Summary

This is a Complete Solicitation Documents package from the West Virginia Department of Health and Human Resources (DHHR) for Medicaid Managed Care Rate Setting and Program Administration services. The solicitation seeks proposals from qualified entities to provide actuarial and rate-setting services, including development of capitated rates for Medicaid managed care plans, assumption setting, financial modeling, and related program administration support. The request encompasses comprehensive rate certification, financial analysis, and technical consulting services to support West Virginia's Medicaid managed care program operations. The solicitation includes detailed specifications for deliverables, timeline requirements, and evaluation criteria for assessing proposal quality and vendor capability.

The procurement includes specific pricing requirements tied to services rendered and hours of work, with evaluation criteria addressing technical qualifications, relevant experience with state Medicaid programs, staffing and resource availability, and cost reasonableness. The contract will be awarded to one or more qualified vendors capable of delivering specialized actuarial services and rate-setting expertise. The engagement supports ongoing Medicaid managed care program administration and is intended to establish a contract term with potential for renewal or extension based on vendor performance and state needs. This represents a critical procurement for West Virginia's Medicaid program operations and requires demonstrated expertise in managed care rate development and regulatory compliance.