MassHealth Provider Operations Business Support Services RFR - Q and A.docx

COMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

ONE ASHBURTON PLACE, 11TH FLOOR

BOSTON, MASSACHUSETTS 02108

QUESTIONS AND ANSWERS

regarding the

REQUEST FOR RESPONSES

FOR THE

MASSHEALTH PROVIDER OPERATIONS BUSINESS SUPPORT SERVICES

Document #: 26EHSPMMHPROBSS Q & A Issued: June 1, 2026 This document contains responses to questions received regarding the MassHealth Provider Operations Business Support Services Request for Response (RFR) issued by the Executive Office of Health and Human Services (EOHHS) on April 24, 2026. Answers have been provided to those questions which are of general interest and relevant to the preparation of a Response to the RFR.

Q.1. For this bid, are you able to bid on certain portions or is it all in bid?

A.1. EOHHS anticipates entering into a Contract with a single selected Bidder for the services described in the RFR and Attachment A. Except for the optional Health Plan Comparison Tool, currently known as MassHealth Choices, Bidders should propose to perform the full required scope. Bidding on the Health Plan Comparison Tool is optional and may be included at the Bidder’s discretion.

Q.2. Is there a preference for local vendors?

A.2. No. All Bidders will be evaluated in accordance with the criteria set forth in the RFR.

Q.3. Can the vendor provide entire services from offshore location (outside US geography)?

A.3. No. As specified in Appendix C (Data Management and Confidentiality Agreement), access to or storage of Protected Information (PI) outside of the United States is not permitted without prior written authorization from EOHHS.

Q.4. We request a 1-2 week extension of the proposal submission deadline.

A.4. EOHHS will extend the deadline until Monday, June 22, 2026, 5:00 P.M., Eastern Time. See BSS RFR Amendment 1.

Q.5. Referencing Section 1.1 of the RFR, “MassHealth also partners with a network of approximately 120,000 providers.” Please confirm if this represents unduplicated provider count and the same should be used for pricing?

A.5. The approximately 120,000-provider figure represents an unduplicated provider count and is provided as a general operational reference and should not be treated as the sole pricing baseline. Bidders should refer to Attachment C – Reference Materials (Amended BSS Average Monthly Volume) data, RFR requirements, and their own assumptions when developing pricing.

Attachment C: Reference Materials of the RFR consist of seven supporting documents, including provider application materials, provider type information, and BSS volume data, as listed below:

1. Provider Types PTs

2. Provider Application Cover Letter and Checklist – Independent Clinic

3. Provider Application – Independent Clinic

4. Provider Application Cover Letter and Checklist – Medical Practitioner

5. Provider Application – Medical Practitioner

6. Provider Application and Contract Ordering, Referring, and Prescribing ORP

7. Amended BSS Average Monthly Volume Q.6. Section 1.2 of the Business Support Services RFR references “Attachment C” as containing operational data and information to support bidder responses. Please confirm our understanding that Attachment C refers to the Reference Materials provided with the RFR.

A.6. Yes. Attachment C refers the Reference Material documents titled as follows at the COMMBUYS link for the RFR:

1. Provider Types PTs

2. Provider Application Cover Letter and Check List – Independent Clinic

3. Provider Application - Independent Clinic

4. Provider Application Cover Letter and Check List – Medical Practitioner

5. Provider Application – Medical Practitioner

6. Provider Application and Contract Ordering Referring and Prescribing ORP

7. Amended BSS Average Monthly Volume.

See also “BSS RFR - Bidders Conference Presentation.pdf,” Slide 17: “RFR Structure and Key Attachments,” which provides additional context regarding the procurement structure and supporting materials.

Q.7. In RFR Section 2.1.19 notes the vendor is to provide a plan comparison tool for members if included in the bidder’s response. Please clarify the intended integrations and source system(s) for vendor access to plan information.

A.7. The Health Plan Comparison Tool, currently known as MassHealth Choices, is an optional component of this procurement. Bidders proposing this functionality should assume that the solution will be required to integrate with MMIS and other applicable EOHHS systems to obtain and display information necessary to support plan comparison. Specific source systems, interfaces, data elements, and integration requirements will be finalized during implementation.

Q.8. We note that the RFR, Section 2.4, identifies an anticipated Contract Effective Date of October 1, 2026, and an anticipated Operational Start Date of July 1, 2027, which implies an approximate 9-month implementation (DDI) period. However, in Attachment A – Model Contract (page 42), the document states that the contract, “anticipates nine (9) to twelve (12).” Please confirm the implementation months.

A.8. The RFR identifies an anticipated Contract Effective Date of October 1, 2026, and an anticipated Operational Start Date of July 1, 2027, which represents approximately nine months. Attachment A contemplates a nine-to-twelve-month implementation period. Bidders should propose an implementation plan that supports the anticipated Operational Start Date while identifying assumptions, dependencies, risks, and any proposed mitigation strategies.

Q.9. RFR Section 5 (Instructions for Submission) – “Alterations,”. May a Bidder propose exceptions or redlines to the RFR documents (e.g., Attachment A Model Contract or Attachment C Data Management and Confidentiality Agreement?).

A.9. Bidders are expected to accept the RFR documents without substantive change, but limited, non-substantive exceptions or redlines may be made after award by mutual agreement of the parties.

Q.10. RFR Section 5.2.A.6 Organizational Overview. Please confirm the Bidder’s organizational chart does not require listing the subsidiaries of its parent company A.10. The Bidder’s organizational chart should be sufficient to identify key organizational officers, reporting relationships, relevant subsidiary relationships, and subcontractors. The chart need not list every subsidiary of a parent company if those subsidiaries are not relevant to the proposed Contract.

Q.11. RFR Section 5.2.H Required Forms and Certifications. If the Cover Letter should be located at the beginning of the Business Response section, please confirm Bidders can number Required Forms and Certifications as 5.2.G.

A.11. Bidders should follow the RFR numbering and headings as closely as possible. Required Forms and Certifications should be submitted under the RFR section heading applicable to those materials.

Q.12. Section 5.3 Programmatic Response, Section G. Detailed Response Questions Will EOHHS increase the 3-page limit for each question?

A.12. No.

Q.13. Section 5.3 Programmatic Response, Section C.1-7 Approach Narrative. How should the Bidder address items 1-7 in response to Section 5.3.C?

A.13. Bidders should address the items identified in Section 5.3.C, items 1–7, within the Approach Narrative. Section headings and numbering should only be included as applicable and helpful to the narrative (e.g. to explain the approach to a particular portion of the model contract).

Q.14. RFR Section 5.3.A.1 Bidder experience with Medicaid and similar organizations – Items 1 and 3. Please confirm Bidders may provide the most relevant sampling of their projects meeting this requirement as we have over 50 active projects meeting this requirement.

A.14. Bidders should provide information responsive to the RFR within the applicable page limit. Bidders may focus the narrative on the most relevant projects, including a relevant sampling, but the response should provide enough information for EOHHS to evaluate the Bidder's experience.

Q.15. . RFR Section 5.3.D Project Plan. Based on the 5-page limit, please confirm Bidders may provide a high-level Project Plan with major milestones and tasks in the narrative and include the comprehensive Project Plan as an attachment should the plan exceed 5 pages.

A.15. Bidders should provide the comprehensive Project Plan within the stated five-page limit. Bidders may use summary-level milestones and tasks if needed to stay within the page limit. Bidders should not include the Project Plan as an attachment.

Q.16. RFR Section 5.3.E Bidder’s Organization – Item 1 and 3. Please confirm Bidders can submit one comprehensive planned organizational chart noting Key Personnel and any Material Subcontractor with roles and responsibilities rather than two separate charts showing the same information.

A.16. Bidders may provide one comprehensive planned organizational chart if it clearly identifies Key Personnel, reporting relationships, material subcontractors, functional responsibilities, and any responsibilities assigned to subcontractors.

Q.17. RFR Section 5.3.G.7 Provider Materials. Please confirm the Attachment A referenced section number is 3.2.K as the attachment does not include Section 3.2.11.

A.17. The reference to Attachment A Section 3.2.11 is a typo; the appropriate reference is to Section 3.2.K. See BSS RFR Amendment 1.

Q.18. RFR Section 5.3.G.16 Health Plan Comparison Tool. Is the optional Health Plan Comparison Tool part of the programmatic response evaluation?

A.18. The Health Plan Comparison Tool is optional. If a Bidder proposes to provide that functionality, EOHHS will evaluate the Bidder's response to that optional section as part of the programmatic evaluation. Bidders who do not respond will not be evaluated on this section.

Q.19. RFR Section 5.3.G.16 Health Plan Comparison Tool. Is the optional Health Plan Comparison Tool part of the cost evaluation?

A.19. The Health Plan Comparison Tool is optional. Bidders are required to respond to this section only if they propose to provide that functionality. If a Bidder proposes to provide that functionality, the Bidder should include the associated costs in the Cost Response Workbook as instructed, and EOHHS may consider those costs in evaluating the optional functionality. Bidders that do not propose the optional functionality should not include costs for it.

Q.20. RFR Section 5.3.G. Please confirm the Attachment A referenced section number in Section 5.3.G. is 4.0 as the attachment does not include Section 4.1.

A.20. The Health Plan Comparison Tool requirements are set forth in Attachment A Section 4.0, MassHealth Choices – Health Plan Comparison Tool. See BSS RFR Amendment 1.

Q.21. Subcontractor experience treatment, Section 6.1 of the RFR. Will EOHHS consider subcontractor experience and qualifications in evaluating the bidder’s demonstrated ability to perform BSS functions, and may a bidder refine subcontractor roles during negotiations or implementation, subject to EOHHS approval, provided the bidder identifies material subcontractors and proposed responsibilities in its response?

A.21. The prime Bidder remains responsible for Contract performance. EOHHS may consider the experience and qualifications of Material Subcontractors as part of the evaluation of the Bidder's response, where relevant to the proposed Contract responsibilities. Subcontractor roles may be refined only with EOHHS approval and consistent with Contract requirements. See Attachment A, Section 3.11.D.1.

Q.22. Business Support Services RFR document, Section 7.18 Public Records states that “All responses and related documents submitted in response to this RFR are public records and are subject to the Massachusetts Public Records Law, M.G.L. c. 66, § 10 and M.G.L. c. 4, § 7 subsection 26. Any statements in submitted responses that are inconsistent with these statutes will be disregarded, including but not limited to marking by bidders of information as confidential during the quote submission process in COMMBUYS.” Please confirm the Bidder may mark items as confidential and provide a separate redacted version of the response.

A.22. Responses and related documents submitted in response to the RFR are subject to the Massachusetts Public Records Law, M.G.L. c. 66, § 10, and M.G.L. c. 4, § 7, clause 26EOHHS will respond to any public records request in accordance with applicable law.

Q.23. RFR Section 7.21(Program Modifications & New Initiatives) Could EOHHS please clarify how future scope changes or new initiatives would be handled under the contract? For example, if there are significant program additions or material volume changes, would those be addressed through change orders or negotiated amendments with corresponding pricing and schedule adjustments? Understanding this process would help bidders better assess and manage the risk of unbounded scope expansion.

A.23. Future scope changes, new initiatives, material program changes, significant volume changes, or changes required by law, regulation, settlement, judicial order, CMS requirement, or Commonwealth initiative will be handled in accordance with the Contract, including Section 7.3 of Attachment A. Section 7.3 requires EOHHS to provide written notice and requires the parties to negotiate in good faith to implement changes proposed by EOHHS. Section 7.3 also reserves EOHHS’s rights, at its discretion and subject to appropriate approvals, to modify, increase, reduce, terminate, or amend activities under the Contract to address program modifications, new initiatives, legal requirements, judicial orders, settlement agreements, or state or federal initiatives affecting EOHHS or the Contract.

Q.24. Attachment A BSS Model Contract, Section 3.1.D.2.c-f Key Personnel, please confirm Bidders may use the term “Lead” rather than “Staff” for Key Personnel where the Key Personnel descriptions indicates a level of responsibility commensurate with a lead position:

A.24. Bidders may use titles such as “Lead” where appropriate, provided the proposed roles satisfy the Key Personnel responsibilities, qualifications, availability, accountability, and reporting requirements described in Attachment A. Use of an alternative title does not reduce or modify the required responsibilities.

Q.25. Attachment A, Section 3.1.F.1.d Business Infrastructure. Does EOHHS have additional data to provide related to Call Center volume?

A.25. EOHHS has provided the available CY2025 operational volume information in Attachment C – Reference Materials (Amended 7.BSS Average Monthly Volume). Please refer to Responses Q5 and Q6 for additional details regarding Attachment C - Reference Materials.

Q.26. In the Model Contract - Pg 52, Section 3.1.F.2.b.vii., please further clarify the State licensure, certification or inspection databases that are in use today? Additionally, please clarify the technological methods of access available to these system(s).

A.26. EOHHS currently utilizes a combination of federal and state databases to support provider screening, verification, licensure, certification, exclusion, and inspection activities.

Federal database checks include:

· SSA Death Master File

· HHS OIG List of Excluded Individuals and Entities (LEIE)

· GSA System for Award Management (SAM)

· Adverse Actions Report

· CMS Medicare Exclusion File (MedFile)

· National Plan and Provider Enumeration System (NPPES)

State-specific database checks include:

· Department of Industrial Accidents – Debarment List

· Division of Health Professionals Licensure Verification (DHPLLV)

· Massachusetts Board of Registration in Medicine (BORIM)

· Massachusetts Division of Professional Licensure (DPL)

· Secretary of the Commonwealth – Corporations Division

Access methods vary by system and may include web portal access, online search tools, file-based verification, and/or system-to-system integrations, depending on the capabilities and requirements of each database.

Q.27. Attachment A BSS Model Contract, Section 3.1.F.2.b Information System. What are the specific data elements and/or interface layouts and requirements the bidder should be prepared to support to meet this requirement?

A.27. Bidders should propose a solution capable of secure data exchange with the systems identified in Attachment A and Appendix G. Specific data elements and interface layouts will be finalized during implementation and through EOHHS-approved interface and integration processes.

Q.28. Attachment A, Section 3.1.F.2.b.ii., notes the Contractor must have the ability to access and utilize data with the POSC system that is accessed for "certain electronic transactions". Would MassHealth please further clarify what functions providers perform within the POSC and how this may complement functions supported by the Contractor?

A.28. MassHealth providers currently utilize the Provider Online Service Center (POSC) to perform a variety of provider-facing administrative and claims-related functions, including:

· Direct Data Entry (DDE) claims submission for providers approved for an electronic claims’ waiver

· Upload of EDI 837 batch transactions, including approved 90-day bypass submissions for authorized waiver requests

· Access to certain electronic transactions and provider self-service functions available through the POSC portal

In support of these activities, the contractor will be responsible for performing operational support functions related to Direct Data Entry (DDE) claims processing and EDI upload activities associated with approved 90-day waiver batch submissions. See Attachment A, Sections 3.4.A, 3.4.B, and 3.4.D.

These functions complement the services supported by the Contractor by enabling providers to directly interact with MassHealth systems for select administrative and claims submission activities, while the Contractor would support broader provider operations, business services, and related workflow processes as defined in the RFR and Model Contract. See RFR Section 2.1 and Attachment A, Sections 3.2 through 3.5.

Q.29. Attachment A - BSS Model Contract, Section 3.2.A and Appendix G - Medicaid Enterprise Technical Requirements - Can the State clarify the State’s intended direction for the Provider Services Module system. Does the State plan to retain the existing POSC system, or, as referenced in Attachment A – 3.2.A and Appendix G-3b, is the State seeking to replace it with a solution that provides a self-service provider portal with configurable workflows as part of the modernization of Provider Module Services?

A.29. Yes, EOHHS is intendent to retain existing POSC system. EOHHS expects the proposed solution to support provider operations workflows, provider self-service capabilities, and configurable workflow functionality consistent with the requirements described in the RFR, Attachment A, and Appendix G.

EOHHS anticipates continued evolution and modernization of Provider Services Module capabilities, including provider portal functionality and workflow automation. The selected Contractor’s solution may be required to integrate with, complement, enhance, and/or support existing POSC functionality based on EOHHS operational and technical requirements during implementation and throughout the Contract term.

Q.30. Appendix G Medicaid Enterprise Technical Requirements for the MassHealth Provider Services Module Replacement and Attachment A BSS Model Contract, 3.2.B Provider Enrollment, Credentialing and Onboarding – Item 1.b. As a clarification, is the Appendix G document title reference to a Provider Services Module Replacement intended to be the same solution as the Attachment A automated system to support the provider enrollment process and the 3.2.A reference to a Provider Portal?

A.30. Yes, Appendix G’s Provider Services Module Replacement requirements should be read together with Attachment A’s requirements for an automated provider enrollment system and Provider Portal.

Q.31. We understand this RFR requires vendors to include provider systems needed to perform the services outlined in the RFR and to be a CMS-certified, pre-developed solution including Provider Enrollment, Provider Screening, Provider Data Management, Self-Service Portal, and Provider Universal Credentialing, is that correct?

A.31. Bidders should propose the systems, tools, workflows, and services necessary to perform the functions described in the RFR, Attachment A, and Appendix G. Bidders should not assume that EOHHS requires a specific pre-developed or CMS-certified product unless expressly stated in the RFR or Attachment A.

Q.32. Attachment A, Section 3.2.B.1 Provider Enrollment – Item d, Pg. 68 Please confirm that only provider types included in Attachment C – Reference Materials (1.Provider Types PTs) are in scope for this RFR.

A.32. The Provider Types PTs document includes the current provider types; EOHHS may modify provider types over the course of the contract.

Q.33. RFR Attachment A (Model Contract), Section 3.2(F–H). Could EOHHS please clarify the division of responsibility between the Commonwealth and the contractor for data conversion and systems integration? For example, if a new provider system is introduced, would the Commonwealth provide legacy data extracts or integration support, or would the contractor be expected to independently migrate historical data and interfaces? Additional clarity on available EOHHS support, such as MMIS connectivity or data migration tools, would help us better assess transition risk.

A.33. Yes, Commonwealth will provide legacy data extract or integration support. Data conversion and systems integration responsibilities will be finalized during implementation, in accordance with Attachment A, Sections 3.2.F through 3.2.H, and Appendix G.

Q.34. Attachment A, 3.3.B. 1.d Mail Services & Fulfillment - Can the State provide a 1 yr historical monthly postage expense related to all mailroom outbound USPS delivered communications as noted in this section?

A.34. As set forth in Attachment A, Section 5.5.B EOHHS will provide sufficient postage to support mailings in accordance with Attachment A, Section 3.3.B.

Q.35. Referencing Attachment A, Section 3.4.B, for mail/scanning scope is the contractor processing all mail for 120K in-scope providers?

A.35. Yes. Bidders should assume that mail, scanning, imaging, indexing, and document management scope includes provider-related correspondence and materials described in Attachment A, including but not limited to enrollment, revalidation, claims-related, returned mail, fulfillment, provider communication, and operational support documents.

Q.36. Attachment A, Section 3.3.C.6.c Document Management, what is the required retention period for the paper files?.

A.36. For paper claims, Attachment A, Section 3.4.A requires retention in accordance with the statewide records retention schedule or other applicable state or federal law or regulations, whichever is longer, and requires paper claims submissions to be retained on site for 60 Calendar Days.

Q.37. Attachment A, Section 3.4, what is the monthly average volume of paper claims to be processed that are in scope for this contract?

A.37. Please see Amended BSS Average Monthly Volumes, Section 2.b.i (monthly average of 40 paper claims).

Q.38. Attachment C – Reference Materials (Amended BSS Average Monthly Volume) provides volumes for specific Provider waiver claims. Can you please provide confirmation and further descriptions on waiver claims to be processed?

A.38. Waiver claims include provider claims-related activities requiring review, tracking, support, routing, processing, or coordination consistent with MassHealth policy and Attachment A, Section 3.4.

Q.39. For paper claims processing, Attachment A, Section 3.4, are you intending to procure a new system in addition to the services outlined? If not, what system will be utilized, and can we receive major system components and workflow information?

A.39. EOHHS is not separately procuring a new paper claims processing system. MMIS is expected to remain the claims adjudication system of record. The Contractor will be expected to perform paper claims operational functions described in Attachment A, Section 3.4, including direct date entry into MMIS, which is the system of record. Available paper claims volume information is provided in Attachment C, Reference Materials, Amended BSS Average Monthly Volume and Attachment A, BSS Model Contract.

Q.40. Can the State confirm the format and transmission method the State will use to provide legacy provider data for vendor ingestion, along with any data quality processes that will be completed prior to delivery?

A.40. EOHHS anticipates that legacy provider data required to support Contract operations will be provided through secure transmission methods and in industry-standard electronic formats appropriate to the applicable data type, interface, operational workflow, and technical environment.

Q.41. Claims operations scope and system of record. For claims operations, Attachment A, Section 3.4 should bidders assume that MMIS remains the system of record and claims adjudication system, with the Contractor providing operational support including DDE, paper claims processing, claims attachments, voids/adjustments, trading partner support, 90-day waiver review, TPL/COB support, and monitoring? Could EOHHS also confirm which categories of Medicaid claims are within the BSS contractor’s claims operations support scope, specifically whether MCO encounter data processing, pharmacy claims, dental claims, and behavioral health claims operations are within scope or are handled by separate contractors or modules?

A.41. MMIS remains the system of record. The Contractor's claims operations scope is the operational support described in Attachment A Section 3.4, including DDE paper claims, paper-claim voids, electronic claims submitter support, EDI testing and trading partner support, TPL/COB support, 90-day waiver review, claims monitoring, and related reporting and outreach.

Q.42. Could EOHHS confirm which categories of Medicaid claims are within the BSS contractor’s claims operations support scope, specifically whether MCO encounter data processing, pharmacy claims, dental claims, and behavioral health claims operations are within scope or are handled by separate contractors or modules?

A.42. Bidders should not assume responsibility for MCO encounter data processing, pharmacy claims processing, dental claims processing, or behavioral health claims operations except to the extent expressly included in Attachment A or directed by EOHHS.

Q.43. In Attachment A, Section 3.8 Non-Emergency Transportation Authorization (NETA) and RFR Section2.1.18 Procurement Purpose, notes responsibility for responding to Non-Emergency Transportation Authorization (NETA) requests. Would MassHealth please clarify if the chosen vendor is responsible for adjudication of request per MassHealth policy, or a conduit for receipt to the request and funneling to another department?

A.43. The Contractor is responsible for NETA operational processing as described in Attachment A, Section 3.8. This includes supporting the receipt, processing, tracking, and authorization processing workflow for PT-1 transportation requests in accordance with MassHealth regulations, EOHHS requirements, and EOHHS-approved protocols. The Contractor will be adjudicating the PT-1 request, not referring it to another department.

Q.44. Attachment A, Section 3.8, Non-Emergency Transportation Authorization (NETA) For NETA, should bidders assume responsibility for both the technology/system capability and the operational adjudication of PT-1 transportation authorization requests, including member and provider notices, broker coordination, member/provider self-service status tracking, reporting, and appeal support? Does the incumbent currently operate a Transportation Management and Reporting System that the successor Contractor will receive, or is the Contractor expected to provide replacement technology?

A.44. Bidders should assume responsibility for NETA operational support and related technology capabilities described in Attachment A, Section 3.8, including processing and tracking PT-1 requests, notices, broker and HST transparency, provider and member self-service status functions, reporting, and appeal support. Bidders should propose a flexible approach capable of supporting NETA operations and integration with applicable EOHHS systems. Bidders should not assume access to, or transfer of, any incumbent proprietary system unless EOHHS expressly provides otherwise.

Q.45. Attachment A, Section 3.8 Non-Emergency Transportation Authorization (NETA) For the NETA requests, would you please outline the key components of the workflow and the tasks for the process?

A.45. NETA workflow may include receipt of PT-1 or transportation authorization requests, validation of required information, review against MassHealth policy, automated or manual adjudication support, provider/member communication, status tracking, documentation, broker coordination, reporting, and support for escalations or appeals as applicable. Final workflow details, decision rules, system integration, notification processes, and reporting requirements will be finalized during implementation, in accordance with Attachment A Section 3.8.

Q.46. Attachment A, Section 3.8 Non-Emergency Transportation Authorization (NETA), does a potential denial warrant a medical physician review to render a medical necessity denial? Is there a specific MD specialty required to perform medical necessity reviews?

A.46. NETA denial, review, medical necessity, and escalation processes will be governed by MassHealth policies and procedures. At this time, EOHHS does not anticipate the Contractor will make clinical decisions requiring a medical physician review.

Q.47. Attachment A BSS Model Contract, Section 3.10.C.3 Contractor Property and License – Item a Under the proposed contract structure, will the parties have the opportunity post-award to identify and designate specific items as Contractor Property to clarify ownership and license scope?

A.47. Contractor Property and license scope will be governed by Attachment A Section 3.10. After award, EOHHS and the selected Contractor may document the specific Contractor Property used in performance of the Contract, but only to the extent consistent with Attachment A, Section 3.10.C and the Contractor’ Response. Any such designation will not alter EOHHS’s ownership of Commonwealth Property or Deliverables, or EOHHS’s license rights in Contractor Property embodied in or necessary to use the Deliverables. See also Commonwealth Terms and Conditions.

Q.48. Commonwealth Terms & Conditions, Section 11 Indemnification, Would the State be willing to negotiate limiting Contractor’s indemnity obligations to third-party claims only?

A.48. The Commonwealth Terms and Conditions and applicable Contract provisions govern indemnification obligations and cannot be changed.

Q.49. Incumbent transition obligations and system ownership. Could EOHHS describe the expected transition obligations from the current BSS vendor, including what data, system artifacts, CRM history, document repositories, operating procedures, knowledge-transfer materials, open work queues, domain names, email inboxes, and performance reports will be made available to a successor Contractor? Additionally, which current systems, tools, workflows, knowledge bases, CRM tools, and mail/fulfillment systems are owned by EOHHS versus the incumbent vendor?

A.49. EOHHS expects the incumbent Contractor to comply with the transition and turnover obligations in its current contract, including cooperation with EOHHS and the successor Contractor to support an orderly transition of services and avoid disruption to EOHHS, providers, members, and other customers.

The incumbent Contractor’s current transition obligations include, as directed by EOHHS and subject to applicable privacy, security, confidentiality, and intellectual-property requirements, transfer or transition of Contract-related information and data, the most recent data and documentation, user and systems documentation, reports, records, and other information EOHHS determines reasonably necessary to sustain and facilitate operations. The incumbent Contractor also must continue performing Contract obligations until turnover is complete. Consistent with the current contract, EOHHS expects transition activities to include, as applicable:

1. transition of electronic trading partners, transaction-file transfer activities, telecommunications, and EDI activities;

2. conversion and transition of encounter-history data into the successor Contractor’s applicable system;

3. transition of open issues or open work queues, regardless of age, to support continuity of customer support;

4. transition of document-storage information, physical documents, image-retrieval functionality, and inventory validation;

5. transition of provider-enrollment tracking data;

6. transition of transportation-related data and open transportation requests, to the extent applicable to the successor scope;

7. review and transition of publications, forms, materials, and publications-inventory information needed for ongoing operations;

8. transfer of toll-free and non-toll-free phone numbers, central domain names, central email addresses, and related emails used to perform the services; and

9. provision of relevant reports, records, call recordings, correspondence, system documentation, and other Contract-related materials as directed by EOHHS.

Q.50. Attachment B - Cost Response Instructions and Workbook. In the Cost Response Workbook, Line 11 is labeled for respondent input (green), but it also contains a formula. Should we overwrite the formula and enter a value manually, or leave the formula in place and let it calculate automatically?

A.50. See BSS RFR Amendment 1. Amended Attachment B – Cost Response Instructions and Workbook. For Line 11 only (Column C / Row 37), the formula has been removed so that bidders can manually enter the applicable value Days.

Q.51. Attachment B - Cost Response Instructions and Workbook. The “MassHealth Choices (Optional)” column is included in intermediate calculations (e.g., Lines 2, 4, and 6) but does not appear to roll into Line 9 (Total Direct and Indirect Costs) or the Total Cost for each contract year. Should costs for MassHealth Choices (Optional) be included in the total evaluated price for each year, or should they be excluded from Line 9 and the Total Cost calculations?

A.51. All bidders who intend to bid for MassHealth Choices should manually enter cost numbers for MassHealth Choices (Column N).

Q.52. Attachment B Cost Response, cell C42 and Contract Year 3 Tab. There are minor formula errors in the sheet, for example, for some rows the total does not include Optional Service and the Contract Year 3 tab does show the Admin % on cell C42 A.52. All bidders who intend to bid for MassHealth Choices should manually enter cost numbers for MassHealth Choices (Column N). Bidders proposing the optional MassHealth Choices functionality should manually enter the applicable costs in Column N of the Cost Response Workbook. EOHHS has reviewed the identified workbook calculations and determined that the workbook is functioning as intended. Bidders should complete the workbook as provided.

Q.53. Attachment B Cost Response Instructions and Workbook – Implementation Cost tab. Please clarify where Bidders should enter startup costs in the Implementation Cost tab.

A.53. Bidders should enter startup costs on the STARTUP row directly below the note on the Implementation Cost tab. Startup costs should not be reported in the Cost Proposal for Contract Year 1.

Q.54. Startup cost payment treatment, Attachment A and Attachment B. Could EOHHS clarify whether startup costs incurred during the implementation period will be paid during the implementation period, included in Contract Year 1 invoicing, amortized across operational years, or handled through another mechanism?

A.54. Bidders should propose startup costs only in the Implementation Cost tab and should not duplicate startup costs in Contract Year 1. Payment for any approved startup costs will be governed by the final Appendix B - Payment Schedule and the Contract's payment provisions.

Q.55. Attachment A, Section 6.3 and Attachment B establish that Administrative Costs plus Earnings Factor shall not exceed 12.5% of the total paid. Please clarify:

1) how the 12.5% cap will be calculated;

2) whether the cap applies to subcontractor costs, software and hosting costs, postage, fulfillment, other third-party services, and other pass-through costs; and

3) the meaning of the term “Earnings Factor” as used in the Cost Response Workbook A.55. “Earnings Factor” refers to the Bidder’s proposed earnings/profit component included in the cost structure. The 12.5% cap will be calculated on the total annual contract cost, inclusive of subcontractor costs, software and hosting costs, postage, fulfillment, other third-party services, and other pass-through costs, in accordance with Attachment B and the Cost Response Workbook. Bidders should complete the workbook as structured and should not modify formulas, cost categorizations, or assumptions.

Q.56. Appendix E MES Outcomes – CMS Required Provider Management. Please clarify the list of tasks and activities the vendor is expected to conduct associated with site visits for moderate- and high-risk providers.

A.56. Site visit activities associated with provider screening and risk level will be performed in accordance with applicable CMS requirements, including 42 CFR 455.432 and 42 CFR 455.450, MassHealth requirements, and EOHHS-approved policies and procedures.

See BSS RFR Amendment 1. The following items, previously marked as not applicable, have been updated from “No” to “Yes” in Column E, “Applicable?”.

PM 11 – Risk Level Assignment PM 16 – Notices and Communications PM 17 – Fraud PM 18 – Payment Suspension Q.57. Appendix G, 6. CMS Modularity and Certification Requirements – Will the contractor be responsible for obtaining the third-party security and privacy assessment and Security Audit Report (SAR) or will EOHHS obtain the third-party assessor or conduct the assessment themselves?

A.57. . The selected Contractor will be responsible for supporting and coordinating required third-party security and privacy assessments and related Security Audit Report (SAR) activities for the proposed solution, in accordance with applicable EOTSS, CMS, and Medicaid Enterprise System requirements and EOHHS direction.

Q.58. Is the work that is in-scope part of a collective bargaining agreement (CBA)?

A.58. No, it is not part of a collective bargaining agreement. The Contractor is responsible for providing, managing, training, and retaining staff necessary to perform the Contract and for complying with all applicable employment, labor, wage, and workplace requirements.

Q.59. RFR Attachment C – Reference Materials (Amended BSS Average Monthly Volume) Could EOHHS please clarify how the volume metrics in Attachment C should be interpreted, including the definitions and timeframes used? For example, does the monthly average of applications distributed refer to requests received or work processed, and do the reported volumes represent steady-state operations or include unusual conditions such as policy changes or one-time initiatives?

A.59. Attachment C volume metrics are provided as historical operational reference information from Calendar Year 2025. The metrics should be interpreted according to the descriptions in Attachment C and should not be treated as a guarantee of future volume, steady-state conditions, or absence of unusual conditions. Bidders should apply their own assumptions in developing responses and pricing.