F77106498_AHCAITN0022122_AddendumNo.1.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

November 12, 2021

Prospective Vendor(s):

Subject: Solicitation Number: ITN 002-21/22

Title: Provider Services Module (PSM)

Addendum No. 1

The enclosed information has been provided for consideration in the preparation of your response to the above referenced solicitation.

All other terms and conditions of the solicitation remain in effect.

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 Issuing Officer, Purchasing Manager Bureau of Support Services

Enclosures: Addendum No. 1 (7 Pages)

Exhibit A-4-a, Submission Requirements and Evaluation Criteria Components (Technical Response) (32 Pages)

Exhibit B-1-a, Deliverables and Performance Standards (22 Pages) Questions and Answers (14 Pages)

ITN 002-21/22

ADDENDUM NO. 1

ITN 002-21/22, Addendum No. 1, Page 1 of 7

Item #1

Attachment A, Instructions and Special Conditions, Exhibit A-4, Submission Requirements and Evaluation Criteria Components (Technical Response), is hereby deleted in its entirety and replaced with Exhibit A-4-a, Submission Requirements and Evaluation Criteria Components (Technical Response), attached hereto, and made a part of the ITN. All references in the ITN to Exhibit A-4 shall hereinafter refer to Exhibit A-4-a.

Item #2

Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 8, Transition/Design, Development, and Implementation (DDI), Item 8.2, Implementation Plan, sub-item 8.2.3, PSM Implementation Timeline Assumptions, is hereby deleted in its entirety and replaced with the following:

8.2.3 PSM Implementation Timeline Assumptions

The FX Strategic Roadmap depicted in Section A., Services to be Provided, subsection 3, General Overview, demonstrates the fact that the Agency has many simultaneous initiatives occurring over the next several years to support the FX Enterprise Transformation to Medicaid Management Information System (MMIS) modularity in Florida. Given this complexity and the level of effort required from Agency Stakeholders and Subject Matter Experts (SMEs), and other Stakeholder vendors, the PSM Vendor shall assume that the earliest possible Go-Live date for the PSM is in Q3 of SFY 22/23, and that the legacy Fiscal Agent contract must be fully resolved by Q2 of SFY 24/25.

The PSM Vendor shall provide additional DDI services for new FX projects incorporated into the PSM Solution during DDI which shall be authorized by the Agency as Task Orders (TO) based on their potential complexity of implementation (Low, Medium, or High) as appropriate.

The PSM Vendor’s work will be managed by the Agency’s Contract Manager who shall issue written authorization to work in the form of individual TOs. Each TO shall include project or service requirements (Scope of Services) which the PSM Vendor shall assist in developing and finalizing with the Agency; PSM Vendor activities; activities the PSM Vendor expects the Agency to perform; timelines; staffing plan;

specific fixed price deliverables, milestones, and delivery dates; and cost reimbursable bill of materials. The PSM Vendor is not authorized to initiate work on any TO prior to approval by the Agency. The PSM Vendor is also not authorized to perform work on any TO beyond the services completion date as identified in the individual TO unless approved by the Agency and reduced to writing in the form of a change order to the TO. The format and processes associated with TOs shall be developed during Contract initiation activities.

Deliverables completed for a TO shall be submitted to the Agency for review and approval, and in accordance with the timeframes established in the applicable TO. The TO shall be signed by the Agency and the PSM Vendor.

ITN 002-21/22, Addendum No. 1, Page 2 of 7

In accordance with Attachment A, Instructions and Special Conditions, Exhibit A-5-a, Detailed Budget, Tab F, Low complexity TOs shall be implemented within 30 business days of approval to begin services; TOs of Medium complexity shall be implemented within 90 business days of approval to begin services; High complexity TOs shall be implemented within 180 business days of approval to begin services.

Item #3

Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 9, PSM Platform Solution (Technology), Item 9.3, Disaster Recovery and Business Continuity, is hereby amended to delete the second paragraph, and shall now read as follows:

The PSM Vendor must meet each of the disaster recovery and business continuity requirements included in Exhibit B-3, Requirements Matrix, to this attachment.

Item #4

Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 13, Staffing, is hereby amended to include Item 13.1.2, DDI System Implementation Support Staffing, as follows:

13.1.2 DDI System Implementation Support Staffing

In order to keep the PSM software product usable in the changing FX environment, the PSM Vendor must maintain a staff of managers including a project manager, business analysts, programmers, and system operators for the purpose of implementing requirements and responding to FX enterprise changes and integration needs during DDI. The resources dedicated to system implementation support will prioritize low and medium complexity requests and then address high complexity requests, if capacity allows, all of which will be agreed upon by the Agency. Final decisions on the system implementation support staffing level will be agreed to by the Agency.

The PSM Vendor must provide this system implementation support staffing level to analyze systems and business processes, design and implement technical solutions to respond to FX Enterprise changes and system integration needs over and above any staff used for base requirements implementation. This staff shall implement changes requested or approved by the Agency during DDI. All such work shall be completed based on priorities set by the Agency. If system implementation support requests exceed the system implementation support staffing level agreed to by the Agency and the PSM Vendor, the Agency will authorize additional support staff through Task Orders (TO) as specified in subsection 8, Transition / Design, Development, and Implementation (DDI), Item 8.2, Implementation Plan, sub-item 8.2.3, PSM Implementation Timeline Assumptions, based on the Support Staff Hourly Rates specified in the Contract.

ITN 002-21/22, Addendum No. 1, Page 3 of 7

No additional or separate payment will be made to the PSM Vendor by the Agency for the above system implementation support staff, or the cost of computer resources, or other items necessary for system modifications due to error, continued system operation, or system modifications.

Item #5

Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 13, Staffing, Item 13.1.1, Key Personnel Roles, is hereby amended to include the following:

The CVO Medical Director shall maintain a Doctor of Medicine degree and be in good standing and must not have: prior professional disciplinary actions from a state licensing board, specialty board, or organized medical organization such as a state or county medical society; licensure revocations; or board certification revocations.

Item #6

Attachment B, Scope of Services, Section E., Special Provisions, subsection 7, Information Technology, Item 7.1, Development Requirements, sub-item v. is hereby amended to now read as follows:

The PSM Vendor must conform to current and updated publications of the principles, standards, and guidelines of the FIPS, the National Institute of Standards and Technology (NIST) publications, including but not limited to Cybersecurity-Framework and NIST 800-53.

Item #7

Attachment B-1, Scope of Services, Exhibit B-1, Deliverables and Performance Standards, is hereby deleted in its entirety and replaced with Exhibit B-1-a, Deliverables and Performance Standards, attached hereto, and made a part of the ITN. All references in the ITN to Exhibit B-1 shall hereinafter refer to Exhibit B-1-a.

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

http://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-53r4.pdf

ITN 002-21/22, Addendum No. 1, Page 4 of 7

Item #8

Attachment B, Scope of Services, Exhibit B-2-a, Service Level Metrics, the following metrics are hereby amended to now read:

SLM

Number SLM Description Measure-ment Formula

Data Source

Measure-ment

Frequency

Reporting Frequency

Financial Consequence

SLM-

B009

Provider Credentialing activities shall be completed 100% of the time within 60 calendar days from a complete enrollment submission to final disposition.

Monitoring Dashboard or Performance monitoring logs

Quarterly Quarterly $500.00, per business day, after 60 calendar days a provider's credentialing activities remain uncompleted.

SLM-

B024

The PSM Vendor shall provide flex staff to support Provider Enrollment, Provider Maintenance and Management, and Site Visit Agency services within 30 business days from formal Agency written request, unless otherwise agreed to by the Agency in writing.

Workflow Report

Daily Monthly $1,000.00, per business, day after the required number of business days a flex staffing request remains unfulfilled.

SLM-

T007

Removed.

SLM-

T008

The PSM Vendor shall perform patching and corrections to mitigate security vulnerabilities according to the vulnerability priority: Critical within 24 hours, Major priority within seven (7) calendar days, High priority within 30 calendar days, Minor priority within 90 calendar days, Low priority within 180 calendar days. The Agency will determine the level of priority in consultation with the PSM Vendor.

Security vulnerability scans

Quarterly Quarterly $2,000.00, per occurrence, if the patch or correction is not implemented within the Performance Standard timeframe.

ITN 002-21/22, Addendum No. 1, Page 5 of 7

SLM

Number

SLM Description Measure-ment

Formula

Data Source

Measure-ment

Frequency

Reporting Frequency

Financial Consequence

SLM-

T016

Vendor shall notify the Agency of any critical level Deficiencies, as defined by the Agency, it identifies where essential functionality is non-operational (e.g., system has crashed), within one hour of the initial Deficiency or within 30 minutes of becoming aware of the issue, whichever is earlier. Vendor shall provide its plan for resolution within 4 hours of the notification of the Deficiency to the Agency and resolve the Deficiency within 24 hours of the notification of the Deficiency to the Agency.

Monitoring Dashboard or Performance monitoring logs

Daily Monthly Agency shall assess the financial consequences as specified below for failure to meet the Performance Standard timeframe:

$2,000.00 /24-hour period 0 to 72 hours beyond Performance Standard

$2,500.00 /24-hour period 73 to 168 hours beyond Performance Standard

$5,000.00 /24-hour period > 169 hours beyond Performance Standard

ITN 002-21/22, Addendum No. 1, Page 6 of 7

Item #9

Attachment B, Scope of Services, Exhibit B-3, Requirements Matrix, the following requirements are hereby amended to now read:

Scope of Services Section Number

Scope of Services Section

Subsection Requirement

ID

Requirement Description

B.6.3 FX Project Life Cycle and Management

Testing TEST-003

The PSM Vendor shall ensure, in order to release code to UAT or production, the code meets the minimum acceptable defect levels:

• Critical:100% have been resolved.

• Major: 100% have been resolved.

B.9.1 PSM Platform Solution (Technology)

Technology Standards and Compliance

CMP-008 The PSM Vendor shall adhere to recognized best practices during the execution of the Contract including the latest version of the National Institute of Standards and Technology (NIST) 800 series related to cyber security and the Florida Cybersecurity Standards

(FCS) FAC 60GG 2.001-2.006.

B.9.2 PSM Platform Solution (Technology)

Hosting and Environments

ENV-006 The PSM Vendor shall provision environments as requested by the Agency and submit Environmental Readiness Review, which details the scope of work, planned tasks, and completed tasks as part of the configure/build process for the PSM Solution including, implementation of detailed requirements, detailed design, configuration, development, unit testing, and documentation.

B.9.7 PSM Platform Solution (Technology)

Security SEC-020 The PSM Vendor will provide a completed Security Audit Report with results to the Agency by September 30th of each year. The Security Audit Report must include either an electronic data processing (EDP) systems audit using SSAE - 18 at a minimum level service organization control (SOC) 2 Type II or a NIST 800-53 assessment at a "moderate" system risk control level.

The PSM Vendor shall perform patching and corrections to mitigate security vulnerabilities according to the vulnerability priority: Critical within 24 hours, Major priority within seven (7) calendar days, High priority within 30 calendar days, Minor priority within 90 calendar days, Low priority within 180 calendar days. The Agency will determine the level of priority in consultation with the PSM Vendor.

ITN 002-21/22, Addendum No. 1, Page 7 of 7

B.10.5 Provider Services Module (PSM) Solution

Self-Service Portal

PSER-022 The PSM Vendor's Solution shall have the ability to use information from the Core Module using the Agency’s Integration Platform to support the Health Plans' information needs.

B.15 Facilities and Service Location(s)

FAC-002 All of the PSM Vendor’s facility locations shall be fully and solely dedicated to PSM Vendor Services. Services provided remotely shall be agreed to, in writing, by the Agency.

Attachment B, Exhibit B-1-a

Deliverable Management

DEL-001 The PSM Vendor shall develop and submit a Deliverable Expectations Document (DED) for each deliverable, to include the PSM Vendor’s format and content, within 30 calendar days of the Agency’s approval to commence work on the deliverable, unless otherwise directed by the Agency. The PSM Vendor shall conduct walk-throughs of the DED with the Agency, unless otherwise directed by the Agency. The Agency will establish Agency deliverable review timeframes and PSM Vendor revision timeframes customized for each deliverable.

EXHIBIT A-4-a

SUBMISSION REQUIREMENTS AND EVALUATION CRITERIA

COMPONENTS (TECHNICAL RESPONSE)

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 1 of 32

Instructions to Respondents for the Completion of Exhibit A-4-a, Components (Technical Response):

The Agency is seeking information to determine the ability of Respondents to provide a Provider Services Module (PSM) as described in this ITN, to include development and ongoing operations and maintenance services.

All Respondents to this ITN shall utilize Exhibit A-4-a, 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 unless otherwise instructed within a particular SRC.

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 the 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 SRC 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-a, Submission Requirements and Evaluation Criteria Components (Technical Response).

STANDARD EVALUATION CRITERIA SCALE

Point Score Evaluation

0 The component was not addressed anywhere in the response submission.

1 The component contained significant deficiencies and omissions and lacked meaningful detail.

2 The component is below average. It met some of the minimum requirements but did not address all elements requested.

3 The component is average and met the minimum requirements with minimum detail.

4 The component is above average. It exceeded the minimum requirements and provided good detail.

5 The component is excellent. It exceeded the minimum requirements and contained exceptional content and detail.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 2 of 32

The SRCs in Exhibit A-4-a, Submission Requirements and Evaluation Criteria Components (Technical Response), may not be retyped and/or modified and must be submitted in the original format.

Failure to submit SRC responses via Exhibit A-4-a, Submission Requirements and Evaluation Criteria Components (Technical Response), may result in the rejection of the response.

Exhibit A-4-a, Submission Requirements and Evaluation Criteria Components (Technical Response), is available for Respondents to download at:

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

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

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 3 of 32

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. The Table of Contents page(s) shall be provided as the first page(s) of the Respondent’s Technical Response.

Response:

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

SRC #2 – EXECUTIVE SUMMARY

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

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

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 4 of 32

SRC #3 – ORGANIZATIONAL STRUCTURE AND HISTORY

The Respondent shall demonstrate its capability to provide the services specified in this ITN by describing its organizational structure and history. For responses including the use of proposed subcontractors, the same descriptions of organizational structure and history shall be provided for each subcontractor, including the organizational structure connecting the Respondent and each proposed subcontractor. At a minimum, the description shall include:

1. The Respondent's, and its proposed subcontractor’s, organizational structure, ownership, affiliations, and location(s)

2. The Respondent's, and its proposed subcontractor’s, corporate organizational chart, and a depiction of where the PSM Solution services described in this ITN falls within the organizational structure

3. Background information on the Respondent’s corporation, and on its proposed subcontractor’s corporation(s), the size, and resources, to include:

a. Name of Respondent and any subcontractor(s)

b. Date established

c. Ownership (public company, partnership, subsidiary, etc.)

d. Corporation's Federal Employer Identification Number (FEIN) and Florida Corporate

Charter Number

e. Corporation's primary line of business

f. Total number of employees

Attachments are limited to the following:

• Organizational chart of the Respondent and its subcontractor(s)

• List of the Respondent’s, and its proposed subcontractor’s, physical location(s)

Score: No points will be awarded for Organizational Structure and History.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 5 of 32

SRC #4 – RESPONDENT QUALIFICATIONS

The Respondent shall demonstrate its capability to provide the services specified in Attachment B, Scope of Services, by describing its relevant experience with large healthcare systems, qualifications, and length of experience in providing technology and services similar in nature to those described in this ITN. The description shall include how these experiences will be applied to move the Agency forward, based on its own current Strategic Plan. Details of corporate experience (including any subcontractor experience and capabilities) shall include a list of all contracts related to services similar in nature to those described in this ITN within the last five (5) years, and shall include, at a minimum:

1. Relevant experience with designing, developing, implementing, hosting, and maintaining information technology and business solutions including provider enrollment, provider management and maintenance, provider site visits, and a credentials verification organization.

2. Relevant experience with developing and implementing technology services and support, business operations for large healthcare systems, including project and program management, business requirements elicitation and development, system testing, and system implementation.

3. Capability to work in parallel on multiple projects, with multiple vendors, and maintain timelines while effectively working as a single, distributed team to meet State and federal requirements.

4. How the Respondent’s, and any subcontractor’s, qualifications and experience prepare the

Respondent to move the Agency forward, based on the goals, objectives, and guiding principles specified within the Agency’s Strategic Plan.

5. Any relevant experience the Respondent has with obtaining CMS certification for overall operations.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 6 of 32

SRC #4 Evaluation Criteria:

1. The adequacy of the Respondent’s capability and approach to meet the requirements described in this ITN, based on the relative experience in the performance of current or previous contracts for which it is/was the lead vendor on any projects similar in size, scope, and complexity to the PSM Project in the past five (5) years.

2. The adequacy of the Respondent's relevant experience with large healthcare systems.

3. The adequacy of the Respondent’s experience and demonstrated capability to work in parallel to perform project and program management, business requirements elicitation and development, systems testing, and systems implementation.

4. The adequacy of the Respondent’s and any subcontractor’s qualifications and experience to move the Agency forward based on the goals, objectives, and guiding principles as described within the Agency’s Strategic Plan and to limit the potential for vendor lock-in and conflict of interest for future Agency acquisitions.

5. The adequacy of the Respondent's relevant experience with obtaining CMS certification.

Score: This section is worth a maximum of 25 raw points with each of the above criteria being worth a maximum of 5 points each.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 7 of 32

SRC #5 – CUSTOMER EXPERIENCE

The Respondent shall demonstrate its capability to integrate its proposed PSM Solution with other Agency and vendor systems where the end-user has a consistent and unified digital user experience across all modules. In addition, the Respondent shall demonstrate its capability to continuously improve the experience of PSM customers, including recipients, providers and other Stakeholders. The Respondent shall provide an overview of its experience in improving customer experience and using tools (i.e., customer experience blueprint, customer journey maps) to continuously improve the customer experience.

Score: No points will be awarded for Customer Experience. The response will be reviewed by the Agency and may be addressed with the respondent in the negotiation phase of the ITN, at the Agency’s discretion.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 8 of 32

SRC #6 – SANCTIONS

The Respondent shall list and describe any sanctions levied against the Respondent, its affiliates, its subsidiaries, its parent company, the affiliates and subsidiaries of its parent company, its affiliate’s subsidiaries, and subcontractors (handling subcontracts related to consultant services when the subcontracts are for $250,000.00 or more annually), within the five (5) years preceding the date of its response to this ITN. Sanctions shall include those imposed by a state or federal entity in relation to a contract under which the Respondent provided health care system implementation and operations services or government services contracts in excess of one million dollars ($1,000,000.00). Sanctions shall include financial consequences, damages, liquidated damages, or other amounts paid by the Respondent in a settlement of a contract dispute.

Information requested for each sanction shall be provided by the Respondent for administrative and non-administrative sanctions. An administrative sanction means the issue pertains to timeliness or the use of an incorrect format (i.e., report, deliverable, or another required item submitted late or submitted in the wrong format). A non-administrative sanction means the issue pertains to performance in accordance with the contract scope of services (i.e., incomplete, or inaccurate deliverable or services).

SRC #6 Evaluation Criteria:

1. The extent to which sanctions were due to issues with performance (non-administrative) in accordance with the contract scope of services, versus administrative issues.

2. The severity of the sanction(s) from minor (dollar amounts less than $10,000.00 or resolution time less than 90 calendar days) to significant ((dollar amounts above $10,000.00 or resolution time longer than 90 calendar days or numerous sanctions (more than one sanction among two or more contracts)).

Score: This section is worth a maximum of 10 raw points with each of the above criteria

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 9 of 32

For Item 1:

a. 5 points if no sanctions.

b. 4 points if sanction(s) were related only to administrative issues.

c. 3 points if non-administrative sanction(s) were all minor and there were fewer than four (4) incidents.

d. 2 points if non-administrative sanctions were all minor but four (4) or more incidents.

e. 1 point if any significant administrative sanction.

f. 0 points if any significant non-administrative sanction.

For Item 2:

a. 5 points if no sanctions.

b. 4 points if sanction(s) were minor and there were fewer than four (4) incidents.

c. 3 points if sanctions were all minor but four (4) or more incidents.

d. 2 points if up to two (2) significant sanction(s); or more than two (2) contracts with multiple sanctions.

e. 1 point if more than two (2) significant sanctions but fewer than five (5); or more than two

(2) but fewer than five (5) contracts with multiple sanctions.

f. 0 points if performance falls below the above limits.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 10 of 32

SRC #7: SECURITY RISK RATING SCORE SCAN

In accordance with Attachment B, Scope of Services, Section E., Special Provisions, subsection 7, Information Technology, Item 7.1, Development Requirements, sub-item ee, the Agency will conduct an initial IT security risk rating score scan on the Respondent through an IT security risk rating service, at the Agency's expense, to enable the Agency to effectively measure and mitigate the successful Respondent’s security risks. The Respondent shall work with the Agency’s security risk rating service provider to define the relevant Respondent assets providing Agency services.

SRC #7 Evaluation Criteria:

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

a. A score in the top 90-100% of the scan recommendations.

b. A score in the top 80-89% of the scan recommendations.

c. A score in the top 70-79% of the scan recommendations.

d. A score in the top 60-69% of the scan recommendations.

e. A score in the top 50-59% of the scan recommendations.

f. A score in the lower 0-49% of the scan recommendations.

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

a. 5 points for a score in the top 90-100% of the scan recommendations.

b. 4 points for a score in the top 80-89% of the scan recommendations.

c. 3 points for a score in the top 70-79% of the scan recommendations.

d. 2 points for a score in the top 60-69% of the scan recommendations.

e. 1 point for a score in the top 50-59% of the scan recommendations.

f. 0 points for a score in the lower 0-49% of the scan recommendations.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 11 of 32

SRC #8 – PROJECT MANAGEMENT AND SERVICE DELIVERY

APPROACH

The Respondent shall present its project management and service delivery approach and explain how it reflects industry best practices in service delivery excellence. The Respondent shall demonstrate its capabilities in working with third-party organizational standards by developing an approach that complies with the Agency's FX Project Management Standards included in the PSM Proposal Library.

The Respondent shall describe its proposed approach to PD-1: Project Management Plan (includes the PSM Vendor Resource Management Plan) and provide a draft PD-2: Project Schedule, as described in Attachment B, Scope of Services, Exhibit B-1, Deliverables and Performance Standards.

The proposed draft Project Schedule should show the Respondent’s thorough understanding of the services required in this ITN, and the capability to successfully complete each deliverable.

The draft Project Schedule shall include a high-level project timeline for successful management and completion of the project, as well as identify major project phases with consideration to Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 8, Transition/Design, Development, Implementation (DDI), Item 8.2, Implementation Plan, and any applicable requirements specified in Exhibit B-3, Requirements Matrix. The draft Project Schedule must include timeframes and durations for key milestones and deliverables.

The Respondent shall demonstrate the following:

1. Approach to following project management best practices to ensure adherence to the P-2:

FX Project Management Standards, including, but not limited to:

a. Communications management

b. Risk and issue management

c. Change management

d. Scope management

e. Schedule management

f. Requirements management

g. Quality management

h. Status reporting

i. Human resource management

2. Experience following third party standards (such as the FX Program standards included in the PSM Proposal Library).

3. Experience implementing the System Development Life Cycle (SDLC) for multi-component configurable and customizable technology platforms.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 12 of 32

4. Experience in and approach to successful delivery of services and solutions in a multi-vendor and multi-agency environment.

5. Ability to effectively manage multiple teams that would include the Respondent, subcontractor(s), and Agency Provider Services staff.

6. Ability to implement and provide services and solutions to be adapted to accomplish the PSM Objectives and FX Guiding Principles outlined in Attachment B, Scope of Services, Section A., Services to be Provided, subsection 3, General Overview, Items 3.2, Overview of the FX Transformation and 3.5, PSM Objectives.

SRC #8 Evaluation Criteria:

1. The adequacy of the Respondent’s proposed approach to project management and service delivery, and its alignment with FX Project Management Standards, including demonstrated understanding and approach to the System Development Life Cycle (SDLC) for a multi-component configurable and customizable technology platform.

2. The adequacy of the Respondent’s draft Project Schedule to demonstrate a high-level project timeline for successful management and capability to successfully complete each deliverable.

3. The adequacy of the Respondent's experience following third party standards (such as the

FX Program standards included in the PSM Proposal Library).

4. The adequacy of the Respondent’s experience and demonstrated ability to successfully deliver in a multi-vendor and multi-agency environment.

5. The demonstrated ability of the Respondent to effectively manage multiple teams including

PSM Vendor, subcontractor, and Agency staff.

Score: This Section is worth a maximum of 25 raw points with each of the above criteria

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 13 of 32

SRC #9 – DISASTER RECOVERY AND BUSINESS CONTINUITY

1. The Respondent shall demonstrate its capability and approach to meeting the disaster recovery and business continuity requirements described in the referenced subsections, below, of Attachment B, Scope of Services, Section B., Manner of Services Provisions, and Exhibit B-3, Requirements Matrix.

a. Subsection 9.3, Disaster Recovery and Business Continuity

b. Subsection 11.1, Operations and Maintenance Phase Requirements

c. Subsection 15, Facilities and Service Location(s)

SRC #9 Evaluation Criteria:

For both technology and services, the adequacy of the Respondent’s ability to:

1. Maintain and annually test a Contingency Plan (for Disaster Recovery and Business continuity) for the PSM Solution with the FX Technical Management Strategy.

2. Support the Agency’s Enterprise Contingency Plan and coordination of related activities.

3. Provide backup procedures, hot sites, redundancy, and support to prevent and accommodate the disruption of systems and communications.

4. Minimize downtime and disruption of services.

5. Provide timely failover.

6. Create effective policies and procedures to implement a recovery, as well as business continuation services.

Score: This Section is worth a maximum of 30 raw points with each of the above criteria

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 14 of 32

SRC #10 – TECHNICAL SOLUTION COMPONENTS – PLATFORM

REQUIREMENTS

The Respondent shall demonstrate its capability and approach to meeting the requirements described in Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 9, PSM Platform Solution (Technology), and any applicable requirements specified in Exhibit B-3, Requirements Matrix, including, but not limited to, ensuring its PSM Solution provides all the required technology components and specified options, and all components are integrated into one common solution. In addition, the Respondent shall complete and submit with its response to this SRC, Attachment B, Exhibit B-4, PSM Technology Matrix, to provide its proposed solution components.

SRC #10 Evaluation Criteria:

The adequacy of the Respondent's demonstrated ability to:

1. Provide hosting services to meet the Agency’s requirements and support optimal performance of the PSM Solution.

2. Provide a PSM solution that includes adequate quality management capabilities.

3. Provide a PSM solution with relevant business operations technologies.

Score: This Section is worth a maximum of 15 raw points with each of the above criteria

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 15 of 32

SRC #11 – BUSINESS SOLUTION COMPONENTS – PROVIDER

SERVICES SOLUTION

The Respondent shall demonstrate its experience and proposed approach to the PSM Solution, addressing all requirements specified in Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 10, Provider Services Modules (PSM) Solution, and any applicable requirements specified in Exhibit B-3, Requirements Matrix. This shall include, at a minimum, the following:

1. Providing a PSM Solution that facilitates the enrollment of new providers, including the following services:

a. Web-based tool for providers to electronically enroll in Medicaid.

b. Automated tools for screening provider application, evaluating risk factors, assessing site visits, and accessing primary source documentation that comply with federal or State laws, statutes, policies, or mandates.

c. NCQA compliant provider credentialing that align with managed care plan standards and their accrediting organizations.

2. Providing a PSM Solution that maintains up to date and accurate provider records including, at a minimum, the following:

a. Web-based tool and processes for providers to reenroll or recredential based on defined timeframes.

b. Self-service options for providers to update their records and report changes that may impact their enrollment status.

c. Automated tools or processes that interface with primary source entities to assess and act on renewal or reported changes with limited manual intervention.

d. System alerts to the provider and workflow notification to the Agency when a provider’s information has been updated.

e. Automated file reconciliation processes to ensure the integrity of the provider data.

3. Integrating the PSM Solution with the UOC to facilitate business operations that support the provider management process including, at a minimum, the following:

a. Notification to providers on the status of their Enrollment, Reenrollment, Credentialing, or maintenance activities.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 16 of 32

b. Workflow and integration with the UOC Mailroom and Fulfillment operations to process and link incoming and outgoing documents to the provider’s record.

c. Coordination activities with the UOC Vendor to develop provider communications and outreach materials that meet Agency guidelines and approval.

d. Integration with the UOC Complaint portal to monitor and record actions to be taken within the PSM Solution to address complaint outcomes.

e. Coordination with the UOC Vendor to develop training materials, conduct trainings, and ensure that UOC Training staff have the necessary tools and information to disseminate training and to catalog in the UOC Knowledge Management System.

SRC #11 Evaluation Criteria:

The adequacy of the Respondent’s relevant experience with and proposed approach to:

1. Designing, developing, implementing, hosting, and maintaining an automated self-service provider enrollment and maintenance solution that interfaces with primary verification sources to reduce manual processes.

2. Screening provider applications through automation, risk factor evaluation, and criteria for assessing site visits.

3. Evaluating and assessing provider applications that comply with federal or State laws, statutes, policies, or mandates.

4. Complying with NCQA standards, guidelines, and policies to conduct credentialing activities.

5. Contracting with a Credentials Verification Organization (CVO) to support primary source verification for provider credentialing.

6. Conducting account maintenance activities related to provider reenrollment, recredentialing or acting on reported changes from providers or external sources.

7. Generating system alerts to providers and the Agency when updates have been made to provider information.

8. Maintaining integrity of provider records through reconciliation activities and the electronic monitoring of updates or changes initiated.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 17 of 32

9. Integrating services with the UOC Vendor to support the provider business function to notify providers of the status of their application.

10. Integrating services with the UOC Vendor to support the provider business function related to mailroom and fulfillment operations.

11. Integrating services with the UOC Vendor to support provider communications and outreach activities.

12. Integrating services with the UOC Vendor to support the provider complaint and appeals processes.

13. Integrating services with the UOC Vendor to support the development and delivery of training to Agency staff and the provider community.

Score: This Section is worth a maximum of 65 raw points with each of the above criteria

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 18 of 32

SRC #12 – PERFORMANCE STANDARDS AND REPORTING

1. The Respondent shall demonstrate its experience, understanding and ability to provide an automated method or system/operations tools to provide reports of the quality measurements and performance monitoring dashboards for the post-implementation PSM Solution services as specified in Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 12, Reporting and Exhibit B-2, Operations and Maintenance Service Level Agreement, and any applicable requirements specified in Exhibit B-3, Requirements Matrix. This shall include, at a minimum, the following:

a. Providing a PSM performance reporting dashboard system and resulting generated reports to the Agency’s Contract Manager.

b. Providing real-time performance reporting dashboards for contracted performance standards and Service Level Metrics described in Attachment B, Scope of Services, Exhibit B-2-a, Operations and Maintenance Service Level Metrics.

c. Storing and reporting relevant data for ongoing and ad hoc reporting, including methods for conducting quality control.

d. Adhering to and reporting on Service Level Metrics provided in Attachment B, Scope of Services, Exhibit B-2-a, Operations and Maintenance Service Level Metrics.

2. The Respondent shall submit, with its response, samples of the following types of dashboard report exports:

a. Staffing Report

b. Executive Level Dashboard Report

c. Contract Compliance / Service Level Metrics Dashboard

SRC #12 Evaluation Criteria:

1. The adequacy of the Respondent’s relevant experience with and proposed approach to providing web-based reporting dashboard solutions and tools for performance reporting.

2. The adequacy of the Respondent's proposed approach and demonstrated ability to meet the Service Level Metrics.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 19 of 32

3. The adequacy of the Respondent’s relevant experience and proposed approach to developing standard report dashboard extracts and ad hoc queries for the PSM Solution.

4. The adequacy of the Respondent’s sample dashboard reports to demonstrate a successful performance and status reporting approach (storing, data reporting, quality control, etc.) for the PSM Solution.

Score: This Section is worth a maximum of 20 raw points with each of the above criteria

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 20 of 32

SRC #13 – SECURITY

1. The Respondent shall demonstrate its experience, capability, approach, and proposed solution for the Security Life Cycle to include activities defined in certification and accreditation, risk assessment, and system security plan phases and to address the requirements in Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 9.7, Security, to:

a. Coordinate with stakeholders to develop and execute a Systems Security Plan, security controls, security assessments, and risk assessments, in compliance with all State and federal enterprise information security policies, standards, security initiatives, and regulations.

b. Develop and execute a Security Controls Test Plan that includes objectives, scope, misuse cases, testing type, entrance and exit criteria, schedule, testers, software tools, and test results.

c. Develop and execute a Security Test Plan for all shared infrastructure, connectivity, and communications between the EDW Solution, the Integration Platform, and the modules.

d. Conduct periodic Security Control Assessments to monitor ongoing effectiveness of implemented security controls and remediate those issues as determined by the Agency.

2. The Respondent shall describe its proposed plan and approach to resolving security breaches in relation to the PSM Solution. The Respondent shall also describe any security breaches that have occurred within the last five (5) years and the remedies used for those breaches, if applicable. The described security breach(s) may pertain to more than one (1) system.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 21 of 32

SRC #13 Evaluation Criteria:

1. The adequacy of the Respondent’s proposed approach and demonstrated ability to meet all federal, state, and Agency security requirements.

2. The adequacy of the Respondent’s proposed PSM Solution in terms of including all security/vulnerability testing as outlined in T-8: Enterprise Data Security Plan, in the PSM Proposal Library.

3. The demonstrated ability of the Respondent to provide a hosting environment that is

FEDRAMP compliant.

4. The demonstrated capability of the Respondent to resolve security breach incidents.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 22 of 32

SRC #14 – DELIVERABLE APPROACH

The Respondent shall describe its relevant experience, proposed approach, and representative content, relative to the PSM deliverables described in Attachment B, Scope of Services, Exhibit B-1, Deliverables and Performance Standards. Where proposed approaches and content for a deliverable are addressed by the Respondent in another SRC, the Respondent shall refer to the other SRC(s) within its response to SRC #14.

a. PD-1 Project Management Plan (Includes Vendor Resource Management Plan)

b. PD-2 Project Schedule

c. PD-3 High-Level Technical Design

d. PD-4 System Security Plan

e. PD-5 Requirements Management Plan

f. PD-6 Bill of Materials

g. PD-7 Completed Requirements Traceability Matrix

h. PD-8 System Design Document (Architecture Specifications)

i. PD-9 Implementation Plan/Software Release Plan

j. PD-10 Contingency Plan (for Disaster Recovery and Business Continuity)

k. PD-11 Test Plan

l. PD-12 Customer Experience Blueprint Integration

m. PD-13 Organizational Change Management Plan

n. PD-14 Training Approach and Plan

o. PD-15 Training Materials

p. PD-16 Training Delivery

q. PD-17 Operations and Maintenance Manual

r. PD-18 Production Readiness Review

s. PD-19 Post Implementation Report

t. PD-20 Warranty Completion Report

u. PD-21 Annual Operational Analysis (AOA)

v. PD-22 Vendor Turnover Plan

SRC #14 Evaluation Criteria:

Score: No points will be awarded for Deliverable Approach. The response will be reviewed by the Agency and may be addressed with the respondent in the negotiation phase of the ITN, at the Agency’s discretion.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 23 of 32

SRC #15 - OPTIONAL ADDITIONAL INNOVATION OPPORTUNITIES

1. General Opportunities – The Respondent may include any additional innovations offered to the Agency that are not included in Attachment B, Scope of Services. The requirements described in Attachment B, Scope of Services are not intended to limit innovations, cost effective solutions, or creativity in preparing a response, which provides the Agency the best solution. Innovative ideas, product offerings, and new concepts other than those presented in this ITN can be considered by the Respondent. Responses to this SRC will not be scored and may, at the Agency’s discretion, be included in the Negotiations phase of this ITN.

The market for operations and business services is constantly changing, offering new or modified service delivery methods and technologies. The Agency is seeking a PSM vendor that will utilize Agency-approved innovative methods and technologies to meet PSM objectives and demonstrate tangible benefits.

Following are examples of areas where potential innovations may be of benefit:

a. Self service capabilities

b. 100% paperless service delivery

c. Leveraging process automation and Artificial Intelligence (AI)

d. Real-time decision-making tools and predictive analytics

e. Scalable staffing models

f. Virtual service delivery

g. Employee engagement

h. Knowledge management

2. Facility Licensure Opportunity – The Agency is particularly receptive to considering innovative approaches from Respondents to providing facility licensure capabilities within their proposed PSM Solution. Respondents are encouraged to describe solutions for integrating necessary functionality to support facility licensure and maintenance activities within its proposed PSM Solution. The Agency’s anticipated specifications for such capabilities are provided in the Anticipated Facility Licensure Specifications – Optional Innovation document within the PSM Proposal Library.

Respondents interested in proposing facility licensure capabilities as part of their PSM Solution shall articulate their approach to integrating necessary functionality to support facility licensure and maintenance activities within their proposed PSM Solution. Respondents shall provide sufficient detail in their response that will allow the Agency to determine the viability of the Respondent’s proposed innovation.

AHCA ITN No. 002-21/22, Attachment A, Exhibit A-4-a, Page 24 of 32

Score: No points will be awarded for any proposed Optional Additional Innovation Opportunities. The response will be reviewed by the Agency and may be addressed with the respondent in the negotiation phase of the ITN, at the Agency’s discretion.

SRC #16 – VENDOR STAFFING

1. The Respondent shall describe its proposed baseline staffing solution as described in

Attachment B, Scope of Services, Section B., Manner of Services Provisions, subsection 13, Staffing, and any applicable requirements specified in Exhibit B-3, Requirements Matrix. The Respondent shall identify its proposed team, including Key Personnel, and describe how its team will implement and support operations during the Contract term.

The Respondent’s proposed baseline staffing solution shall include, but may not be limited to, the following:

a. PSM Vendor staff organizational chart that identifies the number of Key Personnel and other staff dedicated to PSM support, including FTE hours, roles, and hierarchies for all identified staff.

b. Qualifications and experience of the PSM Vendor’s Key Personnel, including resumes with references, and…