IT Scope of Work RFP 74BAI-S2436.docx

SCOPE OF WORK RFP 74BAI-S2436

TABLE OF CONTENTS

GOALS AND OBJECTIVES

Workers’ Compensation Section (WCS) aims to enhance its external user base and streamline the process of submitting forms to CARDS. Presently, only the D-38 claim form is directly submitted to Claims and Regulatory Data System (CARDS). To achieve this objective, both existing external users i.e. insurers/Third-Party Administrators (TPAs) and the newly included user base (injured workers, injured worker authorized representatives, employers, and medical providers) will have the ability to directly submit a broader range of form types to CARDS. This expansion of document submissions will significantly improve stakeholder access to WCS services and procedures while reducing the workload on WCS staff responsible for manually processing submitted forms.

WCS aims to streamline the Annual Assessment process by automating it, allowing entities (insurers) to directly submit their reports and make payments through CARDS. Insurers are currently obligated to submit annual assessment reporting data and pay the workers' compensation assessment, which is manually processed by the Department of Business & Industry (B&I) Fiscal staff. This manual approach results in inefficiencies in ensuring timely notice and accurate tracking of payment(s), sometimes leading to late or overlooked assessments. By modernizing the system, insurers will experience a more efficient way to submit reports, receive notices, and access payment invoicing, simplifying the process and improving overall stakeholder experience.

Integrate/build a secure online payment feature to route users to Nevada’s preferred online payment portal Wells Fargo to make online payments for assessments, fines and penalties and accept credit cards, debit cards, and eChecks.

Automate online account receivables/account payable transactions. Currently, WCS can only receive payments via check or money order, and WCS Accounting staff are required to manually invoice and track all payments.

E-Signature functionality options for internally generated notices and letters, as well as forms and documents requiring external user signatures. Modernization here cross enables additional form submission modernization in electronic format and promotes greater efficiency in document handling for both WCS staff and external users.

Improve Report Functions for insurers and TPAs by enhancing industry access to data summaries and reports based on stated needs.

Improve Division of Industrial Relations (DIR) Data Tracking

Update CARDS with Technology Framework Upgrades and Security Upgrades

Expand External User Types and Self Service via access improvements to the external facing web portal.

Add North American Industry Classification System (NAICS) Code field to D-38 Claims Indexing

WCS aims to enhance the functionality of CARDS to improve the efficiency and user experience for WCS staff. These improvements encompass various areas, such as expanding the range of forms that can be generated, redesigning the staff dashboard layout, adding new fields to capture crucial data, enhancing document storage capabilities, refining note functionality, improving page navigation, implementing a transaction activity log to record database changes, automating additional WCS processes, and integrating functionality from existing WCS custom applications whenever feasible. Through these enhancements, CARDS will provide a more comprehensive and user-friendly platform, empowering WCS staff to work more efficiently and effectively.

The integration of the Yellowfin Embedded BI platform, or a similar solution, into CARDS serves the purpose of facilitating reporting, enabling WCS to achieve its goals, execute the WCS Strategic Plan, and meet statutory requirements.

BACKGROUND

PROJECT

CARDS, a custom software solution, was initially deployed in April 2017 to revolutionize and optimize WCS systems and processes. Its primary objective was to replace two outdated and separate legacy systems: the Nevada Department of Information Technology's (DoIT) custom-built claims indexing system, developed over 20 years ago, and Versa, a commercially available regulatory licensing and enforcement system. Additionally, CARDS aimed to replace multiple Access databases and Excel spreadsheets that fell short in adequately supporting WCS's specific business requirements. The implementation of CARDS marked a significant step towards automation, streamlining operations, and ensuring a more robust and tailored solution for WCS's evolving needs. In addition, via the external web portal functionality, it serves as a centralized platform where insurers and TPAs can provide claims information and contact details, ensuring accurate and up-to-date records.

One of the key functions of CARDS is to track all aspects of the regulatory process related to workers' compensation. This includes conducting investigations, performing audits, assessing fines, managing debt collection, and assigning physicians to cases. By consolidating these activities within a single system, WCS (Workers' Compensation Section) can effectively manage and streamline the regulatory workflow.

One significant advantage of CARDS is its ability to reduce manual processes and promote information sharing between different units involved in the regulatory process. This automation and integration of data facilitates smoother operations and eliminates the need for extensive paperwork in various areas. Moving towards a paperless environment reduces administrative burdens and improves efficiency within the system.

From an external stakeholder perspective, CARDS offers improved reporting capabilities for insurers. Insurers can now submit claims information online, simplifying the process and ensuring proper indexing. Moreover, the system enables faster assignment of rating physicians to cases by linking relevant claims, thereby expediting the entire process.

In summary, CARDS has brought numerous benefits to the Nevada Workers' Compensation system. It has streamlined operations, reduced manual tasks, improved information sharing, eliminated paperwork, and provided enhanced reporting capabilities for external stakeholders like insurers. These advancements have contributed to greater efficiency and effectiveness in managing and regulating workers' compensation claims.

However, there have been opportunities missed as a result of limited funding. Enhancements are needed for several reasons:

Revenue Collection Improvement: By integrating assessment data reporting, invoicing, online payment, and collections into CARDS, the system can improve the efficiency of revenue collection processes. This integration would help track who has reported, streamline invoice delivery, and ensure timely payment compliance, which can be challenging when using standalone forms and traditional mail.

Enhanced Security: The current process of submitting the D-35 form, which contains sensitive information like social security numbers and confidential medical data, through paper or fillable PDF forms, email, or fax can pose security risks. Enhancements that enable users to submit such requests online would not only improve efficiency but also enhance data security by reducing errors and processing time.

Time Savings for Staff: Implementing enhancements like online submission of various reports and forms (such as D-35s, Claims Activity Reports, Occupational Disease Reports, and assessments) would save staff time spent on manual data entry. This time saved could be redirected towards analysis and other value-added tasks.

Expanded User Access: Allowing additional users, such as injured workers, attorneys, and other stakeholders, to create accounts and submit information to CARDS would broaden the system's reach. This would reduce the burden on the state to manage user accounts and facilitate easier access for those who need to interact with the system.

E-Signatures: Implementing e-signature capabilities within CARDS would eliminate the need to print documents and letters for signature. This enhancement would streamline internal processes and improve efficiency by enabling users to sign documents electronically directly within the system.

Overall, these enhancements are necessary to improve the system's functionality, user experience, data security, revenue collection, staff efficiency, and accessibility for various stakeholders.

AGENCY

WCS plays a pivotal role in overseeing Nevada's workers' compensation programs to ensure that injured workers receive prompt and precise wage loss compensation, physical impairment compensation, medical compensation, and rehabilitation benefits. This objective is accomplished through a multifaceted approach that encompasses training, auditing, and investigation. Furthermore, WCS is responsible for regulating various entities, including employers, private insurers, self-insured employers, associations of self-insured public and private employers, third-party administrators, managed care organizations, and healthcare providers. By effectively overseeing these stakeholders, WCS ensures compliance with relevant regulations and promotes the delivery of fair and comprehensive workers' compensation services in Nevada.

The source of funding for the Workers’ Compensation Section is through assessments of insurers providing workers’ compensation coverage for Nevada employers. This funds the operations and staffing for WCS which has 58 employees (37 in Las Vegas and 21 in Carson City/Reno).

The WCS has 5 functional units as follows:

Employer Compliance Unit – Employers may purchase insurance from a private carrier licensed in Nevada or be certified by the Division of Insurance (DOI) as a self-insured employer or a member of an association of self-insured public or private employers. This unit ensures that all employers with one or more employees in the state of Nevada provide those employees workers’ compensation insurance. This unit also investigates uninsured workers’ compensation claims to determine if an employee- employer relationship exists when an injury occurs which is related to the injured person’s employment. Investigators in this unit issue fines and premium penalties against employers that fail to secure and/or maintain workers’ compensation coverage for their employees. The WCS has statutory authority to investigate potentially uninsured employers, order cessation of business when warranted, and levy penalties and fines for non-compliance. This unit uses CARDS to track investigations, upload important documents, issue fines and premium penalties, and generate forms like the State Action Letter.

This program derives its authority from Nevada Revised Statutes (NRS) 616A through 616D and NRS 617, specifically NRS 616B.633, 616D.110, 616D.200 and 616A.430.

Number of Employer Compliance Investigations Completed in FY22: 31,009 Number of Fines Issued in FY22: 1018 Dollar Amount of Fines Issued in FY22: $714,750 Number of Premium Penalties Issued in FY22: 710 Dollar Amount of Premium Penalties Issued in FY22: $636,366.02

Audit Unit – This unit audits each workers’ compensation insurer at least every 5 years. The purposes of the audits are to ensure compliance by insurers, third party administrators, employers, and health care providers with the statutes and regulations which govern workers’ compensation in Nevada and to identify areas of non-compliance in order to facilitate corrective action. This unit also investigates complaints brought by injured workers or their representatives and renders determinations on these complaints. This unit uses CARDS to track complaints and issue administrative fines.

This unit may issue notices of correction, order plans of corrective action, and levy administrative fines as a result of compliance audits and complaint investigations.

This unit also derives its authority from Nevada Revised Statutes (NRS) 616A through 616D and NRS 617. Statutes which apply specifically to this unit include, but are not limited to, NRS 616A.400, NRS 616A.465, NRS 616B.003, NRS 616D.120, and NRS 616D.130.

Note: The Division of Insurance (DOI) also conducts audits and examinations of insurers; however, the goal of the DOI audits is to ensure financial solvency, adequate reserving practices and appropriate market conduct of the insurer rather than to ensure the proper benefits are being delivered.

Number of Insurer and TPA Audits/Investigations Completed in FY22: 142 Number of Fines Issued in FY22: 937 Dollar Amount of Fines Issued in FY22: $658,475

Medical Unit – This unit is responsible for establishing and maintaining the Panel of Treating Physicians and Chiropractors and the Panel of Rating Physicians and Chiropractors. The unit also establishes reviews and makes recommendations for changes to the Medical Fee Schedule, adopts and reviews the Standards of Care for injured employees, and establishes and oversees the Permanent Partial Disability (PPD) Review Panel. It is responsible for investigating complaints regarding billing disputes between medical providers and insurers and/or third-party administrators, and complaints regarding rating and treating physicians. The unit also conducts audits and special investigations of managed care organizations and medical providers as needed. This unit may issue notices of correction, order plans of corrective action, and levy administrative fines as a result of compliance audits and complaint investigations. This unit uses CARDS to track D-35's which are requests for the assignment of a rotating physician or chiropractor, assign a rotation physician or chiropractor and track investigations for billing determinations and medical complaints.

This unit derives its authority from NRS 616A through NRS 616D and NRS 617. Statutes which specifically apply to this unit include, but are not limited to NRS 616C.260, NRS 616C.090, NRS 616C.490, and NRS 616C.250.

Number of Medical Investigations Completed in FY22: 177 Number of Fines Issued in FY22: 12 Dollar Amount of Fines Issued in FY22: $11,375

The Research, Analysis and Indexing Unit conducts research relating to workers’ compensation issues, generates reports and disseminates data and information to DIR management, WCS units and externally as necessary. This unit participates in special projects as directed by the CAO and Administrator and interacts with and aids the other WCS units on various assignments such as drafting regulations and reviewing performance. The unit is also responsible for processing and collecting all administrative fines. In addition, this unit is responsible for indexing claims submitted for processing and Information Technology development. This unit uses CARDS to track each workers’ compensation claim through the indexing process. The unit also uses CARDS to track insurers, administrative fines, and penalties assessed.

Insurer Compliance Unit – This unit includes three components discussed below. This unit uses CARDS to track benefit penalties and Subsequent injuries.

Benefit Penalty – Staff conduct investigations of insurers and third-party administrators that may result in a monetary award (benefit penalty) to the injured worker if violations of specific statutes and regulations are identified. These investigations are often of a higher level than a regular complaint investigation and the determinations made as a result are often contested.

Number of Benefit Penalty Investigations Completed in FY22: 129 Number of Benefit Penalties Issued in FY22: 30 Dollar Amount of Benefit Penalties Issued in FY22: $259,000

Subsequent Injury Coordinator – The primary purpose of the Subsequent Injury Account(s) is to encourage employers to hire workers who have suffered a permanent physical impairment. The impairment can be congenital or caused by a previous accident, illness or work-related injury/occupational disease. The costs of the subsequent injury are paid from a designated “subsequent injury account” which is supported by assessments received from workers’ compensation insurers rather than having the current insurer pay the entire cost of a qualifying claim. There are currently three separate subsequent injury accounts. The Self-insured Employers Account and the Associations of Self-insured Public or Private Employers Account each have their own review board. They each have five board members who are appointed by the Governor. The Administrator of the Division of Industrial Relations (DIR) administers the account for private carriers. The Subsequent Injury Coordinator is responsible for reviewing claims against the Subsequent Injury Accounts and providing a recommendation for approval or denial of such claims to the Subsequent Injury Boards and issuing determinations on claims against the private carrier account.

Number of Initial Subsequent Injury Claims Submissions Reviewed in FY22: 8 Number of Supplemental Subsequent Injury Claims Reviewed in FY22: 54

Uninsured Employers Claims Coordinator - The Uninsured Employers’ Claim Account (UECA) provides workers’ compensation benefits to employees whose employers did not have industrial insurance at the time of their injuries. The account is administered by the DIR and is financed through fines and penalties collected by the Workers’ Compensation Section. The uninsured employer is liable for money paid from the fund to provide benefits and compensation to the injured employee (NRS 616C.220).

Claims administration for uninsured employers is handled by a TPA contracted by the DIR. The contract is obtained via a Request for Proposal (RFP) that is opened every two to four years. The Uninsured Employers Claims Coordinator oversees the claims administration to ensure appropriate benefits are being provided and gives prior authorizations for medical and vocational rehabilitation services.

Current Number of Open Uninsured Claims: 61 Uninsured Claims Expenditures in FY22: $2,327,696

CURRENT COMPUTING ENVIRONMENT

DIR has three (3) offices located in Reno, Carson City, and Las Vegas, Nevada. The following outlines the computing environment:

Desktops – Windows 10 Pro and Window 11 Pro Servers – Windows Server 2016 and 2022 Domain controllers and shared file servers Web, application & database servers Network – The local area network with the DIR offices is managed by Department of Business & Industry IT staff. The statewide network is managed by the Enterprise IT Services Division (EITSD).

WCS has two major systems that support the section:

CARDS is a custom web-based application that was deployed in 2017 as noted in the project overview.

Sputnik – Developed by WCS IT staff, after deployment of CARDS, to provide additional CARDS functionality not coded in the current CARDS application are generating specific reports, user management, transaction management, and search capabilities. Several additional custom applications called DTapps developed in Sputnik include WCS Debt, SIPlus, PTDCola, PTClaim, Paneling, OccDisease, NCCIScrub, Merlin, D38Reader, ClaimsActivity, CITwo, and Checkin.

WCS also has various user developed spreadsheets that are used to fill “gaps” in functionality.

PROJECT SOFTWARE

All software used for project management shall be approved by the State. Current desktop tools utilized include:

The primary desktop tools used by DIR are the Microsoft Office Suite (Word, Excel, PowerPoint) and Microsoft Visio and Microsoft Project (for project schedules).

Sputnik and other DT Apps – Developed by WCS IT staff, after deployment of CARDS, to provide additional CARDS functionality not coded in the current application, including generating specific reports, user management, transaction management, and search capabilities. Several additional applications developed in Sputnik include WCS Debt, SIPlus, PTDCola, PTClaim, Paneling, OccDisease, NCCIScrub, Merlin, D38Reader, ClaimsActivity, CITwo, and Checkin.

DEVELOPMENT SOFTWARE

All proposed software used in design, development, testing and implementation of deliverables outlined in this solicitation shall be approved by the State.

If the application software is not public domain, the awarded vendor shall provide a licensing strategy.

The State is not currently using development software.

DIR does not have specific standards for software development tools (e.g., .net, J2EE, etc.). However, solutions proposed by vendors must meet current acceptable industry standards and have a mainstream pool of technical resources for support.

STATE RESOURCES

The following paragraphs describe resources the State has committed to this project.

Project Sponsor. The Division of Industrial Relations, Workers’ Compensation Section is the Project Sponsor. All project activities shall be conducted under the authority of the Department of Business and Industry, Division of Industrial Relations, Workers’ Compensation Section.

Project Manager. A Project Manager has been appointed to coordinate the activities of all individuals and organizations involved in the project. The Project Manager shall provide on-going daily direction and oversight to State project staff and Contractor and report progress and problems to the Project Sponsor. The Project Manager shall coordinate all organizations involved in the project and ensure resource requirements are identified and addressed. The Project Manager sets priorities when choices of alternatives are required.

State Project Staff

The awarded vendor shall be expected to work closely with State project staff assigned to this project.

State project staff shall be available to attend meetings, interviews and assist assigned staff in reviewing functions with the awarded vendor.

State project staff shall be assigned to the project on an as-needed basis, as determined by project and technical management to represent the various functional and technical areas.

State project staff shall report to the Project Manager who shall act as a conduit to the awarded vendor.

Quality Assurance Monitor. A Quality Assurance (QA) monitor may be utilized and shall act as technical assistant to the State. The QA monitor shall report to the State Project Manager. Major functions shall include, but not be limited to the following.

Review of project tasks Validation of results Provide recommendations, as required Review of deliverables Project plan monitoring

SYSTEM REQUIREMENTS

VENDOR RESPONSE TO SYSTEM REQUIREMENTS

Vendor shall explain in sufficient detail how Vendor shall satisfy project requirements described below and in Requirements Matrix. If subcontractors shall be used for any tasks, vendors shall indicate what tasks and the percentage of time subcontractor(s) shall spend on those tasks.

COMPUTING PLATFORM

The server and desktop environments at the Department of Business & Industry and DIR is Windows. Virtualization is managed by VM Ware.

In terms of hosting applications, DIR is State hosted.

Systems hosted on State servers should run Windows Server. However, DIR is open to other platforms.

TECHNICAL REQUIREMENTS

These technical requirements have the highest priority.

Technology Framework Upgrades:

CARDS shall include Technology Framework Upgrades Upgrade the API framework ASP.NET to the current version or migrate to .NET Core.

CARDS is currently on ASP.NET Framework 4.5.2 which reached end of life on 04/26/2022.

The current version of .NET Framework is 4.8.1.

Prioritize this upgrade for supportability and security.

Evaluate if web servers require update and upgrading.

Upgrade the web application framework, AngularJS to Angular. CARDS is currently on AngularJS v1.5.7; v1.7 was the final version of AngularJS which reached end of life on 01/31/2021.

System Performance Upgrades:

CARDS shall include System Performance Upgrades.

Retain 48 GB RAM on web servers.

Optimize Indexes.

Add non-clustered indexes on stored procedures.

Maintenance tasks such as rebuilding key indexes.

Add server-side caching as part of CARDS caching strategy with testing considered.

Adjust logic to query subsets of data needed.

Move long and/or complex queries to Stored Procedures.

To be evaluated on a case-by-case basis with development and test effort considered.

CARDS shall have an average load speed of 2 seconds for both "Back office" users (state staff) and external customers (accessing services over the Internet).

CARDS shall handle 10,000 concurrent users while meeting performance objective.

FUNCTIONAL REQUIREMENTS

Requirements 3.4.3 to 3.4.17 have the highest priority, in addition to 3.3.3 and 3.3.6.

Expanding External User Types & Self Service – Priority CARDS shall allow more types of external users to access and use the external web portal.

Web portal registration shall be expanded to allow injured workers, injured worker authorized representatives, medical providers and employers to securely register for web portal access.

Injured workers, injured worker authorized representatives, medical providers, and employers will use CARDS for WC processes that are currently still completed manually or otherwise outside of CARDS.

Permissions shall be implemented to handle new user types.

External users will be able to create their own accounts/profiles.

Assessments Process & Invoicing – Priority The Annual Assessment process for Insurers/TPAs will be automated.

CARDS features will be added to request claims expenditure and premium data from Insurers/TPAs.

A web form will be developed allowing insurers to submit claims expenditure and premium data electronically.

Insurers/TPAs will receive automated reminders at different stages of the assessment process and CARDS will display banner messages reminding insurers of payments that are due or overdue.

CARDS will generate invoices and will send notifications to Insurers on the assessment amount owed and will direct users to make payments electronically via the external web portal.

Integrate functionality of FRED as practicable, which is an application currently used to calculate the assessment, create invoices, and track payments.

WCS and B&I staff will be able to process manual payments like cash and checks and record the payment to CARDS.

Internal staff will be able to generate transaction reports like daily transactions.

Installment payment tracking required for split payments.

Data will not be editable after the assessment is completed.

Modernize Additional Document Submissions/Electronic Forms – Priority Functionality will be expanded to allow a variety of form submissions for external users.

Injured workers, injured workers authorized representatives, medical providers, and employers will be able to securely submit additional forms like D-35, C-4, written statements, Claims Activity Reports, and other insurance claim documentation. Provide functionality for additional creation of web forms as needed.

E- Signature Adoption – Priority E-signature functionality for internal and external documents needed.

Standard language and formatting will be used.

Support for the submission of forms requiring multiple signatures using save-and-print capabilities to web forms or route documents to other CARDS users.

Online Payment Portal & Financial System Integration – Priority The primary financial functions that WCS performs involve accounts receivables and payment processing related to the collection of fines and penalties. CARDS and web portal must support fiscal business functions within WCS, including:

Integrate/build a secure online payment feature to route users to Nevada’s preferred online payment portal Wells Fargo to make online payments for assessments, fines and penalties and accept credit cards, debit cards, and eChecks.

View payment invoicing.

Send invoice documents.

Track all payments, types of payments, and accounts.

More Robust Report Functions for External Stakeholders – Priority Industry reports available to Insurers and TPAs will be enhanced by adding new reports or making existing reports more robust.

Insurers/TPAs will be able to flexibly design and create reports based on needs.

NAICS Code Field Addition for Indexing – Priority A single mandatory field will be added for NAICS Code used in the indexing process located on the Employer Section of the D-38 claims indexing form used by internal and external users via the web portal.

D- 35 Request for a Assignment of Rating Physician or Chiropractor Physician Process Automation – Priority Automate the D-35 process to allow insurers/TPAs to submit the D-35 forms online and randomly assign the next physician/chiropractor physician.

Development of a web form allowing external users to submit data and documents electronically.

External users can check on their request status.

Same functionality as the D-38 process allowing for creation/rejection/correction transactions.

Electronically link the D-35 request to the indexed claim in CARDS through the D-38 process. Submittal cannot be executed if a D-38 has not been indexed in CARDS.

Human error capabilities incorporated to detect errors prior to submission and use mandatory fields as needed.

Support data export of reports in multiple formats.

Web form will be easily updatable as requirements change.

Software Application for Reporting Functionality Integrate Yellowfin Embedded BI platform or similarly capable application for reporting.

All fields will be reportable.

Internal users will be able to select the desired data elements to be display in a report.

Internal users will be able to create interactive operational dashboards displaying desired analytic information.

Exporting reports in multiple formats will be standard.

Internal users will easily create multiple types of charts to visualize report data.

Internal users will easily be able to format how report information is displayed.

Reports will be filtered with the desired data in multiple ways.

Reports can be drilled down.

Report modifications will be easily executed as requirements may change over time.

Internal users will be able to link together and report data from various tables in the database, for example:

Workers’ compensation claims.

Complaints.

Cases (investigations/audits).

Employers.

Insurers.

TPAs.

Medical providers; and Violations/fines/penalties/actions.

Statistical data will be generated from the system, e.g., record counts, summations, averages, etc.

Enable reporting on historical trends based on user defined criteria.

Publish reports so that other individuals can view them.

CARDS Internal Enhancements Implement enhancements to CARDS functionality which impacts the efficiency and user experience for WCS staff.

Enable the generation of forms used offline or generated from Sputnik like below (not all inclusive).

State Action Letters for non-cancellation list cases Stop Work Order Intent to Issue a Stop Work order Moratorium Letter Notice of Corrections Account Statement form for debtors after WCS receives payment Generated forms can be saved directly to the documents section.

Form templates will easily be created and modified as needed.

Incorporate staff dashboard layout changes like adding columns for business name and address and closed Monetary Assessments/NC determinations on determinations dashboard.

Addition of needed fields or column displays to capture/display important data.

Multiple site visit dates (Investigation Results).

Multiple violation dates (Monetary Assessment - only allows one date for form generation).

Audit Start Date (Audit).

Prior Investigations conducted (Employer screen).

Capture NRS subsections (Determination screen).

Add column to show NRS subsection (Determination/Employer Determination screens).

Add column to show if adjustments were made yes/no and adjustment reason (Determination screens).

C-4 email address to be displayed on Coverage Verification System inquiry for external users.

Enable date formatting to allow a single digit entry for day/month and two-digit entry for year. Date display would still be xx/xx/xxxx.

Incorporate Payment History screen changes to view all payments issued, paid or sent to collections on 1 page.

Internal users will have the choice to create an investigation at the same time a new ticket is generated.

Historical data integrity shall not be lost when a user is deactivated.

Search functionality parameters will be expanded to return words containing abbreviations, misspellings, dashes, or commas.

Document storage functionality enhancements.

Increase the allowed size of file uploads beyond 10mb to 100mb.

Allow zip files to be uploaded.

Allow for several files to be uploaded in a single transaction with different descriptions or types.

Add more document types in drop down menu like (not all inclusive).

a. AUD Claim file

b. AUD Notice of Correction letter

c. AUD Emails/Correspondence

d. ECU Emails/Correspondence

e. AUD selected claims list

f. AO/HO Hearing/Appeal notice

g. Legal Memo

h. AUD legal business entity info Note functionality enhancements.

Spell check and grammar capabilities.

Note button will be added at the top of the notes page.

Centralize notes and documents into one location for easy viewing and uploading while keeping current functionality.

Data entry will be improved by auto-generating duplicate data where applicable so users can skip inputting data multiple times.

Incorporate address auto-complete allowing the user to manually select a complete address after entering a few values. The address will not automatically populate unless selected by the user.

Internal user dashboard layout flexibility.

Internal user to be able to choose columns showing in their “My Work” dashboard instead of pre-determined fixed columns. Headers would be determined based on applicable workload parameters.

Implement and maintain a transaction activity log.

Track on all users logging in/out.

Track all changes made to the database.

Integrate CLEAR investigation software, through CARDS, to allow authorized internal staff to locate information regarding businesses and business owners.

Authorized users will be able to search by any data field defined as searchable during the requirements phase. (All such identified data entered in CARDS should be searchable).

Users will be able to configure "alerts" based on dates, timeframes, task dependencies, etc.

Incorporate functionality from existing WCS custom applications where possible like DTapps and Sputnik.

Data table footer will allow the user to navigate to a particular page number.

Insurer/TPA Audit Process Automation Automate the insurer/TPA audit process.

Expand CARDS features to enable the requesting of documents from Insurers.

Send notifications to insurers of the auditing process.

Incorporate the development of a web form allowing Insurers/TPAs to submit documents electronically.

Support the data export of reports.

SECURITY STANDARDS

System shall meet or exceed all applicable Nevada Revised Statutes (NRS), Nevada Administrative Code (NAC), State Information Security Program Policy, and State and Department Security Standards related to product or service being required/provided.

State Security Policy Standards can be found at: https://it.nv.gov/Governance/Security/State_Security_Policies_Standards___Procedures/ CARDS must meet State security standards for transmission of personal information as outlined in NRS 205.4742 and NRS 603A.

Protection of sensitive information will include the following:

Sensitive information in existing legacy applications will encrypt data as is practical.

Confidential Personal Data will be encrypted whenever possible.

Sensitive Data will be encrypted in all newly developed applications.

All information technology services and systems developed or acquired by agencies shall have documented security specifications that include an analysis of security risks and recommended controls (including access control systems and contingency plans).

Security requirements shall be developed at the same time system planners define the requirements of CARDS. Requirements must permit updating security requirements as new threats/vulnerabilities are identified and/or new technologies implemented.

Security requirements and evaluation/test procedures shall be included in all solicitation documents and/or acquisition specifications.

CARDS developed by either internal State or contracted system developers shall not include back doors, or other code that would cause or allow unauthorized access or manipulation of code or data.

Security specifications shall be developed by the system developer for approval by the agency owning CARDS at appropriate points of CARDS development or acquisition cycle.

All CARDS development projects must include a documented change control and approval process and must address the security implications of all changes recommended and approved to a particular service or system. The responsible agency must authorize all changes.

CARDS applications and information that become obsolete and no longer used must be disposed of by appropriate procedures. The application and associated information must be preserved, discarded, or destroyed in accordance with Electronic Record and Record Management requirements defined in NRS and NAC 239, Records Management.

Software development projects must comply with State Information Security Consolidated Policy 100, Section 4.7, Software Development and Maintenance and State Standard 131, “Security for System Development”.

Separate development, test and production environments must be established on State systems.

Processes must be documented and implemented to control the transfer of software from a development environment to a production environment.

Development of software and tools must be maintained on computer systems isolated from a production environment.

Access to compilers, editors and other system utilities must be removed from production systems.

Controls must be established to issue short-term access to development staff to correct problems with production systems allowing only necessary access.

Security requirements and controls must be identified, incorporated in and verified throughout the planning, development, and testing phases of all software development projects. Security staff must be included in all phases of the System Development Lifecycle (SDLC) from the requirement definitions phase through implementation phase.

REQUIREMENTS MATRIX OVERVIEW

Vendor shall:

Present the platform requirements for efficient operation of CARDS.

Review Requirements Matrix carefully to ensure proposed system design addresses all requirements Tie each data element/function to Vendor project plan by task number Respond to all requirements by properly coding and indicating how requirement is satisfied Proposed costs and project plan shall reflect effort needed to satisfy requirements Identify whether each requirement is in price included within the cost proposal Describe how proposed system meets requirements specified within this solicitation Identify whether each requirement is in the firm fixed price included within the cost proposal.

Describe how the proposed CARDS meets the requirements specified within this RFP.

Identify, for each system requirements identified in Requirements Matrix, whether it is:

SCOPE OF WORK

The scope of work is broken down into tasks, activities, and deliverables. The tasks and activities within this section are not necessarily listed in the order that they shall be completed. Vendor shall reflect within their proposal and preliminary project plan their recommended approach to scheduling and accomplishing all tasks and activities identified within this solicitation.

All tasks performed by the awarded vendor may be reviewed by the QA monitor as well as State staff.

VENDOR RESPONSE TO SCOPE OF WORK

Within the proposal, Vendor shall provide information regarding their approach to meeting requirements described herein.

If subcontractors shall be used for any tasks, Vendor shall indicate what tasks and the percentage of time subcontractor(s) shall spend on those tasks.

Vendor response shall be limited to no more than five (5) pages per task not including appendices, samples and/or exhibits.

DELIVERABLE SUBMISSION AND REVIEW PROCESS

Once the detailed project plan is approved by the State, the following subsections detail the process for submission and review of deliverables during the life of the project/contract.

General

The contractor shall provide one (1) master pdf soft copy to the appropriate State Project Manager as identified in the contract.

Once a deliverable is approved and accepted by the State, the contractor shall provide an electronic copy. The State may, at its discretion, waive this requirement for a particular deliverable.

The electronic copy shall be provided in software currently utilized by the agency or provided by the contractor.

Deliverables shall be evaluated by the State utilizing mutually agreed to acceptance/exit criteria.

Deliverable Submission

Prior to development and submission of each contract deliverable, a summary document containing a description of the format and content of each deliverable shall be delivered to the State Project Manager for review and approval. The summary document shall contain, at a minimum, the following:

Cover letter Table of Contents with a brief description of the content of each section Anticipated number of pages Identification of appendices/exhibits The summary document shall contain an approval/rejection section that can be completed by the State. The summary document shall be returned to the contractor within a mutually agreed upon time frame.

Deliverables shall be developed by the contractor according to the approved format and content of the summary document for each specific deliverable.

At a mutually agreed to meeting, on or before the time of delivery to the State, the contractor shall provide a walkthrough of each deliverable.

Deliverables shall be submitted no later than 5:00 p.m., per the approved contract deliverable schedule and shall be accompanied by a deliverable sign-off form with the appropriate sections completed by the contractor.

Deliverable Review

General

The State’s review time begins on the next working day following receipt of the deliverable.

The State’s review time shall be determined by the approved and accepted detailed project plan and the approved contract.

The State has up to five (5) working days to determine if a deliverable is complete and ready for review. Unless otherwise negotiated, this is part of the State’s review time.

Any subsequent deliverable dependent upon the State’s acceptance of a prior deliverable shall not be accepted for review until all issues related to the previous deliverable have been resolved.

Deliverables determined to be incomplete and/or unacceptable for review shall be rejected, not considered delivered and returned to the contractor.

After review of a deliverable, the State shall return to the contractor the project deliverable sign-off form with the deliverable submission and review history section completed.

Accepted

If the deliverable is accepted, the original deliverable sign-off form signed by the appropriate State representatives shall be returned to the contractor.

Once the contractor receives the original deliverable sign-off form, the State can then be invoiced for the deliverable.

Comments/Revisions Requested by the State. If the State has comments and/or revisions to a deliverable, the following shall be provided to the contractor:

The original deliverable sign-off form with an updated entry to the deliverable submission and review history section.

Attached to the deliverable sign-off form shall be a detailed explanation of the revisions to be made and/or a marked-up copy of the deliverable.

The State’s first review and return with comments shall be completed within the times specified in the contract.

The contractor shall have five (5) working days, unless otherwise mutually agreed to, for review, acceptance and/or rejection of the State’s comments.

A meeting to resolve outstanding issues shall be completed within three (3) working days after completion of the contractor’s review or a mutually agreed upon time frame.

Agreements made during meetings to resolve issues shall be documented separately.

Once an agreement is reached regarding changes, the contractor shall incorporate them into the deliverable for resubmission to the State.

All changes shall be easily identifiable by the State.

Resubmission of the deliverable shall occur within five (5) working days or a mutually agreed upon time frame of the resolution of any outstanding issues.

The resubmitted deliverable shall be accompanied by the original deliverable sign-off form.

This review process continues until all issues have been resolved within a mutually agreed upon time frame.

During the re-review process, the State may only comment on the original exceptions noted.

All other items not originally commented on are considered accepted by the State.

Once all revisions have been accepted, the original deliverable sign-off form signed by the appropriate State representatives shall be returned to the contractor.

The contractor shall provide one (1) updated and complete master paper copy of each deliverable after approval and acceptance by the State.

Once the contractor receives the original deliverable sign-off form, the State can then be invoiced for the deliverable.

Rejected, Not Considered Delivered. If the State considers a deliverable not ready for review, the following shall be returned to the contractor:

The original deliverable sign-off form with an updated entry to the deliverable submission and review history section.

The original deliverable and all copies with a written explanation as to why the deliverable is being rejected, not considered delivered.

The contractor shall have five (5) working days, unless otherwise mutually agreed to, for review, acceptance and/or rejection of the State’s comments.

A meeting to discuss the State’s position regarding the rejection of the deliverable shall be completed within three (3) working days after completion of the contractor’s review or a mutually agreed upon time frame.

Resubmission of the deliverable shall occur within a mutually agreed upon time frame.

The resubmitted deliverable shall be accompanied by the original deliverable sign-off form.

Upon resubmission of the completed deliverable, the State shall follow the steps outlined herein.

PROJECT KICKOFF MEETING. A project kickoff meeting shall be held with representatives from the State and the contractor after contract approval and prior to work performed. Items to be covered in the kickoff meeting shall include, but not be limited to:

Deliverable review process.

Determining format and protocol for project status meetings.

Determining format for project status reports.

Setting the schedule for meetings between representatives from the State and the contractor to develop the detailed project plan.

Defining lines of communication and reporting relationships.

Reviewing the project mission.

Pinpointing high-risk or problem areas.

Issue resolution process.

PLANNING AND ADMINISTRATION

Objective. The objective of this task is to ensure that adequate planning and project management are dedicated to this project.

Activities. The awarded vendor shall:

Work with the State to provide a detailed project plan with fixed deadlines to include, but not be limited to:

Project schedule including tasks, activities, activity duration, sequencing and dependencies Project work plan for each deliverable, including a work breakdown structure Completion date of each task Project milestones Entrance and exit criteria for specific project milestones Project organization including a resource plan defining roles and responsibilities for the awarded vendor, subcontractors (if applicable) and State

Attend and participate in all project related meetings requested by the State at a location to be determined by the State. Attendance may be in person or via video conferencing, as mutually agreed to by the project team. These meetings shall follow an agenda mutually developed by the awarded vendor and the State. The awarded vendor shall prepare materials or briefings for these meetings as requested by the State. Minutes shall be taken and distributed by State staff within five (5) working days after the meeting. Minutes may be distributed via facsimile or email. The agenda may include, but not be limited to:

Review and approval of previous meeting minutes Contractor project status State project status Contract status and issues, including resolutions Quality Assurance status New action items Outstanding action items, including resolutions Setting of next meeting date Other business

Provide written semi-monthly project…