PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 1 of 43 Version 2.0 (02/27/2026)

Stephanie Muth, Executive Commissioner

Request for Qualifications (RFQ) for

Recovery Audit Contractor (RAC) Services

RFQ No. HHS0017023

Date of Release: August 11, 2026

See Section 3.1 for Schedule of Events

NIGP Class/Item Codes

946-11 Accounting Services (Not Otherwise Classified) 946-20 Audit Services 948-07 Administration Services, Health 948-47 Health Care Center Services 948-48 Health Care Services (Not Otherwise Classified) 948-74 Professional Medical Services: Physicians, Pharmacists, and All Specialties 952-59 Human Services (Not Otherwise Classified)

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Table of Contents

Article I. Introduction, Definitions, and Authority

1.1 Introduction

1.2 Definitions

1.3 Authority

Article II. Scope of Work

2.1 Description of Services

2.2 Contract Award, Term, and Historical Compensation

2.2.1 Contract Award and Reservation of Rights

2.2.2 Contract Term

2.2.3 Historical Compensation

2.3 No Guarantee of Volume, Usage, or Compensation

2.4 Data Use Agreement and Security Privacy Inquiry

2.5 Texas Risk And Authorization Management Plan

2.6 Governmental Entities

Article III. Administrative Information

3.1 Schedule of Events

3.2 Ambiguity, Conflict, or Discrepancy

3.3 Inquiries

3.3.1 Sole Point of Contact

3.3.2 Exceptions to Sole Point of Contact

3.3.3 Prohibited Communication

3.3.4 Solicitation Questions

3.4 Pre-proposal Conference

3.4.1 Attendance

3.4.2 Pre-proposal Conference Logistical Information

3.5 Solicitation Response Composition

3.5.1 General Information

3.5.2 Page Limit and Supporting Documentation

3.5.3 Discrepancies

3.5.4 Exceptions

3.5.5 Binding Offer

3.6 Solicitation Response Submission and Delivery

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3.6.1 Deadline

3.6.2 Delivery

3.6.2.1 General Instructions

3.6.2.3 Submission Options

3.6.3 Submission Checklist

3.6.4 Modifications and Withdrawals of Solicitation Response

3.6.5 Retention of Solicitation Responses

Article IV. Solicitation Response Evaluation and Award Process

4.1 Conformance with State Law

4.2 Best Value Determination

4.2.1 Selection Methodology

4.2.2 Minimum Qualifications

4.2.3 Initial Compliance Screening

4.2.3.1 Verification of Past Vendor Performance

4.2.4 Written Solicitation Response Evaluation

4.2.5 Written Response Evaluation Criteria

4.2.6 Advancement Criteria

4.2.7 Demonstrations

4.2.8 Demonstration Criteria

4.2.9 Final Written Response Score

4.2.10 No Consideration for Pricing

4.2.11 Summary of Best Value Determination

4.3 Questions or Requests for Clarification

Article V. Statement of Qualifications

5.1 Executive Summary

5.2 Minimum Qualification Documentation

5.3 Qualifications

5.4 Experience

5.5 Staffing Profile

5.6 Project Work Plan

5.7 Technical Proposal

5.7.1 Technology Architecture

5.7.2 System Availability and Capacity

5.7.3 Software and Hardware Components

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5.7.4 System Integration

5.7.5 System Administration, Support, and Maintenance

5.7.6 System Security and Disaster Recovery

Article VI. Required Respondent Information

6.1 Company Information

6.1.1 Company Narrative

6.1.2 Company Profile

6.1.3 Conflict of Interest Disclosure

6.2 Authorization to Conduct Business in Texas

6.3 References

6.4 Affirmations and Certifications

6.5 Financial Capacity

6.5.1 Demonstration of Reasonable Stability and Financial Solvency

6.5.2 Dun & Bradstreet Reports

6.5.3 Financial Statements and Financial Reports

6.5.4 Alternate Report

6.6 Corporate Guarantee

6.7 Major Subcontractor Information

Article VII. VetHUB Subcotracting Plan Requirement

7.1 VetHUB Subcontracting Plan Submission Instructions

Article VIII. General Terms and Conditions

8.1 General Conditions

8.1.1 Changes, Modifications, and Cancellation of the Solicitation

8.1.2 Offer Period

8.1.3 Costs Incurred

8.1.4 Contract Responsibility

8.1.5 Public Information Act - Respondent Requirements Regarding Disclosure

8.1.6 Respondent Waiver – Intellectual Property

8.1.7 Standards of Conduct for Vendors

8.1.8 Disclosure of Interested Parties

8.2 Insurance

8.2.1 Required Coverage

8.2.2 Alternative Insurance

8.3 Protest

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Article IX. List of Exhibits

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ARTICLE I. INTRODUCTION, DEFINITIONS, AND AUTHORITY

1.1 INTRODUCTION

The Texas Health and Human Services Commission (HHSC), on behalf of the Office of Inspector General (HHSC OIG), is seeking a qualified Contractor to perform recovery audit review services as described in 42 U.S.C. § 1396(a)(42)(B), 42 CFR Part 455 Subpart F, Texas Government Code Section 544.0504, and 1 TAC § 354.1451, which require states to contract with a Recovery Audit Contractor (RAC) for the purpose of identifying Medicaid Underpayments and Overpayments (also referred to as “Improper Payments”) under the Medicaid state plan, and any waiver of the Medicaid state plan including Fee for Services (FFS) and Managed Care Organizations (MCO).

Pursuant to Section 5 of House Bill (HB) 142, Texas’ 89th Legislative Session (2025), which amends Texas Government Code Ch. 544.054, the RAC program has expanded to include both FFS and managed care. Accordingly, the Contractor will perform federally required RAC functions to detect, identify Improper Payments and to recoup Overpayments for items or services defined under the Medicaid State Plan or a waiver of the Medicaid State Plan.

Information regarding HHSC and its programs is available online and can currently be accessed at https://www.hhs.texas.gov/.

The mission of the HHSC OIG, as prescribed by statute, is the "prevention, detection, audit, inspection, review, and investigation of fraud, waste, and abuse in the provision and delivery of all health and human services in the state, including services through any state-administered health or human services program that is wholly or partly federally funded, and the enforcement of state law relating to the provision of these services."

Information regarding HHSC OIG can be found online https://oig.hhs.texas.gov/.

HHSC PCS will administer the procurement process for this Solicitation and will manage Respondent communications as well as the receipt of Solicitation Responses for review and evaluation.

1.2 DEFINITIONS

As used in this Solicitation, unless a different definition is specified or the context clearly indicates otherwise, the terms and conditions have the meanings assigned below. Refer to Exhibit B, Health and Human Services (HHS) Uniform Terms and Conditions – Vendor, Version 3.4, for additional definitions (e.g., Contract, Contractor, Deliverable, Effective Date, Services, Solicitation Response, Subcontractor, System Agency, Work, and Work Order).

https://www.hhs.texas.gov/ https://oig.hhs.texas.gov/

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“Addendum” means a written clarification or revision to this Solicitation posted on the ESBD.

“Advancement Criteria” means the published criteria for Respondent to advance to the next phase of evaluation if multiple evaluation methods are utilized.

“Artificial Intelligence System" means a machine-based system that for explicit or implicit objectives infers from provided information a method to generate outputs, such as predictions, content, recommendations, or decisions, to influence a physical or virtual environment with varying levels of autonomy and adaptiveness after deployment.

“Automated Scenarios” means scenarios that rely on claims data and do not require the review of medical documentation to identify a potential Improper Payment.

“Award Consideration (AC) Documents” means documents Respondent must submit as part of the Solicitation Response to be considered for negotiations or award.

“Business Day” refers to any day, Monday through Friday, in which normal business operations of HHSC are conducted.

“Calendar Day” refers to any day of the week including Saturday, Sunday, a skeleton crew day, and national, state, or optional holidays.

“Competitive Range” has the same meaning as the definition under Title 1 of the Texas Administrative Code Part 15, Chapter 391, Subchapter A, Rule §391.107(3).

“Complex Scenario” means scenarios that require the examination of medical documentation to identify a potential Improper Payment.

“Contract Term” means the duration of the Contract, including any exercised extensions or renewals, commencing on the Effective Date and ending when the Contract expires in accordance with its terms, or when it has been terminated.

“Demonstration” refers to a secondary evaluation method following the evaluation of the written responses and is utilized for the purpose of distinguishing between Respondents by scoring them on a demonstration of use cases typically aimed at verifying the functionality of a Respondent’s software. Although most often used in information technology (IT) procurements, the method can be used in RFQs where software is a smaller component of the overall procurement but needs to be verified.

“ESBD” means the Electronic Business Daily, an online directory where State of Texas solicitations over $25,000 are posted. The ESBD may currently be accessed at https://www.txsmartbuy.gov/esbd https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=1&pt=15&ch=391&rl=107 https://www.txsmartbuy.gov/esbd

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“Fee For Service” or “FFS” means the traditional Medicaid health care services payment system under which providers receive a payment for each specific service (e.g., an office visit, laboratory test, or surgical procedure) a Medicaid beneficiary receives.

“Final Written Response Score” refers to the final scoring of the written response as documented in the Solicitation.

“HHSC PCS” means the Procurement and Contracting Services division of HHSC. HHSC PCS provides purchasing support services to DSHS and the Department of Family and Protective Services pursuant to Section 531.00553 of the Texas Government Code.

“Holiday” refers to a Texas State or Federal holiday. The list of observed holidays by state fiscal year can be found here: https://hr.sao.texas.gov/Holidays/.

“Improper Payment” means an Overpayment or an Underpayment, per 1 TAC § 354.1451.

“Managed Care Organization” or “MCO” means an organization contracted with HHSC to provide Medicaid services, including a dental MCO or a health care MCO.

“Overpayment” means any payment made to a provider by HHSC or an MCO to which the provider is not entitled under Medicaid, including Medicaid waiver programs and the Medicaid managed care program.

“Recovery Audit Contractor” or “RAC” means an eligible company or consultant contracted with HHSC to perform recovery audit review services, per 1 TAC § 354.1451.

“Respondent” means the individual or entity responding to this Solicitation.

“Review Scenario” means a particular violation of Medicaid or healthcare law, rule, contract, or policy and the associated Improper Payment detection methodology used to identify the Improper Payments through data and/or medical record reviews.

“Solicitation Consideration (SC) Documents” means documents that must be submitted by Respondent with the Solicitation Response in order to be considered for evaluation and cannot be resubmitted or have errors remedied after the submission due date and time in the Schedule of Events has passed.

“State” means the State of Texas and its instrumentalities, including HHSC, as well as any other state agency, its officers, employees, or authorized agents.

“Statement of Qualifications” means the portion of the Solicitation Response that comprises a Respondent’s qualifications and skills as set out in Article V of the Solicitation.

https://hr.sao.texas.gov/Holidays/

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“Technical Denial” means a potential Improper Payment detected through a Complex Scenario that is identified as an Improper Payment and recovered based on the failure of the provider or other responsible party on behalf of the provider to supply medical records or documentation upon request and/or within required timeframes.

“Total Score” means the Final Written Response Score plus any additional points for secondary evaluation activities, as outlined by this Solicitation.

“Transition Plan” means a plan to transition all Deliverables, activities, materials, products, services, and reports to be generated during the Contract Term, from the current, incumbent contractor to the selected Contractor in order to timely commence operations on the Operational Start Date.

“Transition Readiness Assessment Results Report” means written documentation indicating the Contractor has completed transition activities from the incumbent contractor within the specified Calendar Days after the Contract Effective Date and is able to commence performance of all operational functions with successful achievement of all performance measures for Recovery Audit Contractor Services.

“Turnover” means those activities required by the Contractor to turnover Contract operations, assets, or information to HHSC OIG or a subsequent contractor upon termination, cancellation, or expiration of the Contract.

“Turnover Plan” means a plan developed by Contractor that describes Contractor’s policies and procedures that will ensure the least disruption in the delivery of the Work during turnover to System Agency or its designee.

“TX-RAMP” means the Texas Risk and Authorization Management Program established by the Texas Department of Information Resources that provides a standardized approach for security assessment, certification, and continuous monitoring of cloud computing services that process the data of Texas state agencies.

“Underpayment” means any payment made to a provider by HHSC or an MCO that is less than the amount to which the provider is entitled under Medicaid, including Medicaid waiver programs and the Medicaid managed care program.

“VetHUB Subcontracting Plan” or “Subcontracting Plan” means the written documentation regarding the use of Subcontractors that is required by Section 2161.252 of the Texas Government Code for a purchase with an expected value of $100,000 or more when the state agency has determined subcontracting opportunities are probable. The Subcontracting Plan subsequently becomes a provision of the Contract and Contractor’s compliance with the Subcontracting Plan will be monitored during the Contract Term.

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“VPTS” means the Vendor Performance Tracking System maintained by the Texas Comptroller of Public Accounts. The VPTS may be currently accessed at https://comptroller.texas.gov/purchasing/programs/vendor-performance-tracking/

1.3 AUTHORITY

This Solicitation is issued pursuant to the authority of Title 10, Subtitle F of the Texas Government Code Section 2254, Subchapter A, Professional Services.

ARTICLE II. SCOPE OF WORK

2.1 DESCRIPTION OF SERVICES

Refer to Exhibit F, Scope of Work.

2.2 CONTRACT AWARD, TERM, AND HISTORICAL COMPENSATION

2.2.1 Contract Award and Reservation of Rights

HHSC intends to award one or more Contract(s) as a result of this Solicitation. If a single qualified Contractor is unable to serve the entirety of the Texas Medicaid program due to a conflict of interest, HHSC OIG reserves the right to award more than one Contract. Any award is contingent upon approval of the HHSC executive commissioner or their designee.

If, for any reason, a Contract cannot be executed with a Contractor selected for award within ten

(10) business days of HHSC’s determination to seek to contract with that Contractor, HHSC may avail itself of any option permissible under applicable law including, but not limited to, negotiate a contract with the next highest scoring Respondent, make a partial award, or withdraw the Solicitation.

HHSC reserves the right to cancel, make partial award, or decline to award a Contract under this Solicitation at any time at its sole discretion.

2.2.2 Contract Term

The initial term of the Contract will be three (3) years. HHSC, at its sole option, may extend any Contract awarded pursuant to this Solicitation for up to two (2) additional years.

Notwithstanding the limitation in the preceding paragraph and with thirty (30) Calendar Days’ advance written notice to Contractor, at the end of the initial term or any extension period, https://comptroller.texas.gov/purchasing/programs/vendor-performance-tracking/

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HHSC, at its sole discretion, may extend the Contract as necessary to ensure continuity of Service, for purposes of transition, or as otherwise determined by HHSC to serve the best interest of the State for up to twelve (12) months, in 1 month intervals, at the then-current contract rate or rates (if applicable) as modified during the Contract Term.

2.2.3 Historical Compensation

Historical compensation under transactions similar in scope and size to this Solicitation has been approximately $10 Million per State Fiscal Year. General cost information regarding previous transactions is provided solely for historical context and, as such, does not constitute a funding restriction for this Solicitation.

2.3 NO GUARANTEE OF VOLUME, USAGE, OR COMPENSATION

HHSC makes no guarantee of volume, usage, or total compensation to be paid under the Contract. The Contract is subject to appropriations and the continuing availability of funds and any restrictions or limitations thereof.

2.4 DATA USE AGREEMENT AND SECURITY PRIVACY INQUIRY

a. By entering into a Contract, or purchase order with the System Agency as a result of this Solicitation, Respondent agrees to be bound by the terms of the Data Use Agreement attached as Exhibit D, Data Use Agreement (DUA) and Exhibit D-1, Attachment 2 to the DUA, Security and Privacy Inquiry (SPI).

b. The Respondent must complete and return Exhibit D-1, Attachment 2 to the DUA, Security, and Privacy Inquiry (SPI).

c. Contractor shall ensure that all Confidential Information (as defined in the DUA), including such information residing on back-up systems, remains within the United States. Confidential Information shall not be accessed by Contractor personnel located outside of the United States. Furthermore, Confidential Information may not be received, stored, processed, or disposed via information technology systems located outside of the United States

2.5 TEXAS RISK AND AUTHORIZATION MANAGEMENT PLAN

Commencing on the Contract Effective Date and during the entire Contract Term, Contractor must provide Services that comply with TX-RAMP Certification Level 2 or the equivalent Fed- RAMP Certification. Contractor acknowledges that TX-RAMP Provisional Status does not satisfy the TX-RAMP Certification Level 2 requirement.

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2.6 GOVERNMENTAL ENTITIES

If Respondent is responding to this Solicitation in its capacity as a governmental entity, certain terms and conditions found in this Solicitation, including the exhibits and attachments, may not be applicable. Furthermore, to the extent permitted by law, if a Solicitation Response is received from a governmental entity, HHSC reserves the right to enter into an interagency or interlocal agreement with the governmental entity.

ARTICLE III. ADMINISTRATIVE INFORMATION

3.1 SCHEDULE OF EVENTS

EVENT DATE/TIME

Solicitation Posting Date on the ESBD August 11, 2026

Pre-proposal Conference

Attendance is Optional

August 13, 2026 at 10:30 a.m.

Central Time

Deadline for Submitting Questions August 17, 2026 at 10:30 a.m.

Central Time

Tentative Date Responses to Questions Posted on the

ESBD

August 25, 2026

Deadline for optional courtesy VetHUB Subcontracting Plan review

August 28, 2026 at 10:30 a.m.

Central Time

Deadline for Submission of Solicitation Responses [NOTE: Responses must be RECEIVED by HHSC by the deadline.]

September 9, 2026 at 10:30 a.m.

Central Time

Evaluation Period Late September – early October

Tentative Date for Notice of Award Posted on the ESBD March 2027

Anticipated Contract Effective Date April 2027

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All dates specified in the Schedule of Events are tentative and HHSC reserves the right to modify the dates or cancel the scheduled events at any time. Scheduling changes or cancellation determinations made by HHSC prior to the Solicitation Response deadline will be posted as an Addendum on the ESBD. If, after the Solicitation Response deadline, there are delays that significantly impact the anticipated award date, HHSC, at its sole discretion, may publish updates regarding the anticipated award date in the Procurement Forecast located on the HHS Procurement Opportunities webpage currently accessed at https://www.hhs.texas.gov/business/contracting-hhs/procurement-opportunities.

In accordance with Texas Administrative Code, Title 1, Part 15, Chapter 391, Subchapter C, Rule §391.305, HHSC will issue a Notice of Intent to Award in the Procurement Forecast located on the HHS Procurement Opportunities webpage under Future Opportunities, Intent to Award Notices & Delayed Procurements.

Each Respondent is responsible for periodically checking the ESBD and the HHSC Procurement Forecast for updates.

3.2 AMBIGUITY, CONFLICT, OR DISCREPANCY

Respondent must notify the individual specified in Section 3.3.1 (Sole Point of Contact) of any ambiguity, conflict, discrepancy, exclusionary specification, omission, or other error in the Solicitation in the manner and by the deadline described in Section 3.3.4 (Solicitation Questions).

Respondent submits a Solicitation Response at its own risk.

If Respondent fails to properly and timely notify the individual specified in Section 3.3.1 (Sole Point of Contact) of any ambiguity, conflict, discrepancy, exclusionary specification, omission, or other error in the Solicitation, Respondent, whether awarded a contract or not:

a. Waives any claim of error or ambiguity in the Solicitation and any resulting contract;

b. Must not contest the interpretation by HHSC of such provision(s); and

c. Is not entitled to additional compensation, relief, or time by reason of ambiguity, conflict, discrepancy, exclusionary specification, omission, or other error or its later correction.

3.3 INQUIRIES

3.3.1 Sole Point of Contact

All requests, questions, or other communication regarding this Solicitation shall be made in writing to HHSC PCS and addressed to the person identified below (Sole Point of Contact), except as https://apps.hhs.texas.gov/procurement-calendar/procurement-forecast.pdf https://www.hhs.texas.gov/business/contracting-hhs/procurement-opportunities https://www.hhs.texas.gov/business/contracting-hhs/procurement-opportunities https://apps.hhs.texas.gov/procurement-calendar/procurement-forecast.pdf https://apps.hhs.texas.gov/procurement-calendar/procurement-forecast.pdf https://apps.hhs.texas.gov/procurement-calendar/procurement-forecast.pdf

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 14 of 43 permitted in Section 3.3.2 (Exceptions to Sole Point of Contact). If a telephone number is provided by the Sole Point of Contact, its use is limited to administerial matters such as instructing a potential Respondent on accessing an IT system or locating a website referenced in the Solicitation. Communications via telephone are not binding. Respondent shall rely only on written statements issued by or through HHSC PCS designated staff as provided by Section 3.3 (Inquiries).

Name Stacy Elizondo, CTCD, CTCM

Title Contract Specialist V, PCS Purchaser

Address Procurement and Contracting Services Building 1100 W 49th St. MC: 2020 Austin, TX 78756

Phone (512) 406-2526

Email stacy.elizondo@hhs.texas.gov

3.3.2 Exceptions to Sole Point of Contact

Exceptions to Section 3.3.1 (Sole Point of Contact) are as follows:

a. A Respondent with a question relating to the VetHUB Subcontracting Plan is permitted to direct its written question(s) to the VetHUB coordinator via email at cherl.bradley@hhs.texas.gov.

b. The Sole Point of Contact may expressly direct another designated HHSC representative to speak to the Respondent, such as during contract negotiations. It is the Respondent’s responsibility to ensure that communications with an individual other than the Sole Point of Contact have been authorized by the Sole Point of Contact before engaging in such communication. Failure to comply with this requirement may result in the disqualification of a Respondent’s Solicitation Response as provided in Section 3.3.3 (Prohibited Communication).

c. The Sole Point of Contact will authorize an alternate or backup Sole Point of Contact in the event of their extended absence from the office and, in such an event, the contact information for the secondary Sole Point of Contact will be in placed in an automatic reply out-of-office email message. A Respondent seeking to contact the Sole Point of Contact should do so via email in order to timely receive updated contact information.

mailto:cherl.bradley@hhs.texas.gov

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3.3.3 Prohibited Communication

Except as provided in Section 3.3.1 (Sole Point of Contact) and Section 3.3.2 (Exceptions to Sole Point of Contact), a Respondent or potential Respondent is prohibited from communicating with HHSC regarding this Solicitation. HHSC, including its representative(s) and partners, will not answer any verbal or written questions or otherwise discuss the contents of this Solicitation with any Respondent, potential Respondent, or their associated representative(s).

This restriction does not preclude discussions between affected parties for the purposes of conducting business unrelated to this Solicitation. Failure to comply with this restriction may result in disqualification of Respondent's Solicitation Response.

3.3.4 Solicitation Questions

Written questions regarding this Solicitation must be submitted by email to the individual specified in Section 3.3.1 (Sole Point of Contact) by the deadline specified in Section 3.1 (Schedule of Events). Responses to the Solicitation questions will not be emailed to the individual requestors. Responses to all Solicitation questions timely received will be posted on the ESBD by the deadline specified in Section 3.1 (Schedule of Events). If same or similar Solicitation questions are submitted, a single consolidated answer may be posted on the ESBD.

All questions regarding the Solicitation must include the following information:

a. Solicitation number;

b. Solicitation package reference (page number, section, and exhibit or attachment, if applicable;

c. Question topic (e.g., “Schedule of Events,” or “Exhibit A, HHS Solicitation Affirmations, Version 2.10"); and

d. Question.

In addition, the following contact information must be provided by the requestor with its submission of the Solicitation question(s):

a. Business entity name;

b. Business entity representative name;

c. Phone number; and

d. Email address.

Solicitation questions received after the deadline specified in Section 3.1 (Schedule of Events) may not be answered. Prior to the Solicitation Response deadline specified in Section 3.1 (Schedule of Events), HHSC PCS reserves the right to amend answers previously posted on the ESBD. Amended answers will be posted on the ESBD. It is the Respondent's responsibility to periodically check the ESBD.

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3.4 PRE-PROPOSAL CONFERENCE

3.4.1 Attendance

HHSC PCS will conduct a pre-proposal conference. Attendance is optional but highly recommended.

3.4.2 Pre-proposal Conference Logistical Information

HHSC PCS will hold the pre-proposal conference by webinar on the date and time specified in Section 3.1 (Schedule of Events).

People with disabilities who wish to attend the meeting and require auxiliary aids or services should contact the individual identified in Section 3.3.1 (Sole Point of Contact) at least seventy-two (72) hours before the pre-proposal conference in order to have reasonable accommodations made by HHSC.

Webinar Information:

https://events.teams.microsoft.com/event/2faebee7-16b7-43e7-bc0b-f566e120e2d6@9bf97732- 82b9-499b-b16a-a93e8ebd536b?source=copyLinkLegacyShareEventDialog

3.5 SOLICITATION RESPONSE COMPOSITION

3.5.1 General Information

Respondent should focus on the instructions and requirements of the Solicitation. Respondent should prepare a Solicitation Response that clearly and concisely represents its qualifications and capabilities. Expensive bindings, colored displays, promotional materials, etc. are not necessary or desired. Failure of Respondent to submit all required information and documents within its Solicitation Response in the required format(s) may result in disqualification of the Solicitation Response without further consideration.

3.5.2 Page Limit and Supporting Documentation

The Statement of Qualifications, described in Article V, must not exceed twenty-five (25) pages, not including supporting documentation provided as appendices or attachments to the Statement of Qualifications. A Statement of Qualifications may be submitted with supporting documentation if (1) complete and concise responses cannot be provided within the Statement of Qualifications without referencing the supporting documentation, (2) the Statement of Qualifications clearly specifies the location (e.g., file, page, section, and/or paragraph) where the https://events.teams.microsoft.com/event/2faebee7-16b7-43e7-bc0b-f566e120e2d6@9bf97732-82b9-499b-b16a-a93e8ebd536b?source=copyLinkLegacyShareEventDialog https://events.teams.microsoft.com/event/2faebee7-16b7-43e7-bc0b-f566e120e2d6@9bf97732-82b9-499b-b16a-a93e8ebd536b?source=copyLinkLegacyShareEventDialog

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 17 of 43 supporting information can be found, and (3) such supporting documentation is submitted as part of the Solicitation Response.

The Statement of Qualifications must be properly paginated, formatted as an 8 ½" x 11" page with 1-inch margins, and use a 12 point or larger font, except that a smaller font may be used for page headers and footers, footnotes, and illustrations such as tables, charts, diagrams, figures, graphs and other visual aids. If a font smaller than 12 point is used, the text when printed on 8 ½" x 11" paper must not require magnification to be legible. Times New Roman font is preferred.

The Statement of Qualifications must not include other documents embedded as electronic files within the text and must not include hypertext links. The Statement of Qualifications, including supporting documentation, submitted as an electronic file should be pre-formatted for printing on 8 ½" x 11" paper.

3.5.3 Discrepancies

In the event of any discrepancies or variations between copies, HHSC is under no obligation to resolve the inconsistencies and may make its scoring and selection decisions accordingly, including the decision to potentially disqualify a Solicitation Response. If Respondent is required to designate an “Original” Solicitation Response but fails to do so, HHSC, in its sole discretion, will determine the version to be used as the original or may disqualify the Solicitation Response.

If the Respondent submits a redacted Solicitation Response as the “Original” HHSC will disqualify the Solicitation Response and it will not be evaluated. HHSC will not accept submissions after the “Deadline for Submission of Solicitation Responses” specified in Section

3.1 (Schedule of Events) to remedy discrepancies or variations in Solicitation Response submissions.

3.5.4 Exceptions

A Respondent is highly encouraged, in lieu of including exceptions in its Solicitation Response, to address all issues that might be advanced by way of exception by submitting such issues as questions in accordance with Section 3.3.4 (Solicitation Questions).

A Solicitation Response that is not responsive to the Solicitation requirements may result in disqualification. If a Respondent includes any exception(s) in its Solicitation Response, Respondent must specifically and clearly identify each exception on the Exceptions Form, Exhibit E and provide all information requested on the form. Any exception that is not submitted on the form and in the format prescribed by the Exceptions Form, Exhibit E may be rejected without consideration. An exception includes any business, economic, legal, programmatic, or practical assumptions that underlie the Respondent’s Solicitation Response.

Respondent must complete Exhibit E, Exceptions Form if Respondent takes an exception to any exhibit. When completing Exhibit E, Exceptions Form, Respondent must explain the basis for the exception as it relates to this Solicitation. Nonresponsive explanations include references

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 18 of 43 to (1) a prior version of the exhibit published by System Agency and (2) different terms in a previous transaction with System Agency or another State agency. Respondent represents that it takes no exceptions to any part of this Solicitation if the Solicitation Response does not include a completed Exhibit E, Exceptions Form. A Solicitation Response that is not responsive to the Solicitation requirements may result in disqualification.

No exception, nor any other term, condition, or provision in a Solicitation Response that differs, varies from, or contradicts this Solicitation will be considered to be part of the Contract unless specifically identified and expressly accepted by System Agency in writing in the Contract. Any terms and conditions attached to a Solicitation Response will not be considered unless specifically referred to in the Solicitation Response.

3.5.5 Binding Offer

A Solicitation Response constitutes a binding offer to contract based upon the terms, conditions, and specifications set forth in this Solicitation. By submitting a Solicitation Response, Respondent represents and warrants that any individual submitting the Solicitation Response and any related documents on behalf of the Respondent is authorized to do so and to bind the Respondent under any contract that may result from this Solicitation.

A Solicitation Response must be responsive to the Solicitation as worded and without any expectation that any or all terms, conditions, or provisions of the Solicitation will be negotiated.

A Solicitation Response may be disqualified as non-responsive to the Solicitation if it includes any disclaimer asserting a conditional offer (e.g., Respondent’s ability to contract is contingent on an exception or assumption provided in accordance with Section 3.5.4 (Exceptions) or other similar statement indicating that the Solicitation does not constitute a binding offer.

3.6 SOLICITATION RESPONSE SUBMISSION AND DELIVERY

3.6.1 Deadline

Respondent is solely responsible for ensuring timely delivery of its Solicitation Response by the date and time specified in Section 3.1 (Schedule of Events). HHSC PCS will timestamp each Solicitation Response. Solicitation Responses received after the deadline specified in Section

3.1 (Schedule of Events) will be rejected and not considered for Contract award.

3.6.2 Delivery

3.6.2.1 General Instructions

It is the Respondent’s responsibility to appropriately mark and deliver the Solicitation Response to HHSC PCS by the date and time specified in Section 3.1 (Schedule of Events). HHSC will not be responsible for submission errors that may lead to disqualification due to nonreceipt or

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 19 of 43 late delivery of a Solicitation Response. In no event will HHSC be responsible or liable for any delay or error in delivery.

3.6.2.2 Solicitation Response – Component Parts

Respondent shall submit its Solicitation Response in component parts as described below:

a. One file/folder named “Original” that contains the Respondent’s entire Solicitation Response (except the VetHUB Subcontracting Plan) in searchable portable document format (PDF), unless otherwise specified for a particular attachment or exhibit.

b. In accordance with Section 7.1 (VetHUB Subcontracting Plan Submission Instructions), one file/folder named “VetHUB Subcontracting Plan” in searchable PDF, that contains the Respondent’s Subcontracting Plan, and all supporting documentation.

c. If applicable, one file/folder named “Public Information Act Copy” that contains the Respondent’s entire Solicitation Response, including all exhibits and attachments, in searchable PDF prepared in accordance with Section 8.1.5 (Public Information Act – Respondent Requirements Regarding Disclosure).

3.6.2.3 Submission Options

Respondent must submit the Solicitation Response using one of the following submission options. A Solicitation Response submitted by any other method will not be considered.

a. Submission Option No. 1: HHS Online Bid Room. Respondent shall submit the Solicitation Response packet through the Online Bid Room utilizing the procedures outlined in Exhibit O, Online Bid Room Information.

b. Submission Option No. 2: USB Drive. Respondent shall submit the Solicitation

Response using the procedures specified in this section.

Respondent must place the Solicitation Response on two USB drives. The content on each USB drive must be identical. One USB drive must be labeled “Original” The second USB drive must be labeled “Copy”.

Respondent must deliver the Solicitation Response by one of the methods specified below.

Overnight/Express/Priority Mail Hand Delivery

Health and Human Services Commission ATTN: Response Coordinator

Tower Building Room 108 1100 W. 49th St., MC 2020

Health and Human Services Commission ATTN: Response Coordinator

Procurement & Contracting Services Building

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 20 of 43

Austin, Texas 78756 1100 W. 49th St., MC 2020 Austin, Texas 78756

A Solicitation Response delivered by mail or hand delivery must be placed in a sealed package. It is Respondent’s sole responsibility to ensure that packaging is sufficient to prevent damage to contents. HHSC will not be held responsible for any Solicitation Response that is mishandled prior to receipt by HHSC PCS.

The sealed package and each USB drive must be clearly labeled on the outside as follows:

SOLICITATION NO: HHS0017023

SOLICITATION NAME Recovery Audit Contractor Services (RAC)

SOLICITATION RESPONSE DEADLINE See Section 3.1 (Schedule of Events).

PURCHASER NAME: Respondent to include purchaser name from Section 3.3.1 (Sole Point of Contact).

RESPONDENT NAME: Respondent to include its name.

Respondent is solely responsible for ensuring its Solicitation Response is submitted in accordance with all Solicitation requirements including, but not limited to, proper labeling of packages, sufficient postage or delivery fees, and ensuring timely receipt by HHSC. A dated shipping label, invoice of receipt from the delivery carrier, or any other documentation in lieu of the HHSC PCS time stamp WILL NOT be accepted.

3.6.3 Submission Checklist

Solicitation Consideration and Award Consideration Documents, defined in Section 1.2 (Definitions), must be submitted by the deadline for Solicitation Response submissions specified in Section 3.1 (Schedule of Events). Solicitation Consideration Documents will be reviewed as received, and Respondent will not have an opportunity to remedy missed requirements. At its sole discretion, HHSC may request some, or all of, the Respondents to remedy missing elements of Award Consideration Documents. Those marked “SC” are Solicitation Consideration Documents and those marked “AC” are Award Consideration Documents.

Below are the documents required to be submitted with the Solicitation Response. Where searchable PDF files are required, submission of non-searchable (image only) PDF files may result in disqualification of the Solicitation Response.

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 21 of 43

a. Statement of Qualifications and Respondent Information

1. Statement of Qualifications (Article V) SC ____

2. Minimum Qualification Documentation

(Sections 4.2.2 and 5.2) SC ____

3. SPI (Section 2.4, Exhibit D-1) AC ____

4. Exceptions, if applicable (Section 3.5.4, Exhibit E) AC ____

5. Company Information (Section 6.1) SC ____

6. Authorization to Conduct Business in Texas and Franchise Tax Exemption

(Section 6.2) AC ____

7. References (Section 6.3) AC ____

8. HHS Solicitation Affirmations (Section 6.4, Exhibit A) SC ____

9. Federal Assurances – Non- Construction Programs

(Section 6.4, Exhibit J) AC ____

10. Certification Regarding Lobbying (Section 6.4, Exhibit L) AC ____

11. HHS FFATA Certification form (Section 6.4, Exhibit K) AC ____

12. Financial Capacity (Section 6.5) AC ____

13. Major Subcontractor Information (Section 6.7) SC ____

14. Signed Addenda (if applicable) AC ____

15. Voluntary Product Accessibility Template v2.5

(Section 6.4, Exhibit N) AC ____

b. VetHUB Subcontracting Plan (Article VII, Exhibit H) SC ____

3.6.4 Modifications and Withdrawals of Solicitation Response

Prior to the Solicitation Response submission deadline specified in Section 3.1 (Schedule of Events), Respondent may either (1) withdraw its Solicitation Response by submitting a written request to the individual identified in Section 3.3.1 (Sole Point of Contact), or (2) modify its

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 22 of 43

Solicitation Response by submitting a written amendment to the individual identified in Section

3.3.1 (Sole Point of Contact). When modifying its Solicitation Response, Respondent must provide written notice signed by an authorized representative that specifically identifies the portion(s) of the Solicitation Response that will be replaced or removed by the amendment.

3.6.5 Retention of Solicitation Responses

A Solicitation Response becomes the property of HHSC after submission and will not be returned to the Respondent.

ARTICLE IV. SOLICITATION RESPONSE EVALUATION AND AWARD

PROCESS

4.1 CONFORMANCE WITH STATE LAW

Solicitation Responses shall be evaluated in accordance with Texas Government Code Section 2254.003.

HHSC will make the selection of one or more Respondents (if any) to contract with HHSC on the basis of demonstrated competence and qualifications to perform the required Services and for a fair and reasonable price.

4.2 BEST VALUE DETERMINATION

4.2.1 Selection Methodology

Solicitation Responses that meet the minimum qualifications will be submitted to the evaluation team for review and scoring. Each member of the evaluation team will receive a copy of each responsive Solicitation Response. The evaluators will review the Solicitation Responses considering the criteria listed in Section 4.2.5 (Written Response Evaluation Criteria).

Evaluators will individually score the Solicitation Responses. This procurement will utilize an aggregated individual evaluation methodology as outlined by this section.

The following subsections describe the evaluation process, including any criteria for advancement to the various phases of evaluation, if applicable.

4.2.2 Minimum Qualifications

Respondent must meet the minimum qualifications listed below:

a. Respondent must have recently been in business for a minimum of two (2) years, or the principals/owners must have had recent ownership/executive management experience in a previous company that provided public healthcare program integrity services;

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 23 of 43

b. Respondent must be financially solvent and adequately capitalized, as determined based on a review of documentation required by Section 6.5 (Financial Capacity); and

c. Respondent has submitted the Solicitation Response in accordance with Section 3.6, (Solicitation Response Submission and Delivery) including all Solicitation Consideration and Award Consideration Documents, see Section 3.6.3 (Submission Checklist).

4.2.3 Initial Compliance Screening

HHSC will review Solicitation Responses for compliance with Section 3.6.3 (Submission Checklist) and for demonstrated ability to meet the minimum qualifications specified in Section

4.2.2 (Minimum Qualifications) required to advance to evaluations. Failure to meet the minimum qualifications specified in Section 4.2.2 (Minimum Qualifications), will result in the disqualification of the Solicitation Response.

HHSC will automatically disqualify any Solicitation Response that does not include one or more of the completed and signed (as applicable) Solicitation Consideration Documents listed in Section 3.6.3 (Submission Checklist).

At its sole discretion, HHSC may disqualify any Solicitation Response that does not include all required Award Consideration Documents. Reference Section 3.6.3 (Submission Checklist).

HHSC may contact references provided in response to this Solicitation. HHSC may contact Respondent’s clients, or solicit information from any available source, including the Comptroller’s VPTS. Any information received may be grounds for disqualification if that information, in HHSC’s sole discretion, suggests that the Respondent may perform poorly if selected.

4.2.3.1 Verification of Past Vendor Performance

By submitting a Solicitation Response, Respondent generally releases from liability and waives all claims against any party providing information about Respondent at the request of HHSC.

At its sole discretion, Respondents may be rejected as a result of unsatisfactory past performance under any contract(s) as reflected in vendor performance reports, reference checks, or other sources.

Respondent’s past performance may be considered prior to making an award determination.

a. Reasons for which a Respondent may be denied a contract include, but are not limited to:

1. Respondent has unfavorable reports or grade less than a “C” on the CPA Vendor Performance Tracking System (VPTS);

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 24 of 43

2. Respondent is currently under a corrective action plan through HHSC;

3. Respondent has had repeated, negative vendor performance reports for the same reason;

4. Respondent has a record of repeated non-responsiveness to vendor performance issues; or

5. Respondent has contracts or purchase orders that have been cancelled in the previous 12 months for non-performance or sub-standard performance.

b. HHSC may examine other sources of vendor performance, which may include information provided by any governmental entity, whether an agency or political subdivision of the State of Texas, another state, or the federal government. The performance information may include, but is not limited to:

1. Notices of termination;

2. Cure notices;

3. Assessments of liquidated damages;

4. Litigation;

5. Audit reports; and

6. Non-renewals of contracts.

c. HHSC, at its sole discretion, may initiate investigations or examinations of vendor performance based upon media reports. Any negative findings, as determined by HHSC in its sole discretion, may result in HHSC’s removing Respondent from further consideration for award.

4.2.4 Written Solicitation Response Evaluation

Each member of the evaluation team will read the Solicitation Responses in preparation for evaluation. The evaluation team will score all Solicitation Responses that pass initial screening, Section 4.2.3 (Initial Compliance Screening). Solicitation Responses will be scored against the criteria in Section 4.2.5 (Written Response Evaluation Criteria).

4.2.5 Written Response Evaluation Criteria

A Solicitation Response shall be consistently evaluated and scored in accordance with the following criteria. See also Exhibit G, Evaluation Tool.

a. Qualifications (30%)

b. Experience (30%)

c. Project Work Plan (20%)

d. Technical Proposal (20%)

4.2.6 Advancement Criteria

After the written Solicitation Response evaluation, Respondents may be selected for invitation to Demonstrations using the Advancement Criteria specified by this section. Demonstrations will

PCS 570 HHS RFQ Template, RFQ No. HHS0017023 Page 25 of 43 be determined by the Competitive Range.

HHSC will limit advancement to secondary evaluation activities, and further award consideration, to Respondents that meet the specified Advancement Criteria.

The Competitive Range will consist of the Solicitation Responses that receive the highest scores or most satisfactory ratings, based on the published evaluation criteria and procedures governing this procurement. Cutoff for the Competitive Range will be based on the “natural break” in scores and on reasoned judgment that Solicitation Responses below the cutoff cannot be made successful through clarification and negotiation. By way of example, in a scenario where initial evaluation scores are 97, 93, 82, 81, 79 and 68, the Competitive Range may include only the top two Respondents. HHSC is not obligated to enforce a natural break in scores and reserves the right to advance as many or as few Proposals as qualified under this criterion.

4.2.7 Demonstrations

To further identify the Respondent providing best value, Demonstrations may be requested. The Advancement Criteria, as described by Section 4.2.6 (Advancement Criteria), will be utilized to determine which Respondents will advance to Demonstrations.

Respondents selected for Demonstrations will be the final group of Respondents eligible for award.

Demonstrations will allow for points to be added to Respondent’s Final Written Response Score, in accordance with Section 4.2.8 (Demonstration Criteria).

HHSC may require a Demonstration from any or all Respondents to make a determination for award recommendation. Information from the Demonstration will be used in addition to the scoring of the criteria in Section 4.2.5 (Written Response Evaluation Criteria). Respondents will be provided with advance notice of any such Demonstration and are responsible for their own presentation equipment. Advance notice will include an agenda and specific scenarios or use cases for each category or criteria listed in Section 4.2.8 (Demonstration Criteria). Failure to participate in the requested Demonstration may eliminate a Respondent from further consideration. HHSC is not responsible for any costs incurred by the Respondent in preparation for any Demonstration. All costs incurred by Respondent are the responsibility of Respondent.

4.2.8…