IFB__SD25-00049.pdf

INVITATION FOR BID

Notice to Prospective Bidders

IFB #SD25-00049

August 11, 2026

The California Department of Corrections and Rehabilitation (CDCR), California Correctional Health Care Services (CCHCS) is soliciting for service under the authority of California Public Contract Code Section 10340, subdivisions (a) and (b). You are invited to review and respond to this Invitation for Bid (IFB), entitled IFB #SD25-00049 – Pre-Payment Claim Review (PPCR) and Post Payment Audit and Recovery Services (PPAR).

Note that all Contracts entered into with the CDCR/CCHCS will include by reference General Terms and Conditions (GTC 02/2025) and the Contractor Certification Clauses (CCC 04/2017) that may be viewed and downloaded at Internet site:

https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List- Folder/Standard-Contract-Language

If you do not have Internet access, a hard copy can be provided by contacting the person listed below.

In the opinion of CDCR/CCHCS, this IFB is complete and without need of explanation. However, if you have questions, or should you need any clarifying information, the contact person for this IFB is:

Maggie Villucci CDCR – California Correctional Health Care Services

916-691-2865 Maggie.villucci@cdcr.ca.gov

Please note that no verbal information given will be binding upon the CDCR/CCHCS unless such information is issued in writing as an official addendum.

Maggie Villucci

Maggie Villucci Contract Analyst https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language

California Department of Corrections and Rehabilitation IFB #SD25-00049 California Correctional Health Care Services Pre-Payment Claim Review (PPCR) and Post Payment Audit and Recovery Services (PPAR)

Table of Contents Section Page

A) Purpose and Description of Services

B) Bidder Minimum Qualifications

C) Bid Requirements and Information

1) Key Action Dates

2) Submission of Bid

3) Evaluation and Selection

4) Award and Protest

5) Disposition of Bids

6) Contract Execution and Performance

7) Executive Order N-6-22 – Russia Sanctions

D) Disabled Veteran Business Enterprise (DVBE) Participation Program

E) Preference Programs

1) Small Business Preference

2) Non-Small Business Preference

3) Disabled Veteran Business Enterprise (DVBE) Incentive Requirements

4) Commercially Useful Function

5) Target Area Contract Preference Act (TACPA)

F) Required Attachments

1) Attachment 1 – Required Attachments Checklist

2) Attachment 2 – Rate Sheet

3) Attachment 3 – Bid/Bidder Certification Sheet

4) Attachment 4 – Bidder References

5) Attachment 5 – Bidder Declaration (Subcontractor List)

6) Attachment 6 - DVBE Declaration (STD 843)

7) Attachment 7 – Minimum Qualifications Statement

8) Attachment 8 – Bidder Attestation of License/Board Certifications

9) Attachment 9 – Payee Data Record (STD 204)

10) Attachment 10 – Darfur Contracting Act Certification

11) Attachment 11 – Iran Contracting Act Certification

12) Attachment 12 – California Civil Rights Laws Certification

13) Attachment 13 – Contractor Certification Clauses

14) Attachment 14 – Non Disclosure Agreement

15) Attachment 15 – Statement of Economic Interests (Form 700)

16) Attachment 16 – Security Awareness, Understanding and Accountability Form ... 37

17) Attachment 17 – GenAI Reporting and Factsheet (AMS 708)

Sample Contract (Includes the following): Separate

Standard Agreement (STD 213) Exhibit A – Scope of Work Exhibit A-1 – Detailed Scope of Work Exhibit B – Budget Detail and Payment Provisions Exhibit B-1 – Rate Sheet https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std843.pdf

California Department of Corrections and Rehabilitation IFB #SD25-00049

Exhibit C – General Terms and Conditions* Exhibit D – CCHCS Special Provisions Exhibit E – Insurance Requirements Exhibit F – Business Associate Agreement (HIPAA) Exhibit G – Information Security Agreement Exhibit H – Non Redisclosure Agreement Attachment 1 – Security Awareness Understanding and Accountability

*Included by reference

California Department of Corrections and Rehabilitation IFB #SD25-00049

A. PURPOSE AND DESCRIPTION OF SERVICES:

The California Department of Corrections and Rehabilitation (CDCR)/California Correctional Health Care Services (CCHCS) requires Pre-Payment Claim Review (PPCR) and Post Payment Audit and Recovery Services (PPAR) as defined in the Sample Contract. The Contractor shall furnish all labor, including travel and per diem, materials, non-consumable supplies, transportation, equipment, and every other item of expense necessary to provide Pre- Payment Claim Review (PPCR) and Post Payment Audit and Recovery Services (PPAR).

PPCR and PPAR services shall operate independently from each other, but in coordination.

Bidders may provide a bid for both PPCR and PPAR services or an independent bid for one of the services requested.

The term of the Contract, resulting from this IFB, shall be October 1, 2026, or upon approval, whichever is later, through September 30, 2029. The Contractor is not authorized to commence work, as described in the Sample Contract, until the ensuing Contract has been fully executed.

CDCR/CCHCS shall have the option to extend this Contract for five (5) additional one (1) year terms, at the rates listed in Attachment 2 – Rate Sheet – Part 3.

B. BIDDER MINIMUM QUALIFICATIONS:

All Bidders must submit an Attachment 7 – Bidder Minimum Qualification Statement that clearly demonstrates how they meet the following applicable minimum qualifications below in alignment with the Sample Contract, scope of work applicable to be performed in the ensuing contract for PPCR and/or PPAR services. This includes volume and timeframes as applicable to the Attachment 2 – Rate Sheet – Part 3.

Respond to all qualifications below if providing a bid for both PPCR and PPAR services. If providing a bid for only one of the services (PPCR or PPAR), respond accordingly only to the minimum qualifications as indicated below. The Bidder’s response must be single-spaced, in Arial 11-point font, may not exceed eight (8) pages, and must clearly address each applicable qualification, specifying the qualification being responded to.

1. Contractor Minimum Qualifications:

Bidders not meeting the following minimum qualifications will be disqualified:

a. PPCR & PPAR:

i. The Contractor must be located in the United States of America (USA).

ii. The Contractor (if Corporation, LLC or Partnership) must be active and in good standing with the California Secretary of State’s Office. Certification must be provided. The Contractor (if Sole Proprietor) must have a valid business license.

Copy of business license must be provided.

iii. The Contractor must provide an example of previous work experience performing complex medical record audits, determinations of medical necessity and the appropriate level of care as required. The example shall be for at least 12 consecutive months of services, to include a timeline.

California Department of Corrections and Rehabilitation IFB #SD25-00049

iv. The Contractor must provide an example of previous work experience reflecting the knowledge and resources to perform fraud, abuse, waste, and error detection. The example shall be for at least 12 consecutive months of services, to include a timeline.

v. The Contractor must have the ability to provide a secure web portal in accordance with the Sample Contract’s Exhibit A-1 – Detailed Scope of Work, Section (B)(1)(e).

vi. The Contractor must provide two (2) references for services performed within the last five (5) years, which are similar to the scope of work to be performed in the ensuing contract, must be provided on Attachment 4 - Bidder References. Bidders are responsible for ensuring that the references provided are available and respond during the time period specified in the Key Action Dates. CDCR/CCHCS retains the right to conduct reference checks beyond those supplied by the Bidder.

CDCR/CCHCS must not be listed as a reference. The inability to confirm references, or if any reference provides an unsatisfactory review, may cause the bid to be rejected and deemed nonresponsive.

b. PPCR only:

The Contractor must demonstrate the ability to review claims prior to payment within specified timeframes to ensure accurate billing practices including clinical reviews (Diagnosis-Related Group [DRG]), industry guidelines, level of care, etc.) provider billing practices, contract compliance, accurate documentation, and patient eligibility.

c. PPAR only:

The Contractor must demonstrate previous experience using health care industry-standard Recovery Audit Contractor (RAC) methodologies, tools, expertise and technology in compliance with applicable state and federal requirements, accepted medical, clinical, coding, and audit standards.

2. Contractor Staff Minimum Qualifications:

Bidder must complete Attachment 8 – Bidder Attestation of License/Board Certifications to respond to this minimum qualification.

a. PPCR & PPAR:

Bidder’s staff shall possess a current, valid license or board certification issued by the applicable licensing/credentialing authority in Bidder’s proposed staff’s State of operation for the services required under this IFB. The license must be in good standing, and the Bidder shall ensure any subcontractors providing the same services also possess such licenses.

• Licensed Physician

• Medical Review Registered Nurse

• Advanced Practice Practitioner

California Department of Corrections and Rehabilitation IFB #SD25-00049

C. BID REQUIREMENTS AND INFORMATION:

1. Key Action Dates:

Listed below are the important dates and times by which action must be taken or completed. If CDCR/CCHCS finds it necessary to alter any of these dates, it will be accomplished by issuance of an addendum to the IFB. All dates after the deadline for Final Date for Bid Submission are approximate and may be adjusted without an addendum to this IFB.

Event Date and Time

1. IFB Available to Prospective Bidders Tuesday, August 11, 2026

2. Final Date for Bidder Questions* Friday, August 14, 2026

3. CDCR/CCHCS Response to Questions** Wednesday, August 19, 2026

4. Final Date for Bid Submission Tuesday, August 25, 2026, by 3:00 PM

5. Public Bid Opening*** Wednesday, August 26, 2026, at 2:00 PM

6. References Contacted**** Wednesday, August 26, 2026

7. Due Date for Responses from References**** Friday, August 28, 2026

8. Notice of Intent to Award Friday, August 28, 2026

9. Proposed Award Date Tuesday, September 8, 2026

* Submit all questions via email to the contact person indicated on the cover page of this IFB no later than the date and time specified in the Key Action Dates.

** Written responses to IFB questions will be released by the date and time specified and will be viewable online at https://caleprocure.ca.gov/pages/index.aspx under this IFB posting.

*** If interested in attending, please dial (916) 701-9994 and enter Phone Conference ID 567971061# on the date and time listed in the chart above.

**** Bidders are responsible for ensuring that the References are available to respond within the time period specified.

2. Submission of Bid:

a) All bids must be submitted and received by CCHCS by the dates and times shown in the Key Action Dates.

b) IFB documents MUST be submitted to CDCR/CCHCS electronically (by email) to the contact analyst listed below:

Maggie Villucci Maggie.villucci@cdcr.ca.gov

Subject Line: IFB #SD25-00049 Pre-Payment Claim Review (PPCR) and Post Payment Audit and Recovery Services (PPAR)

c) All attachments MUST be submitted in ONE email.

https://caleprocure.ca.gov/pages/index.aspx

California Department of Corrections and Rehabilitation IFB #SD25-00049

d) All attachments must be combined into one PDF document and labeled “IFB” with the exception of Attachment 2 - Rate Sheet – Parts 2 and 3, which must be submitted as a separate attachment.

e) Attachment 2 - Rate Sheet – Parts 2 and 3, must be submitted as a separate attachment and labeled “Attachment 2 - Rate Sheet”.

f) All bids shall include the documents identified in Attachment 1 – Required Attachments Checklist. Bids that do not include the required documents and/or attachments shall be deemed non-responsive. A non-responsive bid is one that does not meet the basic bid requirements.

g) All documents requiring a signature must bear a certified scanned signature of a person authorized to bind the Bidder’s firm.

Note to Bidders: It is the sole responsibility of the Bidder to contact the Contract Analyst listed for this IFB to verify receipt of the submitted IFB documents.

h) Bids must be submitted for the performance of all the services described herein. Any deviation from the work specifications will not be considered and will cause a bid to be rejected.

i) A bid may be rejected if it is conditional or incomplete, or if it contains any alterations of form or other irregularities of any kind. The State may reject any or all bids and may waive an immaterial deviation in a bid. The State's waiver of an immaterial deviation shall in no way modify the IFB document or excuse the bidder from full compliance with all requirements if awarded the Contract.

j) Costs incurred for developing bids and in anticipation of award of the Contract are entirely the responsibility of the bidder and shall not be charged to the State of California.

k) An individual who is authorized to bind the bidder contractually shall sign the Bid/Bidder Certification Sheet, (Attachment 3). The signature should indicate the title or position that the individual holds in the firm. An unsigned bid may be rejected.

l) A bidder may modify a bid after its submission by withdrawing its original bid and resubmitting a new bid prior to the bid submission deadline. Bidder modifications offered in any other manner, oral or written, will not be considered.

m) A bidder may withdraw its bid by submitting a written withdrawal request to the State, signed by the bidder or an authorized agent. A bidder may thereafter submit a new bid prior to the bid submission deadline. Bids may not be withdrawn without cause subsequent to bid submission deadline.

n) The awarding agency may modify the IFB prior to the date fixed for submission of bids by the issuance of an addendum which will be posted within this IFB’s posting at:

https://caleprocure.ca.gov/pages/index.aspx.

o) The awarding agency reserves the right to reject all bids. The agency is not required to award a Contract.

https://caleprocure.ca.gov/pages/index.aspx

California Department of Corrections and Rehabilitation IFB #SD25-00049

p) Before submitting a response to this solicitation, bidders should review, correct all errors and confirm compliance with the IFB requirements.

q) Where applicable, bidder should carefully examine work sites and specifications.

Bidder shall investigate conditions, character, and quality of surface or subsurface materials or obstacles that might be encountered. No additions or increases to the Contract amount will be made due to a lack of careful examination of work sites and specifications.

r) The State does not accept alternate contract language from a prospective Bidder. A bid with such language will be considered a counter proposal and will be rejected. The State’s General Terms and Conditions (GTC) are not negotiable.

s) No oral understanding or agreement shall be binding on either party.

3. Evaluation and Selection:

a) At the time of bid opening, each bid will be checked for the presence or absence of required information in conformance with the submission requirements of this IFB.

b) The State will evaluate each bid to determine its responsiveness to the published requirements. This may include, but is not limited to:

• Minimum Qualifications verified.

• Commercially Useful Function verified (if applicable).

• Verification of References.

• Rate Sheet Calculations.

• Application of Preferences, if applicable.

• DVBE Incentives, if applicable.

• Required certifications/licenses have been received/verified.

• Secretary of State certification/Business License verified.

• Largest Tax Delinquency List verified. Pursuant to PCC Section 10295.4, persons identified as the largest tax delinquents by the FTB or BOE are ineligible to enter into any contract with the State.

c) Bids that contain false or misleading statements, or which provide references, which do not support an attribute or condition claimed by the bidder, may be rejected.

d) Award if made, will be to the lowest responsive, responsible bidder.

e) In the event of a tie between two responsive, responsible bidders, a coin toss will be conducted and observed by witnesses.

f) In the event of a precise tie between the low responsible bid of a certified small business and the low responsible bid of a certified disabled veteran owned business that is also a small business, the contract must be awarded to the disabled veteran owned small business. (GC § 14838 (f); 2 CCR 1896.8(f)).

California Department of Corrections and Rehabilitation IFB #SD25-00049

4. Award and Protest:

a) Whenever a Contract is awarded under a procedure which provides for competitive bidding, but the Contract is not being awarded to the lowest bidder, the low bidder must be notified of that fact five (5) working days prior to contract award.

b) Upon written request by any Bidder, notice of the proposed award shall be posted to Cal eProcure (www.caleprocure.ca.gov) by the awarding agency at least five (5) business days prior to awarding the Contract.

c) If any bidder, prior to the award of Contract, files a written protest with the:

Department of General Services Office of Legal Services 707 Third Street, 7th Floor, Suite 7-330 West Sacramento, CA 95605 Email: OLSProtests@dgs.ca.gov and the CDCR/CCHCS on the grounds that the (protesting) bidder is the lowest responsive responsible bidder, the Contract shall not be awarded until either the protest has been withdrawn or the Department of General Services has decided the matter.

d) Within five (5) days after filing the initial protest, the protesting bidder shall file with the Department of General Services, and the awarding agency, a detailed written statement specifying the grounds for the protest, the IFB number, the name of the agency involved and the agency contract person. The detailed written statement should be submitted to both the CDCR/CCHCS Contract Analyst listed on page 1 of this IFB and:

Department of General Services Office of Legal Services Attention: Bid Protest Coordinator 707 Third Street, 7th Floor, Suite 7-330 West Sacramento, CA 95605 Email: OLSProtests@dgs.ca.gov

Protests may be sent by email, regular mail, courier or personal delivery. Protestants should include their email address if they have one and advise the DGS Bid Protest Coordinator if they will accept service of documents pertaining to the protest via email.

e) Upon resolution of the protest and award of the Contract, the Contractor must complete and submit to the awarding agency the Payee Data Record (STD 204), to determine if the Contractor is subject to state income tax withholding pursuant to California Revenue and Taxation Code Sections 18662 and 26131. This form can be found on the Internet at http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf. No payment shall be made unless a completed STD 204 has been returned to the awarding agency.

f) Upon resolution of the protest and award of the Contract, the Contractor must sign and submit to the awarding agency, page one (1) of the Contractor Certification Clauses (CCC), which can be found on the Internet at:

https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services- Resources-List-Folder/Standard-Contract-Language http://www.caleprocure.ca.gov/ mailto:OLSProtests@dgs.ca.gov mailto:OLSProtests@dgs.ca.gov http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language

California Department of Corrections and Rehabilitation IFB #SD25-00049

This document is only required if the Bidder has not submitted this form to the awarding agency within the last three (3) years.

5. Disposition of Bids:

a) Upon bid opening, all documents submitted in response to this IFB will become the property of the State of California, and will be regarded as public records under the California Public Records Act (Government Code Section 7920.000 et seq.) and subject to review by the public.

b) Bid packages may be returned only at the bidder's expense, unless such expense is waived by the awarding agency.

6. Contract Execution and Performance:

a) Performance shall start not later than 10 days, or on the express date set by the awarding agency and the Contractor, after all approvals have been obtained and the Contract is fully executed. Should the Contractor fail to commence work at the agreed upon time, the awarding agency, upon five (5) days written notice to the Contractor, reserves the right to terminate the Contract. In addition, the Contractor shall be liable to the State for the difference between the Contractor's bid price and the actual cost of performing work by the second lowest bidder or by another contractor.

b) All performance under the Contract shall be completed on or before the termination date of the Contract.

7. Executive Order N-6-22 – Russia Sanctions

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals.

“Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. By submitting a bid or proposal, Contractor represents that it is not a target of Economic Sanctions. Should the State determine Contractor is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for rejection of the Contractor’s bid/proposal any time prior to contract execution, or, if determined after contract execution, shall be grounds for termination by the State.

D. DISABLED VETERAN BUSINESS ENTERPRISE (DVBE) PROGRAM REQUIREMENTS:

Mandatory DVBE participation goals have been waived for this solicitation.

E. PREFERENCE PROGRAMS:

The preferences programs are as follows:

1. Small Business Preference:

Certified small businesses or microbusinesses can claim the five percent (5%) preference when submitting a bid on a state contract. A non-small business may receive a preference of five percent if the business commits to subcontract at least twenty-five percent of its net bid price with one or more small businesses or microbusinesses. The five percent

California Department of Corrections and Rehabilitation IFB #SD25-00049 preference is used only for computation purposes, to determine the winning bidder and does not alter the amounts of the resulting contract. The value of the preference is limited to $50,000 when a contract award is based upon (5%) award to the lowest compliant bid.

A contract awarded on the basis of the five percent (5%) preference is awarded to the small business, microbusiness or non-small business for the actual amount of its bid.

To apply or re-apply for certification as a small business, follow the instructions at the following location:

https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List- Folder/Certify-or-Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise

2. Non-Small Business Preference:

The preference to a non-small business bidder that commits to small business or microbusiness subcontractor participation of twenty-five percent (25%) of its net bid price shall be five percent (5%) of the lowest, responsive, responsible bidder’s price. A non-small business, which qualifies for this preference, may not take an award away from a certified small business.

To locate potential small business sub-contractors, visit https://caleprocure.ca.gov/pages/PublicSearch/supplier-search.aspx?psNewWin=true.

Ensure “Micro Business (MB)” and “Small Business (SB)” are selected. Search by “Keywords” or “United Nations Standard Products and Services Codes (UNSPSC)” that apply to the elements of work you desire to subcontract to a small business.

Prime contractors wishing to subcontract to a small business may also check for subcontractor advertisements in the California State Contracts Register (CSCR) for this solicitation prior to the bid due date. The CSCR can be accessed here:

https://caleprocure.ca.gov/pages/Events-BS3/event-search.aspx.

3. Disabled Veteran Business Enterprise (DVBE) Incentive Requirement:

In accordance with Section 999.5(a) of the Military and Veterans Code, an incentive will be given to Bidders who provide DVBE participation. For evaluation purposes only, the State shall apply an incentive to bids that propose California certified DVBE participation as identified on the Bidder Declaration GSPD-05-105 and confirmed by the State.

The following percentages will apply for awards based on low price:

Confirmed DVBE Participation of: DVBE Incentive 5% Inclusive 5% 4% to 4.99% Inclusive 4% 3% to 3.99% Inclusive 3% 2% to 2.99% Inclusive 2% 1% to 1.99% Inclusive 1%

The incentive is applied by reducing the bid price by the amount of incentive as computed from the lowest responsive bid price submitted by a responsible bidder.

This incentive is for evaluation purposes only.

https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Certify-or-Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Certify-or-Re-apply-as-Small-Business-Disabled-Veteran-Business-Enterprise https://caleprocure.ca.gov/pages/PublicSearch/supplier-search.aspx?psNewWin=true https://caleprocure.ca.gov/pages/Events-BS3/event-search.aspx

California Department of Corrections and Rehabilitation IFB #SD25-00049

Application of the incentive shall not displace an award to a small business with a non-small business.

4. Commercially Useful Function

“Commercially useful function” is defined as a person or entity doing all of the following: 1) Is responsible for the execution of a distinct element of the work of the contract (including the supplying of services and goods); 2) Carries out its obligation by actually performing, managing or supervising the work involved; 3) Performs work that is normal for its business services and functions; 4) Is responsible, with respect to products, inventories, materials, and supplies required for the contract, for negotiating price, determining quality and quantity, ordering, installing, if applicable, and making payment; and 5) Is not further subcontracting a portion of the work that is greater than that expected to be subcontracted by normal industry practices. (Tit. 2 CCR § 1896.71(b).)

It is not a “commercially useful function” if the DVBEs role is limited to that of an extra participant in a transaction, contract or project through which funds are passed in order to obtain the appearance of DVBE participation. (Mil. & Vet. Code § 999(b)(5)(B); Tit. 2 CCR § 1896.71(c).)

5. Target Area Contract Preference Act (TACPA):

This solicitation provides for the optional TACPA preference. Bidders are not required to apply for this preference. Denial of the TACPA preference request is not a basis for rejection of the bid/offer.

The TACPA workplace and workforce preferences will be evaluated for this solicitation.

California-based companies seeking TACPA preferences will need to complete and submit preference request forms with the bid/offer. The following webpage contains required preference request forms and an interactive map to determine if a business is located within a TACPA qualified zone: Request-a Target-Area-Contract-Preference

By submitting TACPA forms, a bidder given a TACPA preference agrees to the TACPA contract provisions required by Government Code section 4535 and provided in section 1896.40 of Title 2 of the California Code of Regulations (CCR) in addition to requirements specified on the TACPA form STD 830.

F. REQUIRED ATTACHMENTS:

Refer to Attachment 1 for the Required Attachments that are a part of this IFB.

https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Request-Target-Area-Contract-Preference?search=TACPA https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=4535.&lawCode=GOV https://govt.westlaw.com/calregs/Document/I5407E8A35A0A11EC8227000D3A7C4BC3?viewType=FullText&listSource=Search&originationContext=Search+Result&transitionType=SearchItem&contextData=(sc.Search)&navigationPath=Search%2fv1%2fresults%2fnavigation%2fi0a8999fc0000019e3c2fe937b914e0c3%3fppcid%3d846b52c5300b46619ef4d26b48ca4a35%26Nav%3dREGULATION_PUBLICVIEW%26fragmentIdentifier%3dI5407E8A35A0A11EC8227000D3A7C4BC3%26startIndex%3d1%26transitionType%3dSearchItem%26contextData%3d%2528sc.Default%2529%26originationContext%3dSearch%2520Result&list=REGULATION_PUBLICVIEW&rank=1&t_T1=2&t_T2=1896.40&t_S1=CA+ADC+s https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std830.pdf

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 1

REQUIRED ATTACHMENTS CHECKLIST

A complete bid or bid package must consist of the items identified below.

Complete this checklist to confirm the items in your bid. Place a check mark or “X” in each box next to the item that you are submitting to the State. For your bid to be responsive, all required attachments must be returned. This checklist should be returned with your bid package also.

One (1) scanned copy of the complete IFB response (except for Attachment 2

– Rate Sheet – Parts 2 and 3) in one attachment entitled “IFB #SD25-00049”

Attachment 1 – Required Attachments Checklist Attachment 2 – Rate Sheet – Parts 2 and 3 submitted as a separate attachment entitled “Attachment 2 – Rate Sheet” Attachment 3 – Bid/Bidder Certification Sheet Attachment 4 – Bidder References Attachment 5 – Bidder Declaration (GSPD 05-105) Attachment 6 – DVBE Declaration (STD 843) (if applicable) Attachment 7 – Minimum Qualifications Statement (not to exceed eight [8] pages) Attachment 8 – Bidder Attestation of License/Board Certifications Attachment 9 – Payee Data Record (STD 204) and Payee Data Record

Supplement (STD 205) if applicable Attachment 10 – Darfur Contracting Act Certification Attachment 11 – Iran Contracting Act Certification Attachment 12 – California Civil Rights Laws Certification Attachment 17 – GenAI Reporting and Factsheet** (AMS 708) California Secretary of State Business Entity Filing Certification http://www.sos.ca.gov/business-programs/business-entities/statements (if business entity is a Corporation, LLC or Partnership)

OR

Copy of Business License (if sole proprietorship)

Small Business/DVBE Certification (if applicable) STD 830 & GSPD 526 Forms – TACPA (if applicable) http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std830.pdf https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0525.pdf http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0526.pdf

The following documents are required upon Contract award:

• Insurance Certifications (with endorsements) for General Liability, Automobile Liability, Workers’ Compensation, and Professional Liability (See Exhibit E of the Sample Contract)

• Attachment 13 – Contractor Certification Clauses (CCC-04/2017)

• Attachment 14 – Non Disclosure Agreement (This form must be signed by all parties involved in the Contract)

• Attachment 15 – Form 700 (Note that this form does not need to be filed with the FPPC – just submitted to CDCR/CCHCS)

• Attachment 16 – Security Awareness, Understanding and Accountability

(SAUA) Form (This form must be signed by all parties involved in the Contract)

The following attachment is included in the IFB as reference only and should not be included in the bid submission:

• Sample Contract http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/pd_843.pdf http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std205.pdf http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std205.pdf http://www.sos.ca.gov/business-programs/business-entities/statements http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std830.pdf https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0525.pdf http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd0526.pdf

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 2 – RATE SHEET

PART 1 – RATE SHEET INSTRUCTIONS

1. To submit a bid, Bidder must be able to provide Pre-Payment Claim Review (PPCR) services and/or Post-Payment Audit & Recovery (PPAR) services, as defined in the Sample Contract.

2. PPCR and PPAR shall operate independently from each other, but in coordination to prevent duplicative reviews causing provider abrasion. Bidders may provide a bid for both PPCR and PPAR services or may provide an independent bid for one of the services requested. Bidders must indicate which service(s) they are submitting rates for, as well as reflect their total bid calculation in Attachment 2 – Rate Sheet – Part 2.

3. CDCR/CCHCS intends to award either one (1) contract covering both PPCR and PPAR services to the lowest responsible bidder or two (2) separate contracts—one for PPCR and one for PPAR— each awarded to the respective lowest responsible bidder(s).

4. A rate must be provided on each line item, in clear legible figures, in the space provided. Failure to provide the required applicable bid rates shall be cause for rejection of bid.

5. Upon contract award, the rates for the services submitted in Attachment 2 – Rate Sheet – Part 3 remain in effect for the term of the Agreement, including any extension of the term through a formal amendment.

6. The State does not expressly or by implication guarantee business, as services are subject to change depending on CDCR/CCHCS fluctuation in the patient population.

California Department of Corrections and Rehabilitation IFB #SD25-00049

PART 2 – BIDDER SERVICE SELECTION AND TOTAL BID CALCULATION

A. BIDDER SERVICE SELECTION:

Bidders must indicate which service(s) they are submitting rates for by checking one or both boxes below. Submit only the rate information applicable to the selected service(s).

I am submitting a Rate Sheet for the following service(s) (check one or both):

Pre-Payment Claim Review (PPCR) Services

Post Payment Audit and Recovery (PPAR) Services

B. TOTAL BID CALCULATION:

By referencing Attachment 2 – Rate Sheet, Parts 3A and 3B, Bidders shall complete the chart below to provide their total bid amount.

Bidders who are not submitting a bid for either PPCR or PPAR services shall populate the below “Cost” column with an “X” for the services they are not submitting a bid for.

Total Bid Cost

SERVICE COST

Pre-Payment Claim Review (PPCR) Services See Attachment 2 – Rate Sheet – Part 3A (C) $___________________

Post-Payment Audit and Recovery (PPAR) Services See Attachment 2 – Rate Sheet – Part 3B (F) $___________________

TOTAL BID (C+F): $___________________

California Department of Corrections and Rehabilitation IFB #SD25-00049

PART 3A – BIDDER RATE SUBMISSION (PPCR)

Pre-Payment Claim Review (PPCR) Services

The Contractor shall furnish all labor, including travel and per diem, materials, non-consumable supplies, transportation, equipment, and every other item of expense necessary to provide Pre- Payment Claim Review (PPCR) services as defined in the Sample Contract.

Service Description

Dates of Service Estimated Amount of Claims*

= Cost

Comprehensive Pre-Payment Claim Review

(PPCR) services

10/1/2026 ( or upon approval, whichever is later) – 6/30/2027

300 = $____________ (a)

7/1/2027-6/30/2028 500 = $____________ (b)

7/1/2028-6/30/2029 500 = $____________ (c)

7/1/2029-9/30/2029 200 = $____________ (d)

10/1/2029-6/30/2030** 3000 = $____________ (e)

7/1/2030-6/30/2031** 5000 = $____________ (f)

7/1/2031-6/30/2032** 5000 = $____________ (g)

7/1/2032-6/30/2033** 5000 = $____________ (h)

7/1/2033-6/30/2034** 5000 = $____________ (i)

7/1/2034-9/30/2034** 3000 = $____________ (j)

TOTAL FOR INITIAL TERM (10/1/2026 or UA – 9/30/2029 [a+b+c+d]): $_________________ (A)

TOTAL FOR OPTION YEAR EXTENSIONS ** (10/1/2029 – 9/30/2034

[e+f+g+h+i+j]):

(B)

PPCR GRAND TOTAL (A + B) $_________________

(C)

*Estimated amount of claims indicated above shall be used solely for computing the cost as a fair and equitable formula to determine the lowest Bidder and is not binding on the contracting agency.

However, the actual costs quoted above by the Bidder shall be binding for the term of the agreement.

**Optional years are at the sole discretion of CDCR/CCHCS to utilize, and there is no guarantee of utilization of such option years.

Note: All services performed are paid in arrears.

California Department of Corrections and Rehabilitation IFB #SD25-00049

PART 3B – BIDDER RATE SUBMISSION (PPAR)

Post-Payment Audit & Recovery (PPAR) Services

The Contractor shall furnish all labor, including travel and per diem, materials, non-consumable supplies, transportation, equipment, and every other item of expense necessary to provide Post- Payment Audit and Recovery (PPAR) services as defined in the Sample Contract.

CDCR/CCHCS shall be reimbursed in the full recovery amount, then, the Contractor shall invoice CDCR/CCHCS detailing the total recovered amount and shall be paid at the rates listed below.

Reductions in the compensation may apply as described below.

Service Description

Dates of Service Estimated Recovery Amount* x Percentage of Recovery Amount Paid to Contractor

(not to exceed 20%)***

= Cost****

Post Audit Review and Recovery Services

(PPAR)

10/1/2026 (or upon approval, whichever is later) – 6/30/2027

$7,000,000.00 x _______% = $____________ (i)

7/1/2027-6/30/2028 $10,000,000.00 x _______% = $____________ (j)

7/1/2028-6/30/2029 $10,000,000.00 x _______% = $____________ (k)

7/1/2029-9/30/2029 $5,000,000.00 x _______% $____________ (l)

10/1/2029-6/30/2030** $7,000,000.00 x _______% = $____________ (m)

7/1/2030-6/30/2031** $10,000,000.00 x _______% = $____________ (n)

7/1/2031-6/30/2032** $10,000,000.00 x _______% = $____________ (o)

7/1/2032-6/30/2033** $10,000,000.00 x _______% = $____________ (p)

7/1/2033-6/30/2034** $10,000,000.00 x _______% = $____________ (q)

7/1/2034-9/30/2034** $7,000,000.00 x _______% = $____________ (r)

TOTAL FOR INITIAL TERM (10/1/2026 or UA – 9/30/2029 [i+j+k+l]): $_________________ (D)

TOTAL FOR OPTION YEAR EXTENSIONS ** (10/1/2029 – 9/30/2034

[m+n+o+p+q+r]):

(E)

PPAR GRAND TOTAL (D + E) $_________________

(F)

*Estimated Refund Recovery Amount indicated above shall be used solely for computing the cost as a fair and equitable formula to determine the lowest Bidder and is not binding on the contracting

California Department of Corrections and Rehabilitation IFB #SD25-00049 agency. However, the actual costs quoted above by the Bidder shall be binding for the term of the agreement.

**Optional years are at the sole discretion of CDCR/CCHCS to utilize, and there is no guarantee of utilization of such option years

***Percentage of Recovery Amount Paid to the Contractor shall not exceed twenty percent (20%).

****Cost is a good faith estimate and used for bidding purposes only; Contractor shall be paid the Percentage of actual Recovery Amount.

Reductions in Compensation:

1. Contractor shall receive a 20% reduction in compensation per recovery of total claim refund recovery amount as a result of CDCR/CCHCS’s assistance or intervention.

2. Contractor shall receive a 20% reduction in compensation per recovery of total claim refund recovery amount as a result of prior PPAR audit(s).

3. Contractor shall receive a 35% reduction in compensation per recovery of total claim refund recovery amount as a result of CDCR/CCHCS’s legal review or action.

4. Contractor shall receive a 35% reduction in compensation per recovery of total claim refund recovery amount as a result of Contractor’s failure to meet specified timelines or accuracy expectations as listed in the Sample Contract.

5. Contractor shall receive a 50% reduction in compensation per recovery for all refunds identified by contractor and sent to CDCR/CCHCS for review and recovery.

6. For all recovered refunds or payments to the Contractor based on savings realized from the avoidance of improper billing that the CDCR/CCHCS subsequently determines to be inaccurate, in whole or in part, solely due to Contractor's error, the Contractor shall refund the CDCR/CCHCS one hundred percent (100%) of Contractor's compensation for each inaccuracy.

If multiple reductions in compensation are applicable, the single highest appropriate reduction in compensation shall be applied.

Note: All services performed are paid in arrears.

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 3

BID/BIDDER CERTIFICATION SHEET

This Bid/Bidder Certification Sheet must be signed and returned with all other required documents as an entire package in one attachment. The bid must be transmitted via email in accordance with IFB instructions.

A. Our all-inclusive bid is submitted as detailed in Attachment 2 – Rate Sheet – Parts 2 and 3.

B. All required documents are included with this certification sheet.

C. The signature affixed hereon and dated certifies compliance with all the requirements of this bid document. The signature below authorizes the verification of this certification.

An unsigned Bid/Bidder Certification Sheet May Be Cause for Rejection

1. Company Name 2a. Telephone Number 2b. Fax Number

3. E-mail Address

4. Address

Indicate your organization type:

5. Sole Proprietorship 6. Partnership 7. Corporation Indicate the applicable employee and/or corporation number:

8. Federal Employee ID No. (FEIN) 9. California Corporation #:

10. Indicate applicable license and/or certification information:

11. Bidder’s Name (Print) 12. Title

13. Signature 14. Date

15. Are you certified with the Department of General Services, Office of Small Business Certification and Resources (OSBCR) as:

a. California Small Business

Yes No If yes, enter certification number:

b. Disabled Veteran Business Enterprise Yes No

If yes, enter your service code below:

NOTE: A copy of your Certification is required to be included if either of the above items are checked “Yes”.

Date application was submitted to OSBCR, if an application is pending:

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 3 (CONTINUED)

Completion Instructions for Bid/Bidder Certification Sheet

Complete the numbered items on the Certification Sheet by following the instructions below:

Item Numbers

Instructions

1, 2a, 2b, 3, 4 Must be completed. These items are self-explanatory.

5 Check if your firm is a sole proprietorship. A sole proprietorship is a form of business in which one person owns all the assets of the business in contrast to a partnership and corporation. The sole proprietor is solely liable for all the debts of the business.

6 Check if your firm is a partnership. A partnership is a voluntary agreement between two or more competent persons to place their money, effects, labor, and skill, or some or all of them in lawful commerce or business, with the understanding that there shall be a proportional sharing of the profits and losses between them. An association of two or more persons to carry on, as co-owners, a business for profit.

7 Check if your firm is a corporation. A corporation is an artificial person or legal entity created by or under the authority of the laws of a state or nation, composed, in some rare instances, of a single person and his successors, being the incumbents of a particular office, but ordinarily consisting of an association of numerous individuals.

8 Enter your federal employee tax identification number.

9 Enter your corporation number assigned by the California Secretary of State’s Office. This information is used for checking if a corporation is in good standing and qualified to conduct business in California.

Complete, if applicable, by indicating the type of license and/or certification that your firm possesses and that is required for the type of services being procured.

11, 12, 13, 14 Must be completed. These items are self-explanatory.

If certified as a California Small Business, place a check in the "Yes" box, and enter your certification number on the line. If certified as a Disabled Veterans Business Enterprise, place a check in the "Yes" box and enter your service code on the line. If you are not certified to one or both, place a check in the "No" box.

If your certification is pending, enter the date your application was submitted to

OSBCR.

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 4

BIDDER REFERENCES

Submission of this attachment is mandatory. Failure to complete and return this attachment with your bid will cause your bid to be rejected and deemed non-responsive. CDCR/CCHCS must not be listed as a reference. Letters of recommendation and/or letters of references are not acceptable.

List below two (2) references for services performed within the last five (5) years, which are similar to the scope of work to be performed in the ensuing contract. Bidders are responsible for ensuring that the references provided are available and respond during the time period specified in the Key Action Dates. CDCR/CCHCS retains the right to conduct reference checks beyond those supplied by the Bidder. The inability to confirm references, or if any reference provides an unsatisfactory review, may cause the bid to be rejected and deemed nonresponsive.

Please Print or Type

REFERENCE 1

Name of Firm:

Street Address: City: State: Zip Code:

Contact Person: Telephone Number:

E-mail Address: Fax Number:

Dates of Service: Value or Cost of Service: $

Brief Description of Service Provided:

REFERENCE 2

Name of Firm:

Street Address: City: State: Zip Code:

Contact Person: Telephone Number:

E-mail Address: Fax Number:

Dates of Service: Value or Cost of Service: $

Brief Description of Service Provided:

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 5

BIDDER DECLARATION

The GSPD-05-105 can be found at: http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

Bidders must complete the Bidder Declaration and include it with their response. When completing the declaration, bidders must identify all sub-contractors proposed for participation in the contract. Bidders awarded a contract are contractually obligated to use the sub-contractors indicated in the Bidder Declaration for requested services unless CDCR/CCHCS agrees to a substitution via amendment to the Contract.

http://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 6

DVBE DECLARATION (STD 843)

The STD 843 can be found at: https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/pd_843.pdf.

Bidders must complete the DVBE Declaration when a DVBE Contractor or Subcontractor will provide materials, supplies, services or equipment (Military and Veterans Code Section 999.2). Violations are misdemeanors and punishable by imprisonment or fine and violators are liable for civil penalties. All signatures are made under penalty of perjury.

https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/pd_843.pdf

California Department of Corrections and Rehabilitation IFB #SD25-00049

ATTACHMENT 7

MINIMUM QUALIFICATIONS STATEMENT

All Bidders must submit an Attachment 7 – Bidder Minimum Qualification Statement that clearly demonstrates how they meet the following applicable minimum qualifications below in alignment with the Sample Contract, scope of work applicable to be performed in the ensuing contract for PPCR and/or PPAR services. This includes volume and timeframes as applicable to the Attachment 2 – Rate Sheet.

Bidders submitting proposals for both PPCR and PPAR services must respond to all minimum qualifications listed below. Bidders submitting a proposal for only one service (either PPCR or PPAR) shall respond only to the minimum qualifications applicable to that specific service.

The Bidder’s response must be single-spaced, in Arial 11-point font, may not exceed eight (8) pages, and must clearly address each applicable qualification, specifying the qualification being responded to.

The minimum qualifications can be found on Page 4. Bidders not meeting all qualifications for the service they are bidding on (PPCR and/or PPAR) will be disqualified).

1. Contractor Minimum Qualifications:

Bidders not meeting the following minimum qualifications will be disqualified:

a. PPCR & PPAR:

i. The Contractor must be located in the United States of America (USA).

ii. The Contractor (if Corporation, LLC or Partnership) must be active and in good standing with the California Secretary of State’s Office. Certification must be provided. The Contractor (if Sole Proprietor) must have a valid business license. Copy of business license must be provided.

iii. The Contractor must provide an example of previous work experience performing complex medical record audits, determinations of medical necessity and the appropriate level of care as required. The example shall be for at least 12 consecutive months of services, to include a timeline.

iv. The Contractor must provide an example of previous work experience reflecting the knowledge and resources to perform fraud, abuse, waste, and error detection. The example shall be for at least 12 consecutive months of services, to include a timeline.

v. The Contractor must have the ability to provide a secure web portal in accordance with the Sample Contract’s Exhibit A-1 – Detailed Scope of Work, Section (B)(1)(e).

vi. The Contractor must provide two (2) references for services performed within the last five (5) years, which are similar to the scope of work to be performed in the ensuing contract, must be provided on Attachment 4 - Bidder References.