Billing and Data Collection Services.doc

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Billing and Data Collection Services
Solicitation number
300000284245845
Issued by
Missouri

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This is a Request for Proposal (RFP) issued by the State of Missouri Office of Administration, Division of Purchasing, on behalf of the Department of Elementary and Secondary Education for Billing and Data Collection Services supporting Missouri School for the Severely Disabled (MSSD), Missouri School for the Deaf (MSD), and Missouri School for the Blind (MSB). The contractor shall serve as the third-party MO HealthNet billing agent and submit all claims for direct therapy services, School District Administrative Claiming (SDAC), and non-emergency medical transportation (NEMT) to MO HealthNet on behalf of the state agency schools. The contractor must provide an electronic web-based data system for collecting billing information, submit claims in formats required by MO HealthNet, check MO HealthNet eligibility at least quarterly, and deliver monthly progress reports detailing claims filed, pending status, paid claims, denied claims with reasons, and services provided. The RFP was issued September 22, 2026, with proposals due by October 14, 2026, at 2:00 p.m. Central Time. The contract period is one year from the effective date, with two optional renewal periods of one year each. The contractor must meet minimum experience requirements of five years providing billing and data collection services, with preferred experience of three years in MO HealthNet billing services and three years serving Missouri state operated schools.

Compensation is based on a firm fixed percentage of claims received by the state agency and a price for quarterly eligibility determinations, as specified in Exhibit C, Pricing Pages. The incumbent contractor information can be reviewed under bid number IFB23DESE1005 and contract number CS192767002. In FY25, MO HealthNet program revenue for state operated schools totaled approximately $9.1 million across direct service claiming, administrative claiming, and NEMT transportation. The contractor must comply with all applicable federal and state laws, including HIPAA, E-Verify requirements, and Missouri business registration requirements. The contractor is required to maintain detailed financial records for five years, provide personnel meeting specified qualifications including a primary lead with three years of experience in billing, data collection, school-based services, Medicaid rules, leadership, and project management, and designate a contact person serving as liaison with the state agency. The contractor shall be responsible for all material, labor, facilities, equipment, and supplies necessary to perform services, with the state agency reserving the right to request removal of any assigned personnel without cause.

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State of Missouri Office of Administration, Division of Purchasing

Request for Proposal (RFP) for

Billing and Data Collection Services

SOLICITATION NO.:
STATE 0000000587SL
SOLICITATION ISSUED ON BEHALF OF:
Department of Elementary & Secondary Education
ISSUE DATE:
September 22, 2026
CONTRACT PERIOD:
Effective Date of Contract through One Year
REQUISITION NO.:
ROCO2601904

PROPOSAL DUE NO LATER THAN: October 14, 2026 AT 2:00 PM CENTRAL TIME

Proposal response must be submitted electronically through MissouriBUYS, powered by MOVERS, at https://missouribuys.mo.gov.

E-mailed, mailed, courier, or hand-delivered proposal responses will not be accepted.

RFP CONTACT INFORMATION:

BUYER: Ariel Bradford

PHONE NO.: (573) 751-2497

EMAIL: Ariel.Bradford@oa.mo.gov

See “RFP Questions” in Section 1 for appropriate communications during the procurement process.

DELIVER SUPPLIES/SERVICES FREE ON BOARD (FOB) DESTINATION TO THE FOLLOWING ADDRESS:

Department of Elementary and Secondary Education Missouri Schools for the Severely Disabled Missouri School for the Deaf Missouri School for the Blind Various Locations

ATTENTION:

1. After reviewing the Request for Proposal (RFP), the vendor must complete and return Exhibit A, Proposal Signature Page and all other necessary exhibits.

2. Due to lead times for obtaining the information needed to complete the various Business Compliance Exhibits herein as explained in the RFP’s Vendor Response Exhibits, vendors are encouraged to IMMEDIATELY begin securing these verifications.

3. The vendor must be registered in MissouriBUYS, powered by MOVERS in a “Prospective” or “Spend Authorized” registration status to submit a proposal. The vendor must achieve “Approved” registration status in MissouriBUYS (WebProcure/Proactis) and “Spend Authorized” registration status in MissouriBUYS, powered by MOVERS to be considered for a contract award. Reference Section 5.

RFP Organization:

RFP Sections
Section 1
Introduction and Background Information Section
Section 2
Scope of Work Section
Section 3
Terms and Conditions Section
Section 4
General Contractual Requirements Section
Section 5
Vendor Submission, Evaluation, and Award Information Section

RFP Vendor Response Exhibits

(Return these exhibits with the proposal)

Exhibit A
Proposal Signature Page
Exhibit B
Proposal Submittal Checklist
Exhibit C
Pricing Page
Exhibit D
Technical Proposal – Experience of Organization and Past Performance
Exhibit E
Technical Proposal – Team Qualifications
Exhibit F
Technical Proposal – Methodology, Approach and Work Plan
Exhibit G
Participation Commitment
Exhibit H
Documentation of Intent to Participate

BUSINESS COMPLIANCE EXHIBITS

Exhibit I
State of Missouri Tax Compliance
Exhibit J
Registration of Business Name with the Missouri Secretary of State
Exhibit K
Business Entity Certification, Enrollment Documentation, and Affidavit of Work Authorization
Exhibit L
Anti-Discrimination Against Israel Act Certification
Exhibit M
Services Outside the United States
Exhibit N
Employee/Conflict of Interest
Exhibit O
Federal Funding Unique Identity ID

RFP

Attachments Attachment (Separate Document) (Do not return the document with response)

Attachment 1
Federal Funds Requirements

Separate Document: The vendor is advised that a separate document to this document referenced above provides additional requirements, information, and/or instruction. The separate document must be downloaded from the Division of Purchasing’s MissouriBUYS, powered by MOVERS, website at: https://missouribuys.mo.gov/. The separate document is downloadable from the same web page where the solicitation document is downloadable. It shall be the sole responsibility of the vendor to obtain the separate document. The vendor shall not be relieved of any responsibility for performance under the subsequent contract due to the failure of the vendor to obtain a copy of the separate document.

1. INTRODUCTION AND BACKGROUND INFORMATION SECTION

1.1 Introduction:

1.1.1 Purpose: This document constitutes a request for competitive, sealed proposals for the provision of MO HealthNet billing and data collection services for Missouri School for the Severely Disabled (MSSD) and Missouri School for the Deaf (MSD).

1.1.2 Minimum Experience Qualifications: There are minimum experience qualifications in the RFP (See Section 2.2, Minimum Experience Requirements in Section 2: Scope of Work).

1.1.3 Titles: Titles of paragraphs used herein are for the purpose of facilitating reference only and shall not be construed to infer a contractual construction of language.

1.2 Background and Historical Usage Information:

1.2.1 Per Section 162.730, RSMo, the Department of Elementary and Secondary Education (DESE) shall establish state operated schools sufficient to serve students with severe disabilities when the local public school district is unable to meet the student's educational needs. The state operated programs in Missouri include the Missouri School for the Deaf (MSD), and the Missouri Schools for the Severely Disabled (MSSD). The Missouri School for the Deaf (MSD) is in Fulton and provides on-site educational and residential services for hearing impaired and deaf students in Missouri. Missouri Schools for the Severely Disabled (MSSD) is a state operated program serving Missouri students with severe disabilities among 34 schools across the state. Each year funding is appropriated through the Missouri Legislature for staff, facilities, and the operational functions for the state operated programs. These state operated schools function in a manner like public schools; however, they receive no direct local tax support or state aid.

1.2.2 The MO HealthNet Division (MHD) within the Department of Social Services (DSS) is responsible for the administration of the medical assistance program (Title XIX) and Title XXI, the State Children’s Health Insurance Program (S-CHIP) in Missouri. The Department of Elementary and Secondary Education (DESE) has an interagency agreement with DSS for the public schools in Missouri, including the state operated schools, to participate in the MO HealthNet programs and provide MO HealthNet covered services to students with disabilities for reimbursement. These programs include:

a. Direct Service Claiming: Licensed therapy providers, both employed and contracted, may enroll as performing providers with MHD to deliver medically necessary covered school based direct services (DS) to MO HealthNet students. Eligible services are listed below. Invoices for direct service claiming are paid based on the federal participation percentage rate.

1) Behavioral Services

2) Occupational Therapy

3) Physical Therapy

4) Speech Therapy b.

Administrative Claiming: Schools may participate in the approved school district administrative claiming (SDAC) program which assists students with accessing MO HealthNet covered services. School districts must have an active Cooperative Agreement with MHD to participate in administrative claiming. Invoices for administrative claiming are paid based on the federal participation percentage rate.

c.

Transportation Claiming: Schools may seek reimbursement from MHD for specialized non-emergency medical transportation (NEMT) provided to students. School districts must have an active Cooperative Agreement with MHD to participate in transportation claiming. Invoices for transportation claiming are paid based on the federal participation percentage rate.

1.2.3 Currently, the MO HealthNet program participation for the state operated schools is as follows:

MO HealthNet Program
MSSD
MSD
Direct Service Claiming
Yes
No
Administrative Claiming
Yes
Yes
NEMT Transportation Claiming
Yes
No

1.2.4 Students must be deemed eligible for the MO HealthNet program to participate in DS claiming. In addition, the student eligibility rate is utilized in the SDAC reimbursement formula. The approximate MO HealthNet eligibility rate for the state operated schools is as follows:

MO HealthNet Eligibility Rate
MSSD
MSD
Total Number of Students
538
29
Eligibility Rate
83%
59%

1.2.5 In FY25, the approximate MO HealthNet program revenue for the state operated schools was as follows:

MO HealthNet Program
MSSD
MSD
Direct Service Claiming
$2,012,962
Not Applicable
Administrative Claiming
$740,655
$93,849.16
NEMT Transportation Claiming
$6,326,442
Not Applicable

1.2.6 The state operated schools currently have the following numbers of therapists, both employed and contracted, providing services. Therapists are encouraged to enroll with MO HealthNet prior to providing services for the state operated schools.

Therapists
MSSD
MSD
Occupational Therapists
66
1
Physical Therapists
27
1
Speech Therapists
50
1
Behavioral Therapists
3
0

1.2.7 The Missouri Department of Social Services – MO HealthNet (MO HealthNet) has awarded a contract for management of the Missouri pool of School District Administrative Claiming (SDAC) participants, to provide training for all SDAC participants, to distribute the surveys to SDAC participants, and to code all surveys and to release quarterly data on the MO HealthNet website for use by third party claimers in submitting participating school district SDAC claims.

1.3 Current and/or Previous Contract Information:

1.3.1 A current contract exists for the products and/or services being obtained via this RFP. A copy of the contracts can be viewed and printed from the Division of Purchasing Awarded Bid & Contract Document Search System located on the Internet at: https://purch.oa.mo.gov/bidding-contracts/awarded-bid-contract-document-search. In addition, all proposal and evaluation documentation leading to the award of that contract may also be viewed and printed in the Division of Purchasing’s Awarded Bid & Contract Document Search System. Please reference the Bid number IFB23DESE1005 and RFPS30034901902767 Contract Number CS192767002.

1.3.2 State Expenditures: The Missouri Accountability Portal (MAP) located on the Internet at: http://mapyourtaxes.mo.gov/MAP/Expenditures/ provides financial data related to the purchase of the services under the contract. Be sure to read the information provided in the site information and disclaimer links: https://mapyourtaxes.mo.gov/MAP/Help/MapExpendituresHelp.htm and https://mapyourtaxes.mo.gov/MAP/Help/MapExpendituresHelp.htm#disclaimer. Then search by the contract numbers shown above when searching for the financial information.

1.4 RFP Questions:

1.4.1 Buyer is Single Point of Contact for Solicitation: Vendors and their agents (including subcontractors, employees, consultants, or anyone else acting on their behalf) must direct all of their questions or comments regarding the RFP, the evaluation, etc., to the buyer indicated on the first page of this RFP. It is preferred that questions be emailed to the buyer.

a. Except as noted herein, vendors and their agents are instructed not to contact any other state employee regarding any of these matters during the solicitation and evaluation process. Inappropriate contacts are grounds for suspension and/or exclusion from specific procurements. Vendors can be sanctioned for unauthorized contact with any evaluator under 1 Code of State Regulation (CSR) 40-1.060(8)(G) and (H) available at http://www.sos.mo.gov/adrules/csr/csr.asp.

b. Service Disabled Veteran Enterprise and Honorably Discharged Veteran Enterprise certifications or subcontract questions should be directed to the Office of Equal Opportunity (OEO) at http://oeo.mo.gov.

1.4.2 Vendor is Responsible for Asking Questions About the RFP: It is the vendor’s responsibility to ask questions, request changes or clarifications, or otherwise advise the Division of Purchasing if the vendor believes that any language, specifications, or requirements are: (1) ambiguous, (2) contradictory or arbitrary, (3) violate any state or federal law or regulation, (4) restrict or limit the requirements to a single source, or (5) restrict or limit the vendor’s ability to submit a proposal.

1.4.3 Vendor Question Deadline: Every attempt shall be made to ensure that the vendor receives an adequate and prompt response. However, in order to maintain a fair and equitable procurement process, all vendors will be advised, via the issuance of an amendment to the RFP, of any relevant or pertinent information related to the procurement. All questions and issues should be submitted no later than ten (10) calendar days prior to the proposal closing date and time of the proposals. If not received prior to ten (10) calendar days before the proposal closing date and time, the Division of Purchasing may not be able to fully research and consider the respective questions or issues.

1.4.4 State’s Response to Vendor Questions: Upon the Division of Purchasing’s consideration of questions and issues, if the Division of Purchasing determines that changes are necessary, the resulting changes will be included in a subsequently issued RFP amendment(s); absence of such response indicates that the questions and issues were considered but deemed unnecessary for an RFP amendment. All vendors will be advised of any change to the RFP’s language, specifications, or requirements by a formal amendment to the RFP. There will be no posted written records of the questions/communications (i.e., formal question/answer document).

1.4.5 RFP is State’s Only Official Position: The only official position of the State of Missouri shall be that which is contained in the RFP and any amendments thereto.

1.5 Amendments:

1.5.1 If the Division of Purchasing determines that changes to the RFP are necessary, the resulting changes will be included in a subsequently issued RFP amendment(s) prior to the proposal closing date and time.

1.6 Glossary of Terms and Acronyms:

1.6.1 Whenever the following terms and acronyms appear in the RFP document or any amendment thereto, the definitions or meanings described below shall apply.

1.6.2 General Glossary, Acronyms, and Abbreviations:

a. Agency and/or State Agency means the statutory unit of state government in the State of Missouri for which the equipment, supplies, and/or services are being purchased by the Division of Purchasing (Purchasing). The agency is also responsible for payment, unless otherwise specified herein.

b. Amendment means a written, official modification to a solicitation or contract.

c. Attachment applies to all documents which are included with an RFP to incorporate any informational data or requirements related to the performance requirements and/or specifications.

d. Buyer means the procurement staff member of Purchasing.

e. Code of State Regulation (CSR) contains the current administrative rules of executive agencies of Missouri government. The regulations are arranged by agency rather than by subject.

f. Contract means a legal and binding agreement between two or more competent parties, for a consideration for the procurement of equipment, supplies, and/or services.

g. Contractor means a supplier, offeror, person, or organization who is a successful vendor as a result of an RFP and who enters into a contract.

h. Exhibit applies to forms which are included with an RFP for the vendor to complete and submit with their proposal prior to the specified closing date and time.

i. May means that a certain feature, component, or action is permissible, but not required.

j. Must means that a certain feature, component, or action is a mandatory condition.

k. Party refers to either the State of Missouri or the contractor as an entity that may enter into a contract pursuant to the terms herein.

l. Pricing Page(s) applies to the form(s) on which the vendor must state the price(s) applicable for the equipment, supplies, and/or services required in the RFP. The pricing pages must be completed and submitted by the vendor with the proposal prior to the specified proposal closing date and time.

m. Proposal Closing Date and Time and similar expressions mean the exact deadline required by the RFP for the receipt of sealed proposals.

n. Purchase Order means the authorized document issued by the state agency to the contractor indicating descriptions, quantities, and agreed prices for products and/or services.

o. Reasonable, Necessary or Proper as used herein shall be interpreted solely by the State of Missouri.

p. Request for Proposal (RFP) means the solicitation document issued by Purchasing to potential vendors for the purchase of equipment, supplies, and/or services as described in the document. The definition includes the following sections: Introduction and Background Information; Scope of Work; Terms and Conditions (“terms and conditions” and “Terms and Conditions” are used interchangeably throughout the RFP); General Contractual Requirements; and Vendor Submission, Evaluation, and Award Information; and the RFP Vendor Response Exhibits, Attachments, and Amendments of the RFP.

q. RSMo (Revised Statutes of Missouri) refers to the body of laws enacted by the Legislature which govern the operations of all agencies of the State of Missouri. Chapter 34 of the statutes is the primary chapter governing the operations of Purchasing.

r. Shall has the same meaning as the word must.

s. Should means that a certain feature, component and/or action is desirable but not mandatory.

t. State collectively referring to the state government and/or the agencies thereof.

u. Supplier has the same meaning as the word, vendor.

v. Vendor means the supplier, offeror, person, or organization that responds to an RFP by submitting a proposal with prices to provide the equipment, supplies, and/or services as required in the RFP document.

1.7 Accuracy of Background Information:

1.7.1 Although an attempt has been made to provide accurate and up-to-date information, the State of Missouri does not warrant or represent that the background information provided herein reflects all relationships or existing conditions related to this RFP.

****END OF INTRODUCTION AND BACKGROUND INFORMATION SECTION****

2. SCOPE OF WORK SECTION

2.1 General Requirements:

2.1.1 The contractor shall provide MO HealthNet billing and data collection services for the Department of Elementary and Secondary Education, including Missouri Schools for the Severely Disabled (MSSD), Missouri School for the Deaf (MSD), and Missouri School for the Blind (MSB), (hereinafter referred to as the state agency), in accordance with the provisions and requirements stated herein and to the sole satisfaction of the state agency.

2.1.1 Contractor’s Obligation: Unless otherwise specified herein, the contractor shall furnish all material, labor, facilities, equipment, and supplies necessary to perform the services required herein.

2.2 Minimum Experience Requirements:

2.2.1 The contractor must meet or exceed the following minimum experience requirements at the time of proposal submission and for the duration of the contract:

a. The contractor shall have a minimum of five (5) years of experience providing Billing and Data Collection Services.

b. The contractor should have a minimum of three (3) years of experience providing MO HealthNet billing services to school districts.

c. The contractor should have a minimum of three (3) years of experience providing services to the Missouri schools for Severely Disabled and Missouri School for the Deaf.

2.3 Team Qualifications:

2.3.1 The contractor shall include the following team members to administer and perform the contract requirements:

a. Leadership Team: The contractor’s leadership team shall include a primary lead position to administrate and perform the contract requirements:

1) The contractor’s primary lead position shall have a minimum of three (3) years of experience with each of the following:

· billing and data collection,

· school-based services,

· Medicaid rules,

· leadership, and

· project management.

2) The contractor’s primary lead position should have minimum of three (3) years of experience with Missouri State Operated Programs.

3) Each member of the contractor’s leadership team should have a bachelor’s degree. The team members’ bachelor’s degree should preferably be in a field related to the scope and magnitude of the RFP, such as degrees in management, business, accounting, finance and/or human resources.

b. Working Team: The contractor’s working team shall include (2) project managers, consultants, analysts, and other support staff.

1) Each of the project managers shall have a minimum of three (3) years of experience with each of the following:

· billing and data collection,

· school-based services, and

· Medicaid rules.

2) The contractor’s consultants. analysts, and other support staff should have a minimum of three (3) years of experience with Missouri State Operated projects/clients of similar size and scope and background commensurate with the requirements included herein.

c. Contact Person: The contractor shall designate a contact person who shall serve as the contractor’s contact and shall be the liaison between the contractor and the state agency. By no later than five (5) state business days after authorization by the state agency to proceed with services, the contractor shall provide the state agency with the name, address, email address, and telephone number of the contractor’s contact person. The contractor’s contact person shall (1) oversee all services being provided, (2) assume responsibility and liability for services performed per the contract, and (3) serve as the primary point of contact with the state agency.

2.3.2 The contractor shall understand and agree that the state agency reserves the right to request any of the contractor’s personnel assigned to provide the services be removed without just cause. The contractor shall understand and agree that the state agency will allow the contractor a reasonable time to find a replacement. The state agency shall approve all replacement personnel. The state agency reserves the right to require background checks and non-disclosure agreements (NDA) of selected contractor personnel, at the contractor’s expense.

2.4 Contractor Requirements:

2.4.1 The contractor shall serve as the Third-Party MO HealthNet Billing Agent for all claims submitted to MO HealthNet (or other agency or vendor appointed to process MO HealthNet claims) on behalf of the state agency for direct therapy services provided to students attending the state agency schools (hereinafter referred to as direct services).

2.4.2 The contractor shall submit all School District Administrative Claiming (hereinafter referred to as SDAC) to MO HealthNet (or other agency or vendor appointed to process Missouri SDAC) on behalf of the state agency for services provided by employed and contracted staff at the state agency schools.

a. The contractor shall be responsible for submitting the SDAC claim utilizing MO HealthNet’s data combined with the state agency’s salary and benefits for the quarter. The contractor shall not be expected to create and oversee a participant pool, to train participants and to code activities.

2.4.3 If requested by the state agency, the contractor shall submit all Transportation claims to MO HealthNet (or other agency or vendor appointed to process Missouri Transportation claims) on behalf of the state agency for all transportation provided to students attending the state agency schools.

2.5 Billing and Data Collection Requirements:

2.5.1 The contractor shall understand and agree to submissions for claims for direct services, SDAC and NEMT unless otherwise indicated.

a. The contractor shall have an electronic web-based data system for collecting information to submit claims to MO HealthNet.

b. The contractor shall notify the state agency of the required data for each submission to MO HealthNet and for other required periodic reports.

c. The contractor shall provide any programming necessary to permit interface between the state agency’s current database(s) and that of the contractor.

d. If the contractor utilizes technology such as but not limited to augmented reality tools for billing data collection services that need to connect to the State IT network or system, the contractor must understand and agree that the contractor’s tools may need to be assessed by the State’s ITSD for approval. Any introduction of technology tools must be approved by the state agency and ITSD prior to being introduced into the State’s IT infrastructure.

e. The contractor shall submit to MO HealthNet all current and future claims of the state agency in the format and mode required by MO HealthNet. The contractor shall pay any filing fees or other costs associated with filing the claims.

f. The contractor shall check the MO HealthNet eligibility at least quarterly for students prior to submitting any claims under the contract.

g. The contractor shall submit MO HealthNet claims on behalf of the state agency for state agency students eligible for MO HealthNet at the time a claimable service was provided by the state agency.

h. At the request of the state agency, the contractor shall submit MO HealthNet claims for services provided within the year prior to award of the contract, even if the service dates were prior to the date of the contract. The contractor shall not be expected to submit new data on denied MO HealthNet direct service claims originally submitted on behalf of the state agency prior to the date of this contract.

i. The contractor shall execute all documents and forms necessary for the contractor to operate as a third-party agency for submitting claims under the contract.

j. Within one month of the contractor receiving notification of claim denial, the contractor shall provide the state agency with a report specifying the reason for each denied claim. The state agency shall provide the contractor with required data or documents and the contractor shall resubmit the claim to MO HealthNet.

k. The contractor shall provide a designated account representative to be available by phone and/or email Monday to Friday from 8:00 a.m. to 4:00 p.m. Central Time.

l. Within seven (7) calendar days after the contractor receives notice from the state agency, the contractor shall attend any audit or similar meeting in Jefferson City, Missouri between the state agency and MO HealthNet at no cost to the state agency. The contractor shall work with MO HealthNet to resolve issues and keep the state agency informed of all discussions.

m. No later than thirty (30) calendar days after authorization from the state agency to proceed with services and at any time there is a significant change in the contractor’s program or MO HealthNet’s claims procedure, the contractor shall provide training and support on all aspects of the claims procedures to key state agency staff at no additional cost.

n. At the request of the state agency, the contractor shall develop materials for training state agency staff. The contractor shall provide any training materials to the state agency free of charge for the state agency to conduct training of participating state agency staff.

o. The contractor shall advise the state agency on policy changes related on all three claims programs within fourteen (14) business days after receiving notification of changes from MO HealthNet.

p. At the request of the state agency, the contractor shall analyze the problems arising with the claims and shall advise the state agency on possible solutions to reduce denials of claims.

q. The contractor’s services provided under the contract shall comply with all applicable Federal and state laws and regulations.

2.6 Reporting Requirements:

2.6.1 Periodic Reports: the contractor shall provide the state agency with a progress report outlining the following:

Report Name
Description
Frequency (e.g. weekly, monthly, quarterly, annually, as needed)
Claims Filed
Pending, paid and denied
Monthly
Percentage of Claims
After first submission
As needed
Percentage of Claims
After second submission
As needed
Claim Denials
Reasons for Denial
As needed
Services Provided
Show date service provided, receipt of data from state agency, claim submitted and payment received.
As needed

2.6.2 Retention of Records and Documents: Unless specified in writing as a shorter period of time, the contractor shall preserve and make available with no limitation all books, documents, papers, and records involving transactions related to the contract for a period of ten (10) years from the date of the cancellation, expiration, or termination of the contract. Records and supporting documentation under audit or involved in litigation shall be kept for two (2) years following the conclusion of the litigation or audit. During the contract period, access to these items shall be provided through a vehicle specified by the state agency. During the post contract period delivery and access to these items shall be at no cost to the state agency.

2.7 Financial Records and Document Retention:

2.7.1 The contractor must maintain financial and accounting records and evidence pertaining to the contract in accordance with generally accepted accounting principles.

2.7.2 The contractor shall maintain all financial records, supporting documentation, and all other records pertinent to the contract for a period of five (5) years from the date of the final payment by the state agency or the completion of an audit, whichever is later, or as otherwise stated in the contract.

a. If any litigation, claim, negotiation, audit, investigation, or other action involving the records has been started before the expiration of the five (5) year period, the contractor shall retain the records until completion of such action and resolutions of all issues that arise from it or until the end of the regular five (5) year period, whichever is later.

b. If the state agency is subject to any litigation, claim, negotiation, audit, or other action involving the records, the state agency will notify the contractor in writing to extend the contractor’s retention period.

2.7.3 The contractor shall maintain a financial management methodology that, at a minimum, records expenditures in a manner that readily identifies the expenditure as an allowable activity and allows required federal financial reports to be easily prepared.

2.8 Electronic Funds Transfer, Invoicing, and Payment Requirements:

2.8.1 Electronic Funds Transfer (EFT): The State of Missouri will submit contract payments to the contractor at the remittance address listed in the contractor’s MissouriBUYS (WebProcure/Proactis) vendor registration. However, the contractor understands and agrees the state reserves the right to make contract payments to the contractor through electronic funds transfer (EFT). Therefore, prior to any payments becoming due under the contract, the contractor must verify and update, if applicable, their vendor registration with their current remittance address and ACH-EFT payment information at https://MissouriBUYS.mo.gov.

2.8.2 Invoicing: The contractor shall submit invoices monthly. Invoices shall be due by the last day of the month following the month in which the contractor provided services under the contract. The contractor shall perform the services prior to invoicing the state agency.

a. The contractor shall submit separate invoices for successfully submitted claims for direct services, SDAC, and NEMT that are separated by MSD, and MSSD.

b. The contractor’s invoices shall refer to the month(s) and year of the claim and the amount of the paid claim received by the state agency. The contractor shall include the remittance advice, if applicable, for all claims invoice for billing period.

c. The contractor’s invoices shall include the amount of the percentage of the claims due to the contractor and the price for quarterly eligibility determination in accordance with the Pricing Page.

d. The contractor shall invoice the state agency on the contractor’s original descriptive business invoice form and submit the invoice to the address on the front page of this document or the following address:

Missouri School for the Severely Disabled- DESE.MSSDBusinessServices@dese.mo.gov Missouri School for the Deaf – BusinessOffice.MSD@MSD.dese.mo.gov

e. The contractor shall use uniquely identifiable invoice numbers to distinguish an invoice from a previously submitted invoice and shall include on the invoice the remittance address listed in the contractor’s MissouriBUYS (WebProcure/Proactis) vendor registration.

f. Each contractor invoice must be on the contractor’s original descriptive business invoice form and must contain a unique invoice number and the remittance address included in the contractor’s MissouriBUYS (WebProcure/Proactis) vendor registration. The invoice number will be listed on the state’s EFT addendum record to enable the contractor to properly apply state payments to invoices. The contractor must comply with all other invoicing requirements stated in the RFP.

g. The statewide financial management system has been designed to capture certain receipt and payment information. For each purchase order received, an invoice must be submitted that references the purchase order number and should be itemized in accordance with items listed on the purchase order. Failure to comply with this requirement may delay processing of invoices for payment.

h. The contractor shall not invoice federal or state taxes unless required under law or regulation.

2.8.3 Payment:

a. After the state agency receives reimbursement from MO HealthNet for each claim paid, the contractor shall be paid in accordance with the percentages and/or price as stated on the Pricing Page of this document for each type of claim.

b. Payments are due upon receipt of a valid invoice, payable in 30 calendar days. All invoices for equipment, supplies, and/or services purchased by the State of Missouri shall be subject to late payment charges as provided in section 34.055, RSMo.

c. The State of Missouri does not pay state or federal taxes unless otherwise required under law or regulation.

d. The State of Missouri assumes no obligation for equipment, supplies, and/or services shipped or provided in excess of the quantity ordered. Any unauthorized quantity is subject to the state's rejection and shall be returned at the contractor's expense.

e. The state will not pay for a software component until the initiation of the implementation of that software component.

f. The contractor may obtain detailed information for payments issued for the past 24 months from the State of Missouri’s central accounting system (SAM II) on the Vendor Services Portal at https://www.vendorservices.mo.gov/vendorservices/Portal/Default.aspx.

2.8.4 If the state agency denies a request by the contractor for payment or reimbursement, the state agency will provide the contractor with written notice of the reason(s) for denial.

2.8.5 If the contractor is overpaid by the state agency the contractor, upon notification by the state agency, shall provide the state agency (1) with a check payable as instructed by the state agency or (2) deduct the overpayment from the invoice(s) as requested by the state agency.

2.8.6 The total payments and reimbursements to the contractor for all services and expenses shall be firm, fixed of the total percentage and price stated on the Exhibit C, Pricing Pages.

2.8.7 Other than the payments and reimbursements specified in the contract, no other payments or reimbursements shall be made to the contractor.

2.9 Competitive Procurement Practices By Subrecipient:

2.9.1 In the event the contractor performs as a subrecipient, the contractor shall follow competitive procurement practices.

****END OF SCOPE OF WORK SECTION****

3. TERMS AND CONDITIONS SECTION

3.1 Applicable Laws and Regulations:

3.1.1 The contract shall be construed according to the laws of the State of Missouri. The contractor and the State of Missouri must follow all applicable federal, state, and local laws and regulations that apply to the performance of the contract. To the extent that a provision of the contract is contrary to the Constitution or laws of the State of Missouri or of the United States, the provisions shall be void and unenforceable. However, the balance of the contract shall remain in force between the parties unless terminated by consent of both the contractor and Purchasing.

3.2 Non-Discrimination and Affirmative Action:

3.2.1 The contractor must comply with applicable federal and state laws and regulations addressing discrimination in employment.

3.3 Americans with Disabilities Act:

3.3.1 In connection with the furnishing of equipment, supplies, and/or services under the contract, the contractor and all subcontractors shall comply with all applicable requirements and provisions of the Americans with Disabilities Act (ADA), ADA is 42 U.S.C. section 12101, et seq.

3.4 Anti-Discrimination Against Israel Act Contractor Requirements:

3.4.1 If the contractor meets the definition of a company as defined in section 34.600, RSMo, and has ten or more employees, the contractor shall not engage in a boycott of goods or services from the State of Israel; from companies doing business in or with Israel or authorized by, licensed by, or organized under the laws of the State of Israel; or from persons or entities doing business in the State of Israel as defined in section 34.600, RSMo.

3.4.2 If during the life of the contract, the contractor’s business status changes according to section 34.600, RSMo, then the contractor shall comply with, complete, and submit to the Division of Purchasing an updated Exhibit L, Anti-Discrimination Against Israel Act Certification.

3.5 Authorized Personnel/E-Verify:

3.5.1 For work performed under the contract, the contractor shall only employ personnel authorized to work in the United States in accordance with applicable federal and state laws, including section 285.530, RSMo and Executive Order 07-13. If the contractor employs personnel not authorized to work in the United States, the state shall have the right to cancel the contract immediately without penalty or recourse, and to pursue any other remedies permitted by the contract or by applicable state or federal law.

3.5.2 Prior to the performance of any services, a contractor meeting the definition of a business entity in section 285.525, RSMo, shall maintain enrollment and participation in the E-Verify Federal work authorization program with respect to the employees hired after enrollment in the program for work in connection with the contracted services included herein. If the contractor’s business status changes during the life of the contract to become a business entity as defined in section 285.525, RSMo, pertaining to section 285.530, RSMo, then the contractor shall enroll and participate in the E-Verify program.

3.5.3 The contractor shall only be required to provide the affidavits required in section 285.530.2, RSMo, to the state on an annual basis. https://purch.oa.mo.gov/vendor-information/affidavit-work-authorization-annual-renewal

3.5.4 The contractor shall ensure that its subcontractors comply with section 285.530, RSMo.

3.6 Business Registration:

3.6.1 The contractor must meet the requirements for conducting business in the State of Missouri, prior to performance of services under the contract, and for the duration of the contract. The contractor must be registered and maintain good standing with the Secretary of State of the State of Missouri and other regulatory agencies, as may be required by law or regulations. Such business requirements for formation and operation include, but are not limited to, those in Chapters 347-359, RSMo.

3.7 Data Breach:

3.7.1 If a data breach impacting the State of Missouri’s data requires the state to comply with section 407.1500, RSMo, the contractor shall assist the state by providing to the state any requested information held by the contractor concerning the breach and the state’s data stored in the software and services being provided as a result of the contract.

3.8 Elected or Appointed Officials and Employees:

3.8.1 Elected or appointed officials or employees of the State of Missouri or any political subdivision thereof, serving in an executive or administrative capacity, must comply with sections 105.452 and 105.454, RSMo, regarding conflict of interest.

3.9 Indemnification:

3.9.1 Unless expressly provided by Missouri law to the contrary, pursuant to the Constitution of the State of Missouri, Article III, section 39, subsections 2 and 5, the state shall not indemnify, hold harmless, or agree in advance to defend, any person or entity.

3.10 Legal Proceedings:

3.10.1 For any legal action or other proceedings, per section 27.050 and section 27.060, RSMo, the Missouri Attorney General is given the authority to represent the State of Missouri’s interests. The venue for any legal proceeding relating to or arising out of the RFP or resulting contract shall be in circuit court for Cole County, Missouri or the United States District Court for the Western District of Missouri, Central Division.

3.10.2 The contractor and the state agree that if a dispute concerning the contract arises that the parties shall make an attempt to resolve the dispute through informal methods before initiating litigation.

3.10.3 The State of Missouri does not agree to any arbitration. The State of Missouri does not voluntarily agree to the payment of attorneys’ fees. The state may, but is not required to, mediate any dispute arising under the contract, and any vendor provisions requiring mediation or dispute resolution processes shall not be binding upon the state.

3.11 Negotiations:

3.11.1 The State of Missouri does not negotiate contracts after award. Any competitive negotiation, if conducted by the state, must have occurred prior to contract award in accordance with Chapter 34, RSMo, 1 CSR 40-1.050 and as stated in this RFP.

3.12 Federal Funds Requirements:

3.12.1 The contractor shall understand and agree that the contract may involve the use of federal funds. The contractor shall comply with applicable Federal Funds Requirements, as amended by the federal government, which may include some or all of the paragraphs contained in Attachment 1 or other requirements identified by the federal government.

3.13 Invoicing and Payment:

3.13.1 Invoicing and payments must follow section 33.120, section 34.055, and section 8.960, RSMo. All payments shall be made in arrears, unless the requirements of 1 CSR 10-3.010 allow for advance payment of goods or services.

3.14 Non-Appropriation of Funds:

3.14.1 The contractor understands and agrees that funds required to fund the contract must be appropriated by the General Assembly of the State of Missouri for each fiscal year included within the contract period. The contract shall not be binding upon the state for any period in which funds have not been appropriated, have been withheld, or have been restricted, and the state shall not be liable for any costs associated with termination caused by lack of appropriations or authority to spend. This includes, but is not limited to, the provisions of the Mo. Const. Article IV, sections 23, 27, 28 and in sections 33.030 and 33.065, RSMo and 1 CSR 10-3.010 (1)(B).

3.14.2 To the extent that federal funding is used for the contract, the contract shall not be binding upon the state for any period in which such funding is reduced, terminated, withheld, restricted, or is frozen or paused.

3.15 Work Outside the United States:

3.15.1 Unless work outside the United States is prohibited by the RFP, any work performed outside of the United States for the contract must comply with Executive Order 04-09.

3.16 Open Records:

3.16.1 Pursuant to section 610.021, RSMo, the contract and related documents are available for public review. Pursuant to section 610.021, RSMo, proposals and related documents shall not be available for public review until after a contract is executed or all proposals are rejected.

3.17 Protests:

3.17.1 Any proposal award protest must be received within ten (10) state business days after the date of award in accordance with the requirements of 1 CSR 40-1.050.

3.18 Record Access:

3.18.1 The contractor shall grant the State Auditor access to records/items as stated in section 29.235, RSMo.

3.19 State Preferences:

3.19.1 If the contractor’s awarded proposal includes state preferences, the contractor must comply with the rules applicable to those preferences including:

a. Section 34.070 and section 34.073 RSMo for Missouri business preferences.

b. Section 34.074 RSMo and 1 CSR 40-1.050 for Service-Disabled Veteran Enterprises;

c. Section 34.069 RSMo for Honorably Discharged Veteran Enterprises;

and

d. Section 34.165 RSMo and 1 CSR 40-1.050 for Organizations for the Blind/Sheltered Workshops.

3.20 Taxes:

3.20.1 The contractor must timely file and pay all Missouri sales, withholding, corporate and any other required Missouri tax returns and taxes, including interest and additions to tax. No contract shall be awarded to a vendor that does not meet the conditions of section 34.040.7, RSMo.

*****END OF TERMS AND CONDITIONS SECTION*****

4. GENERAL Contractual REQUIREMENTS SECTION

4.1 Contract Definition:

4.1.1 A binding contract shall consist of the following documents:

a. the most current version of the RFP (including all Exhibits and Attachments included in the RFP) as amended by: RFP amendment(s) issued prior to bid closing, Best and Final Offer (BAFO) requests, and contract amendment(s);

b. the most current version of the contractor’s proposal, including the contractor’s BAFO responses, state-requested clarification responses, and contract amendment responses and

c. the Division of Purchasing’s acceptance of the proposal by “notice of award”.

4.1.2 The contract expresses the complete agreement of the parties and performance shall be governed solely by the specifications and requirements contained therein.

4.1.3 The vendor’s response, whether responding to a mandatory requirement or a desired attribute, will be binding upon the contractor in the event the vendor’s response is accepted by the state and a contract is awarded.

4.1.4 The contractor further agrees that the language of the RFP shall govern in the event of a conflict with the contractor’s proposal.

4.1.5 The contractor shall agree to furnish all awarded services specified in the contract, at the percentages and prices quoted therein.

4.1.6 A notice of award issued by the State of Missouri does not constitute an authorization for shipment of equipment or supplies or a directive to proceed with services. Before providing services for the State of Missouri, the contractor must receive a properly authorized purchase order or other form of written authorization to proceed from the state, such as an order form, (in addition to the Division of Purchasing’s “notice of award”).

4.1.7 State agencies may sign or “click-through” and accept agreements if required by the contractor in order to receive services; however, all provisions of such agreements that conflict with the contract shall have no force or effect.

4.2 Contract Amendment:

4.2.1 All changes to the contract must be accomplished by a formal contract amendment executed by both the contractor and the Division of Purchasing prior to the effective date of such change. No other means shall be used or construed as an amendment or modification to the contract.

4.3 Contract Period:

4.3.1 The original contract period shall be as specified on the cover page and the subsequent Notice of Award of the RFP.

4.3.2 Renewal Option(s): The Division of Purchasing shall have the right, at its sole option, to renew the contract for two (2) additional one-year period(s), or any portion thereof. In the event the Division of Purchasing exercises such right, all terms and conditions, requirements and specifications of the contract, including pricing shall remain the same and apply during the renewal period, pursuant to applicable option clauses of this document.

4.4 Contract Pricing:

4.4.1 All percentages and prices shall be firm, fixed, and as indicated in the Exhibit C, Pricing Pages. The state shall not pay nor be liable for any other additional costs, including but not limited to taxes, shipping charges, insurance, interest, penalties, termination payments, liquidated damages, attorney fees, etc.

4.5 Termination for Convenience:

4.5.1 The Division of Purchasing reserves the right to terminate the contract at any time, for the convenience of the State of Missouri, without penalty or recourse, by giving written notice to the contractor at least thirty (30) calendar days prior to the effective date of such termination. The contractor shall be entitled to receive compensation for services and supplies delivered to and accepted by the State of Missouri pursuant to the contract prior to the effective date of termination.

4.5.2 The contractor understands and agrees that funds required to fund the contract must be appropriated by the General Assembly of the State of Missouri for each fiscal year included within the contract period. The contract shall not be binding upon the state for any period in which funds have not been appropriated or where the funds are withheld by the governor, and the state shall not be liable for any costs associated with termination caused by lack of appropriations or due to the governor’s withholding.

4.6 Cancellation for Breach of Contract:

4.6.1 In the event of material breach of the contractual obligations by the contractor, the Division of Purchasing may cancel the contract. At its sole discretion, the Division of Purchasing may give the contractor an opportunity to cure the breach or to explain how the breach will be cured. As specified by the Division of Purchasing, the actual cure must be completed within no more than ten (10) state business days from notification, or at a minimum the contractor must provide the Division of Purchasing within ten (10) state business days from notification a written plan detailing how the contractor intends to cure the breach.

4.6.2 If the contractor fails to cure the breach or if circumstances demand immediate action, the Division of Purchasing will issue a notice of cancellation terminating the contract immediately.

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