HSCRC-25-0305 Solicitation Document FINAL - To Advertise.pdf

Financial Policy Review

Solicitation #: HSCRC-25-0305 RFP Document

RFP for Health Services Cost Review Commission Page 1 of 44

STATE OF MARYLAND

HEALTH SERVICES COST REVIEW COMMISSION (HSCRC)

REQUEST FOR PROPOSALS (RFP)

FINANCIAL POLICY REVIEW

RFP NUMBER HSCRC-25-0305

ISSUE DATE: DECEMBER 31, 2025

A Prospective Offeror that has received this document from a source other than eMarylandMarketplace

Advantage (eMMA) https://procurement.maryland.gov should register on eMMA https://emma.maryland.gov/

MINORITY BUSINESS ENTERPRISES ARE ENCOURAGED TO RESPOND TO THIS

SOLICITATION.

https://procurement.maryland.gov/ https://emma.maryland.gov/

RFP for Health Services Cost Review Commission Page 2 of 44

STATE OF MARYLAND

HEALTH SERVICES COST REVIEW COMMISSION (HSCRC)

KEY INFORMATION SUMMARY SHEET

Request for Proposals Services - Financial Policy Review

Solicitation Number: HSCRC-25-0305

RFP Issue Date: December 31, 2025

RFP Issuing Office: Health Services Cost Review Commission (HSCRC or the "Agency")

Procurement Officer: Mitchell Coates

4160 Patterson Ave, Baltimore, MD 21215

Email:

Phone Number:

mitchell.coates@maryland.gov

410-764-2605

Proposals are to be sent to:

Submit on emma.maryland.gov under Solicitation

Number HSCRC-25-0305

To submit a proposal, offerors must first register on emma.maryland.gov.

We recommend registering in advance to become acquainted with the site.

No Bid/Proposal Notice

Feedback Form

*If you are not submitting a proposal for this solicitation, submit

Attachment 1 with your reasons why.

Pre-Proposal

Conference:

January 13, 2026, at 10:00 am Local Time, via Zoom Link:

https://us06web.zoom.us/j/81524663310?pwd=hu06BPWIgEojsLQhfp31

ROBrxQn7jc.1

Meeting ID: 815 2466 3310

Passcode: 220077

Join instructions:

https://us06web.zoom.us/meetings/81524663310/invitations?signature=uw

XCRFbaQbR6chKnSJ6ps_VlMJM493DpYXFtDAbKPyc

Scheduled Site Visit N/A

RFP for Health Services Cost Review Commission Page 3 of 44

Questions Due Date and

Time:

January 21, 2026, by 4:00 pm Local Time

Proposal Due (Closing)

Date and Time:

February 5, 2026, by 4:00 pm Local Time

Offerors are reminded that a completed Feedback Form is requested if a no-bid/proposal decision is made (see Attachment 1 - No Bid

Notice/Vendor Feedback Form).

MBE Subcontracting

Goal:

12%

VSBE Subcontracting

Goal:

2%

Procurement Method: A Contract will be awarded in accordance with the Competitive Sealed

Proposals method under COMAR 21.05.03.

Multiple or Alternate

Bids:

Multiple or alternate Proposals will not be accepted.

Contract Type: Indefinite quantity with fixed unit prices.

Contract Duration: Three (3) years

SBR Designation: No

Federal Funding: No

RFP for Health Services Cost Review Commission Page 4 of 44

TABLE OF CONTENTS – RFP

1 Minimum Qualifications

1.1 Offeror Minimum Qualifications

2 Contractor Requirements: Scope of Work

2.1 Summary Statement

2.2 Background and Purpose ............................................................ Error! Bookmark not defined.

2.3 Contractor Responsibilities and Tasks ....................................... Error! Bookmark not defined.

2.4 Experience and Personnel ........................................................... Error! Bookmark not defined.

2.5 Substitution of Personnel

2.6 Supplemental Category of Work Requirements and Responsibilities ...... Error! Bookmark not defined.

3 Standard Terms and Conditions

3.1 Contract Initiation Requirements

3.2 End of Contract Transition

3.3 Invoicing

3.4 Liquidated Damages

3.5 Problem Escalation Procedure

3.6 Work Orders

3.7 Payments by Electronic Funds Transfer

3.8 Prompt Payment Policy

3.9 Federal Funding Acknowledgement

3.10 Conflict of Interest Affidavit and Disclosure

3.11 Non-Disclosure Agreement

3.12 Maryland Healthy Working Families Act Requirements

3.13 The State of Maryland’s Commitment to Purchasing Environmentally Preferred Products and

Services (EPPs)

3.14 Insurance Requirements

3.15 Non-Compete Clause Prohibition

4 Proposal Submission Information and Instructions

4.1 eMaryland Marketplace Advantage (eMMA)

4.2 Electronic Means

4.3 Pre-Proposal Conference

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4.4 Questions

4.5 Proposal Due (Closing) Date and Time

4.6 Economy of Preparation

4.7 Public Information Act Notice

4.8 Oral Presentation

4.9 Duration of Proposals

4.10 Revisions to the RFP

4.11 Cancellations

4.12 Incurred Expenses

4.13 Protest/Disputes

4.14 Offeror Responsibilities

4.15 Acceptance of Terms and Conditions

4.16 Compliance with Laws/Arrearages

4.17 Verification of Registration and Tax Payment

4.18 False Statements

5 Proposal Format

5.1 Two Part Submission

5.2 Proposal Delivery and Packaging

5.3 Volume I - Technical Proposal

5.4 Volume II – Financial Proposal

6 Evaluation and Selection Process

6.1 Evaluation Committee

6.2 Technical Proposal Evaluation Criteria

6.3 Financial Proposal Evaluation Criteria

6.4 Reciprocal Preference ................................................................. Error! Bookmark not defined.

6.5 Selection Procedures

6.6 Documents Required upon Notice of Recommendation for Contract Award RFP Attachments

(Table B)

7 RFP Appendices and Exhibits

7.1 Appendices (Table C)

7.2 Exhibits (Table D)

RFP for Health Services Cost Review Commission Page 6 of 44

RFP for Health Services Cost Review Commission Page 7 of 44

1 Minimum Qualifications

1.1 Offeror Minimum Qualifications

There are no Offeror Minimum Qualifications for this procurement.

THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.

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2 Contractor Requirements: Scope of Work

2.1 Summary Statement

This Request for Proposals (RFP) is issued to procure the goods or services, as specified in this

Section 2, from a contract between the selected offeror(s) and the State of Maryland (“State”). The

State is issuing this solicitation to hire a Contractor to assist the Maryland Health Services Cost

Review Commission (HSCRC) in adjudicating full rate reviews, analyzing health systems’ cost structures, and assessing, reviewing, and evaluating proposed changes to some methodologies under

Maryland. Code, Health-General Article § 19-201 et seq., or to support the HSCRC in other reviews of a similar nature.

2.2 This project includes the following tasks

• Assisting with Full Rate Reviews

• Assessment of Health Systems’ Cost Structure

• Financial and Regulatory Review

2.2 Background and Purpose

HSCRC is an independent state agency responsible for setting the rates Maryland’s hospitals may charge for healthcare services. The HSCRC sets an annual “Update Factor” to adjust overall hospital rates to account for inflation and population growth, and other regular adjustments. Additionally, hospitals may submit a Full Rate Application to the HSCRC if they believe that they have insufficient rates to provide healthcare services. The HSCRC adjudicates these Full Rate Reviews based on a combination of 1) the reasonableness of a hospital’s regulated cost structure, 2) how reasonably charges are related to costs, and 3) performance in total cost of care, both historically and while under the TCOC Model. Hospitals’ relative cost efficiency is assessed using the Inter-Hospital Cost Comparison methodology, which evaluates the cost per case of providing healthcare after adjusting for hospital-specific drivers of healthcare costs – such as the costs of providing graduate medical education and the costs associated with complex socio-economic determinants of health. Hospitals may appeal the

HSCRC’s ruling if they believe that the decision does not align with the HSCRC’s enabling statute or the State’s Administrative Procedure Act. The HSCRC can also review many of these same factors in circumstances other than a Full Rate Review.

The Commission also employs several methodologies to adjust hospital global budgets, including the case mix methodology, which is a unique approach to measuring hospital utilization by comparing inpatient and outpatient services on a common scale. The state uses the results to measure market shifts in service use between hospitals and to estimate volume growth due to demographic changes, as well as other irregular volume shifts (deregulation, repatriation, and out-of-state volume change). In addition, the ECMAD methodology is a powerful analytic tool for analyzing hospital utilization trends by product service lines, and it forms the basis of other methodologies such as those used to calculate hospital efficiency and total cost of care performance. All of these methodologies are continually evolving.

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2.3 Timing

The contract will last 3 years. The HSCRC expects that work will begin upon receiving an application for a Full Rate Review or the initiation of a specific project. The timing and number of full-rate reviews are uncertain, but the HSCRC is under a legal obligation to resolve Full-

Rate Reviews within 150 days of the application being docketed. The Contractor will be expected to be fully staffed on a project within 21 days of receipt of notification of the project from the HSCRC. For Full-Rate Reviews, senior contractor staff will need to be available for a preliminary review of the application within the first seven days following notification. The

HSCRC recognizes this may require changes in the Contractor’s assigned personnel. HSCRC expects to conduct approximately three Full Rate Reviews (or similar projects) per year, but may potentially conduct more. It is also possible that there will be no reviews and no work will be incurred under this contract for extended periods.

2.4 Bid Structure

HSCRC has budgeted $4.5 M for this contract over 3 years. As the amount and timing of services are to be determined, the award amount for this contract will be set at $4.5 M

(although there is no commitment by the State to incur the full amount). As the total amount is fixed, financial proposals will be evaluated based on a comparison of hourly rates for various categories of staff across a hypothetical distribution of 1,000 hours defined by HSCRC in

Attachment B. Attachment B contains additional instructions on submitting the financial proposal.

2.5 Responsibilities and Tasks

The Contractor shall complete the following tasks on an as-needed basis.

2.5.1 Assisting with Full Rate Reviews

To initiate a Full Rate Review process, hospitals may submit an application to the HSCRC that documents the need for the additional revenue to cover healthcare costs. The hospital has the burden to prove that its proposed rates will enable it to provide the most effective and efficient service. The Full Rate Review application must specify why the existing rates authorized by the

HSCRC are insufficient. Hospitals may point to exogenous cost-drivers that are not covered by existing methodology or may document shortfalls in the existing HSCRC methodology for assessing relative cost efficiency. The HSCRC Staff reviews the Full Rate Review and makes a recommendation to the Commission for a resolution. The contractor will have two primary responsibilities: 1) Financial analysis and modelling of issues raised in the Full Rate Review application in the direction of the HSCRC staff; and 2) Preparation of the Full Rate Review responses and responses required to any further action by the hospital.

2.5.2 Financial Analysis and Modelling

The Contractor will analyze issues raised in the Full Rate Review at the direction of the

HSCRC staff. This may include an assessment of the impact that HSCRC policies have on the hospital’s cost structure and modelling the impact of different policy alternatives.

RFP for Health Services Cost Review Commission Page 10 of 44

2.5.3 Preparation of Full Rate Review Responses

The Contractor will assist the HSCRC staff in drafting responses for Full Rate Reviews. This will include the creation of charts and figures and may include drafting significant portions of responses to the Full Rate Review. The Contractor will be expected to explain the impact of complex financial regulations on the hospital’s cost structure.

2.5.4 Assessment of Health Systems’ Cost Structure

The HSCRC’s enabling statute allows the HSCRC to review hospitals' costs to determine that those costs are reasonable. The Contractor will assist the HSCRC staff in reviewing the hospitals cost structure to determine whether: 1) the hospital’s labor costs, including physician compensation, are reasonable given local labor market conditions; 2) the hospital’s operating costs, including purchasing costs for medical drugs and supplies, are reasonable given local conditions and the size and complexity of the hospital; 3) the hospital’s capital costs are reasonable given financial market conditions, the age of the hospital’s physical assets, and the patient volume those assets most support; 4) the hospital’s corporate structure, including the ownership and cross subsidization of other healthcare entities, is conducive to efficient operations; 5) the hospital’s financial reserves are sufficient given the hospital’s debt and liquidity needs. Task 2 may be assigned within the context of a Full Rate Review or independently. The conclusions from Task 2 will be documented either within the Full Rate

Review response under Task 1 or in a stand-alone document suitable for public release.

2.5.4.1 Determination of Reasonable Benchmarks

The Contractor will establish cost benchmarks for hospitals’ labor, operating, and capital costs by identifying peer hospitals that operate in economically similar markets, provide a similar service mix, and services similar patient populations.

The Contractor will then identify areas where hospital costs are significantly above or below the industry average.

2.5.4.2 Make Recommendations to Address Cost-Inefficiency

The Contractor will make recommendations for improving the hospital’s cost efficiency. This may include recommendations to align labor, operating, and capital costs with industry standards. It may also include recommendations on corporate restructuring to spin off non-hospital healthcare entities (such as physician practices) that operate inefficiently and/or financial restructuring to improve cash flow and reduce financial risk.

2.5.4.3 Data Collection and Management

The Contractor will be expected to collect data on hospitals of varying sizes and types to enable the previous two tasks. The Contractor will be expected to utilize both publicly available data (such as Medicare cost reports) and commercial databases on hospital and physician costs and become experts in that data to ensure that the data is reliable, accurate, and up-to-date, and is representative of the hospital industry. Any required data acquisitions will be funded separately by HSCRC. However, if the contractor already has access to data sources that would be available for use in this project and would be covered by the hourly rates offered by the Contractor, these sources should be described in the

Contractor’s RFP response.

RFP for Health Services Cost Review Commission Page 11 of 44

2.5.5 Financial and Regulatory Review

The HSCRC’s financial methodologies constantly require review and potential revision to ensure accuracy and criterion validity. Additionally, HSCRC policies must be responsive to changes in market dynamics and regulatory requirements, such as the implementation of the

Achieving Healthcare Efficiency through Accountable Design (AHEAD) Model. In this task, the Contractor will be required to assist HSCRC staff in reviewing current methodologies and potentially developing new methodologies/policies. Examples include:

a) Reviewing and evaluating case mix weighting methodology:

The HSCRC uses the case mix methodology (often referred to as the Equivalent Case-

Mix Adjusted Discharges (ECMAD) methodology) as the basis for various analytic activities and payment adjustments that determine hospitals’ global budgets. The

Contractor will assist the HSCRC staff in reviewing the ECMAD weighting methodology to determine 1) whether the current outlier logic needs to be replaced; 2) whether the weighting methodology needs to change to include/exclude hospitals' profits in order to accurately produce cost-based weights.

A comparative analysis of charge versus cost weight setting will be required to determine what is the most reasonable method, given the Maryland regulatory landscape.

b) Evaluating the appropriateness of market definitions in the Market Shift Policy:

The Commission reviews changes in market share every six months through its Market

Shift policy, assessing the year-over-year change in service line delivery at either the zip code or county level. HSCRC staff utilize 3M definitions of service lines, and for geographies, services are either evaluated at a county level if the service is deemed to be surgical in nature and/or if the region is rural and less populated; for more populated areas and for medical services, the market share calculations are performed at a zip code level. There is face validity to this approach, but the Commission would benefit from statistical analyses to assess whether the defined markets are large enough to ensure that random variation is not being attributed to the Market Shift policy. This assessment will become particularly important as the HSCRC transitions from all-payer oversight to non-

Medicare oversight.

c) Assessing GME and broader physician supply interventions:

The objective of this potential task is to provide policy guidance that HSCRC can use to review and make decisions about requests for new or expanded residency training programs in the state. The Contractor will assist the HSCRC staff in identifying methods to measure and evaluate the costs and benefits of such requests, with particular emphasis on meeting the need for primary care physicians in rural areas of Maryland.

Consideration will be given to both the direct (DME) and indirect (IME) costs of medical education programs, as well as the cost-effectiveness of these programs compared to other interventions, such as loan forgiveness programs.

d) Reviewing the status of denials:

The denial of health care services as a whole or in part affects some of HSCRC's policies, such as the UCC. Prior authorization is intended to ensure that health care services are medically necessary by requiring providers to obtain approval before a service or other

RFP for Health Services Cost Review Commission Page 12 of 44 benefit is covered. If prior authorization is not obtained, the provider is denied in whole or in part for the cost of providing the services.

In this potential task, the Contractor will evaluate the effect of denials of hospital financial positions and its impact on the data that hospitals report to the HSCRC for the implementation of policies. Hospitals may have different experiences depending on the patients' medical plans and payers for the healthcare services rendered. The review of denial would include (1) current information and trends about current hospitals' denials, by hospital and payer; (2) companion analysis describes the status and nature of denials;

and (3) potential policy changes to improve the rate of denials in the State.

e) Health care access quantification/qualification and new policies to address unmet demand:

Health care access and quality include key issues, such as access to health care, access to primary care, health insurance coverage, and health literacy. Access to both health care and quality improvement is an important factor in ensuring that patients receive the best care possible.

In this potential task, the Contractor would identify and evaluate resources, plans, and procedures needed to realistically meet the healthcare needs of any given population or segment of the population in Maryland. The Contractor would also identify practices (i.e., interventions that include measurable results and report successful outcomes) that have positively impacted or reduced barriers to health care access and quality.

2.6 Staffing Requirements and Qualifications

The methodologies are integral to the operations of HSCRC. The Contractor must possess both the expertise and flexibility to assist the HSCRC staff in responding to complex and technically demanding analytics of these methodologies within a specified timeframe. The HSCRC understands that due to this requirement, absolute commitments of project staff may not be feasible; however, the

Contractor’s proposal should include resumes for staff who would be available under typical circumstances. The Contractor’s proposal should be responsive to the following requirements:

2.6.1 Expertise in Financial Modelling: The Contractor should have expertise in modelling the impact of policy and regulatory changes on hospitals’ finances.

2.6.2 Knowledge of the Healthcare Environment: The Contractor should have experience with and commitment to independent analysis of healthcare finances generally and be familiar with the Maryland hospital industry and Maryland healthcare finance specifically.

2.6.2 Expertise in Hospital Operations and Cost Accounting: The Contractor should have expertise in how hospitals operate, and particularly how those operations are reflected in the hospital’s cost accounting systems. Preferably, the Contractor will have expertise in analyzing the reasonableness of hospital costs and identifying areas of excessive hospital costs.

2.6.3 Expertise in Healthcare Corporate Structures: The Contractor should have expertise in how healthcare systems are structured and experience in identifying underperforming parts of a healthcare system. The Contractor should have experience in making recommendations on restructuring healthcare systems to increase efficiency.

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2.6.4 Expertise in Statistical Modelling: The Contractor should have expertise in statistical modelling that can support policy decisions, such as determining the best approach to identifying outliers in case mix charges, defining valid markets, and identifying outlier trends in denials.

2.6.5 Knowledge of the HSCRC Regulatory Regime: The contracting team should be familiar with the HSCRC’s regulatory approach, including the concept of Global Budgets and other related policies such as Market Shift, Demographic Adjustment, the Interhospital

Cost Comparison, Integrated Efficiency Policy, and Full Rate Application policy. The contracting team should also be familiar with healthcare access quantification and qualification, as well as new policies to address unmet demand.

It is the state’s intention to obtain services, as specified in this RFP, from a contract between the selected Offeror and the State.

This is a single award. See RFP Section 6.5 Selection Procedures for more Contract award information.

2.7 Substitution of Personnel

2.7.1 Continuous Performance of Key Personnel

When Key Personnel are identified for the Contract, the following apply:

A. Key Personnel shall be available to perform Contract requirements as of the NTP Date.

Unless explicitly authorized by the Contract Monitor or specified in the Contract, Key

Personnel shall be assigned to the State of Maryland as a dedicated resource.

B. Key Personnel shall perform continuously for the duration of the Contract, or such lesser duration as specified in the Technical Proposal. Key Personnel may not be removed by the Contractor from working under the Contract without the prior written approval of the

Contract Monitor.

C. The provisions of this section apply to Key Personnel identified in any Task Order proposal and agreement, if issued, and any Work Order Request and Work Order, if issued.

2.7.2 Definitions

For the purposes of this section, the following definitions apply:

A. Extraordinary Personal Event – means any of leave under the Family Medical Leave

Act; an Incapacitating injury or Incapacitating illness; or other circumstances that, in the sole discretion of the state, warrant an extended leave of absence, such as extended jury duty or extended military service that precludes the individual from performing his/her job duties under the Contract.

B. Incapacitating – means any health circumstance that substantially impairs the ability of an individual to perform the job duties described for that individual’s position in the RFP or the Contractor’s Technical Proposal.

2.7.3 Contractor Personnel General Substitution Provisions

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The following provisions apply to all of the circumstances of Contractor Personnel substitution described in Section 2.5.4.

A. The Contractor shall demonstrate to the Contract Monitor’s satisfaction that the proposed substitute has qualifications at least equal to those of the Contractor Personnel proposed to be replaced.

B. The Contractor shall provide the Contract Monitor with a substitution request that shall include:

1. A detailed explanation of the reason(s) for the substitution request;

2. The resume of the proposed substitute, signed by the substituting individual and his/her formal supervisor;

3. The official resume of the current personnel for comparison purposes; and

4. Evidence of any required credentials.

C. The Contract Monitor may request additional information concerning the proposed substitution and may interview the proposed substitute personnel prior to deciding whether to approve the substitution request.

D. The Contract Monitor will notify the Contractor in writing of: (i) the acceptance or denial, or (ii) contingent or temporary approval for a specified time limit, of the requested substitution. The Contract Monitor will not unreasonably withhold approval of a proposed Contractor Personnel replacement.

2.7.4 Replacement Circumstances

A. Directed Personnel Replacement

1. The Contract Monitor may direct the Contractor to replace any Contractor Personnel who, in the sole discretion of the Contract Monitor, are perceived as being unqualified, non-productive, unable to fully perform the job duties, disruptive, or known, or reasonably believed, to have committed a major infraction(s) of law, Agency policies, or Contract requirements. Normally, a directed personnel replacement will occur only after prior notification of problems with requested remediation, as described in paragraph 2.5.4.A.2.

2. If deemed appropriate in the discretion of the Contract Monitor, the Contract

Monitor may give written notice of any Contractor Personnel performance issues to the Contractor, describing the problem and delineating the remediation requirement(s). The Contractor shall provide a written response to the remediation requirements in a Remediation Plan within ten (10) days of the date of the notice and shall immediately implement the Remediation Plan upon written acceptance by the

Contract Monitor. If the Contract Monitor rejects the Remediation Plan, the

Contractor shall revise and resubmit the plan to the Contract Monitor within five (5) days, or in the timeframe set forth by the Contract Monitor in writing.

3. Should performance issues persist despite an approved Remediation Plan, the

Contract Monitor may give written notice of the continuing performance issues, and either request a new Remediation Plan within a specified time limit or direct the substitution of Contractor Personnel whose performance is at issue with a qualified substitute, including requiring the immediate removal of the Contractor Personnel at issue.

4. Replacement or substitution of Contractor Personnel under this section shall be in addition to, and not in lieu of, the State’s remedies under the Contract or which otherwise may be available by law or in equity.

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5. If the Contract Monitor determines to direct substitution under 2.5.4.A.1, then if possible, at least fifteen (15) days’ advance notice shall be given to the Contractor.

However, if the Contract Monitor deems it necessary and, in the state’s, best interests to remove the Contractor Personnel with less than fifteen (15) days’ notice, the Contract Monitor may direct the removal in a timeframe of less than fifteen (15) days, including immediate removal.

6. In circumstances of directed removal, the Contractor shall, in accordance with paragraph 2.5.4.A.1 of this section, provide a suitable replacement for approval within fifteen (15) days of the notification of the need for removal, or the actual removal, whichever occurs first.

B. Key Personnel Replacement

To replace any Key Personnel in a circumstance other than as described in 2.5.4.C, including transfers and promotions, the Contractor shall submit a substitution request as described in Section 2.5.3 to the Contract Monitor at least fifteen (15) days prior to the intended date of change. A substitution may not occur unless and until the Contract Monitor approves the substitution in writing.

C. Key Personnel Replacement Due to Sudden Vacancy

1. The Contractor shall replace Key Personnel whenever a sudden vacancy occurs

(e.g., Extraordinary Personal Event, death, resignation, termination). A termination or resignation with thirty (30) days or more advance notice shall be treated as a replacement under Section 2.5.4.B.

2. Under any of the circumstances set forth in this paragraph B, the Contractor shall identify a suitable replacement and provide the same information and items required under Section 2.5.3 within fifteen (15) days of the actual vacancy occurrence or from when the Contractor first knew or should have known that the vacancy would be occurring, whichever is earlier.

D. Key Personnel Replacement Due to an Indeterminate Absence

1. If any Key Personnel has been absent from his/her job for a period of ten (10) days and it is not known or reasonably anticipated that the individual will be returning to work within the next twenty (20) days to fully resume all job duties, before the 25th day of continuous absence, the Contractor shall identify a suitable replacement and provide the same information and items to the Contract Monitor as required under

Section 2.5.3.

2. However, if this person is available to return to work and fully perform all job duties before a replacement has been authorized by the Contract Monitor the Contract

Monitor may, at his/her sole discretion, authorize the original personnel to continue to work under the Contract, or authorize the replacement personnel to replace the original personnel, notwithstanding the original personnel’s ability to return.

2.7.5 Substitution Prior to and Within 30 Days After Contract Execution

Prior to Contract execution or within thirty (30) days after Contract execution, the Offeror may not substitute proposed Key Personnel except under the following circumstances: (a) for actual full-time personnel employed directly by the Offeror: the vacancy occurs due to the sudden termination, resignation, or approved leave of absence due to an Extraordinary Personal Event, or the death of such personnel; and (b) for any temporary staff, subcontractors or 1099 contractors:

the vacancy occurs due to an Incapacitating event or the death of such personnel. To qualify for such substitution, the Offeror must demonstrate to the state's satisfaction the event necessitating substitution. Proposed substitutions shall be of equal caliber or higher, in the State's sole

RFP for Health Services Cost Review Commission Page 16 of 44 discretion. Proposed substitutes deemed by the state to be less qualified than the originally proposed individual may be grounds for pre-award disqualification or post-award termination.

THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK

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3 Standard Terms and Conditions

3.1 Contract Initiation Requirements

Once all approvals have been obtained and the Contract is fully executed, the Procurement Officer may schedule a kickoff meeting to be held prior to commencement of Contract performance.

3.2 End of Contract Transition

The Contractor shall cooperate in the orderly transition of services from it to a subsequent contractor at the end of the contract term or upon receipt of a Notice of Termination from the State. Transition shall be provided in a prompt and timely manner and shall proceed in accordance with the schedule provided to the Contractor by the State in the Notice of Transition. Additional instructions regarding transition services may be provided in the event of a Notice of Termination issued by the State.

3.3 Invoicing

Submission of an invoice constitutes the Contractor’s verification that the information in the invoice is accurate as of the time of submission.

An invoice not satisfying the requirements of a Proper Invoice (as defined in COMAR 21.06.09) will not be processed for payment. To be considered a Proper Invoice, invoices must include the following information, without error:

A. Contractor name and address;

B. Remittance address;

C. Federal taxpayer identification (FEIN) number, social security number, as appropriate;

D. Invoice period (i.e., time period during which services covered by invoice were performed);

E. Invoice date;

F. Invoice number;

G. State assigned Contract number;

H. State assigned (Blanket) Purchase Order number(s);

I. Goods or services provided;

J. Amount due; and

K. Any additional documentation required by regulation or the Contract.

Invoices that contain both fixed price and labor hour or time and material items shall clearly identify each item as either fixed price, and labor hour, or time and material billing.

The State reserves the right to reduce or withhold Contract payment in the event the Contractor does not provide all required deliverables within the time frame specified in the Contract or otherwise fails to satisfy the terms and conditions of the Contract until such time as the

Contractor brings itself into full compliance with the Contract.

The State is generally exempt from federal excise taxes, Maryland sales and use taxes, District of

Columbia sales taxes and transportation taxes. The Contractor, however, is not exempt from such sales and use taxes and may be liable for the same.

Invoices for final payment shall be clearly marked as “FINAL” and submitted when all work requirements have been completed, and no further charges are to be incurred under the Contract.

In no event shall any invoice be submitted later than 60 calendar days from the Contract termination date.

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3.3.1 Invoice Submission Schedule

The Contractor shall submit invoices in accordance with the following schedule:

A. For items of work for which there is one-time pricing (see Attachment B –The Price

Form), those items shall be billed in the month following the acceptance of the work by the State.

B. For Items of work for which there is annual pricing (see Attachment B–The Price

Form), those items shall be billed in equal monthly installments for the applicable

Contract year in the month following the performance of the services

C. Invoices for deliverables shall be submitted upon completion and acceptance of the deliverables as defined in Section 2 of the RFP.

3.3.2 Travel Reimbursement

Travel will not be reimbursed under this RFP.

3.4 Liquidated Damages

3.4.1 MBE Liquidated Damages

MBE liquidated damages are identified in Exhibit 2 – Sample Contract.

3.4.2 Liquidated Damages other than MBE

Liquidated damages other than MBE are identified in Exhibit 2 – Sample Contract.

3.5 Problem Escalation Procedure

No later than ten (10) Business Days after notice of recommended award or after the date of the

Notice to Proceed, whichever is earlier, the Contractor must provide, and thereafter, maintain a

Problem Escalation Procedure (PEP) for both routine and emergency situations. The PEP must state how the Contractor will address problem situations as they occur during the performance of the

Contract, especially problems that are not resolved to the satisfaction of the State within appropriate timeframes and must include:

A. Contact information

B. The process for establishing the existence of a problem;

C. Names, titles, and contact information for progressively higher levels of personnel in the

Contractor’s organization who would become involved in resolving a problem;

D. For each individual listed in the Contractor’s PEP, the maximum amount of time a problem will remain unresolved with that individual before the problem escalates to the next contact person listed in the Contractor’s PEP;

E. Expedited escalation procedures and any circumstances that would trigger expediting them;

F. The method of providing feedback on resolution progress, including the frequency of feedback to be provided to the State;

G. Contact information for persons responsible for resolving issues after normal business hours (e.g., evenings, weekends, holidays) and on an emergency basis; and

H. A process for updating and notifying the Contract Monitor of any changes to the PEP.

I. The PEP must be updated within ten (10) Business Days after any change in circumstance which changes the PEP but not less than annually within ten (10) Business

Days after the start of each Contract year .

RFP for Health Services Cost Review Commission Page 19 of 44

Nothing in this section shall be construed to limit any rights of the Contract Monitor or the State which may be allowed by the Contract or applicable law.

3.6 Work Orders

THIS SECTION IS INAPPLICABLE TO THIS RFP.

3.7 Payments by Electronic Funds Transfer

By submitting a Proposal in response to this solicitation, the Offeror, if selected for award:

Agrees to accept payments by electronic funds transfer (EFT) unless the State Comptroller’s Office grants an exemption. Payment by EFT is mandatory for contracts exceeding $200,000. The successful

Offeror shall register using the COT/GAD X-10 Vendor Electronic Funds (EFT) Registration Request

Form.

Any request for exemption must be submitted to the State Comptroller’s Office for approval at the address specified on the COT/GAD X-10 form, must include the business identification information as stated on the form, and must include the reason for the exemption. The COT/GAD X-10 form may be downloaded from the Comptroller’s website at:

http://comptroller.marylandtaxes.com/Vendor_Services/Accounting_Information/Static_Files/GADX

10Form20150615.pdf.

3.8 Prompt Payment Policy

This procurement and the Contract(s) to be awarded pursuant to this solicitation are subject to the

Prompt Payment Policy Directive issued by the Governor’s Office of Small, Minority & Women

Business Affairs (GOSBA) and dated August 1, 2008. Promulgated pursuant to Md. Code Ann., State

Finance and Procurement Article, §§ 11-201, 13-205(a), and Title 14, Subtitle 3, and COMAR

21.01.01.03 and 21.11.03.01, the Directive seeks to ensure the prompt payment of all subcontractors on non-construction procurement contracts. The Contractor shall comply with the prompt payment requirements outlined in the Contract, Section 31 “Prompt Pay Requirements” (see Exhibit 2 -

Sample Contract). Additional information is available on GOSBA’s website at:

http://www.gomdsmallbiz.maryland.gov/documents/legislation/promptpaymentfaqs.pdf.

3.9 Federal Funding Acknowledgement

This Contract does not contain federal funds.

3.10 Conflict of Interest Affidavit and Disclosure

The Offeror shall complete and sign the Conflict-of-Interest Affidavit and Disclosure (Attachment I) and submit it with its Proposal.

By submitting a Conflict-of-Interest Affidavit and Disclosure, the Contractor shall be construed as certifying that all Contractor Personnel and subcontractors are also without a conflict of interest as defined in COMAR 21.05.08.08A.

Additionally, a Contractor has an ongoing obligation to ensure that all Contractor Personnel are without conflicts of interest prior to providing services the Contract. For policies and procedures applying specifically to Conflict of Interests, the Contract is governed by COMAR 21.05.08.08.

Participation in Drafting of Specifications: Disqualifying Event: Offerors are advised that Md. Code

Ann. State Finance and Procurement Article §13-212.1(a) provides generally that “an individual who assists an executive unit in the drafting of specifications, an invitation for bids, a request for proposals

RFP for Health Services Cost Review Commission Page 20 of 44 for a procurement, or the selection or award made in response to an invitation for bids or a request for proposals, or a person that employs the individual, may not: (1) submit a bid or proposal for that procurement; or (2) assist or represent another person, directly or indirectly, who is submitting a bid or proposal for that procurement.” Any Offeror submitting a Bid in violation of this provision shall be classified as “not responsible.”

3.11 Non-Disclosure Agreement

3.11.1 Non-Disclosure Agreement (Bidder/Offeror)

Certain confidential information is necessary to disclose to potential Offerors before Offerors can submit their proposals and may be available for potential Offerors to obtain electronically or to review hard copies at a location identified by the Procurement Officer. If such confidential information is identified, Offerors are required to sign a Non-Disclosure Agreement in the form of Attachment 3 – Non-Disclosure Agreement (Bidder/Offeror) prior to the confidential information being provided by the Procurement Officer.

3.11.2 Non-Disclosure Agreement (Contractor)

This solicitation and any Contract(s) are subject to the terms of the Non-Disclosure Agreement

(NDA) contained in this solicitation as Attachment S. This Agreement must be provided within five (5) Business Days of notification of recommended award; however, to expedite processing, it is suggested that this document be completed and submitted with the Proposal.

3.12 Maryland Healthy Working Families Act Requirements

On February 11, 2018, the Maryland Healthy Working Families Act went into effect. All Bidders should be aware of how this Act could affect your potential contract award with the State of

Maryland. See the Department of Labor, Licensing and Regulations website for Maryland Healthy

Working Families Act Information: https://dllr.state.md.us/paidleave/.

3.13 The State of Maryland’s Commitment to Purchasing Environmentally

Preferred Products and Services (EPPs)

Maryland’s State Finance & Procurement Article §14-410 defines environmentally preferable purchasing as “the procurement or acquisition of goods and services that have a lesser or reduced effect on human health and the environment when compared with competing goods or services that serve the same purpose.” Accordingly, Bidders are strongly encouraged to offer EPPs to fulfill this contract, to the greatest extent practicable.

3.14 Insurance Requirements

The Contractor shall maintain, at a minimum, the insurance coverages outlined below, or any minimum requirements established by law if higher, for the duration of the Contract, including option periods, if exercised:

3.14.1 The following type(s) of insurance and minimum amount(s) of coverage are required:

A. Commercial General Liability - One million dollars ($1,000,000) combined single limit per occurrence for bodily injury, property damage, and personal and advertising injury and three million dollars ($3,000,000) annual aggregate. The minimum limits required herein may be satisfied through any combination of primary and umbrella/excess liability policies.

https://dllr.state.md.us/paidleave/ https://trackbill.com/bill/maryland-house-bill-629-environmentally-preferable-procurement-maryland-green-purchasing-committee/647077/

RFP for Health Services Cost Review Commission Page 21 of 44

B. Errors and Omissions/Professional Liability - One million dollars ($1,000,000) per combined single limit per claim and three million dollars ($3,000,000) annual aggregate.

C. Crime Insurance/Employee Theft Insurance - to cover employee theft with a minimum single loss limit of one million dollars ($1,000,000) per loss, and a minimum single loss retention not to exceed ten thousand dollars ($10,000), with the State of Maryland listed as a “loss payee.”

D. Cyber Security / Data Breach Insurance – Five million dollars ($5,000,000) per occurrence. The coverage must be valid at all locations where work is performed or data or other information concerning the State’s claimants or employers is processed or stored.

E. Worker’s Compensation - The Contractor shall maintain such insurance as necessary or as required under Workers’ Compensation Acts, the Longshore and Harbor Workers’

Compensation Act, and the Federal Employers’ Liability Act, to not be less than. one million dollars ($1,000,000) per occurrence (unless a state’s law requires a greater amount of coverage). Coverage must be valid in all states where work is performed.

3.14.2 The State shall be listed as an additional insured on the faces of the certificates associated with the coverages listed above, including umbrella policies, excluding

Workers’ Compensation Insurance and professional liability.

3.14.3 All insurance policies shall be endorsed to include a clause requiring the insurance carrier to provide the Procurement Officer, by certified mail, not less than 30 days’ advance notice of any non-renewal, cancellation, or expiration. The Contractor shall notify the Procurement Officer in writing, if policies are canceled or not renewed within five (5) days of learning of such cancellation or nonrenewal. The Contractor shall provide evidence of replacement insurance coverage to the Procurement Officer at least 15 days prior to the expiration of the insurance policy then in effect.

3.14.4 Any insurance furnished as a condition of the Contract shall be issued by a company authorized to do business in the State.

3.14.5 The recommended awardee must provide current certificate(s) of insurance with the prescribed coverages, limits and requirements set forth in this section within five (5)

Business Days from notice of recommended award. During the period of performance for multi-year contracts, the Contractor shall provide certificates of insurance annually, or as otherwise directed by the Contract Monitor.

3.14.6 Subcontractor Insurance

The Contractor shall require any subcontractors to obtain and maintain comparable levels of coverage and shall provide the Contract Monitor with the same documentation as is required of the Contractor.

3.15 Non-Compete Clause Prohibition

The State of Maryland seeks to maximize the retention of personnel working under the Contract whenever there is a transition of the Contract from one contractor to another so as to minimize disruption due to a change in contractor and maximize the maintenance of institutional knowledge accumulated by such personnel. To help achieve this objective of staff retention, each Offeror shall agree that if awarded the Contract, the Offeror’s employees and agents filling the positions set forth in the staffing requirements of Section 2.4 Experience and Personnel working on the State contract

RFP for Health Services Cost Review Commission Page 22 of 44 shall be free to work for the contractor awarded the State contract notwithstanding any non-compete clauses to which the employee(s) may be subject. The Offeror agrees not to enforce any non-compete restrictions against the State with regard to these employees and agents if a different vendor succeeds it in the performance of the Contract. To evidence compliance with this non-compete clause prohibition, each Offeror must include an affirmative statement in its technical Proposal that the

Offeror, if awarded a Contract, agrees that its employees and agents shall not be restricted from working with or for any successor contractor that is awarded the State business.

RFP for Health Services Cost Review Commission Page 23 of 44

4 Proposal Submission Information and Instructions

4.1 eMaryland Marketplace Advantage (eMMA) eMMA is the electronic commerce system for the State of Maryland. The RFP, Pre-Proposal

Conference (Conference) summary and attendance sheet, Offerors’ questions and the Procurement

Officer’s responses, addenda, and other solicitation-related information will be made available via eMMA.

To receive a contract award, a vendor must be registered on eMMA. Registration is free. Go to emma.maryland.gov, click on “New Vendor? Register Now” to begin the process and then follow the prompts.

4.2 Electronic Means

The following transactions related to this procurement and any Contract awarded pursuant to it are not authorized to be conducted by electronic means:

A. Submission of Bond documents determined by the State to require original signatures; or

B. Any transaction, submission, or communication where the Procurement Officer has specifically directed that a response from the Contractor or Offeror be provided in writing or hard copy.

Any e-mail transmission is only authorized to the email addresses for the identified person as provided in the solicitation, the Contract, or in the direction from the Procurement Officer or Contract

Monitor.

“Electronic means” refers to exchanges or communications using electronic, digital, magnetic, wireless, optical, electromagnetic, or other means of electronically conducting transactions.

Electronic means includes e-mail, internet-based communications, electronic funds transfer, specific electronic bidding platforms (e.g., https://procurement.maryland.gov), and electronic data interchange.

4.3 Pre-Proposal Conference

If a Conference will be held, the date, time, and location is indicated on the Key Information

Summary Sheet. Attendance at the Conference is not mandatory, but all interested parties are encouraged to attend in order to facilitate better preparation of their Proposals. If the solicitation includes an MBE participating goal, failure to attend the Conference will be taken into consideration as part of the evaluation of an offeror’s good faith efforts if there is a waiver request.

It is highly recommended that all Prime Contractors bring their intended subcontractors to the

Conference/Site Visit to ensure that all parties understand the RFP requirements and the socio-economic goals for this solicitation.

MBE subcontractors are encouraged to attend the Conference to market their participation to potential prime contractors.

In order to…