F1541382670_AHCAITN0032122_FXClaimsandEncountersProcessingModule_Core.pdf

RON DESANTIS

GOVERNOR

SIMONE MARSTILLER

SECRETARY

Facebook .com/AHCAFlo r ida Youtube.com/AHCAFlor i da

Twi t te r . com/AHCA_FL S l ideShare.net /AHCAFlo r ida

2727 Mahan Dr ive • Mai l S top #15 Ta l lahassee, FL 32308 AHCA.MyFlor i da.com

October 25, 2021

Prospective Vendor(s):

Subject: Solicitation Number: ITN 003-21/22

Title: FX Claims and Encounters Processing (Core) Module

This solicitation is being issued by the State of Florida, Agency for Health Care Administration, hereinafter referred to as “AHCA” or “Agency”, to select a vendor to provide Core services.

The solicitation package consists of this transmittal letter and the following attachments and exhibits:

Attachment A Instructions and Special Conditions Exhibit A-1 Questions Template Exhibit A-2 Transmittal Letter Exhibit A-3 Required Certifications and Statements Exhibit A-4 Submission Requirements and Evaluation Criteria Components

(Technical Response) Exhibit A-5 Cost Proposal Exhibit A-5-a Detailed Budget Exhibit A-6 Summary of Respondent Commitments Exhibit A-7 Certification of Drug-Free Workplace Program Exhibit A-8 Standard Contract Attachment B Scope of Services Exhibit B-1 Deliverables and Performance Standards Exhibit Exhibit Exhibit Exhibit

B-2 B-2-a B-3 B-4

Service Level Agreement Service Level Metrics Requirements Matrix Technology Matrix

Your response must comply fully with the instructions that stipulate what is to be included in the response. Respondents shall identify the solicitation number, date and time of opening on the package transmitting their response. This information is used only to put the Agency mailroom on notice that the package received is a response to an Agency solicitation and therefore should not be opened but delivered directly to the Procurement Officer.

ITN 003-21/22

The designated Agency Procurement Officer for this solicitation is the undersigned. All communications from respondents shall be made in writing and directed to my attention at the address provided in Attachment A, Instructions and Special Conditions, Section A.1., Instructions, Sub-Section A., Overview, Item 5., Procurement Officer unless otherwise instructed in this solicitation.

The term “Proposal”, “Response” or “Reply” may be used interchangeably and mean the respondent’s submission to this solicitation.

Section 120.57(3)(b), Florida Statutes and Section 28-110.003, Florida Administrative Code require that a Notice of Protest of the solicitation documents shall be made within seventy-two hours after the posting of the solicitation. Failure to file a protest within the time prescribed in section 120.57(3), Florida Statutes, or failure to post the bond or other security required by law within the time allowed for filing a bond shall constitute a waiver of proceedings under chapter 120, Florida Statutes.

Sincerely, Ashley Balkcom Procurement Officer, Purchasing Manager Bureau of Support Services

ATTACHMENT A

INSTRUCTIONS AND SPECIAL CONDITIONS

ITN 003-21/22, Attachment A, Page 1 of 27

Table of Contents

A.1. Instructions

A. Overview

1. Solicitation Number

2. Solicitation Type

3. Solicitation Title

4. Date of Issuance

5. Procurement Officer

6. Solicitation Timeline

7. PUR 1000, General Contract Conditions

8. PUR 1001, General Instructions to Respondents

9. Restriction on Communications

10. Respondent Questions

11. Solicitation Addenda

12. Public Opening of Responses

13. Type and Amount of Contract Contemplated

14. Term of Contract

15. Program Overview

B. Response Preparation and Content

1. General Instructions

2. Mandatory Response Content

a. Exhibit A-2, Transmittal Letter

b. Exhibit A-3, Required Certifications and Statements

c. Original Proposal Guarantee

d. Financial Information

e. Exhibit A-4, Submission Requirements and Evaluation Criteria (Technical Response)

f. Exhibit A-5, Cost Proposal

g. Exhibit A-5-a, Detailed Budget

h. Exhibit A-6, Summary of Respondent Commitments

3. Additional Response Content

a. Exhibit A-7, Certification of Drug-Free Workplace Program

C. Response Submission Requirements

ITN 003-21/22, Attachment A, Page 2 of 27

1. Hardcopy and Electronic Submission Requirements

a. General Provision

b. Hardcopies of the Response

c. Electronic Copy of the Response

2. Confidential or Exempt Information

D. Response Evaluation, Negotiations and Contract Award

1. Response Clarification

2. Responsive Reply Determination

3. Non-Scored Requirements

a. Transmittal (Cover) Letter

b. Required Certifications and Statements

c. Original Proposal Guarantee

d. Summary of Respondent Commitments

4. Financial Evaluation - Pass/Fail

5. Scored Requirements – Evaluation Criteria

a. Technical Response Evaluation

b. Cost Proposal Evaluation

6. Ranking of Responses

7. Negotiation Process

8. Number of Awards

9. Posting of Notice of Intent to Award

10. Performance Bond

11. Federal Approval

12. Contract Execution

A.2 Special Terms and Conditions

A. Venue

B. General Definitions

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

ITN 003-21/22, Attachment A, Page 3 of 27

A.1. Instructions

A. Overview

1. Solicitation Number

AHCA ITN 003-21/22

2. Solicitation Type

Invitation to Negotiate

3. Solicitation Title

FX Claims and Encounters Processing (Core) Module

4. Date of Issuance

5. Procurement Officer

Ashley Balkcom Agency for Health Care Administration 2727 Mahan Drive Mail Stop #15 Tallahassee, FL 32308-5403 Email: solicitation.questions@ahca.myflorida.com

6. Solicitation Timeline

The projected solicitation timeline is shown in Table 1, Solicitation Timeline, below (all times are Eastern Time). The Agency for Health Care Administration (Agency) reserves the right to amend the timeline in the State’s best interest. If the Agency finds it necessary to change any of the activities/dates/times listed, all interested parties will be notified by addenda to the original solicitation document posted on the Vendor Bid System (VBS) (http://myflorida.com/apps/vbs/vbs_www.main_menu).

TABLE 1

SOLICITATION TIMELINE

ACTIVITY DATE/TIME LOCATION

Solicitation Issued by Agency

October 25, 2021 Electronically Posted http://myflorida.com/apps/vbs/vbs_www.main_menu

Deadline for Receipt of Written Questions

November 3, 2021 2:00 p.m.

solicitation.questions@ahca.myflorida.com mailto:solicitation.questions@ahca.myflorida.com http://myflorida.com/apps/vbs/vbs_www.main_menu http://myflorida.com/apps/vbs/vbs_www.main_menu mailto:solicitation.questions@ahca.myflorida.com

ITN 003-21/22, Attachment A, Page 4 of 27

TABLE 1

SOLICITATION TIMELINE

ACTIVITY DATE/TIME LOCATION

Anticipated Date for Agency

Responses to Written Questions

November 24, 2021

Electronically Posted

Deadline for Receipt of Responses

December 15, 2021 2:00 p.m.

Attn: Ashley Balkcom Agency for Health Care Administration

2747 Fort Knox Boulevard Mailroom, Building 4

Tallahassee, FL 32308-5403 Public Opening of

Responses December 15, 2021

3:00 p.m.

2727 Mahan Drive, Building 2

Operations Conference Room, 2nd Floor, Room 200 Tallahassee, FL 32308-5403

The Public Opening of Responses will be available via GoToWebinar. Please follow the below instructions to attend.

Please register for Public Opening of Responses:

https://attendee.gotowebinar.com/register/71827943 22722546960

After registering, you will receive a confirmation email containing information about joining the webinar.

Anticipated Posting of

Notice of Intent to Award

July 8, 2022 Electronically Posted

7. PUR 1000, General Contract Conditions

PUR 1000, General Contract Conditions, is incorporated by reference and is available for prospective respondents to download at:

https://www.dms.myflorida.com/content/download/2933/11777/PUR_1000 _General_Contract_Conditions.pdf

8. PUR 1001, General Instructions to Respondents

PUR 1001, General Instructions to Respondents, is incorporated by reference and is available for prospective respondents to download at:

https://www.dms.myflorida.com/content/download/2934/11780/PUR_1001 _General_Instructions_to_Respondents.pdf

Unless otherwise noted, instructions in this Attachment A shall take precedence over the PUR 1001, General Instructions to Respondents.

http://myflorida.com/apps/vbs/vbs_www.main_menu https://attendee.gotowebinar.com/register/7182794322722546960 https://attendee.gotowebinar.com/register/7182794322722546960 http://myflorida.com/apps/vbs/vbs_www.main_menu https://www.dms.myflorida.com/content/download/2933/11777/PUR_1000_General_Contract_Conditions.pdf https://www.dms.myflorida.com/content/download/2933/11777/PUR_1000_General_Contract_Conditions.pdf https://www.dms.myflorida.com/content/download/2934/11780/PUR_1001_General_Instructions_to_Respondents.pdf https://www.dms.myflorida.com/content/download/2934/11780/PUR_1001_General_Instructions_to_Respondents.pdf

ITN 003-21/22, Attachment A, Page 5 of 27

9. Restriction on Communications

Respondents to this solicitation or persons acting on their behalf may not contact, between the release of the solicitation and the end of the seventy-two (72) hour period following the Agency posting the notice of intended award, excluding Saturdays, Sundays, and State holidays, any employee or officer of the executive or legislative branch concerning any aspect of this solicitation, except in writing to the Procurement Officer or as provided in the solicitation documents. Violation of this provision may be grounds for rejecting a response. See Section 287.057(23), Florida Statutes (F.S.).

10. Respondent Questions

a. The Agency will receive all questions pertaining to this solicitation no later than the date and time specified for written questions in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline.

b. Prospective respondents must submit all questions by email at solicitation.questions@ahca.myflorida.com, utilizing Exhibit A-1, Questions Template. Exhibit A-1, Questions Template, is a Microsoft excel document and is available for prospective respondents to download at:

http://ahca.myflorida.com/procurements/index.shtml.

NOTE: Respondents should not paste entire paragraphs or sections of the ITN into the columns of Exhibit A-1 that allow the respondent to identify the attachment or exhibit, page number, and section or subsection for which the respondent is submitting a question. The Agency may delete excessive text entered in Exhibit A-1 if the text compromises the format and readability of the Questions Template.

c. The Agency will not accept questions by telephone, postal mail, hand delivery or fax.

d. The Agency’s response to questions received will be posted as an addendum to this solicitation as specified in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, and may be grouped as to not repeat the same answer multiple times.

e. The Agency reserves the right to post an addendum to this solicitation in order to address questions received after the written question submission deadline. It is the sole discretion of the Agency to consider questions received after the written questions submission deadline.

http://ahca.myflorida.com/Procurements/index.shtml

ITN 003-21/22, Attachment A, Page 6 of 27

11. Solicitation Addenda

If the Agency finds it necessary to supplement, modify, or interpret any portion of this solicitation during this solicitation period, a written addendum will be posted on the VBS as addenda to this solicitation. It is the respondent’s responsibility to check the VBS periodically for any information or updates to this solicitation. The Agency bears no responsibility for any resulting impacts associated with a prospective respondent’s failure to obtain the information made available through the VBS.

12. Public Opening of Responses

Responses shall be opened on the date, time and at the location indicated in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline. Respondents may, but are not required to, attend. The Agency will only announce the respondent(s) name at the public opening. Pursuant to Section 119.071(1)(b), F.S., no other materials will be released. Any person requiring a special accommodation because of a disability should contact the Procurement Officer at least five (5) business days prior to this solicitation opening. If you are hearing or speech impaired, please contact the Agency by using the Florida Relay Service at (800) 955-8771 (TDD).

13. Type and Amount of Contract Contemplated

a. The Contract resulting from this solicitation will be a fixed price contract, and the Agency’s anticipated Contract amount for the original term is $154,500,000. This figure is provided for informational purposes only and is based on historical spend and anticipated funding in future years.

b. The Agency anticipates that the payment structure under the resulting Contract will include fixed price deliverables for design, development and implementation (DDI), and monthly fixed pricing for ongoing operations and maintenance (O&M) services post-DDI.

c. The State of Florida's performance and obligation to pay under the

Contract resulting from this solicitation is contingent upon an annual appropriation by the Legislature.

14. Term of Contract

a. The anticipated term of the resulting Contract is November 1, 2022, through October 31, 2029. The term of the resulting Contract is subject to change based on the actual execution date of the resulting Contract.

ITN 003-21/22, Attachment A, Page 7 of 27

b. In accordance with Section 287.057(13), F.S., the Contract resulting from this solicitation may be renewed for a period that may not exceed three (3) years or the term of the resulting original Contract period whichever is longer. Renewal of the resulting Contract shall be in writing and subject to the same terms and conditions set forth in the resulting original Contract. A renewal Contract may not include any compensation for costs associated with the renewal. Renewals are contingent upon satisfactory performance evaluations by the Agency, are subject to the availability of funds, and optional to the Agency.

c. Respondents shall offer renewal year pricing in its response. The

Agency will not evaluate renewal year pricing as part of the evaluation and scoring process. Renewal year pricing may be a best value consideration for Contract award. Proposed cost, as provided in Exhibit A-5, Cost Proposal, will be applied in the event the resulting Contract is renewed.

d. If the resulting Contract is renewed, it is the Agency’s policy to reduce the overall payment amount by the Agency to the successful respondent by at least five percent (5%) during the period of the Contract renewal, unless it would affect the level and quality of services.

15. Program Overview

On July 24, 2018, the Agency rebranded the Florida Medicaid Enterprise System (MES) to Florida Health Care Connections (FX). The decision was made to reflect this project as a broader project leveraging the Medicaid infrastructure to improve overall Agency functionality and to build better connections to other data sources and programs. Moving forward, the Agency intends to use the term FX when referencing the Florida MES.

Some of these documents, the attachments, and the appendices may reference the MES name, as these documents were produced prior to the recent name change. In the future, documents will be updated as iterative revisions are made to reflect the FX update.

Agency Procurement Restrictions Related to MES – The Vendor awarded the IS/IP contract is precluded from being awarded any functional module. The Vendor awarded the EDW contract is not precluded from being awarded any functional modules merely due to its status as the EDW Vendor. Module Vendors are not precluded from being awarded any other functional modules merely due to their status as a Module Vendor. FX Vendors (including any subcontractors or company affiliates to the FX Vendor) are precluded from entering into a subcontractor relationship for future Florida FX solicitations unless that sub-contract is solely for the provision of hardware and/or software.

The Agency encourages an acquisition approach that limits the potential for conflict of interest in choosing the modular solutions to be incorporated

ITN 003-21/22, Attachment A, Page 8 of 27 into the system. Any contract award remains subject to the restrictions placed on actual or potential organizational conflicts of interest as described in Chapter 48 Code of Federal Regulation (CFR) and Section 287.057(17), Florida Statutes. Vendor shall also be free of any conflicts as provided in 42 CFR § 438.810.

B. Response Preparation and Content

1. General Instructions

a. The instructions for this solicitation have been designed to help ensure that all responses are reviewed and evaluated in a consistent manner, as well as to minimize costs and response time.

Information submitted in variance with these instructions may not be reviewed or evaluated.

b. The Agency has established certain requirements with respect to responses submitted to competitive solicitations. The use of “shall”, “must”, or “will” (except to indicate futurity) in this solicitation, indicates a requirement or condition from which a material deviation may not be waived by the Agency. A deviation is material if, in the Agency’s sole discretion, the deficient response is not in substantial accord with this solicitation’s requirements, provides a significant advantage to one respondent over another, or has a potentially significant effect on the quality of the response or on the cost to the Agency. Material deviations cannot be waived. The words “should” or “may” in this solicitation indicate desirable attributes or conditions but are permissive in nature. Deviation from, or omission of, such desirable features will not in and of itself cause rejection of a response.

c. Respondents shall not retype and/or modify required forms and must submit required forms in the original format. Required forms are available for respondents to download at:

FAILURE TO SUBMIT EACH REQUIRED FORM IN ITS

ORIGINAL FORMAT MAY RESULT IN REJECTION OF THE

RESPONSE.

d. A respondent shall not, directly or indirectly, collude, consult, communicate or agree with any other respondent as to any matter related to the response each is submitting. Additionally, a respondent shall not induce any other respondent to submit or not to submit a response.

e. The costs related to the development and submission of a response to this solicitation is the full responsibility of the respondent and is not chargeable to the Agency.

ITN 003-21/22, Attachment A, Page 9 of 27

f. Joint ventures and legal partnerships shall be viewed as one (1) respondent. However, all parties to the joint venture/legal partnership shall submit all mandatory attachments and documentation required by this solicitation from respondents, unless otherwise stated. Failure to submit all required documentation from all parties included in a joint venture/legal partnership, signed by an authorized official, if applicable, may result in the rejection of a prospective vendor’s response.

g. Pursuant to Section 287.133(2)(a), F.S., a person or affiliate who has been placed on the convicted Vendor list following a conviction for a public entity crime may not submit a Bid, Proposal, or Reply on a contract to provide any goods or services to a public entity;

may not submit a Bid, Proposal, or Reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit Bids, Proposals, or Replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, F.S. for category two for a period of thirty-six (36) months following the date of being placed on the convicted Vendor list.

2. Mandatory Response Content

The respondent shall include the documents listed in this Item with the submission of the Original Response. Violation of this provision may result in the rejection of a response.

a. Exhibit A-2, Transmittal Letter

The respondent shall complete and submit Exhibit A-2, Transmittal Letter, as part of its response in accordance with the instructions contained therein.

b. Exhibit A-3, Required Certifications and Statements

The respondent shall complete and submit Exhibit A-3, Required Certifications and Statements, as part of its response in accordance with the instructions contained therein.

c. Original Proposal Guarantee

1) The respondent’s Original Response must be accompanied by an Original Proposal Guarantee payable to the State of Florida in the amount of $15,450,000. The proposal guarantee is a firm commitment the respondent shall, upon the Agency’s acceptance of its response, execute such

ITN 003-21/22, Attachment A, Page 10 of 27 contractual documents as may be required within the time specified.

2) The respondent must be the guarantor. If responding as a joint venture/legal partnership, at least one party of the joint venture/legal partnership shall be the guarantor.

3) The proposal guarantee shall be in the form of a bond, cashier’s check, treasurer’s check, bank draft or certified check. The Agency will not accept a letter of credit in lieu of the Proposal Guarantee.

4) The Agency will not accept a copy of the Proposal

Guarantee.

5) Proposal Guarantees will be returned upon execution of the legal Contract with the successful respondent and receipt of the performance bond required under this solicitation (See Section A.1., Instructions, Sub-Section D., Response Evaluation, Negotiations and Contract Award, Item 9., Performance Bond).

6) Proposal Guarantees may be returned to respondents not considered responsive and responsible prior to execution of the legal Contract if the respondent is not participating in an administrative challenge regarding this solicitation.

7) Proposal Guarantees will be returned to the Official Contact

Person at the address listed in Exhibit A-2, Transmittal Letter.

8) If the successful respondent fails to execute a contract within ten (10) consecutive calendar days after a contract has been presented to the successful respondent for signature, the proposal guarantee shall be forfeited to the State.

9) The proposal guarantee must not contain any provisions that shorten the time from bringing an action to a time less than that provided by the applicable Florida Statute of Limitations (see Section 95.03, F.S.).

d. Financial Information

In order to demonstrate financial stability, the respondent shall submit its two (2) most recent audited financial statements or its most recent Dun & Bradstreet (D&B) Report.

1) Audited Financial Statements

ITN 003-21/22, Attachment A, Page 11 of 27

If the respondent is a subsidiary of a parent organization, the respondent may submit the two (2) most recent audited financial statements of its parent entity. Audited financial statements of the parent organization in lieu of the respondent must include an organizational chart representing the relationship between the respondent and the parent entity. Respondents submitting audited financial statements shall submit the following:

a) A copy of the respondent’s two (2) most recent audited financial statements (or parent organization’s audited financial statements with organizational chart). If the most recent audit contains columns for the current and previous year on the balance sheet, income statement, and statement of cash flows, then only the most recent year’s audit is required.

b) Audited financial statements must be current. The period covered by the most recent audit cannot be more than one (1) fiscal year and one hundred twenty (120) calendar days old from the solicitation advertisement date.

c) The audit must contain a signed audit statement

(Audit Opinion) from a Certified Public Accountant (CPA) and the statement cannot contain an Adverse Opinion or a Disclaimer of Opinion from the CPA.

2) Dun & Bradstreet (D&B) Report

Respondents shall submit a complete D&B report which at a minimum shall include the Business and Executive Summaries, Credit Class Score, Financial Stress Score, and Paydex Score portions of the report. The D&B report cannot be more than twelve (12) months old at the time of response to this solicitation.

e. Exhibit A-4, Submission Requirements and Evaluation Criteria

(Technical Response)

1) Respondents shall complete and submit Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), and applicable attachments/exhibits as part of its response.

2) Respondents shall comply with the instructions for completing Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), which are contained therein.

ITN 003-21/22, Attachment A, Page 12 of 27

f. Exhibit A-5, Cost Proposal

The respondent shall complete and submit Exhibit A-5, Cost Proposal, as part of its response in accordance with the instructions

g. Exhibit A-5-a, Detailed Budget

The respondent shall complete and submit Exhibit A-5-a, Detailed Budget, as part of its response in accordance with the instructions

h. Exhibit A-6, Summary of Respondent Commitments

The respondent shall complete and submit Exhibit A-6, Summary of Respondent Commitments, as part of its response in accordance with the instructions contained therein.

3. Additional Response Content

a. Exhibit A-7, Certification of Drug-Free Workplace Program

The State supports and encourages initiatives to keep the workplace of Florida’s suppliers and contractors drug free. Section 287.087, F.S. provides that, where identical tie Proposals are received, preference shall be given to a Proposal received from a respondent that certifies it has implemented a drug-free workplace program. If applicable, the respondent shall sign and submit Exhibit A-7, Certification of Drug-Free Workplace Program, to certify that the respondent has a drug-free workplace program.

C. Response Submission Requirements

1. Hardcopy and Electronic Submission Requirements

a. General Provision

Electronic submissions via MyFloridaMarketPlace will not be accepted for this solicitation.

b. Hardcopies of the Response

1) Original Response

The respondent shall submit one (1) Original Response.

The Original Response shall be marked as the “Original” and contain the Transmittal Letter (Exhibit A-2) that bears the original signature of the binding authority. The box that contains the Original Response shall be marked “Contains

ITN 003-21/22, Attachment A, Page 13 of 27

Original”. All forms requiring signature shall bear an original signature with the original response.

2) Duplicate Copy of the Original Response

The respondent shall submit one (1) duplicate copy of the Original Response.

3) Packaging and Delivery

a) A hard copy response shall be bound and submitted in one (1), three-inch, three-ring binder or secured in a similar fashion to contain pages that turn easily for review.

b) Each component of the hard copy response shall be clearly labeled and tabbed in the order specified below:

(1) Exhibit A-2, Transmittal Letter;

(2) Exhibit A-3, Required Certifications and

Statements;

(3) Original Proposal Guarantee Note: The

Original Proposal Guarantee must be provided in the Original Response;

(4) Financial Information;

(5) Exhibit A-4, Submission Requirements and

Evaluation Criteria Components (Technical Response);

(6) Exhibit A-5, Cost Proposal;

(7) Exhibit A-5-a, Detailed Budget;

(8) Exhibit A-6, Summary of Respondent

Commitments;

(9) Exhibit A-7, Certification of Drug-Free

Workplace Program (if applicable); and

c) Hard copy responses shall be double sided.

d) Hard copy responses must be submitted in a sealed package (i.e., outer boxes must be sealed, individual binders within the box do not require individual sealing), to the Procurement Officer identified in Section A.1., Instructions, Sub-Section A., Overview, Item 5., Procurement Officer, no later than the time indicated in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline.

ITN 003-21/22, Attachment A, Page 14 of 27

e) Hard copy responses shall be submitted via United States (U.S.) mail, courier, or hand delivery.

Responses sent by fax or email will not be accepted.

f) The Agency will not consider responses received after the date and time specified in Section A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, and any such responses will be returned to the respondent unopened.

c. Electronic Copy of the Response

1) The respondent shall submit one (1) electronic copy of the entire response on a USB flash drive.

2) The electronic copy of the response, including all attachments, shall be submitted as Portable Document Format (PDF) documents. The PDF documents must be searchable, allow printing and must not be password protected (unlocked).

3) The electronic copy of the PDF documents shall be saved on the USB flash drive, with each component listed below saved separately in individual file folders:

(a) Exhibit A-2, Transmittal Letter;

(b) Exhibit A-3, Required Certifications and

Statements;

(c) Financial Information;

(d) Exhibit A-4, Submission Requirements and

Evaluation Criteria Components (Technical Response) and applicable attachments/exhibits;

(e) Exhibit A-5, Cost Proposal;

(f) Exhibit A-5-a, Detailed Budget;

(g) Exhibit A-6, Summary of Respondent

Commitments; and

(h) Exhibit A-7, Certification of Drug-Free Workplace

Program (if applicable).

4) In addition to the PDF submission, the following exhibits shall also be submitted in Microsoft Excel 2016 or later, utilizing the Agency provided templates and shall be saved on the USB flash drive:

(a) Exhibit A-5, Cost Proposal;

(b) Exhibit A-5-a, Detailed Budget; and

(c) Exhibit A-6, Summary of Respondent

Commitments.

ITN 003-21/22, Attachment A, Page 15 of 27

5) Electronic Redacted Copies

(a) The respondent shall submit an electronic redacted copy of the response suitable for release to the public in one (1) PDF document on the USB flash drive. The electronic copy shall be saved in a separate file folder on the USB flash drive from the rest of the response. The file folder shall be identified as “Redacted Version Suitable for Public Release”.

(b) The PDF document must be searchable, allow printing, and must not be password protected (unlocked).

(c) Any confidential or trade secret information covered under Section 812.081, F.S., should be redacted as described below. The redacted response shall be marked as the “redacted” copy.

2. Confidential or Exempt Information

a. All submittals received by the date and time specified in Section

A.1., Instructions, Sub-Section A., Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, become the property of the State of Florida and are public records subject to the provisions of Chapter 119, F.S. The State of Florida shall have the right to use all ideas, or adaptations of the ideas, contained in any response received in relation to this solicitation. Selection or rejection of the response shall not affect this right.

b. A respondent that asserts that any portion of the response is confidential or exempt from disclosure under Chapter 119, F.S., shall clearly mark each page of such portion as follows:

1) Pages containing trade secret shall be marked “Trade secret as defined in Section 812.081, Florida Statutes”.

Respondents who fail to identify trade secret as directed herein acknowledge and agree that they waive any right or cause of action, civil or criminal, against the Agency, its employees, and its representatives, for the release or disclosure of trade secret information not so identified.

Respondents shall not mark their entire response as trade secret. The Agency may reject a response that is so marked.

2) Pages that do not contain trade secret but are otherwise exempt or confidential shall be marked “exempt” or “confidential,” followed by the statutory basis for such claim.

For example: “The information on this page is exempt from

ITN 003-21/22, Attachment A, Page 16 of 27 disclosure pursuant to Section 119.071(3)(b), Florida Statutes.”

3) Failure to identify and mark such portions as directed above shall constitute a waiver of any claimed exemption and the Agency will provide any unmarked records in response to public records requests for those records without notifying the respondent. Designating material simply as “proprietary” will not necessarily protect it from disclosure under Chapter 119, F.S.

c. All information included in the response (including, without limitation, technical and cost information) and any resulting Contract that incorporates the successful response (fully, in part, or by reference) shall be a matter of public record regardless of copyright status. Submission of a response to this solicitation that contains material for which the respondent holds a copyright shall constitute permission for the Agency to reproduce and disclose such material for the Agency’s internal use, and to make such material available for inspection pursuant to a public records request.

d. If a public records request is submitted to the Agency for responses submitted to this solicitation, the respondent agrees that the Agency may release the redacted response without conducting any pre-release review of the redacted response.

e. Unless otherwise prohibited by law, the Agency will notify the respondent if a requestor contests the respondent’s determination that information is confidential or exempt and asserts a right to the information under Chapter 119, F.S. or other law. The respondent bears sole responsibility for supporting and defending its determination. If an action is brought against the Agency in any appropriate judicial forum contesting the respondent’s determination of confidentiality or the redactions made by the respondent to its response, the respondent agrees that the Agency has no duty to defend against such claims and may elect not to do so, and may elect to release an un-redacted version of the response. By submitting a response, the respondent agrees to protect, defend, hold harmless and indemnify the Agency for any and all claims arising from or relating to the respondent’s determinations of confidentiality or redaction, including the payment of any attorneys’ fees or costs assessed against the Agency.

D. Response Evaluation, Negotiations and Contract Award

1. Response Clarification

The Agency reserves the right to seek written clarification from a respondent of any information contained in the response or to request

ITN 003-21/22, Attachment A, Page 17 of 27 missing items from a response. However, it is a respondent’s obligation to submit an adequately written reply for the Agency to evaluate. The Agency shall have no duty to conduct discussions or attempt to clarify ambiguities in the respondent’s reply if the respondent is not in the competitive range of respondents selected for negotiations.

2. Responsive Reply Determination

A “responsive reply” means a reply submitted by a responsive and responsible vendor, which conforms in all material aspects to the solicitation [Section 287.012(26), F.S.]. A “responsible vendor” means a vendor who has the capacity in all respects to fully perform the Contract requirements and the integrity and reliability that will assure good faith performance [287.012(25), F.S.]. The Procurement Officer may rely on any facts available to make a determination at any time prior to award as to whether a vendor is a responsible vendor. The Agency reserves the right to contact sources outside the reply to obtain information regarding past performance or other matters relevant to responsibility.

3. Non-Scored Requirements

a. Transmittal (Cover) Letter

The Agency will review responses to this solicitation to determine if the respondent included in its response, Exhibit A-2, Transmittal Letter, from each required party.

b. Required Certifications and Statements the respondent included in its response, Exhibit A-3, Required Certifications and Statements.

c. Original Proposal Guarantee the respondent included in its response, an original proposal guarantee in the appropriate amount, as specified in Section B., Response Preparation and Content, Sub-Section 2., Mandatory Response Content, Item c.

d. Summary of Respondent Commitments the respondent included in its response, Exhibit A-6, Summary of Respondent Commitments.

4. Financial Evaluation - Pass/Fail

a. Financial Statements

ITN 003-21/22, Attachment A, Page 18 of 27

The respondent will be deemed to have met the mandatory requirement of financial stability if it meets all three (3) of the minimum financial ratio thresholds listed below in the most recent year or if it meets two (2) of the three (3) minimum financial ratio thresholds for the two (2) most recent years.

1) A positive current ratio of at least one (1.0). The current ratio is determined by dividing current liabilities into current assets.

a) Current assets are those held for conversion within a year or less, such as cash, temporary investments, receivables, inventory, and prepaid expenses.

Board designated assets of cash or near cash instruments, where the board of directors has the option to change the authorized use of the assets and the assets are otherwise unencumbered as disclosed by the auditor, can be considered current assets for this calculation.

b) Current liabilities are short-term debts and unearned revenues to be paid out of current assets within a year or less.

2) A positive tangible net worth as determined by the balance sheet. This shall be determined as equity (total assets less total liabilities) net of intangible assets. An intangible asset is a capital asset having no physical existence, its value being dependent on the rights that possession confers upon the owner. Examples include goodwill and trademarks.

3) A positive operating cash flow. This shall be determined by whether or not the cash flow from operations reported on the statement of cash flows is positive.

b. Dun & Bradstreet (D&B) Report

Agency staff will evaluate the respondent on its Paydex, Financial Stress, and Credit Scores from the D&B report. Scores will be based on Table 2, Responsibility Stability Score, below, for each category. A score of 5 in any of the three (3) categories will result in a determination that financial stability is not met. In order to be deemed financially stable, the respondent’s average score of the three (3) categories must be 3.0 or lower.

ITN 003-21/22, Attachment A, Page 19 of 27

TABLE 2

RESPONDENT STABILITY SCORE

Paydex Score Financial Stress Score

Delinquency Predictor/Commercial Credit

Score

Respondent Stability Score

90 or higher 1570-1875 580-670 = 1

80-89 1510-1569 530-579 = 2

70-79 1450-1509 481-529 = 3

50-69 1340-1449 453-480 = 4

49 or lower 1339 or lower 452 or lower = 5 (Automatically Fails Financial Stability Review)

5. Scored Requirements – Evaluation Criteria

a. Technical Response Evaluation

1) Each evaluator will evaluate responses independently of the other evaluators and award points based on the criteria and points scale indicated in Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), for the detailed evaluation criteria components.

2) Each response will be individually scored by at least three

(3) evaluators, who collectively have experience and knowledge in the program areas and service requirements for which contractual services are sought by this solicitation.

The Agency reserves the right to have specific Sections of the responses evaluated by less than three (3) individuals.

3) The scores of independent evaluators will be computed to determine a total score based on the detailed evaluation criteria components indicated in Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), and the weight factor specified in Table 3, Summary Score Sheet, below.

b. Cost Proposal Evaluation

The Agency will not evaluate each Cost Proposal (Exhibit A-5, Cost Proposal) during the evaluation and scoring process. Pricing

ITN 003-21/22, Attachment A, Page 20 of 27 will be discussed with respondents invited to negotiations and will be a best value consideration for Contract award.

TABLE 3: CORE ITN EVALUATION CRITERIA SCORING SHEET

SUMMARY SCORE SHEET

Maximum Raw Score Possible

Weight Factor

Maximum Points

Possible

A. Technical Response

SRC# 1 Table of Contents

SRC# 2 Executive Summary

SRC# 3 Organizational Structure and History

SRC# 4 Respondent Qualifications 25 X 2.00 = 50.00

SRC# 5 Customer Experience

SRC# 6 Sanctions 10 X 1.00 = 10.00

SRC# 7 Security Risk Rating Score Scan 5 X 4.00 = 20.00

SRC# 8 Project Management and Service Delivery Approach 25 X 1.50 = 37.50

SRC #9 Disaster Recovery and Business Continuity 30 X 1.00 = 30.00

SRC #10 Core Platform Solution (Technology) 15 X 17.00 = 255.00 SRC #11 Core Services Solution - Claims and Encounters 70 X 1.00 = 70.00

SRC #12 Core Services Solution - Capitation Process 55 X 1.40 = 77.00

SRC #13 Core Services Solution - Financial Management

50 X 1.50 = 75.00

SRC #14 Core Services Solution - Federal and Financial Reporting

35 1.50 52.50

SRC #15 Core Services Solution - Recipient Management

X

2.50

75.00

SRC #16 Performance Standards and Reporting

20 X 2.00 = 40.00 SRC #17 Security

20 X 1.50 = 30.00 SRC #18 Deliverable Approach

SRC #19 Optional Additional Innovation Opportunities

SRC #20 Vendor Staffing

SRC #21 Facilities and Service Location(s)

15 X 1.00 = 15.00 SRC #22 Turnover Planning

SRC #23 Operations and Maintenance

35 X 2.30 = 80.50 SRC #24 Implementation and Transition Approach

20 X 2.00 = 40.00

SRC #25 General Core Product Demo

15 X 2.50 = 37.50

Total 480 1,000.00

ITN 003-21/22, Attachment A, Page 21 of 27

6. Ranking of Responses

a. A total score will be calculated for each response based on the total maximum points available as included in Table 3, Summary Score Sheet, above.

b. The total point scores will be used to rank the responses.

7. Negotiation Process

a. The scores from the evaluation process shall be used to determine the respondents with whom the negotiation team will negotiate. The negotiation team shall not utilize the evaluation scores in determining best value.

b. The Agency will negotiate with the three (3) highest ranked respondents (competitive range). However, the Agency may choose not to negotiate with a respondent whose score is lower than seventy-five percent (75%) of the highest score earned by any respondent to this solicitation.

c. The Agency may review any and all data available to the Agency including but not limited to Agency held data and respondents’ performance-based information for use in negotiations.

d. The Agency’s negotiation team will conduct negotiation strategy sessions pursuant to Section 286.0113, F.S. Negotiation strategy includes determining best value criteria and developing award recommendation(s). During its strategy sessions, the Agency’s negotiation team will develop a recommendation as to the award that will provide the best value (as defined in Section 287.012(4), F.S.) to the State.

e. Negotiation sessions will include discussions of the scope of services to be provided by the respondent until acceptable terms and conditions are agreed upon, or it is determined that an acceptable agreement cannot be reached. The Agency will negotiate the terms and conditions determined to be the best value to the State according to Section 287.012(4) F.S., including, but not limited to price/cost, quality, design, and service delivery. Any terms to be negotiated must be addressed during negotiation sessions, prior to award.

f. At least one authorized official who has the authority to bind the respondent to a contract must be present at each negotiation session. The authorized official(s) must be the Official Contact

ITN 003-21/22, Attachment A, Page 22 of 27

Person or Alternate Contact Person named in Exhibit A-2, Transmittal Letter.

g. The Agency reserves the right at any time during the negotiation process to:

1) Negotiate concurrently or sequentially with competing respondents.

2) Schedule additional negotiation sessions with any or all responsive respondents.

3) Require any or all responsive respondents to provide additional, revised, or final written replies addressing specific topics, including modifications to the solicitation specifications, terms or conditions, or business references.

4) Require any or all responsive respondents to provide a written best and final offer or offers.

5) Require any or all responsive respondents to address services, prices, or conditions offered by any other respondents.

6) Decline to conduct further negotiations with any respondent.

7) Re-open negotiations with any responsive respondent.

8) Take any additional, administrative steps deemed necessary in determining the final award, including additional fact-finding, evaluation or negotiations where necessary and consistent with the terms of this solicitation.

9) Review and rely on relevant information contained in the responses.

10) Request pricing options or models different from the initial Cost Proposal submission. This information may be used in negotiations to determine the best pricing solution to be used in the Contract.

h. The Agency has sole discretion in deciding whether and when to take any of the foregoing actions, the scope and manner of such actions, the responsive respondent or respondents affected and whether to provide concurrent public notice of such decision.

i. In the event the Agency cannot reach agreement with a respondent who has been invited to negotiation and/or a respondent withdraws its response during the negotiation phase, the Agency reserves the

ITN 003-21/22, Attachment A, Page 23 of 27 right to invite the next top ranking respondent to negotiations to ensure that the Agency can enter into a contract.

8. Number of Awards

The Agency anticipates the issuance of one (1) contract as a result of this solicitation for all services included within the Scope of Services. The Agency, at its sole discretion, shall make this determination.

9. Posting of Notice of Intent to Award

Tabulation of Results, with the recommended Contract award, will be posted to the Vendor Bid System and will be available for review by interested parties at the time and location specified in Section A.1., Instructions, Sub-Section A. Overview, Item 6., Solicitation Timeline, Table 1, Solicitation Timeline, and will remain posted for a period of seventy-two (72) hours, not including weekends or State observed holidays.

Any respondent desiring to protest the recommended Contract award must file a notice of intent to protest to the Procurement Officer identified in Section A.1., Instructions, Sub-Section A. Overview, Item 5., Procurement Officer, within the time prescribed in Section 120.57(3) F.S.

and Rule 28-110, F.A.C.

Any notice of intent to protest must be filed electronically or via United States (U.S.) mail, courier, or hand delivery at the following address:

Attn: Ashley Balkcom Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #15 Tallahassee, Florida 32308-5403 Email: solicitation.questions@ahca.myflorida.com

Any formal protest must be filed within the time prescribed in Section 120.57(3) F.S. and Rule 28-110, F.A.C. Failure to file a protest within the time prescribed in Section 120.57(3), F.S., or failure to post the bond or other security required by law, shall constitute a waiver of proceedings under Chapter 120, F.S.

Any formal protest must be filed with the Agency Clerk, at the address below, or electronically at http://apps.ahca.myflorida.com/Efile/, a link to which can be found on the Agency’s public website.

Agency for Health Care Administration C/O Agency Clerk 2727 Mahan Drive, Mail Stop #3 Building 3, Room 3407C Tallahassee, Florida 32308-5403 http://apps.ahca.myflorida.com/Efile/

ITN 003-21/22, Attachment A, Page 24 of 27

After submittal of the Notice of Intent to Protest, all communication regarding the solicitation must be submitted to the Agency’s General Counsel’s Office.

10. Performance Bond

a. A performance bond in the amount of ten percent (10%) of the total annual amount of the resulting Contract shall be furnished to the Agency by the successful respondent within thirty (30) calendar days after execution of the resulting Contract and prior to commencement of any work under the resulting Contract.

b. The bond shall be furnished to the Agency’s Procurement Office at:

Procurement Office Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #15 Tallahassee, Florida 32308-5403

c. Thereafter, the performance bond shall be furnished on an annual basis, thirty (30) calendar days prior to the new Contract year and be in the amount of ten percent (10%) of the current annual Contract amount.

d. A copy of all performance bonds shall be submitted to the Agency’s Contract Manager.

e. The performance bond must not contain any provisions that shorten the time for bringing an action to a time less than that provided by the applicable Florida Statute of Limitations. (See Section 95.03, F.S.)

f. No payments will be made to the successful respondent until an acceptable performance bond is furnished to the Agency. The performance bond shall remain in effect for the full term of the resulting Contract, including any renewal period. The Agency shall be named as the beneficiary of the successful respondent’s bond.

The bond shall provide that the insurer or bonding company(s) pay losses suffered by the Agency directly to the Agency.

g. The cost of the performance bond will be borne by the successful respondent.

h. Should the successful respondent terminate the resulting Contract prior to the end of the resulting Contract period, an assessment against the bond will be made by the Agency to cover the costs of issuing a new solicitation and selecting a new Vendor. The successful respondent agrees that the Agency’s damages in the event of termination by the successful respondent shall be

ITN 003-21/22, Attachment A, Page 25 of 27 considered to be for the full amount of the bond.