Exhibit A-4 - SRCs&EvaluationCriteria.docx

EXHIBIT E-6

Technical Proposal Attestation

EXHIBIT A-4

SUBMISSION REQUIREMENTS AND EVALUATION CRITERIA COMPONENTS (TECHNICAL RESPONSE)

Instructions to respondents for the completion of Exhibit A-4:

All respondents to this solicitation shall utilize Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), for submission of its response and shall adhere to the instructions below for each Submission Requirement Component (SRC).

Respondents shall not include website links, embedded links and/or cross references between SRCs.

Each SRC contains form fields. Population of the form fields with text will allow the form field to expand and cross pages. There is no character limit.

Attachments are acceptable for any SRC but must be referenced in the form field for the respective SRC and located behind each respective SRC response. Respondents shall name and label attachments to refer to respective SRCs by SRC identifier number.

Agency evaluators will be instructed to evaluate the responses based on the narrative contained in the SRC form fields and the associated attachment(s), if applicable.

Each response will be independently evaluated and awarded points based on the criteria and points scale using the Standard Evaluation Criteria Scale below unless otherwise identified in each SRC contained within Exhibit A-4.

STANDARD EVALUATION CRITERIA SCALE

The SRCs in Exhibit A-4 may not be retyped and/or modified and must be submitted in the original format.

Failure to submit, Exhibit A-4, may result in the rejection of response.

Respondent Name:

SRC# 1: TABLE OF CONTENTS

The respondent shall include a Table of Contents in its response. The Table of Contents shall contain Section Headings and subheadings along with corresponding page numbers.

Score: No points will be awarded for the Table of Contents.

Response:

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

SRC# 2: EXECUTIVE SUMMARY

The respondent shall include an Executive Summary that demonstrates the respondent’s overall understanding of the Scope of Services and describes the salient features of the respondent’s Technical Proposal.

Score: No points will be awarded for the Executive Summary.

SRC# 3 – ORGANIZATIONAL STRUCTURE AND HISTORY

The respondent shall demonstrate its capability to provide the services described in this solicitation by describing its organizational structure and history. At a minimum, the description shall include:

1. A detailed description of the respondent’s organizational structure, history, legal structure, ownership, affiliations.

2. An organizational chart, including the total number of employees and the respondent’s corporate qualifications.

3. A detailed description of the respondent’s proposed physical business location(s) in the forty-eight contiguous United States and how those locations will be utilized to effectively provide the services required by this solicitation.

The respondent’s entire response for this SRC must be provided within the respective response field below and up to one (1) attachment, as prescribed herein.

Attachments are limited to the following:

· An organizational chart, including the total number of employees and the respondent’s corporate qualifications.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s detailed description of its organizational structure, history, legal structure, ownership, affiliations.

2. The adequacy of the respondent’s staffing levels for this project based on the organizational chart and the respondent’s corporate qualifications.

3. The adequacy of the respondent’s capability to effectively provide services based on its physical business in the forty-eight contiguous United States.

Score: This Section is worth a maximum of fifteen (15) raw points with each of the above components being worth a maximum of five (5) points each.

SRC# 4 – EXPERIENCE AND QUALIFICATIONS

The respondent shall demonstrate its capability to provide the services described in this solicitation by describing its qualifications and experience in providing services similar in nature to those described in this solicitation as well as its proposed subcontractor’s experience and qualifications, if applicable. At a minimum, the description shall include:

1. A list of current or previous contracts for which it provided services within the last five (5) years from the date of solicitation issuance that are similar in nature to those described in this solicitation.

2. For each identified contract, the following information shall be provided:

a. The name and address of the client;

b. The name of the project;

c. The time period of the project;

d. A brief narrative describing the role of the respondent and scope of the work performed, including services provided and size of population served;

e. The scheduled and actual completion dates for development and implementation. The description shall include any barriers encountered that hindered implementation (as applicable), and the respondent’s resolution for overcoming them;

f. Significant accomplishments and achievements;

g. The use of any subcontractor(s) on each project, their scope of work, and the percentage of the work on the project completed by subcontractors; and

h. A list of any monetary penalties or liquidated damages for insufficient performance issued by another party, including but not limited to, a private company, organization, or state, local, or federal government, within the last five (5) years from the date of solicitation issuance.

3. A detailed description of the vendor’s experience with providing federally mandated and optional electronic visit verification technology, as defined in the 21st Century Cures Act (Cures Act, P.L. 114-255) and section 409.9132, Florida Statues.

4. A description of any relevant accreditations or certifications that the respondent has received.

5. A detailed description of previous innovative approaches that were successfully implemented to reduce costs or improve the quality of care to Medicaid enrollees.

6. A description of the vendor’s ability to comply with the most current certification model mandated by CMS and achieve outcomes required by CMS for certification.

7. For a previous contract in which the vendor provided similar services, a detailed description of the respondent’s ability and approach to transitioning from an interface platform with a single entity to integrating with multiple vendors utilizing an integration platform, including how a similar transition would be completed as work under this Contract by December 31, 2024.

8. For a previous contract in which the vendor provided similar services, a detailed description of the respondent’s ability and approach to integrate with, capture, and verify Electronic Visit Verification (EVV) data and other pertinent information from third party (alternate) EVV vendors, including the number of third party EVV vendors with which the vendor has integrated.

9. For a previous contract for which the vendor provided similar services, the monthly average number of unique providers that used the vendor’s EVV system for checking in/out of visits, monthly average number of unique providers that used the vendor’s EVV system for billing, and total average number of claims and claims amounts submitted (billed) per month.

The respondent’s entire response for this SRC must be provided within the respective response field below and up to one (1) attachments, as prescribed herein.

Attachments are limited to the following:

· A list of current or previous contracts for which it provided services within the last five (5) years from the date of solicitation issuance.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s capability to provide services required for the Program based on the description of its cumulative experience within the last five (5) years in the performance of current or previous contracts for which it is/was the lead Vendor on any Projects that are similar in size, scope, and complexity as the services outlined in this solicitation. Also, consider any monetary penalty(ies) or liquidated damage(s) for insufficient performance assessed by another party within the last three (3) years.

2. The adequacy of the respondent’s proposed approach to identifying and responding to any barriers that hindered the implementation of an EVV Program.

3. The adequacy of the respondent’s experience with providing federally mandated and optional EVV-related activities, as defined in the 21st Century Cures Act (Cures Act, P.L. 114-255) and section 409.9132, Florida Statues.

4. The adequacy of the respondent’s relevant accreditations or certifications that the respondent has received.

5. The adequacy of the respondent’s previous innovative approaches that were successfully implemented to reduce costs or improve the quality of care to Medicaid enrollees.

6. The adequacy of the respondent’s description of the vendor’s ability to comply with the most current certification model mandated by CMS and achieve outcomes required by CMS for certification.

7. The adequacy of the respondent’s detailed description of the vendor’s ability and approach to transitioning from an interface platform with a single entity to integrating with multiple vendors utilizing an integration platform, including how a similar transition would be completed as work under this Contract by December 31, 2024.

8. The adequacy of the respondent’s detailed description of the vendor’s ability and approach to integrate with, capture, and verify EVV data and other pertinent information from third party (alternate) EVV vendors, including the number of third party EVV vendors with which the vendor integrated.

9. The adequacy of the respondent’s monthly average number of unique providers that used the vendor’s EVV system for checking in/out of visits, monthly average number of unique providers that used the vendor’s EVV system for billing, and total average number of claims and claims amounts submitted (billed) per month.

Score: This Section is worth a maximum of fifty (50) raw points. The components above are worth a maximum of forty-five (45) raw points with each of the above components being worth a maximum of five (5) points each. Additional points will be awarded as follows:

Five (5) additional points if the respondent possesses a minimum of three (3) years of experience operating an Electronic Visit Verification (EVV) Program that includes Medicaid home health services.

SRC#5 – VENDOR STAFFING

The respondent shall demonstrate its capability to successfully meet the requirements of this solicitation and the resulting Contract by describing its capability to meet the staffing requirements as described in Attachment B, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section B., Services Provided by the Vendor, Item 7., Staffing Requirements. At a minimum, the Response shall include the following:

1. A staff organization chart for the staff that will provide services for this Project that identifies proposed key staff by name and position title.

2. Proposed approach to administer and manage all aspects of this Contract, including all subcontracts, employees, agents, and services performed by anyone acting for or on behalf of the Vendor.

3. Proposed number of staff, including allocation of dedicated staff and time, that is sufficient to provide the services required in this solicitation and to comply with all terms of the resulting Contract.

4. In the event staffing deficiencies are identified by the Agency, the respondent’s proposed approach to address and remedy staff issues or staffing levels.

5. Resumes for key staff listed below, demonstrating their education and experience as required by this solicitation. If the position will need to be filled, indicate the qualifications that must be met by the applicants:

a. Account/Contract Manager;

b. Customer Service/Call Center Supervisor; and

c. Education/Training Associate.

6. Proposed approach to ensure the capability of its Account/Contract Manager to meet with Agency staff both face-to-face and virtually throughout the resulting Contract period.

7. Proposed approach to ensure staff communicate directly with the designated Agency Contract Manager as the single point of contact.

The respondent’s entire response for this SRC must be provided within the respective response field below and up to five (5) attachments, as prescribed herein.

Attachments are limited to the following:

· Staff organization chart, including proposed staffing levels;

· Key staff position descriptions;

· Proposed Account/Contract Manager resume or required qualifications if position is to be filled;

· Proposed Customer Service/Call Center Supervisor resume or required qualifications if position is to be filled;

· Proposed Education/Training Associate resume or required qualifications if position is to be filled; and

· Qualifications of key subcontractors the prospective Vendor intends to utilize for this program (if applicable).

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s staff organization chart for staff that will provide services for this Project that identifies proposed key staff by name and position title.

2. The adequacy of the Respondent’s proposed approach to administer and manage all aspects of this Contract, including all subcontracts, employees, agents, and services performed by anyone acting for or on behalf of the Vendor.

3. The adequacy of the respondent’s proposed number of staff, including allocation of dedicated staff and time, that is sufficient to provide the services required in this solicitation and to comply with all terms of the resulting Contract.

4. In the event staffing deficiencies are identified by the Agency, the adequacy of the Respondent’s proposed approach to address and remedy staff issues or staffing levels.

5. The adequacy of the respondent’s resumes for key staff that demonstrates their education and experience as required by this solicitation, including the adequacy of the respondent’s list of qualifications that must be met by the applicants if the position will need to be filled.

6. The adequacy of the respondent’s proposed approach to ensure the capability of its Account/Contract Manager to meet with Agency staff both face-to-face and virtually throughout the resulting Contract period.

7. The adequacy of the respondent’s proposed approach to ensure staff communicate directly with the designated Agency Contract Manager as the single point of contact.

Score: This Section is worth a maximum of thirty-five (35) raw points with each of the above components being worth a maximum of five (5) points each.

SRC# 6 – ELECTRONIC VISIT VERIFICATION (EVV) SERVICES

The respondent shall demonstrate its capability to successfully meet the requirements of this solicitation and the resulting Contract by describing its approach to develop, implement and provide services required for the operation of Electronic Visit Verification (EVV) Services as described in Attachment B, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section B., Services Provided by the Vendor, Item 1., General Responsibilities and Item 2., EVV System Functionality. At a minimum, the Response shall include the following:

1. Proposed approach to implementing an EVV system that supports and verifies the utilization of home health services using adaptable, user-friendly technology that is effective for identifying and monitoring delivery of the service and deterring fraudulent or abusive billing.

2. Proposed approach to obtain the capacity (e.g., hardware, software) sufficient to access and generate all data and reports needed for the Contract resulting from this solicitation.

3. Proposed protocols and internal procedures that ensure system security and confidentiality of recipient identifiable data in compliance with Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.

4. Proposed approach to interfacing with the Florida Medicaid Management Information System (FMMIS) and demonstrating it can create, receive, upload, transmit and/or process all files (prior authorization, provider, recipient, and claims) within Agency-required timeframes as necessary to support the Home Health EVV system.

5. Proposed approach to enable provider scheduling after receipt of an approved Prior Authorization and prior to the delivery of services using the Vendor’s EVV system.

6. Proposed approach to facilitate a provider’s ability to check in and check out of recipient interactions using the Vendor’s EVV Global Positioning System (GPS) infrastructure, software, biometric applications, and multilevel authentication.

7. Proposed approach to create an interactive, web-based provider group administrator console that displays real-time data, including, but not limited to, provider schedules and visit details, and provides user management functionality.

8. Proposed approach to implement other innovative technologies to verify services when a provider does not have access to or is unable to use a smartphone.

9. Proposed approach to delivering an EVV system that provides an electronic billing interface and the automatic electronic submission of Medicaid claims with accurate dates and times of service, as well as additional required data elements as determined by the Agency.

10. Proposed approach to create and submit HIPAA ANSI X12 837P Professional Health Care Claims to the Agency Fiscal Agent and have the capability to retrieve the acknowledgement response files (X12 999/TA1), resolve associated errors, and timely resubmit affected claims.

11. Proposed approach to enable providers to self-audit and remedy potential billing anomalies.

12. Proposed approach to accurately roll up all services on a single claim form if a recipient has the same service delivered by the same provider multiple times per day.

13. Proposed approach to identify and resolve all system issues related to claims denials within five (5) business days.

14. Proposed approach to develop, implement, and maintain a user-friendly public website with web pages that load (displays content to users) within three (3) seconds or less that provides, at a minimum, information about EVV requirements, relevant state and federal rules and regulations, user-friendly registration functionality, training and resources, frequently asked questions (FAQ), and links to other important resources that relate to the Home Health EVV System.

15. Proposed approach to provide a HIPAA compliant, real-time, interactive web-based EVV data dashboard that the Agency can securely access to generate reports.

16. Proposed approach and capability to integrate, capture, and verify EVV data and other pertinent information from third-party EVV systems as specified by the Agency.

17. Proposed approach to scheduling any planned downtime for system maintenance within required timeframes and resolving issues that cause unexpected and non-scheduled system downtime, including the respondent’s approach to complying with notification requirements described in this solicitation.

The respondent’s entire response for this SRC must be provided within the respective response field below and up to three (3) attachments, as prescribed herein.

Attachments (including flow charts) are limited to the following:

· Diagrams of a proposed EVV system and verification process;

· A description of the respondent’s approach to operationalize and demonstrate the functionalities of its third-party EVV integration capabilities.; and

· Screenshots of one (1) existing Vendor website for contracts similar to the one proposed in this solicitation or a mock-up of the Vendor’s proposed website.

Evaluation Criteria:

1. The adequacy of the respondent’s proposed approach to implementing an EVV system, that verifies the utilization of home health services using adaptable, user-friendly technology that is effective for identifying delivery of the service and deterring fraudulent or abusive billing for the service.

2. The adequacy of the respondent’s proposed approach to obtain the capacity (e.g., hardware, software) sufficient to access and generate all data and reports needed for the Contract resulting from this solicitation.

3. The adequacy of the respondent’s proposed approach to implementing protocols and internal procedures that ensure system security and confidentiality of recipient identifiable data.

4. The adequacy of the respondent’s proposed approach to interfacing with the FMMIS and demonstrating it can create, receive, upload, transmit and/or process all files necessary and within Agency-required timeframes to support the Home Health EVV system.

5. The adequacy of the respondent’s proposed approach to enable provider scheduling after receipt of an approved Prior Authorization and prior to the delivery of services using the Vendor’s EVV system.

6. The adequacy of the respondent’s proposed approach to facilitate a provider’s ability to check in and check out of recipient interactions using the Vendor’s EVV Global Positioning System (GPS) infrastructure, software, biometric applications, and multilevel authentication.

7. The adequacy of the respondent’s proposed approach to create an interactive, web-based provider group administrator console that displays real-time data, including, but not limited to, provider schedules and visit details, and provides user management functionality.

8. The adequacy of the respondent’s proposed approach to implement other innovative technologies to verify services when a provider does not have access to or is unable to use a smartphone.

9. The adequacy of the respondent’s proposed approach to delivering an EVV system that provides an electronic billing interface and the automatic electronic submission of claims with accurate dates and times of service, as well as additional required data elements as determined by the Agency for home health services.

10. The adequacy of the respondent’s proposed approach to create and submit HIPAA ANSI X12 837P Professional Health Care Claims to the Agency Fiscal Agent and have the capability to retrieve the acknowledgement response files (X12 999/TA1), resolve associated errors, and timely resubmit affected claims.

11. The adequacy of the respondent’s proposed approach to enable providers to self-audit and remedy potential billing anomalies.

12. The adequacy of the respondent’s proposed approach to accurately roll up all services on a single claim form if a recipient has the same service delivered by the same provider multiple times per day.

13. The adequacy of the respondent’s proposed approach to identify and resolve all system issues related to claims denials within five (5) business days.

14. The adequacy of the respondent’s proposed approach to develop, implement, and maintain a user-friendly public website with web pages that load within three (3) seconds or less that provides, at a minimum, information about EVV requirements, relevant state and federal rules and regulations, user-friendly registration functionality, training and resources, frequently asked questions (FAQ), known system issues with timelines for resolution, and links to other important resources that relate to the Home Health EVV System.

15. The adequacy of the respondent’s proposed approach to provide secure access to a HIPAA compliant, real-time, interactive web-based EVV data dashboard that enables the creation of interactive home health reports that include, but are not limited to, data related to provider activity, late visits, missed visits, incomplete visits, and claims submission and adjudication status.

16. The adequacy of the respondent’s proposed approach and capability to integrate, capture, and verify EVV data and other pertinent information from third-party EVV systems as specified by the Agency.

17. The adequacy of the respondent’s proposed approach to scheduling any planned downtime for system maintenance within required timeframes and resolving issues that cause unexpected and non-scheduled system downtime, including the respondent’s approach to complying with notification requirements described in this solicitation.

Score: This Section is worth a maximum of eighty-five (85) raw points with each of the above components being worth a maximum of five (5) points each.

SRC# 7 – IMPLEMENTATION

The respondent shall demonstrate its capability to successfully meet the requirements of this solicitation and the resulting Contract by describing its capability to implement the Electronic Visit Verification (EVV) Services as described in Attachment B, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section B., Services Provided by the Vendor, Item 3., Implementation Plan. At a minimum, the Response shall include the following:

1. An itemization and timeline of activities and steps that the Vendor shall undertake to be operational by the project start (go live) date as directed by the Agency.

2. A description of the Vendor’s proposed project management tools that efficiently track changes to the implementation plan and progress toward accomplishing the activities, goals, and objectives set out in the plan.

3. Identification of interdependencies between implementation activities, including potential risks or barriers to timely and successful implementation and proposed methods for overcoming them.

4. Process for review, revision and approval of planning documents, testing processes, and other deliverables such as a staffing plan, training plan, and communication and outreach plan.

5. Description of roles and specific duties of staff and proposed subcontractors in completion of implementation tasks.

6. Identification of Vendor expectations regarding assistance needed from the Agency, including roles and responsibilities.

7. Proposed approach to ensuring interaction and communication with Agency staff and subcontractors during the implementation activities to ensure successful implementation of the EVV system.

8. Proposed approach to achieving 100% compliance in meeting EVV Implementation milestones and target dates related to provider support and adoption of the EVV system as outlined in this solicitation.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s proposed approach to an itemization and timeline of activities and steps that the Vendor shall undertake to be operational by the project start (go live) date as directed by the Agency.

2. The adequacy of the respondent’s description of the Vendor’s proposed project management tools that efficiently track changes to the implementation plan and progress toward accomplishing the activities, goals, and objectives set out in the plan.

3. The adequacy of the respondent’s identification of interdependencies between implementation activities, including potential risks or barriers to timely and successful implementation and proposed methods for overcoming them.

4. The adequacy of the respondent’s proposed approach to its process for review, revision and approval of planning documents, testing processes, and other deliverables such as a staffing plan, training plan, and communication and outreach plan.

5. The adequacy of the respondent’s description of roles and specific duties of staff and proposed subcontractors in completion of implementation tasks.

6. The adequacy of the respondent’s description of vendor expectations regarding assistance needed from the Agency, including roles and responsibilities.

7. The adequacy of the respondent’s proposed approach to ensuring interaction and communication with Agency staff and subcontractors during the implementation activities to ensure successful implementation of the EVV system.

8. The adequacy of the respondent’s proposed approach to achieving 100% compliance in meeting EVV Implementation milestones and target dates related to provider support and adoption of the EVV system as outlined in this solicitation.

Score: This Section is worth a maximum of forty (40) raw points with each of the above components being worth a maximum of five (5) points each.

SRC# 8 – CUSTOMER SERVICE

The respondent shall demonstrate its capability to successfully meet the requirements of this solicitation and the resulting Contract by describing its capability to implement the Electronic Visit Verification (EVV) Services as described in Attachment B, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section B., Services Provided by the Vendor, Item 8., Customer Service and Item 11., Inquiries, Issues, Requests for Assistance, and Complaints. At a minimum, the Response shall include the following:

1. Proposed approach to providing and maintaining a twenty-four (24) hours a day, seven (7) days per week (24/7), toll-free customer service telephone system fully dedicated to the State of Florida EVV system and housed in a secure area that is solely dedicated to this Contract.

2. Proposed approach to handle calls and ensure call center metrics are met during periods of increased call volume.

3. Proposed approach to develop and implement a customer service tracking system or dashboard that reflects real-time data related to all provider or recipient calls, including written or verbal inquiries, issues, requests for assistance, complaints, and customer support tickets generated by the Vendor that is accessible by the Agency.

4. Proposed approach to implement an interactive voice response system with functionality at each level for callers to choose to speak with a “live” person, rather than continue through additional prompts.

5. Proposed approach to monitoring the toll-free customer service telephone system to ensure compliance with the service level requirements of this solicitation.

6. Proposed approach to establishing, maintaining, and monitoring a quality assurance program for the customer service call center.

7. Proposed approach to ensure a sufficient number of staff who are fluent in both English and Spanish and how interpreter services will be provided to enrollees and providers whose primary language is not English and meet the additional service requirements described in this solicitation.

8. Proposed approach to providing the Agency with the ability to monitor customer service calls at any time from a remote location.

9. Proposed approach to resolve all written and verbal inquiries, issues, requests for assistance, and complaints received from the Agency or directly from providers, including support tickets generated by the Vendor, within contractual timeframes.

10. Proposed approach to document and provide the Agency with details related to all inquiries, issues, requests for assistance, and complaints, including date received, description, disposition, and date of resolution.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s proposed approach to providing and maintaining a 24/7 toll-free customer service telephone system fully dedicated to the State of Florida EVV system and housed in a secure area that is solely dedicated to this Contract.

2. The adequacy of the respondent’s proposed approach to handle calls and ensure call center metrics are met during periods of increased call volume.

3. The adequacy of the respondent’s proposed approach to develop and implement a customer service tracking system or dashboard that reflects real-time data related to all provider or recipient calls, including written or verbal inquiries, issues, requests for assistance, complaints, and customer support tickets generated by the Vendor that is accessible by the Agency.

4. The adequacy of the respondent’s proposed approach to implement an interactive voice response system with functionality at each level for callers to choose to speak with a “live” person, rather than continue through additional prompts.

5. The adequacy of the respondent’s proposed approach to monitoring the toll-free customer service telephone system to ensure compliance with the service level requirements of this solicitation.

6. The adequacy of the respondents proposed approach to implement, maintain, and monitor a quality assurance program for the customer service call center.

7. The adequacy of the respondent’s proposed approach to ensure a sufficient number of staff who are fluent in both English and Spanish and how interpreter services will be provided to enrollees and providers whose primary language is not English and meet the additional service requirements described in this solicitation.

8. The adequacy of the respondent’s proposed approach to provide the Agency with the ability to monitor calls at any time from a remote location.

9. The adequacy of the respondent’s proposed approach to resolve all written and verbal inquiries, issues, requests for assistance, and complaints received from the Agency or directly from providers, including support tickets generated by the Vendor, within contractual timeframes.

10. Proposed approach to provide the Agency with details related to all inquiries, issues, requests for assistance, and complaints, including date received, description, disposition, and date of resolution.

Score: This Section is worth a maximum of fifty (50) raw points with each of the above components being worth a maximum of five (5) points each.

SRC# 9 – OUTREACH, COMMUNICATIONS, AND TRAINING

The respondent shall demonstrate its capability to successfully meet the requirements of this solicitation and the resulting Contract by describing its capability to fulfill the training, education, and outreach requirements described in Attachment B, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section B., Services Provided by the Vendor, Item 4., Outreach and Communications and Item 5., Training. At a minimum, the Response shall include the following:

1. Proposed comprehensive training plan which includes proposed number and location of in-person and instructor-led, interactive webinar trainings during implementation through operations (go-live) start date and one month following operations start date. The proposed training plan must also include deadlines and supportive tasks for the planning, design, development, production, and distribution of all training materials to support implementation and ongoing operations.

2. Proposed approach to developing and providing training materials, manuals, and any and all web-based and in-person training for providers, Agency staff and/or Agency designees.

3. Proposed innovative methods and strategies that can be used to communicate and work with providers that are disengaged (not set up or registered), have expressed difficulty using the EVV system or are not using the EVV system appropriately.

4. Proposed approach to developing and meeting the ongoing comprehensive training needs for the EVV system, which at a minimum includes written communication, telephonic support, and webinars for all aspects of the resulting Contract.

5. Proposed approach to develop and maintain a web-based training environment that meets ongoing provider training needs and gives providers the ability to test different scenarios that mimic real-time situations and challenges providers face in interacting with the EVV System.

6. Proposed approach to using technological advancements for more impactful and cost-effective training.

7. Proposed plan (methods and timing) for outreach activities to home health providers and recipients in order to provide regular and on-going outreach and assistance. The proposed plan must include allowances for Agency review and approval.

8. Proposed contingency plan (method and timing) for maintaining compliance with contractual requirements (SLAs) when training, outreach, and communication efforts are escalated.

9. Detailed but succinct gap analysis (including timelines) describing how the respondent will work with and train providers on successful third-party EVV systems integration, information verification protocol, data collection and reporting, including proposed approach to facilitate issue resolution between providers and third-party vendors.

The respondent’s entire response for this SRC must be provided within the respective response field below and up to one (1) attachment, as prescribed herein.

Attachments are limited to the following:

· Draft web-based and non-web-based training plan materials.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s proposed comprehensive training plan that outlines the number, location, and type of trainings and that meets proposed deadlines and supportive tasks.

2. The adequacy of the respondent’s proposed approach to develop and provide training materials, manuals, and any and all web-based and in-person training for providers, Agency staff and/or Agency designees.

3. The adequacy of the respondent’s proposed innovative methods and strategies that can be used to communicate and work with providers that are disengaged (not set up or registered), have expressed difficulty using the EVV system or are not using the EVV system appropriately.

4. The adequacy of the respondent’s proposed approach to developing and meeting the ongoing comprehensive training needs for the EVV Program, which at a minimum includes written communication, telephonic support, and webinars for all aspects of the resulting Contract.

5. The adequacy of the respondent’s proposed approach to develop and maintain a web-based training environment that meets ongoing provider training needs and gives providers the ability to test different scenarios that mimic real-time situations and challenges providers face in interacting with the EVV System.

6. The adequacy and appropriateness of the respondent’s proposed approach to using technological advancements for more impactful and cost-effective training.

7. The adequacy of the respondent’s proposed plan (methods and timing) for ongoing outreach activities to home health service providers and recipients, including allowances for Agency review and approval.

8. The adequacy of the respondent’s proposed contingency plan (method and timing) for maintaining compliance with contractual requirements when training, outreach and communication efforts are escalated.

9. The adequacy of the respondent’s detailed but succinct gap analysis (including timelines) describing how the respondent will work with and train providers on successful third-party EVV systems integration, information verification protocol, data collection and reporting, including proposed approach to facilitate issue resolution between providers and third-party vendors.

Score: This Section is worth a maximum of forty-five (45) raw points with each of the above components being worth a maximum of five (5) points each.

SRC# 10 – FRAUD AND ABUSE PREVENTION

The respondent shall demonstrate its capability to successfully meet the requirements of this solicitation and the resulting Contract by describing its capability to fulfill the fraud and abuse prevention requirements described in Attachment B, Scope of Services, Section II., Manner of Service(s) Provision, Sub-Section B., Services Provided by the Vendor, Item 9., Fraud and Abuse Prevention. At a minimum, the Response shall include the following:

1. Proposed approach to collect and analyze data to identify providers with aberrant scheduling and billing practices.

2. Proposed approach to identify solutions for providers that improve scheduling and billing practices.

3. Proposed approach to identify opportunities for intensified provider review.

4. Proposed approach to conduct education and outreach to identified outliers and providers that may benefit from education regarding more appropriate service utilization.

5. Proposed approach to provide secure read-only access to the home health EVV data dashboard to the Agency, other state entities, or specified stakeholders that effectively supports the investigative and audit oversight functions of these entities.

6. Proposed approach to immediately report suspected fraud and abuse activity to the Agency.

Response:

Evaluation Criteria:

1. The adequacy of the respondent’s proposed approach to collect and analyze data to identify providers with aberrant scheduling and billing practices.

2. The adequacy of the respondent’s proposed approach to identify solutions for providers that improve scheduling and billing practices.

3. The adequacy of the respondent’s proposed approach to identify opportunities for intensified provider review.

4. The adequacy of the respondent’s proposed approach to conduct education and outreach to identified outliers and providers that may benefit from education regarding more appropriate service utilization.

5. The adequacy of the respondent’s proposed approach to provide secure read-only access to the home health EVV data dashboard to the Agency, other state entities, or specified stakeholders to support the investigative and audit oversight functions of these entities.

6. The adequacy of the respondent’s proposed approach to immediately report suspected fraud and abuse to the Agency.

Score: This Section is worth a maximum of thirty (30) raw points with each of the above components being worth a maximum of five (5) points each.

SRC #11: TRANSITION OF RESULTING CONTRACT

The respondent shall demonstrate its capability to successfully meet the requirements of this solicitation and the resulting Contract by describing its capability to fulfill the transition requirements described in Attachment B, Scope of Services, Section XI., Contract Transition. At a minimum, the Response shall include the following:

1. Proposed approach to transitioning responsibilities of the resulting Contract to the Agency or another Vendor in accordance with the requirements set forth in this solicitation and the resulting Contract.

2. Proposed approach to delivering all Contract-related records and data to the Agency within contractual timeframes after expiration or termination of the resulting Contract.

3. Identification of risks and barriers associated with the transition of EVV system services to a new Vendor and solutions for overcoming them.

Response:

Evaluation Criteria

1. The adequacy of the respondent’s proposed approach to transitioning responsibilities of the resulting Contract to the Agency or another Vendor in accordance with the requirements set forth in this solicitation and the resulting Contract.

2. The adequacy of the respondent’s proposed approach to deliver all Contract-related records and data to the Agency within contractual timeframes upon expiration or termination of the resulting Contract.

3. The adequacy of the respondent’s capability to overcome identified risks and barriers associated with the transition of EVV system services to a new Vendor upon the completion of the resulting Contract.

Score: This Section is worth a maximum of fifteen (15) raw points with each of the above components being worth a maximum of five (5) points each.

SRC# 12: INFORMATION TECHNOLOGY REQUIREMENTS

The respondent shall demonstrate its capability and approach to provide the Information Technology Requirements as described in Attachment B, Scope of Services, Section X., Information Technology. At a minimum, the Response shall include the following:

1. Proposed approach to develop, maintain, and operate a secure, web-based system for receipt and processing of information and data received in performing the duties of this Contract that is compliant with the Health Insurance Portability and Accountability Act (HIPAA), 42 U.S.C. 1320d.

2. Proposed approach to develop a database approved by the Agency for the purpose of collecting and storing data and information obtained in performing the duties under this Contract.

3. Proposed approach to providing the Agency and any other state agency authorized by the Agency, direct read-only access to its database(s), including any equipment needed for on-line access to the database(s) at no additional cost to the Agency.

4. Proposed approach to send and receive data, and other information necessary to maintain the web-based system, to and from the Agency, other state agencies, or entities authorized by the Agency.

5. Proposed approach to adhere and comply with the Agency’s Division of IT standards regarding Secure Sockets Layer (SSL) Web interface(s) and Transport Layer Security (TLS).

6. Proposed approach to adhere to the Driver Privacy Protection Act (DPPA) rules that address a memorandum of understanding and security requirements as well as other requirements contained in Rule.

7. Proposed approach to provide immediate notice to the Agency Information Security Manager (“ISM”) in the event the Vendor, its employees, subcontractors, and agents become aware of any security breach and any unauthorized transmission or loss of any or all of the data collected or created for or provided by the Agency (“State Data”).

8. In the event of loss of any State Data or record where such loss is due to the negligence of the Vendor or any of its subcontractors or agents, the respondent’s proposed approach to recreate such lost data in the manner and on the schedule set by the Agency.

9. Proposed approach to conform to current and updated publications of the principles, standards, and guidelines of the Federal Information Processing Standards (FIPS), the National Institute of Standards and Technology (NIST) publications, including but not limited to Cybersecurity-Framework and NIST.SP.800-53r4.

10. Proposed approach to employ traffic and network monitoring software and tools on a continuous basis to identify obstacles to optimum performance, to identify email and Internet spam and scams and restrict or track user access to appropriate websites, to identify obstacles to detect and prevent hacking, intrusion and other unauthorized use of the Vendor’s resources, to prevent adware or spyware from deteriorating system performance, to update virus blocking software daily and aggressively monitor for and protect against viruses, and to monitor bandwidth usage and identify bottlenecks that impede performance.

11. Proposed approach to employ traffic and network monitoring software and tools on a continuous basis to provide methods to flag recipient data to exclude Protected Health Information (PHI) from data exchanges as approved by the State, and to comply with recipient rights under the HIPAA privacy law for: 1) Requests for restriction of the uses and disclosures on PHI (45 Code of Federal Regulations (CFR) 164.522(a)); 2) Requests for confidential communications (45 CFR 164.522(b)); and 3) Requests for amendment of PHI (45 CFR 164.526).

12. Proposed approach to conduct all activities in compliance with 45 CFR 164 Subpart C to ensure data security, including, but not limited to encryption of all information that is confidential under Florida or Federal law, while in transmission and while resident on portable electronic media storage devices.

Response:

Evaluation Criteria:

The adequacy of the respondent’s capability and approach to meet the Information Technology Requirements described in as described in Attachment B, Scope of Services, Section X., Information Technology.

1. The adequacy of the respondent’s proposed approach to develop, maintain, and operate a secure, web-based system for receipt and processing of information and data received in performing the duties of this Contract that is compliant with the Health Insurance Portability and Accountability Act (HIPAA), 42 U.S.C. 1320d.

2. The adequacy of the respondent’s proposed approach to develop a database approved by the Agency for the purpose of collecting and storing data and information obtained in performing the duties under this Contract.

3. The adequacy of the respondent’s proposed approach to providing the Agency and any other state agency authorized by the Agency, direct read-only access to its database(s), including any equipment needed for on-line access to the database(s) at no additional cost to the Agency.

4. The adequacy of the respondent’s proposed approach to send and receive data, and other information necessary to maintain the web-based system, to and from the Agency, other state agencies, or entities authorized by the Agency.

5. The adequacy of the respondent’s proposed approach to adhere and comply with the Agency’s Division of IT standards regarding SSL Web interface(s) and TLS.

6. The adequacy of the respondent’s proposed approach to adhere to the Driver Privacy Protection Act (DPPA) rules that address a memorandum of understanding and security requirements as well as other requirements contained in Rule.

7. The adequacy of the respondent’s proposed approach to provide immediate notice to the Agency Information Security Manager (“ISM”) in the event the Vendor, its employees, subcontractors, and agents become aware of any security breach and any unauthorized transmission or loss of any or all of the data collected or created for or provided by the Agency (“State Data”).

8. In the event of loss of any State Data or record where such loss is due to the negligence of the Vendor or any of its subcontractors or agents, the adequacy of the respondent’s proposed approach to recreate such lost data in the manner and on the schedule set by the Agency.

9. The adequacy of the respondent’s proposed approach to conform to current and updated publications of the principles, standards, and guidelines of the Federal Information Processing Standards (FIPS), the National Institute of Standards and Technology (NIST)…