eligible Members, and conducted per CMS Manuals.

Contract – This agreement executed between EOHHS and the Contractor pursuant to the RFR and any amendments thereto.

Contractor – The entity that enters into an agreement with EOHHS for the provision of services described in the Contract. All requirements applicable to the Contractor, herein, also shall be applicable to the Contractor’s employees and subcontractors.

Core Set Surveys – The versions of the CAHPS (Medicaid) Adult survey, and Child survey, including Children with Chronic Conditions Supplemental Items, pursuant to the CMS Manuals for the corresponding Measurement Year.

Deliverable – Deliverable means any work product that Contractor delivers for the purpose of fulfilling its obligations to EOHHS.

Enrollee – Refers to a Member enrolled in a managed care health plan.

Executive Office of Health and Human Services (EOHHS) – The executive agency within Massachusetts that is the single state agency responsible for the administration of the MassHealth program (Medicaid), pursuant to M.G.L. c. 118E, Titles XIX and XXI of the Social Security Act, and other applicable laws and waivers thereto.

Managed Care Organization (MCO) – any entity, contracted with EOHHS as an MCO at any time during a measurement period, which is approved by the Commissioner of the Massachusetts Division of Insurance as a Health Maintenance Organization (HMO), or is organized primarily for the purpose of providing health care services to MassHealth Members.

MassHealth – The Medicaid and CHIP programs of the Commonwealth of Massachusetts, administered by EOHHS pursuant to M.G.L. c. 6A, § 16, M.G.L. c. 118E, Titles XIX and XXI of the Social Security Act, and other applicable laws and waivers thereto.

Measurement Year (MY) – The year that Members received services for which Member survey data is being collected. Surveys for a specific MY are fielded in the following year (e.g., surveys sent during calendar year 2026 will be for MY2025).

Medicaid Expansion CHIP – A program under which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of Section 2103 of the Social Security Act. Massachusetts has authority under its CHIP State Plan to cover children who are uninsured at application and who have income over the Medicaid limit and generally up to 150% FPL (income limits vary by age) with Standard benefits through Medicaid expansion CHIP.

Member – A person determined by EOHHS to be eligible for MassHealth.

Member Experience Surveys – The PC and CAHPS for Core Measure Set Reporting surveys conducted among Enrollees including all associated activities.

Primary Care (PC) – The provision of coordinated, comprehensive medical services, on both a first contact and a continuous basis, to a Member. The provision of Primary Care incorporates an initial medical history intake, medical diagnosis and treatment, communication of information about illness prevention, health maintenance, and referral services.

Primary Care Provider (PCP) – The individual primary care provider or team selected by or assigned to the Member to provide and coordinate all of the Member’s health care needs and to initiate and monitor referrals for specialty services when required. PCPs include nurse practitioners practicing in collaboration with a physician under Massachusetts General Laws Chapter 112, Section 80B and its implementing regulations or physicians who are board certified or eligible for certification in one of the following specialties: Family Practice, Internal Medicine, General Practice, Adolescent and Pediatric Medicine, or Obstetrics/Gynecology.

Primary Care Member Experience Survey (PC Survey) – The PC Survey conducted among Enrollees including all associated activities.

Progress Reports – Information provided by the Contractor on the Contractor’s activities under this Contract.

Separate CHIP – A program under which a state receives federal funding to provide child health assistance to uninsured, low-income children that meets the requirements of section 2103 of the Social Security Act.

Survey Complete – A PC Survey that has at least 50% of non-skippable items completed.

Survey Cycle 2025 – All activity associated with the administration of the PC Survey, and the Core Set Surveys to samples of eligible MassHealth Members for the period of January 1, 2024 – December 31, 2024, defined as Measurement Year 2024.

Survey Cycle 2026 – All activity associated with the administration of the PC Survey, and the Core Set Surveys to samples of eligible MassHealth members for the period of January 1, 2025 – December 31, 2025, defined as Measurement Year 2025.

Survey Cycle 2027 – All activity associated with the administration of the PC Survey, and the Core Set Surveys to samples of eligible MassHealth members for the period of January 1, 2026 – December 31, 2026, defined as Measurement Year 2026.

Survey Cycle 2028 – All activity associated with the administration of the PC Survey, and the Core Set Surveys to samples of eligible MassHealth members for the period of January 1, 2027 – December 31, 2027, defined as Measurement Year 2027.

CONTRACTOR RESPONSIBILITIES

The Contractor, in consultation with EOHHS, shall administer two surveys, and shall analyze and report on the results of such surveys to EOHHS and/or CMS for each Measurement Year of the Contract Term, as set forth herein. The two surveys are the following:

· The PC Survey according to the specifications set forth in this Section 2.

· CAHPS for CMS Core Measure Set Reporting. The Contractor shall administer the Core Set Surveys pursuant to the CMS Manuals and as otherwise directed by EOHHS.

Surveys Survey Populations PC Survey For Survey Cycle 2026, the Contractor shall administer one adult version and one child version of the PC Survey to samples of Members as described in Section 2.1.B, to (1) ACO Enrollees who received primary care services from an ACO-affiliated PCP and (2) MCO Enrollees who received primary care services from an MCO-affiliated PCP as follows.

Population #1: Adult (ages 18-64 years); and Population #2: Child (ages < 18 years) For Survey Cycle 2027, the Contractor shall administer one adult version and one child version of the PC Survey to samples of Members as described in Section 2.1.B, to (1) ACO Enrollees who received primary care services from an ACO-affiliated PCP, and (2) MCO Enrollees who received primary care services from an MCO-affiliated PCP as follows.

0. Population #1: Adult (ages 18-64 years); and Population #2: Child (ages < 18 years) For Survey Cycle 2028, the Contractor shall administer one adult version and one child version of the PC Survey to samples of Members as described in Section 2.1.B, to (1) ACO Enrollees who received primary care services from an ACO-affiliated PCP, and (2) MCO Enrollees who received primary care services from an MCO-affiliated PCP as follows.

0. Population #1: Adult (ages 18-64 years); and Population #2: Child (ages < 18 years) CAHPS for CMS Core Measure Set Reporting The Contractor shall administer the Core Set Surveys to samples of MassHealth Adult and Child Members as described in Section 2.1.B, and as further specified in CMS Manuals and pursuant to further direction from EOHHS.

Sampling

0. PC Survey The Contractor shall draw random samples of Members from the populations described in Section 2.1.A for each survey to obtain Survey Completes for the Contract Term, and as further directed by EOHHS. Subject to EOHHS approval, the Contractor shall determine the random sample size based on expected response rates to meet approximate volume of Survey Completes.

0. For Survey Cycle 2026, the Contractor shall survey at a level to achieve approximately 15,200 Survey Completes as follows and as directed by EOHHS.

0. Approximately 400 adult and 400 child surveys each for 17 ACOs, for a total of approximately 13,600 Survey Completes.

0. Approximately 400 adult and 400 child surveys each for 2 MCOs, for a total of approximately 1,600 Survey Completes.

0. For Survey Cycle 2027, the Contractor shall survey at a level to achieve approximately 15,200 Survey Completes as follows and as directed by EOHHS.

0. Approximately 400 adult and 400 child surveys each for 17 ACOs, for a total of approximately 13,600 Survey Completes.

0. Approximately 400 adult and 400 child surveys each for 2 MCOs, for a total of approximately 1,600 Survey Completes.

0. For Survey Cycle 2028, the Contractor shall survey at a level to achieve approximately 15,200 Survey Completes as follows and as directed by EOHHS.

1. Approximately 400 adult and 400 child surveys each for 17 ACOs, for a total of approximately 13,600 Survey Completes.

1. Approximately 400 adult and 400 child surveys each for 2 MCOs, for a total of approximately 1,600 Survey Completes.

CAHPS for CMS Core Measure Set Reporting

0. The Contractor shall administer the Core Set Surveys to samples of eligible Adult and Child MassHealth Members, in accordance with the requirements and guidance set forth in the CMS Manuals.

0. At EOHHS’ discretion, and subject to EOHHS approval, the Contractor shall oversample, if necessary, to achieve Complete and Eligible Surveys as described in this Section and in accordance with the requirements and guidance set forth in the CMS Manuals.

CAHPS for CMS Core Measure Set Reporting: Sample

Sample

(ages 18-64)

PC Survey: Interviews and/or Focus Groups At EOHHS’s discretion, the Contractor shall conduct up to 20 interviews and 2 focus groups (which may be conducted in person or by telephone) during each Measurement Year of the Contract Term, as directed by EOHHS, with up to 10 Members per focus group, with Members who are eligible to receive a PC Survey.

Completion of work is dependent on EOHHS identifying topics and Members and approving interview/focus group guides. Topics may include capturing consumer input to inform surveys, such as testing new questions for inclusion in the survey. EOHHS and the Contractor agree to work together to adjust the timeline accordingly.

0. The Contractor shall:

0. Recruit Members in accordance with mutually agreed-upon protocol(s) that are subject to EOHHS’s approval,

0. Conduct the interviews/focus groups,

0. Audio-record and transcribe interview/focus group data, with recording practices consistent with applicable state and federal privacy laws and regulations,

0. Provide a stipend to Members who complete interviews/focus groups,

0. Qualitatively analyze interview/focus group data, and

0. Summarize findings in a report to EOHHS.

0. The Contractor shall draft and finalize interview and focus group guides, in collaboration with EOHHS and subject to EOHHS’s approval, on a mutually agreed upon timeline.

0. Administration Protocols In collaboration with EOHHS, the Contractor shall review implementation protocols for administering the surveys for each Measurement Year of the Contract Term (e.g., number of times each Member is contacted, member outreach and data collection method(s) used).

1. The Contractor shall administer the PC Survey: by mail and email invitation; paper and web based surveys.

1. The Contractor shall administer CAHPS for CMS Core Measure Set Reporting following mutually agreed-upon protocols as detailed in the CMS Manuals.

0. Timing

2. PC Survey

0. The Contractor shall administer the PC Survey described in this Section 2.1 during the Contract Term, as described in Section 2.3, and as otherwise directed by EOHHS.

0. The Contractor shall ensure that specifications for fielding the survey (e.g., frequency, time period, etc.) allow for valid comparisons to previous survey years when possible.

2. CAHPS for CMS Core Measure Set Reporting

0. The Contractor shall administer the surveys described in this Section 2.1 during the Contract Term, as described in r and in accordance with all timeframes and dates as indicated in the CMS Manuals and as further specified by EOHHS.

0. Contractor Performance Specifications

1. Project Management

1. Work Plans and Timelines For each Measurement Year of the Contract Term, the Contractor shall develop, manage, and make available to EOHHS a detailed, comprehensive project work plan in accordance with Section 2.3, encompassing each of the surveys described in Section 2.1. The work plan shall include the following:

0. Timing, assumptions, and task detail for administration of the surveys;

0. If applicable, incorporation of stakeholder feedback; and

0. Roles and responsibilities for EOHHS and Contractor personnel.

Subject to EOHHS approval, the Contractor shall modify the work plan as needed and/or as determined by EOHHS.

2. Meetings

0. The Contractor shall participate in meetings with EOHHS as follows:

i. Kick-off calls or meetings, at which EOHHS will review project-specific expectations, including expected methodology, project scope, budget, and timeline;

ii. Bi-weekly meetings, at which the Contractor shall update EOHHS staff on the project’s progress, ask any questions or share any information with EOHHS staff, and troubleshoot issues; and

iii. Ad-hoc meetings that are mutually agreed upon or as otherwise requested by EOHHS.

b. The Contractor shall provide ongoing meeting management, facilitation, and analytic support to EOHHS. Meeting management shall include but not be limited to:

0. Preparing materials and agendas for EOHHS and Contractor meetings;

0. Following up after meeting with minutes and action items; and

0. Developing documents and maintaining version control of work plan and Deliverable reports.

0. Stakeholder Engagement

0. If applicable, and in collaboration with and under the direction of EOHHS, the Contractor shall support stakeholder engagement and information dissemination by preparing public-facing materials and participating in stakeholder engagement meetings.

0. The Contractor shall further document stakeholder feedback and concerns, as well as any resolution of or follow up/action items regarding the same. Stakeholders, in this context, can include consumers, providers, MassHealth Members, advocacy organizations, researchers, insurers, and other state agencies.

0. Survey Instruments and Fielding As directed by EOHHS and subject to EOHHS’s approval, the Contractor shall utilize the survey instruments outlined in this Section. For each Survey Cycle, the Contractor shall work with EOHHS to include changes, requested by EOHHS and/or proposed by the Contractor and agreed to by EOHHS, related to survey content, provided that the Contractor demonstrates that the change(s) do not increase survey administration costs or suppress response rates.

0. PC Survey

0. For Survey Cycle 2026, the PC Survey shall be adapted from the CG-CAHPS-based surveys (Adult and Child) administered in Survey Cycle 2025.

0. For Survey Cycle 2027, the PC Survey shall be adapted from the surveys (Adult and Child) administered in Survey Cycle 2026.

0. For Survey Cycle 2028, the PC Survey shall be adapted from the surveys (Adult and Child) administered in Survey Cycle 2027.

1. CAHPS for CMS Core Measure Set Reporting

0. The CAHPS Surveys for CMS Core Measure Set Reporting shall be the Core Set Surveys, pursuant to CMS Manuals.

0. PC Survey Administration The Contractor shall administer the surveys, as directed by EOHHS, as follows.

0. Sampling Methodology For each Measurement Year of the Contract Term, EOHHS will provide the Contractor with up to three test sample frames for the Contractor to use prior to the final sample frame. The Contractor shall work with EOHHS to review and correct sample frame file inconsistencies or errors, as requested by EOHHS and/or proposed by the Contractor and agreed to by EOHHS, that could adversely affect sampling or response rates.

0. For Survey Cycle 2026

0. The Contractor shall implement the sampling methodology previously developed and implemented in Survey Cycle 2025, and as further directed by EOHHS, that permits valid comparisons of performance at the state, ACO and MCO levels for the PC Survey.

0. The Contractor shall ensure that an adequate number of Members are surveyed across ACOs and MCOs for the PC Survey, within the constraints of the sample frame provided by EOHHS.

0. For Survey Cycle 2027

14. The Contractor shall implement the sampling methodology previously developed and implemented in Survey Cycle 2026, and as further directed by EOHHS, that permits valid comparisons of performance at the state, ACO and MCO levels for the PC Survey.

14. The Contractor shall ensure that an adequate number of Members are surveyed across ACOs and MCOs for the PC Survey, within the constraints of the sample frame provided by EOHHS.

0. For Survey Cycle 2028

15. The Contractor shall implement the sampling methodology previously developed and implemented in Survey Cycle 2027, and as further directed by EOHHS, that permits valid comparisons of performance at the state, ACO and MCO levels for the PC Surveys.

15. The Contractor shall ensure that an adequate number of Members are surveyed across ACOs and MCOs for the PC Survey, within the constraints of the sample frame provided by EOHHS.

0. Survey Materials Survey materials may include but are not limited to cover letters, envelopes, email invitations, telephone interview scripts, and web page or text message content. The materials may include changes, requested by EOHHS and/or proposed by the Contractor and agreed to by EOHHS, related to survey content provided that the Contractor demonstrates that the change(s) do not increase survey administration costs or suppress response rates.

1. For Survey Cycle 2026 The Contractor shall utilize survey materials developed by EOHHS and implemented in Survey Cycle 2025, and as further directed by EOHHS.

1. For Survey Cycle 2027 The Contractor shall utilize survey materials developed by EOHHS and implemented in Survey Cycle 2026, and as further directed by EOHHS.

1. For Survey Cycle 2028 The Contractor shall utilize survey materials developed by EOHHS and implemented in Survey Cycle 2027, and as further directed by EOHHS.

0. Fielding The Contractor shall field the PC Surveys described in Section 2.1. according to the protocols and specifications set forth in this Section 2.2 and shall collect survey responses.

2. In fielding the surveys and collecting the responses, the Contractor shall Administer all surveys in English. For Members whose Member language preference on file with MassHealth is Spanish, survey mailings will also include a survey in Spanish. In addition, the Contractor shall make the PC web-based surveys available in up to 7 additional languages.

2. The Contractor shall implement additional approaches or methods to improve survey response results, and/or any other survey improvements, as requested by EOHHS and mutually agreed upon by EOHHS and the Contractor, provided that EOHHS determines the change(s) do not increase survey administration costs or suppress response rate.

0. Analysis and Reporting The Contractor shall use the collected survey data to report findings, and other analysis as determined by EOHHS (herein referred to as “results”), for each Measurement Year of the Contract Term, as directed by EOHHS.

3. For Survey Cycle 2026 PC Survey results shall be delivered at the state, ACO and MCO levels. At EOHHS’ discretion, data may be stratified by demographic variables, (e.g., race and ethnicity).

3. For Survey Cycle 2027 PC Survey results shall be delivered at the state, ACO and MCO levels. At EOHHS’ discretion, data may be stratified by demographic variables e.g., race and ethnicity.

3. For Survey Cycle 2028 PC Survey results shall be delivered at the state, ACO and MCO levels. At EOHHS’ discretion, data may be stratified by demographic variables e.g., race and ethnicity.

EOHHS may provide the Contractor with historical documentation or data, including result reports, summary composites, technical reports, or other necessary technical specifications, documentation, or data, as appropriate or necessary at EOHHS’s discretion.

0. CAHPS for CMS Core Measure Set Reporting Administration For each Measurement Year of the Contract Term, the Contractor shall implement and manage the surveys as follows and as further described in the CMS Manuals:

0. Sampling Methodology The Contractor shall draw the survey samples from the sample frames generated by EOHHS as described in Section 2.1.B and according to the requirements and guidance set forth in the CMS Manuals. EOHHS will provide up to three test sample frames for the Contractor to use.

0. Fielding and Survey Materials The Contractor shall field the survey following standard protocols pursuant to the CMS Manuals. The standard survey protocol shall be the mail-only methodology, involving standard survey and standard postcard mailings, as described in the CMS Manuals. The surveys shall be conducted in English and Spanish. At EOHHS’ discretion, Contractor shall implement internet enhancements as described in the CMS Manuals.

0. Analysis and Reporting The Contractor shall submit final data to CMS, according to guidelines, timelines and specifications described in the CMS Manuals. The Contractor shall provide EOHHS with a final report in a mutually agreed-upon format.

EOHHS may provide the Contractor with historical documentation or data from CAHPS surveys previously conducted by EOHHS or other sources as applicable, including result reports, summary composites, technical reports, or other necessary technical specifications, documentation, or data, as appropriate or necessary at EOHHS’s discretion.

0. Deliverables The Contractor shall work with EOHHS to define Deliverables for each Survey Cycle. The Deliverables may be modified, added, or deleted to meet project needs, at EOHHS’ discretion.

0. PC Survey The Contractor shall create, develop, compile, and otherwise provide to EOHHS the following Deliverables, as directed by EOHHS, for each Survey Cycle:

3. Bi-weekly reports detailing response rates, by adult and child, stratified by method of response (e.g., mail, phone, or email). The reports will be provided over the course of the survey field period, with a final report delivered thereafter;

3. A comprehensive workplan for each Survey Cycle that details all tasks and deliverables from project startup through to completion, and incorporating all activities and deliverables as set forth in this contract and activities and timeframes as described in Section 2;

3. Case mix-adjustment of respondent data, including provision of results to EOHHS as appropriate and as directed by EOHHS;

3. Data, including (1) files, by age group (adult and child) that present aggregate survey results at multiple levels (e.g., state, ACO-MCO, as applicable) with summary composites and item level responses for each population as described in Section 2.1, (2) files, by age group (adult and child) that present data at the state and individual ACO-MCO levels), and (3) as directed by EOHHS, files by age group (adult and child) that present summary composites and allow for stratification of composites by demographic variables, e.g., race and ethnicity at the state and individual ACO-MCO levels. All data files shall include companion reports-user guides. Data files shall be complete, member de-identified, and in Excel format, Data files shall allow for composite and question-level viewing, manipulation, sorting, aggregating, combining, and reporting of the data;

3. File user documentation within data files and accompanying data files, including but not limited to project and data files overview, file structure overview and descriptions, variable name definitions, as directed by EOHHS;

3. De-identified, raw extracts of survey data at the Member level for the PC Survey, aggregated at the state and ACO-MCO level;

3. For all surveys, data dictionary(ies) containing survey question details, including as question number, question wording, question variable names, and question response options;

3. Written reports and/or presentations, as needed and as requested by EOHHS, that the Contractor may develop, contribute to, or deliver;

3. Technical report describing the methods used to conduct the survey. The Contractor and EOHHS shall mutually agree on the contents of said report. The report shall describe survey development, sampling, and survey administration with content including but not necessarily limited to:

0. Details of survey instruments administered;

0. Sampling, including inclusion criteria, Member sample selection, and sampling protocol; and

0. Details of survey administration, including but not limited to response rates and returned survey mail due to invalid addresses, and information about survey materials, survey fielding, data cleaning, and case mix adjustment.

3. Analytic report, including findings for adult and child populations and at the state and individual ACO-MCO levels; and an executive summary. The Contractor and EOHHS shall mutually agree on the contents of said report;

3. A report of recommendations for how future survey instruments and administration of the PC survey might evolve as various payment and care delivery reform efforts in the Commonwealth of Massachusetts continue to evolve; and

3. At EOHHS’ discretion, a final oral presentation of findings, for adult and child surveys, in an agreed-upon format.

3. Other deliverables, as determined by EOHHS and as mutually agreed upon by the Contractor and EOHHS.

0. CAHPS for CMS Core Measure Set Reporting For each Measurement Year of the Contract Term, the Contractor shall create, develop, compile, and otherwise provide to EOHHS the following Deliverables, as directed by EOHHS.

0. Periodic reports of response rates (by adult and child), stratified by method of response. The reports shall be provided over the course of the survey field period at mutually agreed-upon intervals, with a final report delivered thereafter;

0. A comprehensive workplan detailing all tasks and Deliverables from startup through to completion.

0. Submission of survey respondent data files to CMS according to the specifications and timeline provided in the CMS Manuals or as otherwise specified by CMS. The Contractor shall provide member-level, deidentified data files to EOHHS.

0. Report of findings, for adult and child surveys, to EOHHS in an agreed-upon format.

0. Develop, contribute to, or deliver written reports and/or presentations as needed at EOHHS’ discretion.

0. A final oral presentation of findings, for adult and child surveys in a format agreed-upon by the Contractor and EOHHS.

0. Privacy and Security In accordance with Sections 2, 5, and 6 of this Contract, the Contractor shall administer the surveys and otherwise perform the responsibilities set forth in this Contract in accordance with all applicable laws, regulations and provisions of this Contract relating to confidentiality and security, including those contained in Section 5 and the Acknowledgement Regarding Confidentiality of Protected Information attached as Appendix 2.

0. Timeline The Contractor shall perform the responsibilities as set forth in this Contract as follows:

1. PC Survey For each Survey Cycle of the Contract Term, The Contractor shall perform the responsibilities as set forth in Sections 2.1 and 2.2, in collaboration with EOHHS or its designee, and shall develop and manage a detailed timeline from the approximate timeframes set forth in this Section 2.3 and this Contract and as directed by EOHHS. Any adjustments to the timeline must be mutually agreed upon by EOHHS and the Contractor and may be based on contingencies such as, but not limited to, the Contract start date, timing of sampling frame provided to Contractor, response rates, changes to Contract scope assumptions, or deliverables, and holiday periods that may influence the time that surveys are in the field to complete required number of surveys.

0. Survey Planning/Protocols

0. Survey Materials Preparation

0. Administration, Analysis, and Reporting

Contractor submits final response rate report and individual ACO-MCO response rate reports

4. Interviews/Focus Groups

1. CAHPS for CMS Core Measure Set Reporting The Contractor shall perform the responsibilities as set forth in Sections 2.1 and 2.2, in collaboration with EOHHS or its designee, according to the timeframes and dates as set forth in the CMS Manuals, including submission of final results to CMS as specified in the Manuals by deadline(s) specified by CMS for the applicable data submission period.

0. Contract Management and Transition Upon execution of this Contract, the Contractor shall participate in the transition of relevant knowledge, information, and responsibilities as specified by EOHHS to successfully transfer work and services described in this Contract from EOHHS and existing EOHHS vendors to the Contractor.

The Contractor shall make all reasonable efforts to work with EOHHS and existing EOHHS vendors to ensure a smooth transition. The transition shall include the provision of EOHHS-specified, EOHHS-supplied data and documents, drafts, and final reports.

Upon the expiration, termination, or non-renewal of this Contract, the Contractor shall participate in the transition of relevant knowledge, information, and responsibilities as specified by EOHHS to successfully transfer relevant work and services described in this Contract to EOHHS and any new vendor conducting Member Experience Surveys on behalf of EOHHS, as applicable.

1. EOHHS RESPONSIBILITIES

1. EOHHS shall:

1. Attribute Members to ACOs and MCOs as applicable according to a mutually agreed upon timeline, as detailed in Section 2.3;

1. Provide MassHealth test and final sampling frame data to the Contractor in a format mutually agreed upon with the Contractor;

1. Provide logos, signatures, and other information needed for survey cover letters and email invitations;

1. Meet with Contractor regularly throughout the duration of the Contract in accordance with Section 2.2.A;

1. Provide timely review of materials as necessary for the Contractor to complete the project in accordance with the timeline;

1. Collaborate with Contractor to identify opportunities to improve future survey fielding.

1.

Subject to EOHHS’s reasonable satisfaction with the Contractor’s performance and other terms and conditions of the Contract, and subject to the availability of funding and any applicable state and federal approvals, EOHHS shall pay the Contractor in accordance with the following provisions:

2. Payment and Invoicing

1. EOHHS shall make payments to the Contractor based on an annual budget and timeline and agreed to by the parties and incorporated into this Contract as Appendix 1.

1. The Contractor shall submit invoices in a form, format, and frequency approved by EOHHS, as specified in Appendix 1. Such invoices shall be delivered to EOHHS’s designated employee by the Contactor by facsimile and U.S. mail, first class, postage prepaid, or e-mail, as specified by EOHHS. Such invoice shall include a brief narrative demonstrating the Contractor achieved the milestones and tasks for the period covered by the invoice.

1. EOHHS shall review all invoices and shall approve or reject each invoice in whole or in part. EOHHS shall notify the Contractor of any rejected portions of any invoice and such rejected portions may be modified by the Contractor or EOHHS and subsequently approved by EOHHS.

1. Subject to Section 4.1.A, EOHHS will make payments to the Contractor based on the invoices described in Section 4.1.B above and the budget specified in Appendix 1. The Contractor shall, upon written notice from EOHHS, refund part or all of a previously approved invoiced payment for a Deliverable or other service that is not timely or successfully completed to EOHHS’s reasonable satisfaction or is otherwise not approved by EOHHS.

1. The Contractor shall satisfy all obligations under the Contract for the total amount invoiced and approved in accordance with this Section 4, and the amounts set forth in Appendix 1.

2. Documentation The Contractor shall maintain supporting documentation for all invoices and related materials (e.g., deliverables, subcontractor invoices, evidence of task milestones, meeting agendas) and shall provide such documentation to EOHHS upon request.

2. Federal Financial Participation The Contractor shall support EOHHS in its claiming of federal financial participation (FFP) by providing monthly cost breakdowns by program and activity type as directed by EOHHS.

1. PRIVACY AND CONFIDENTIALITY

3. Definitions When used in this Section, the following capitalized terms shall have the meanings ascribed to them below:

“Activities” shall mean the activities, functions and/or services to be performed or provided by the Contractor for, on behalf of and/or to EOHHS under the Contract.

“Applicable Law” shall mean M.G.L. c. 66A, 801 CMR 3.00, M.G.L. c. 93H, 201 CMR 17, the Health Insurance Portability and Accountability Act (HIPAA) Rules (inclusive of 45 CFR Parts 160, 162, and 164), 42 CFR Part 431, Subpart F and 42 CFR 434.6(a)(8) (Medicaid Confidentiality Rule), 42 CFR Part 2, 45 CFR §155.260 and any other applicable federal or state law or regulation pertaining to the use, disclosure, maintenance, privacy, confidentiality, or security of PI.

“EOTSS” shall mean the Massachusetts Executive Office of Technology Services and Security.

“Event” shall mean the following, either individually or collectively: 1) any use or disclosure of PI not permitted under this Contract; 2) any Security Incident; or 3) any other event that would trigger notification obligations under the Breach Notification Rule, M.G.L. c. 93H, other similar Applicable Law, or Third Party Agreement (defined below) requiring notice to consumers and/or oversight agencies in connection with an impermissible use or disclosure or breach of PI.

“HIPAA Rules” shall mean 45 CFR Parts 160, 162, and 164, inclusive of the Privacy Rule (45 CFR Part 160 and Part 164, Subparts A and E), the Security Rule (45 CFR Part 160 and Part 164, Subparts A and C), the Breach Notification Rule (45 CFR Part 164, Subpart D) and the Enforcement Rule (45 CFR Part 160, Subparts C, D and E).

“Individual” shall mean the person to whom the PI refers and shall include a person or organization who qualifies as a personal representative in accord with 45 CFR 164.502(g).

“Online Tracking Technology” means any technologies that are used to collect and analyze information about how users interact with websites or mobile applications maintained by or on behalf of EOHHS.

“PI” shall mean any Protected Health Information, any “personal data” as defined in M.G.L. c. 66A, any “patient identifying information” as used in 42 CFR Part 2, any “personally identifiable information” as used in 45 CFR 155.260, “personal information” as defined in M.GL. c. 93H, and Third Party Data (defined below in Section 5.2.B) and any other individually identifiable information that is treated as confidential under Applicable Law or agreement (including, for example, any state and federal tax return information) that the Contractor uses, maintains, discloses, receives, creates, transmits or otherwise obtains in connection with its performance of the Activities. Information, including aggregate information, is considered PI if it is not fully de-identified in accord with 45 CFR 164.514(a)-(c).

“System” shall mean any EOHHS system, database, application or other information technology resource.

When used in this Section, the following terms shall have the same meaning as those terms have in the HIPAA Rules: Business Associate, Minimum Necessary, Notice of Privacy Practices, Personal Representative, Protected Health Information, Required by Law, Secretary, Security Incident and Workforce.

All other capitalized terms used in this Section 5, but not otherwise defined herein, or elsewhere in this Agreement, shall be construed in a manner consistent with the HIPAA Rules, M.G.L. c. 66A and all other Applicable Laws.

3. Contractor’s Obligations

1. Compliance with Applicable Laws The Contractor must comply with all Applicable Laws in performing the Activities including any use and disclosure of PI. that may be in effect upon execution of, or as may be effective during the course of, this Contract, including, but not limited to, the Privacy and Security Rules, 42 CFR 431, Subpart F, 42 CFR Part 2, and M.G.L. c. 66A. Without limiting the generality of the foregoing, the Contractor acknowledges and agrees as follows:

0. Business Associate under HIPAA. In performing the Activities, the Contractor acknowledges and agrees that it is acting as EOHHS’s Business Associate. The contractor shall comply with all requirements of the HIPAA Rules applicable to a Business Associate. This Contract shall serve as the Business Associate Agreement between the Contractor and EOHHS. Workforce members with access to unencrypted PI or an encryption key used to secure such PI must sign the Confidentiality Acknowledgement attached hereto as Appendix 2 prior to being granted such access.

0. Medicaid Confidentiality Rules. In performing the Activities, if the Contractor will create, receive, use, disclose, maintain, transmit or otherwise obtain information concerning Medicaid applicants and beneficiaries, the Contractor agrees to comply with the Medicaid Confidentiality Rule at 42 CFR 431 Subpart F and 42 CFR 434.6(a)(8). Consistent with these obligations, the Contractor shall restrict its use and disclosure of information concerning Medicaid applicants and beneficiaries to purposes directly connected with the administration of the Medicaid plan. 42 CFR 431.302 defines purposes directly related to Medicaid Plan administration to include: (1) establishing eligibility, (2) determining the amount of medical assistance, (3) providing services for beneficiaries; and (4) conducting or assisting an investigation, prosecution, or civil or criminal proceeding related to the administration of the Medicaid plan.

0. 42 CFR Part 2. The Contractor agrees that with respect to any substance use information that the Contractor receives, stores, processes, uses, creates or transmits that was obtained by a Part 2 Program, Lawful Holder, or EOHHS (as such terms are used in 42 CFR Part 2), it is bound by 42 CFR Part 2 and shall not use or disclose information except as permitted under 42 CFR Part 2.

0. M.G.L. c. 66A. The Contractor acknowledges that in performing the Activities it will create, receive, use, disclose, maintain, transmit or otherwise obtain “personal data” (as defined in M.G.L. c. 66A) and that, in so doing, it becomes a “holder” of such data for purposes of M.G.L. c. 66A and shall comply with the same.

0. CORI Regulations. The Contractor shall, pursuant to and in accordance with 101 CMR 15.03(1)(b), require and consider the criminal history information pertaining to all Workforce members of the Contractor who will be given access or potential access to PI, and all applicants for employment with the Contractor where the position applied for entails access or potential access to PI. The Contractor shall otherwise comply with all applicable terms of 101 CMR 15.00 in connection with the review and consideration of employee and applicant criminal records.

0. Additional Requirements. EOHHS, including its Constituent Agencies, reserves the right to add any requirement for EOHHS to comply with any applicable state or federal law or regulation, or any contractual obligation to which EOHHS is subject, relating to privacy and/or security, and the Contractor agrees to negotiate in good faith to promptly execute and comply with any necessary amendment or…