Attachment+E+-+Evaluation+Tool.docx

ATTACHMENT E

EVALUATION TOOL

Proposals will be reviewed for responsiveness and then evaluated using the criteria identified in this RFP.

INSTRUCTIONS FOR EVALUATORS

Each evaluation criterion has been assigned a specific number of points. The questions under each evaluated area help you measure the quality of offeror’s response. Do not assign points to individual questions; instead, award a total score for each evaluation criterion.

RATING SCALE FOR ASSESSING OFFEROR RESPONSES

This rating scale is intended to establish guidelines within that range to ensure members of the RFP evaluation committee perform their evaluation with consistency. You may assign any value for a given criteria from 0 to the maximum number of points. A zero value typically constitutes no response or an inability of offeror to meet the criterion. In contrast, the maximum value should constitute a high standard of meeting the criterion. If a specific criterion would only yield a yes or no response (e.g., offeror can submit an electronic report in required format by noon Friday), the evaluator should award either the maximum points or a zero.

For Example: “Experience and Qualifications” is an evaluation criterion receiving a weighting of 20 of the total possible points. Using a 100 Point Scale, a maximum of 20 points can be awarded. The rating scale would be:

Rating Scale (20 POINT Maximum)

Point Value

Explanation

COST PROPOSAL

If offerors were required to place cost proposals in a separate sealed envelope, do not open the cost proposal until the technical proposals have been evaluated.

Not all members of the evaluation need to evaluate the cost proposal. The cost proposals may be evaluated by selected members of the evaluation committee, reviewed by group, and recorded on the evaluation summary sheets.

Any prompt payment discounts terms offered by the vendor are not taken into consideration in evaluating cost.

EVALUATION CRITERIA AND SCORING

Name of Offeror:

Names of Evaluation Committee Members:

Date of Review:

RFP Title: Disproportionate Share Hospital Audit, Hospital Upper Payment Limits, Intermediate Care Facilities Upper Payment Limits and Payment Transparency, Critical Access Hospital Cost Settlement, and Medicaid Inpatient Utilization Rate Calculation

RFP Number: 325-25-415-027

I hereby certify that I do not have a conflict of interest with this offeror. I further certify that I have reviewed the Request for Proposal Evaluators Guide and that neither I nor my immediate family members have a conflict of interest with regard to this offeror who submitted a proposal in response to this Request for Proposal, in accordance with N.D.A.C. § 4-12-04-04.

Signatures____________________________________Date________________

THE TOTAL NUMBER OF POINTS USED TO SCORE THIS RFP IS 100

Understanding of the Scope of Work

Forty (40) of the total possible evaluation points are assigned to this section.

Rating Scale (40 Point Maximum)

Point Value

Explanation

Proposals will be evaluated against the questions set out below. Do not assign points to individual questions; instead, award a total score for each evaluation criterion.

A) How well does the offeror demonstrate a thorough understanding of the purpose and requirements of the scope of work?

Evaluator’s Notes:

B) How well does the offeror detail a plan that will be sufficient to accomplish the requirements of this RFP?

C) How well does the offeror demonstrate a thorough understanding of the DSH audit process and independent audit report requirements?

D) How well does the offeror demonstrate a thorough understanding of the UPL requirements for PPS hospitals and IMD?

E) How well does the offeror demonstrate a thorough understanding of the cost settlement requirements for CAHs and state-owned ICF?

F) How well does the offeror demonstrate a thorough understanding of the Medicaid Institutional transparency requirements?

G) How well does the offeror demonstrate a thorough understanding of the MIUR calculation?

H) Has the offeror indicated in their proposal that they can meet the report deadlines specified?

POINT TOTAL ___________

Management Plan

Fifteen (15) of the total possible points will be assigned to this criterion.

Rating Scale (15 Point Maximum)

Point Value

Explanation

Proposals will be evaluated against the questions set out below. Do not assign points to individual questions; instead, award a total score for each evaluation criterion.

A) How well does the management plan support all the requirements of this RFP?

B) Does the management plan illustrate the lines of authority and communication?

C) Has the offeror identified the designated staff members responsible and accountable for the completion of each component of the RFP?

D) Has the offeror disclosed any instances where the firm or any individuals working on the contract resulting from the RFP has a possible conflict of interest and, if so, the nature of that conflict (e.g. employed by State of North Dakota)?

POINT TOTAL ___________

Experience and Qualifications

Thirty (30) of the total possible points will be assigned to this criterion.

Rating Scale (30 Point Maximum)

Point Value

Explanation

Proposals will be evaluated against the questions set out below. Do not assign points to individual questions; instead, award a total score for each evaluation criterion.

A) How well does the offeror demonstrate its experience with performing a DSH audit?

B) How well does the offeror demonstrate its experience with performing UPL calculations?

C) How well does the offeror demonstrate its experience with performing hospital cost settlements?

D) Has the offeror demonstrated a proven ability to effectively work with other Medicaid agencies for similar work?

E) How well does the offeror describe its experience and how the experience applies to the work required in this RFP?

F) Has the offeror identified their capacity to complete the work identified in this proposal?

POINT TOTAL ___________

Cost Proposal

Fifteen (15) of the total possible points will be assigned to the total cost.

Not all members of the evaluation committee need to evaluate the Cost Proposal. The Procurement Officer will review the Cost Proposal to determine responsiveness. If the Cost Proposal is responsive, the Procurement Officer will evaluate the Cost Proposal. After the technical proposal has been evaluated, the Cost Proposal scores can be recorded on the offeror evaluation totals sheets.

Applying Preference Laws

STATE will not consider any prompt payment discount terms proposed by the offeror when evaluating cost. The reciprocal preference law, N.D.C.C. § 44-08-01, was repealed effective August 1, 2023.

In the event, N.D.C.C. § 54-44.4-05.1 requires that if two or more proposals contain identical pricing or receive identical evaluation scores, preference must be given to a resident North Dakota bidder, seller, vendor, offeror, or contractor as defined in N.D.C.C. § 44-08-02. In the event the tie is not resolved by application of this law, N.D.A.C. § 4-12-11-05 will be applied.

For a listing of state preference laws, visit the following website:

· North Dakota State Procurement Office Website: North Dakota Purchasing Preferences (nd.gov) For assistance contact: 701-328-2683 or infospo@nd.gov

Converting Cost to Points

The Cost Proposal with the lowest total for all five deliverables (January 1, 2026, through December 31, 2027) will receive the maximum number of points allocated to cost. The point allocations for cost on the other proposals will be determined as follows:

Price of Lowest Total Amount for all Five Deliverables Price of Proposal Being Rated X Total Points for Cost Available = Awarded Points

RFP Evaluation Summary

Name of RFP: Disproportionate Share Hospital Audit, Hospital Upper Payment Limits, Intermediate Care Facilities Upper Payment Limits and Payment Transparency, Critical Access Hospital Cost Settlement, and Medicaid Inpatient Utilization Rate Calculation

RFP Number: 325-25-415-027

Offeror Being Evaluated:

Evaluators’ Names:

Date:

Technical Evaluation (Maximum 85 Points)

Cost Evaluation (Maximum 15 Points)

Calculated points awarded for price.

Price of Lowest Amount for all Five Deliverables Price of Proposal Being Rated X 15 points = Awarded Points

4. Cost

Total