Emergency Purchase Statement -- APO signed.pdf

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EMERGENCY NOTICE: Quality Improvement and Utilization Management
Solicitation number
26-478HFS-MEDPR-B-49952
Issued by
St. Clair County, Illinois

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EMERGENCY PURCHASE STATEMENT

State of Illinois Chief Procurement Office for General Services Emergency Purchase Statement V.25.2 Page of

EMERGENCY PURCHASE STATEMENT

Page of State of Illinois Chief Procurement Office for General Services Emergency Purchase Statement V.25.2 Emergency Purchase Details Emergency Category (select the appropriate option from the drop-down menu below):

Reason for selection of this particular vendor:

Description of supplies or services to be provided:

Emergency procurements shall be made with as much competition as is practicable under the circumstances, and agencies shall utilize best efforts to include contractors certified under the Business Enterprise Program in its emergency procurement process. 30 ILCS 500/20-30(a).

List the actions taken by the agency that constitute its best efforts to include contractors certified under the Business Enterprise Program in this emergency purchase:

Is there an existing State contract available for the required supplies or services?

If Yes is checked above, explain why the existing contract does not meet the need:

Actual or Estimated*:

*Estimated end date and cost will be reported later.

Select the type of funding to be used:

Signature This emergency purchase was made with as much competition as is practicable under the circumstances. Best efforts were utilized to include contractors certified under the Business Enterprise Program in the process.

I am authorized to make this emergency purchase, and I know and understand the contents of this statement and all statements herein are true and correct to the best of my knowledge.

11.0.0.20130303.1.892433.887364

VendorZip: 70809
VendorState: LA
VendorCity: Baton Rouge
VendorAddress: 8440 Jefferson Highway
Vendor: Keystone Peer Review Organization, LLC dba Acentra Health.
AgencyZip: 62704
AgencyState: IL
AgencyCity: Springfield
AgencyAddress: 201 S Grand Ave E
AgencyDivision: Bureau of Quality Management
AgencyUniversity: Healthcare and Family Services
CurrentMasterPage:
MasterPageCount:
ReferenceNumber: 26478HFSMEDPRB-49952
DropDownListQuickPurchase: To prevent or minimize serious disruption in critical State services that affect health, safety, or collection of substantial State revenues
CheckBox1ProtectingHealth: 0
CheckBox2DiscountedPrice: 0
CheckBox3RareItems: 0
CheckBox4Entertainment: 0
CheckBox5AvoidLapsing: 0
ExplanationForSelectingVendor: The current contract with eQHealth Solutions, LLC (2021-35-001) expires on October 29, 2025. Continuity of these services is critical to maintain the State’s federally required surveillance and utilization control program under 42 CFR Part 476. Transitioning to a new vendor is not feasible during the emergency term, as onboarding a new contractor would require an estimated minimum of 3-5 month for staffing, credentialing, systems integration, data exchange configuration, and statewide provider training and readiness. Attempting to transition within the emergency timeframe would threaten the health and safety of Medicaid members by interrupting critical prior authorization and utilization review activities. This includes determinations for medically necessary inpatient services and psychiatric residential treatment for children, creating risk of delayed or denied access to needed care.

The incumbent vendor will maintain the original pricing established under the competitively procured RFP and will continue efforts to meet the existing 5% BEP participation goal for the duration of the emergency term, ensuring both cost stability and supplier diversity commitments remain intact while the State conducts a competitive procurement. The emergency contract will be issued to the legal entity name: Keystone Peer Review Organization, LLC dba Acentra Health.

ExplanationSuppliesServices: The Quality Improvement Organization (QIO) vendor must provide utilization management and quality assurance services for Medicaid members across multiple levels of care. This includes medical necessity determinations and continued stay reviews for inpatient hospital care, as well as review and oversight for hospital outpatient services, psychiatric residential treatment facilities, long-term acute care hospitals (LTAC), integrated health homes (IHHs), and other community-based treatment settings. The vendor will also conduct pre-payment and post-payment utilization reviews, appeals and reconsideration reviews, and investigations into potential quality of care concerns. The vendor will operate and support the web-based referral and authorization platform, provide provider outreach, training, and technical assistance, complete standard and ad hoc reporting, and perform special projects as directed by the Department. These activities collectively support the State’s surveillance and utilization control program in accordance with 42 CFR Part 476.
TextField1: This emergency procurement is a bridge to prevent disruption in critical utilization review services while the State completes a full competitive procurement. Under the current contract, the vendor is required to maintain a 5% BEP participation goal. While the vendor did not meet the 5% participation level in the current term, the State conducted a Good Faith Effort review during the renewal evaluation period in accordance with 30 ILCS 500/20-60(f). The vendor provided documentation of outreach and engagement efforts; however, the amount of work that could be subcontracted was materially lower than originally projected and required.

A new BEP goal was calculated for the renewal period, resulting in an 8% participation goal. However, the emergency term is limited to continuation of existing work to prevent service disruption, and the vendor has not met the current 5% goal to date. Therefore, the BEP participation level will remain at 5% during the emergency term, with the vendor continuing its existing BEP participation structure. This approach preserves supplier diversity to the extent practicable while ensuring continuity of federally required services.

CheckBoxYes: 0
CheckBoxNo: 1
ExplanationDoesNotMeetNeed: The existing contract does meet the need an is currently undergoing the renewal process. To avoid a break in service, HFS is declaring an emergency to bridge the gap between contract expiring and renewal execution.
TextFieldExpectedStartDate: 2025-10-30
TextFieldExpectedEndDate: 2026-01-27
TextFieldAmountExpenditure: 339,000
ActualOrEstimated1: Estimated *
CheckboxFederalFunds: 1
CheckboxStateAppFunds: 1
CheckBoxStateGrantFunds: 0
CheckBoxOther: 1
IfOtherExplainTextField: This contract is 75% Federally funded.
AuthorizedSignature:
TitleField: SPSA
PrintedNameField: Monique Wantland
AuthorizedDateField: 10/30/2025

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