Exhibit A-4 - Submission Requirements_Final.docx

EXHIBIT E-6

Technical Proposal Attestation

EXHIBIT A-4

SUBMISSION REQUIREMENTS AND EVALUATION CRITERIA COMPONENTS (TECHNICAL RESPONSE)

Table of Contents

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

All respondents to this solicitation should 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 should 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. Unless specified in the SRC, there is no character limit. For SRCs with character limits, character counts are inclusive of spaces, but exclude attached tables, charts, exhibits, etc. Text responses must be formatted for 8-1/2’ x 11” paper, single-spaced, and in a size 11 Arial font.

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

Note: In addition to the complete, electronic PDF copy of this Exhibit, the Respondent should submit its response to each SRC in a separate electronic folder that is labeled with the SRC number. The electronic folder for each SRC response should contain the response to the SRC along with all attachments applicable to the SRC.

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 EACH REQUIRED FORM IN ITS ORIGINAL FORMAT MAY RESULT IN REJECTION OF THE RESPONSE.

FAILURE TO SUBMIT AN SRC MAY RESULT IN REJECTION OF THE RESPONSE.

FAILURE TO SUBMIT EACH REQUIRED SRC TEMPLATE IN ITS ORIGINAL FORMAT MAY RESULT IN REJECTION OF THE RESPONSE.

FAILURE TO SUBMIT, EXHIBIT A-4, MAY RESULT IN THE REJECTION OF RESPONSE.

Respondent Name:

SRC# 1: EXECUTIVE SUMMARY

The Respondent should include an Executive Summary, which demonstrates the Respondent’s overall understanding of the services described in this RFP and describes the prominent features of its Technical Response.

Response:

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

SRC# 2: ORGANIZATIONAL STRUCTURE AND HISTORY

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

1. A detailed description of the Respondent’s organizational structure, history, legal structure, ownership, affiliations, and physical business location(s).

2. A detailed description of the Respondent’s office location(s), anticipated server location(s), and backup location(s) for the data storage and website hosting.

The Respondent’s corporate qualifications, including its abilities to manage and complete the proposed services.

Evaluation Criteria:

1. The adequacy of the Respondent’s description of its organizational capability to provide the services required for this Request for Proposal (RFP) based on its organizational structure, history, legal structure, ownership, affiliations, and physical business location(s).

2. The adequacy of the Respondent’s office location(s), anticipated server location(s), and backup location(s) for the data storage and website hosting.

3. The adequacy of the Respondent’s corporate qualifications, including its abilities to manage and complete the proposed services.

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

SRC# 3: VENDOR STAFFING

The Respondent should 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.

1. The Respondent should submit a list of current or previous (10 years) 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.

2. For each identified Contract, the following information should 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;

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

f. Significant accomplishments and achievements; and

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

3. A detailed description of the Respondent’s experience in website design, implementation, maintenance and hosting.

4. A detailed description of the Respondent’s experience in health care data analysis and research methodology experience.

5. A detailed description of the Respondent’s survey development and evaluation experience.

6. A detailed description of other proposed staff by type/credentials including the number (total and by full-time equivalent), qualifications, locations and project functions of staff that are appropriate

7. Resumes for key staff, demonstrating their applicable education and experience as required by the solicitation.

1. The adequacy of the Respondent’s capability to provide services required for this solicitation based on its cumulative experience in the performance of current or previous (10 years) 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.

2. The adequacy of the Respondent’s experience in website design, implementation, maintenance and hosting.

3. The adequacy of the Respondent’s experience in health care data analysis and research methodology experience.

4. The adequacy of the Respondent’s survey development and evaluation experience.

5. The adequacy of the Respondent’s proposed staff by type/credentials including the number (total and by full-time equivalent), qualifications, locations and project functions of staff.

6. The adequacy of the Respondent’s resumes for key staff, demonstrating their education and experience as required by the solicitation.

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

SRC #4: CLAIMS DATA, DATA COLLECTION, AND DATA STORAGE

The Respondent should include a detailed narrative of the claims data currently collected, current technical requirements related to data collection and feasibility of expansion, as well as a proposed development, implementation, hosting, and maintenance of the Internet-based platform that will allow a consumer to research the cost of health care services and procedures based on service bundles and conditions. The Vendor’s response should detail any subcontractors and their responsibilities as it relates to providing services under this project and at a minimum, and should include the following:

1. A brief description of Florida data maintained by the Respondent as of October 1, 2016, including details of Florida specific data and the Respondent’s capability of adding additional claims data/data feeds. Details presented must include the number of covered lives represented for each insurer, time periods for which data is held and available, file types currently collected (medical, pharmacy, dental, eligibility, provider, etc.) along with the capability of expanding to additional file types as needed, the number of claims currently held and available from each participating health insurer nationally and in Florida, etc.

2. A detailed description of the Respondent’s current and proposed data submission policies and procedures. A description of the current and/or proposed methods for incorporating new data files from additional insurers. A description of current protocols for secure data submission, monitoring for compliance with established data standards, and identification of any barriers proposed strategies for the management of relationships with payors (i.e. data sources), as well as the processes for identification, analysis, and mitigation of issues related to data submission.

3. A detailed description of the current and proposed data fields/elements to be collected, including any sensitive data fields, and how specific data fields may differ among plan types and data feeds, including how this may affect the usages documented in the solicitation. The narrative should include an explanation of how the Respondent’s current and proposed data collection processes align with the latest national standards for collecting claims data.

4. A detailed description of how the methodology used, or proposed methodology, links individuals and providers across payors and providers. The description should include the Respondent’s capability to establish a Master Patient Index and/or Master Provider Index and apply it to the claims dataset.

5. A description of the current and/or proposed review and validation processes for payors and providers to verify accuracy prior to any data release or public reporting.

6. A description of the proposed process for onboarding Medicaid claims data, as well as the other required submitters identified in the solicitation.

7. A description of the data submission schedule (i.e. monthly, quarterly, etc.), including the proposed schedule for future submitters and your rationale used to determine this schedule.

8. A detailed description of the proposed Quality Assurance Plan to ensure the data is accurate, valid, reliable and complete. The description must include information on any current and/or proposed data edits, error thresholds and other initiatives for quality assurance purposes.

9. A detailed description of the proposed conditions and service bundles to be published on the Internet-based platform that will allow a consumer to research the cost of health care services and procedures and allow for price comparison.

10. A detailed description of the Respondent’s current and/or proposed methodology for analyzing claims data within the defined service bundles that are understandable by the general public and for which the bundling methodology is available in the public domain. The description must include how the methodology can be used for comparison of state and national benchmarks with local regions and specific providers in Florida.

11. The proposed approach to develop an Internet-based platform that will allow a consumer to research the cost of health care services and procedures and allow for price comparison. The platform must include functionality for a consumer to search by condition or by service bundles that are understandable to an ordinary layperson and must be responsive to a mobile device. This description must include the proposed method to link and/or integrate the resulting pricing information with the Agency’s website, FloridaHealthFinder.

12. A detailed description of the Respondent’s proposed implementation timeline for the analysis and website publication of specific pricing information within the defined service bundles by geographic region, zip code and by a licensed facility or provider.

13. The proposed approach for ensuring that the required consumer pricing website is compliant with all applicable standards contained in the Americans with Disabilities Act (ADA).

14. The proposed schedule and approach for performance of updates to the data and information on the website as described in the solicitation, including the minimum required timeframes for the publication of new data following routine data refreshes as well as when data updates and/or corrections are received within allowable timeframes.

15. A detailed description of how the health care claims data will be stored, accessed and released including any and all applicable security measures and restrictions to uses and access. The description needs to include what resources (i.e. hardware, software, applications, etc.) are needed to access any data sets and reports and any fees associated with the data release.

16. The proposed approach to handling claims data requests from the public, and the Agency, providing data user support and technical assistance, including the method for users to obtain data, customer service and staffing, tracking and processing.

17. The proposed approach to assisting the Agency in health care claims analytics for research topics focusing on improving quality of care and reducing costs such as preventable hospitalizations.

1. The adequacy of the Respondent’s description of Florida’s insurance market, the Respondent’s overview of claims data maintained as of October 1, 2016, including Florida specific information, and their capability of adding additional claims data.

2. The adequacy of the Respondent’s detailed description of their proposed data submission policies and procedures; and the Respondent’s current and proposed approach for incorporating new data files from additional insurers, a description of protocols for secure data submission, monitoring submission compliance and barriers to implementing data submission protocols.

3. The adequacy of the Respondent’s detailed description of current and proposed data fields/elements to be collected, including any sensitive data fields and how specific data fields may differ among plan types and data feeds; including how this may affect the usages documented in the solicitation.

4. The adequacy of the Respondent’s description and capability to track and link individuals and providers across payors and providers; and their capability to establish and apply a master patient index and/or master provider index to the claims dataset.

5. The adequacy of the Respondent’s proposed review and validation process to verify accuracy for payors and providers, prior to data release or public reporting.

6. The adequacy of the Respondent’s proposed process for onboarding Medicaid claims data as well as the other required submitters identified in the solicitation.

7. The adequacy of, and the supporting rationale behind, the Respondent’s proposed data submission schedule (i.e. monthly, quarterly, annually or a combination thereof, etc.), including the proposed schedule for future submitters.

8. The adequacy of the Respondent’s proposed Quality Assurance Plan to ensure data is accurate, valid, reliable and complete, which should include information on any current and proposed data edits, error thresholds and other initiatives for quality assurance purposes.

9. The adequacy of the Respondent’s proposed conditions and service bundles that will be published on the Internet-based platform, allowing consumers to research the cost of health care services and procedures and allow for price comparison.

10. The adequacy of the Respondent’s proposed methodology for analyzing claims data within the defined service bundles that are understandable by the general public and for which the methodology is available in the public domain.

11. The adequacy of the Respondent’s proposed approach to develop an Internet-based platform that will allow a consumer to research the cost of health care services and procedures and allow for price comparison.

12. The adequacy of the Respondent’s proposed implementation timeline for the analysis and website publication of specific pricing information within the defined service bundles by geographic region, zip code and by a licensed facility or provider.

13. The adequacy of the Respondent’s proposed approach for making the website compliant with standards contained within the Americans with Disabilities Act (ADA).

14. The adequacy of the Respondent’s proposed schedule and approach to performance of updates to the data and information to the website, in accordance with the solicitation including the minimum required timeframes for the publication of new data following routine data refreshes as well as when data updates and/or corrections are received within allowable timeframes.

15. The adequacy of the Respondent’s description detailing how the health care claims data will be stored, accessed and released; and any and all applicable security measures and restrictions to uses and access; including the resources (i.e. hardware, software, applications, etc.) needed to access any data sets and reports and any fees associated with the data release.

16. The adequacy of the Respondent’s approach to handling claims data requests from the public and the Agency and providing data user support and technical assistance, including the method for users to obtain data, customer service and staffing, tracking and processing.

17. The adequacy of the Respondent’s proposed approach to assisting the Agency in health care claims analytics for research topics focusing on improving quality of care and reducing costs such as preventable hospitalizations.

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

SRC #5: PROJECT MANAGEMENT

The Respondent should provide a draft Project Management Plan as described in Attachment B, Scope of Services, Section I, Services Provided by the Vendor, and Section III., that is consistent and coherent, and demonstrates a sound project management methodology that addresses, at a minimum: planning, initiation and implementation, maintenance, and change management. The proposed plan must show a thorough understanding of the scope of services and the capability to successfully complete each deliverable, including any deliverables that will be completed by subcontractors, as set forth in this solicitation, and the project as a whole.

1. Any proposed plan will be sufficiently detailed to provide an understanding of how the Respondent will implement the project, guide work execution, manage communication among project stakeholders, and handle required project changes. Additionally, proposed plans should address:

a. Assessment of the deliverables, as noted in this solicitation;

b. Alternatives analysis and resolution;

c. Resource allocation and deployment;

d. Quality assurance activities;

e. Identification of any key dependencies;

f. Identification of potential barriers and a plan for mitigating potential risks;

g. Reporting of project status and other regular communications with the Agency and stakeholders, as appropriate;

h. Identification of any additional assistance needed from the Agency in designing and implementing the project; and

i. Automated tools, including the use of specific software applications that facilitate the management of implementation activities.

2. A detailed project timeline for successful management and completion of the project, which should identify major project phases and key milestones for each project phase and the project as a whole. The timeline must include time frames and durations for:

a. Project implementation, including website deployment and any other significant implementation points for the website;

b. Proposed dates for major data updates and enhancements for onboarding of additional claims data; and

c. Proposed dates for improvements to the website and other important deadlines.

3. The Respondent should provide a Requirements Traceability Matrix detailing how the project plan meets Agency requirements and deliverables.

4. The Respondent should provide a proposed sustainability plan detailing ongoing operations to assist the Agency in the sustainability of data collection efforts and the consumer pricing website.

Evaluation Criteria

1. The adequacy of the Respondent’s proposed plan for management of the project, including guiding and executing work, manage communication among project stakeholders, and handling required project changes.

2. The adequacy and viability of the Respondent’s proposed project timeline for management of the project, including identification of major project phases and key milestones; and time frames and durations for project implementation, website deployment, proposed dates for major data updates and enhancements for onboarding of additional claims data, proposed dates for improvements to the system, and other important deadlines.

3. The adequacy of the Respondent’s Requirements Traceability Matrix detailing how the project plan meets Agency requirements and deliverables.

4. The adequacy of the Respondent’s proposed sustainability plan and ongoing operations for assisting the Agency with sustainability of the data collection efforts and consumer pricing website.

Score: This Section is worth a maximum of 20 raw points with each of the above components being worth a maximum of 5 points each.

SRC #6: WEBSITE EVALUATION AND SURVEY TOOLS

The Respondent should include a detailed narrative of the Respondent’s proposed solution for website evaluation methods, and development and management of survey tools. The narrative should include, at a minimum, the following:

1. A description of your proposal of an online consumer survey and ideas for future development of the website.

2. A plan to track website utilization as well as utilization of the various pages and applications within the website.

3. Provide any innovative and creative suggestions for improving the website that is not specified and already required in this solicitation.

1. The adequacy of the description of your proposal of an online consumer survey and ideas for future development of the website.

2. The adequacy of a plan to track website utilization as well as utilization of the various pages and applications within the website.

3. The adequacy of the innovative or creative suggestions for improving the website that are not specified and already required in this solicitation.

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

SRC #7: SYSTEM FUNCTIONALITY COMPONENTS, WORKFLOWS, AND DEPENDENCIES

The Respondent should demonstrate its capability and approach to provide the System Functionality Components, Workflows, and Dependencies as described in Attachment B, Scope of Services, Section X., System Functionality.

1. Provide a detailed description of your System Functionality Components (hardware, software, and personnel), and how they are sufficient to access and generate data and reports.

2. Provide a detailed visual graphic of your System Functionality Workflows.

3. Provide a detailed description of your System Functionality Dependencies.

1. The adequacy of the Respondent’s capability and approach to have the capacity (hardware, software, and personnel) sufficient to access and generate all data and reports needed for this solicitation.

2. The adequacy of the Respondent’s capability to present a workflow visual graphic that efficiently represents the necessities of this solicitation.

3. The adequacy of the Respondent’s capability to describe the dependencies necessary to provide the requirements for this solicitation.

Score: This Section is worth a maximum of 30 raw points with each of the above components being worth a maximum of 10 points each.

SRC# 8: SECURITY RATING SCORE REQUIREMENTS

In accordance with Attachment B, Scope or Services, Section XI., Information Technology, Sub-section T., the Agency should conduct an initial IT security risk score scan on the Respondent, as well as periodic or continuous security monitoring through an information security rating service, at the Agency's expense, to enable the Agency to effectively measure and mitigate the successful respondent’s security risks. The Respondent will work with the Agency’s Security Rating Score Provider to define the relevant Respondent assets providing Agency services.

Evaluation Criteria:

The adequacy of the Respondent’s security rating score by determining whether the Respondent has received:

1. A score in the top 90-100% of submitters;

2. A score in the top 80-89% of submitters;

3. A score in the top 70-79% of submitters;

4. A score in the top 60-69% of submitters;

5. A score in the top 50-59% of submitters; or

6. A score in the lower 0-49% of submitters.

Score: This Section is worth a maximum of 5 raw points as outlined below:

1. 5 points for a score in the top 90-100% of submitters;

2. 4 points for a score in the top 80-89% of submitters;

3. 3 points for a score in the top 70-79% of submitters;

4. 2 points for a score in the top 60-69% of submitters;

5. 1 point for a score in the top 50-59% of submitters; or

6. 0 points for a score in the lower 0-49% of submitters.

SRC# 9: DISASTER RECOVERY REQUIREMENTS

The Respondent should demonstrate its capability and approach to meet the requirements described in Attachment B, Scope of Services, Section XII., Disaster Recovery.

1. The adequacy of the respondent’s proposed approach and capability to develop and maintain a disaster recovery plan for restoring the application of software and current master files and for hardware backup in the event the production systems are disabled or destroyed.

2. The adequacy of the respondent’s proposed approach and capability to ensure the disaster recovery plan limits service interruption to a period of twenty-four (24) clock hours and ensures compliance with all requirements under the resulting Contract.

3. The adequacy of the respondent’s proposed approach and capability to ensure the records backup standards and a comprehensive disaster recovery plan should be developed and maintained by the Vendor for the entire period of the resulting Contract and submitted for review annually by the anniversary date of the resulting Contract.

4. The adequacy of the respondent’s proposed approach and capability to ensure it maintains a disaster recovery plan for restoring day-to-day operations including alternative locations for the Vendor to conduct the requirements of the resulting Contract.

5. The adequacy of the respondent’s proposed approach and capability to ensure it maintains database backups in a manner that should eliminate disruption of service or loss of data due to system or program failures or destruction.

6. The adequacy of the respondent’s proposed approach and capability to ensure the disaster recovery plan is finalized no later than thirty (30) calendar days prior to the resulting Contract effective date.

7. The adequacy of the respondent’s proposed approach and capability to ensure it amends or updates its disaster recovery plan in accordance with the best interests of the Agency and at no additional cost to the Agency.

8. The adequacy of the respondent’s proposed approach and capability to ensure it makes all aspects of the disaster recovery plan available to the Agency at all times.

9. The adequacy of the respondent’s proposed approach and capability to ensure it conducts an annual Disaster Recovery Plan test and submits the results for review to the Agency.

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

SRC #10: TRANSITION OF RESULTING CONTRACT

The Respondent should demonstrate its capability to fulfill the transition requirements described in Attachment B, Scope of Services, Section IX., Contract Transition. At a minimum, the Response should include:

1. The Respondent’s proposed approach to transitioning the resulting Contract to a new Vendor upon completion of the resulting Contract in accordance with the requirements set forth in this solicitation and the resulting Contract; and

2. Identification of risks and barriers associated with the transition of Program services to a new Vendor and solutions for overcoming them.

1. The adequacy and viability of the Respondent’s proposed approach to transitioning the resulting Contract to a new Vendor upon completion of the resulting Contract in accordance with the requirements set forth in this solicitation and the resulting Contract.

2. The adequacy of the Respondent’s capability to overcome identified risks and barriers associated with the transition of Program services to a new Vendor upon the completion of the resulting Contract.

Score: This Section is worth a maximum of 10 raw points with each of the above components being worth a maximum of 5 points each.

AHCA RFP 002-25/26, Attachment A, Exhibit A-4, Page 7 of 7