Professional Accounting and Financial Mgmt. Specifications, ARFQ OHF 27-2.pdf

REQUEST FOR QUOTATION

Professional Accounting & Financial Management Services

ARFQ OHF27*2

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SPECIFICATIONS

1. PURPOSE AND SCOPE: The West Virginia Office of Shared Administration (OSA) Purchasing Division is soliciting bids on behalf of The Department of Health Facilities (DHF), and its three (3) state owned and operated facilities to establish an open-ended contract for Professional Accounting and Financial Management Services.

NOTE: This request is covered in part or in whole by federal funds. All bidders must acknowledge and adhere to Attachment 1 - “Provisions Required for Federally Funded Procurements.”

NOTE: The WVDHHR has developed an EEOP Utilization Report and it is available at:

https://dhhr.wv.gov/office-of-drug-control-policy/news/Documents/EEO%20Uitlization%20Report%20Completed%20Form%201-29-21-final-PDF%20review%20for%20approval%20to%20submit%20%283%29.pdf

NOTE:THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF

1996 (HEREAFTER, HIPAA) BUSINESS ASSOCIATE ADDENDUM (“ADDENDUM”) IS

MADE A PART OF THE AGREEMENT BY AND BETWEEN THE WEST VIRGINIA

DEPARTMENT OF HEALTH FACILITIES (DHF), AND BUSINESS ASSOCIATE

(VENDOR) AND IS EFFECTIVE AS OF THE DATE OF EXECUTION OF THE

ADDENDUM.

Location of Hospitals and Background Information:

Mildred Mitchell-Bateman Hospital is located at 1530 Norway Avenue, in Huntington, WV 25709-0448. The Facility is a 110-bed, state-supported acute psychiatric hospital with acute, forensic and long-term patients. The hospital is accredited by the Joint Commission and certified by the Center for Medicare & Medicaid Services (CMS). The Fiscal Services Department oversees the financial operations.

William R. Sharpe, Jr. Hospital is located at 936 Sharpe Hospital Road, off Route 33 West, in Weston, WV 26452. The Facility is a 200-bed, state-supported acute psychiatric facility with full accreditation from The Joint Commission on Accreditation of Healthcare Organizations and is certified by CMS. The Fiscal Services Department oversees the financial operations.

Welch Community Hospital is located at 454 McDowell Street, in Welch, WV 24801.

The Facility has 55 licensed beds. Of the 55, there are 45 medical/surgical beds, 8 intensive care beds; 2 pediatric beds. The Hospital serves the counties of McDowell, Wyoming, and

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Mingo with a total market population of approximately 80,000. The hospital certified by the Center for Medicare & Medicaid Services (CMS). The Fiscal Services Department oversees the financial operations.

2. DEFINITIONS: The terms listed below shall have the meanings assigned to them below.

Additional definitions can be found in Section 2 of the General Terms and Conditions.

2.1 “Contract Services” means professional accounting and financial management services as more fully described in these specifications.

2.2 “Pricing Page” means the pages, contained in wvOASIS, upon which Vendor must list its proposed price for the Contract Services.

2.3 “Solicitation” means the official notice of an opportunity to supply the State with goods or services.

2.4 “HCA” means Health Care Authority.

2.5 “HCFA 339”, “CMS 339”, or “339” means Centers for Medicare & Medicaid

Services (CMS), formerly Health Care Financing Administration, Provider Cost Report Reimbursement Questionnaires.

2.6 “CBM-9 Reporting” or “CBM-9 Reports” means Monitor and Variance Reports, commonly referred to as Compliance reports.

2.7 “Facilities” refers to the Medicare and/or Medicaid certified State-owned and operated facility.

2.8 “CFO” means Chief Financial Officer at each facility.

2.9 “DSH” means Disproportionate Share Hospital.

2.10 “CPA” means Certified Public Accountant

3. QUALIFICATIONS: Vendor must have the following minimum qualifications:

3.1 Vendor must be an established Certified Public Accounting (CPA) firm with ten

(10) years experience and registered with the State of West Virginia.

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3.2 Vendor must have five (5) years healthcare consulting experience.

3.3 Vendor must have three (3) years experience in “339” reporting.

3.4 Vendor must have five (5) years experience in preparing Health Care Authority

(HCA) reporting, which included quarterly CBM-9 reports or preparing similar monitor and variance reports for other states’ equivalent authorities.

3.5 Vendor must have five (5) years experience in reimbursement regulation research, rate regulations and Medicare/Medicaid accounting.

3.6 Vendor must have five (5) years of experience in preparing Medicare Cost Reports, DSH reports and/or other reports required by the West Virginia Health Care Authority.

3.7 Vendor must have experience completing a Financial Feasibility Assessment and

Community Needs Assessment for the purposes of providing an analysis and assistance in converting an Acute Care Facility to a Critical Access Hospital.

3.8 Vendor must have the ability to review the hospital charges and assist in adjusting specific rates to increase or maximize net revenue.

3.9 Vendor must be knowledgeable of third-party reimbursement requirements.

3.10 Vendor must be able to assist in evaluating or modeling prospective rates for a privatization model and must also be able to assist in adapting to any changes in reimbursement to any state facilities.

4. MANDATORY REQUIREMENTS

4.1 Mandatory Contract Services Requirements and Deliverables: Contract

Services must meet or exceed the mandatory requirements listed below.

4.1.1 Professional Accounting & Financial Management Services.

4.1.1.1 Vendor must prepare Centers for Medicare & Medicaid Services Cost Reports (CMS2552), Provider Cost Report Reimbursement Questionnaires (CMS339) and supporting documentation for the three state facilities.

These reports are to be submitted prior to the deadline established by The

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Centers for Medicare & Medicaid Services, which can be found at the following link: http://cms.hhs.gov/ .

4.1.1.2 Vendor must prepare all required Health Care Authority (HCA) reports.

All reports are to be submitted prior to the deadline established by HCA, which can be found at the following link:

http://www.hca.wv.gov/Pages/default.aspx .

Welch, William R. Sharpe and Mildred Mitchell-Bateman.

4.1.1.3 Vendor must annually prepare all disproportionate share hospital calculations as requested by the facility and assist with the filing of DSH audit information. Welch, William R. Sharpe and Mildred Mitchell- Bateman.

4.1.1.4 Vendor must provide financial records review and analysis to the facilities on a quarterly basis. Financial analysis must highlight any variances from original budget that exceed 10% cumulatively for the period reported or extrapolated for more than 10% variance when projected for the year using trend data.

4.1.1.5 Vendor must ensure the facility chargemasters are accurate and updated annually for Welch Community Hospital, William R. Sharpe, Jr, Hospital, and Mildred Mitchell-Bateman Hospital.

4.1.1.6 Vendor must prepare annual comparison of cost per patient per day, current charge schedule, and current collections schedule based on contractual allowances and/or percentage of cost to charge rates for all payor sources. Vendor must make recommendations for charges to maximize revenues for the 3 State Hospitals.

4.1.1.7 Vendor must provide ongoing consulting services to the Facilities as requested through utilization of a work of process statement. Once requested by the facilities, the vendor will have five (5) working days to respond to the requestor with a detailed staff classifications and projected hours for the work to be done. All costs must be incurred on an hourly rate for the staffing classifications as listed in the cost sheet by the vendor.

Services and activities to be provided by the vendor and billed at the hourly rates contained within this contract shall include:

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4.1.1.7.1 Vendor must provide assistance to the facilities related to their accounting functions including monthly, quarterly, and yearly analysis of financial statements, general ledger, and support subsidiary.

4.1.1.7.2 Vendor must provide assistance to the hospital business office and accounting personnel to develop the data necessary for the vendor to complete Federal and State regulatory requirements.

4.1.1.7.3 Vendor must provide assistance and training with all prior authorization and pre-certification requirements applicable to patient insurance and billing requirements.

4.1.1.7.4 Vendor must provide technical assistance in setting each facility’s

Medicaid rates.

4.1.1.7.5 Vendor must provide for research and monitoring of

reimbursement regulations and issue guidance to the facilities as to how changes will affect revenues.

4.1.1.7.6 Vendor must provide in-service and technical assistance related to general accounting techniques for healthcare facilities; Medicare and Medicaid cost accounting; and statistical methods for cost reporting purposes.

4.1.1.7.7 Vendor must provide review and recommendation for methods of recovering Medicare deductibles and coinsurance amounts.

4.1.1.7.8 Vendor must provide ongoing review of revenue opportunities with a focus on the revenue cycle process.

4.1.1.7.9 Vendor must prepare and recommend improvements and options related to the efficiency, effectiveness, and opportunities in areas of cost reimbursement and revenue management.

4.1.1.7.10 Vendor must provide technical assistance for maximizing reimbursement from third party payers, including modification and/or updating of each of the facility’s fee schedules and billing

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4.1.1.7.11 Vendor must prepare an observation and recommendation letter to both the DHF and the management of each facility for the purpose of improving reimbursement, collections, and agency funding.

4.1.1.7.12 Vendor must assist and participate in the development of specifications for solicitation of third-party vendors for provision of financial systems and services.

4.1.1.7.13 Vendor must ensure that there is a process in place to collect Insurance deductibles and coinsurance amounts prior to any Surgeries/Outpatient Procedures including Labs and X-Rays.

4.1.1.7.14 Vendor must provide Case Mix/MDS reviews for Coding Compliance and capture patient/resident acuity and provide training for staff.

4.1.1.7.15 Vendor must perform Medical Necessity Audits and Reviews.

4.1.1.7.16 Vendor must provide any technical assistance required to Welch Community Hospital with regards to establishing a Rural Health Clinic.

4.1.1.7.17 Vendor must provide any technical assistance required to Welch Community Hospital with implementation and administration of the 340B Drug Program.

4.1.1.7.18 Vendor shall provide strategic financial planning services to assist and advise the Department of Health Facilities in evaluating and recommending the most appropriate strategic options for the sustainability, operational viability, and effective management of the State-Owned and Operated Hospitals.

4.1.1.7.19 Vendor will provide financial advisory services to support an overall assessment of the operations of the State-Owned and Operated Hospitals. The assessment shall include a

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4.1.1.7.20 Vendor shall analyze existing facilities to determine the extent of needed capital improvements, conduct a financial analysis of the impact on existing facilities, and provide a current market value for the hospitals. The objective of these services is to provide the Department with a thorough understanding of the challenges of maintaining the existing facilities in operational condition subject to Federal and State licensure and survey laws and regulations.

5. CONTRACT AWARD:

5.1 Contract Award: The Contract is intended to provide Agency with a purchase price for the Contract Services. The Contract shall be awarded to the Vendor meeting the required specifications for the lowest Grand Total cost as shown on the Pricing Pages.

5.2 Pricing Page: Vendor should complete the pricing page for each commodity line for lump sum pricing and hourly pricing by completing the area that is not blacked out. Vendor should provide their all-inclusive, comprehensive hourly rate for each facility as the Unit Price for each Commodity Line. Vendor should type or electronically enter the information into the Pricing Pages through wvOASIS, if available, or as an electronic document. If responding on paper, use the pricing page from the last version of the ARFQ. For paper or electronic entry, provide the Hourly Rate as the Unit Price, then multiply the Unit Price times the estimated Quantity (Qty) to calculate the Total Price for each Commodity Line. If submitting electronically through wvOASIS, provide the Hourly Rate as the Unit Price, and the calculation of Unit-Price-Times-Quantity will occur automatically.

Vendor should complete the Pricing Page in full as failure to complete the Pricing Page in its entirety may result in Vendor’s bid being disqualified. Quantities included on the Pricing Page are annual estimates only; actual quantities ordered during Performance of the Contract may vary.

If encountering errors while submitting an electronic bid, contact the wvOASIS Helpdesk at (304) 558-6708 or (855) 666-8823.

6. PERFORMANCE: Vendor and Agency shall agree upon a schedule for performance of Contract Services and Contract Services Deliverables, unless such a schedule is already

P a g e 8 Revised 6.10.22 included herein by Agency. In the event that this Contract is designated as an open-end contract, Vendor shall perform in accordance with the release orders that may be issued against this Contract.

6.1 Ordering Procedure: Agency will notify Vendor of proposed deliverable via notice to the Contract Manager or Agency Approved Designee (see below). Within ten (10) days of the notification, or earlier if specifically required by the Agency in their initial notification, the vendor will provide the Agency with a Statement of Work. The Statement of work shall include estimated number of hours, description of proposed deliverables and an anticipated timeline. Agency will provide approval of the Statement of Work by generating an approved Delivery Order, including the actual quantity of hours, the specific deliverables, and the actual timeline for completion of the deliverable. Delivery Orders estimated to cost in excess of $25,000.00 will be processed as Agency Delivery Order and approved by the OSA Purchasing Division. Any modification to the quantities or scope covered by a Delivery Order may only be implemented by an approved change order to the Delivery Order, approved by the Agency, and the Department of Health and Human Resources Purchasing Division, as applicable.

7. PAYMENT: Agency shall pay each invoice from the vendor for all Contract Services performed and accepted under this Contract. Vendor must include Contract number and Delivery Order number on all invoices. Vendor shall accept payment in accordance with the payment procedures of the State of West Virginia.

8. TRAVEL: Vendor shall be responsible for all mileage and travel costs, including travel time, associated with performance of this Contract. Any anticipated mileage or travel costs may be included in the hourly rate/lump sum listed on Vendor’s bid, but such costs will not be paid by the Agency separately.

9. FACILITIES ACCESS: Performance of Contract Services may require access cards and/or keys to gain entrance to Agency’s facilities. In the event that access cards and/or keys are required:

9.1 Vendor must identify principal service personnel which will be issued access cards and/or keys to perform service.

9.2 Vendor will be responsible for controlling cards and keys and will pay replacement fee, if the cards or keys become lost or stolen.

9.3 Vendor shall notify Agency immediately of any lost, stolen, or missing card or key.

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9.4 Anyone performing under this Contract will be subject to Agency’s security protocol and procedures.

9.5 Vendor shall inform all staff of Agency’s security protocol and procedures.

10. VENDOR DEFAULT:

10.1 The following shall be considered a vendor default under this Contract:

10.1.1 Failure to perform Contract Services in accordance with the requirements contained herein.

10.1.2 Failure to comply with other specifications and requirements contained herein.

10.1.3 Failure to comply with any laws, rules, and ordinances applicable to the Contract Services provided under this Contract.

10.1.4 Failure to remedy deficient performance upon request.

10.2. The following remedies shall be available to Agency upon default:

10.2.1 Immediate cancellation of the Contract.

10.2.2 Immediate cancellation of one or more release orders issued under this

Contract.

10.2.3 Any other remedies available in law or equity.

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11. MISCELLANEOUS:

11.1 Contract Manager: During its performance of this Contract, Vendor must designate and maintain a primary contract manager responsible for overseeing Vendor’s responsibilities under this Contract. The Contract Manager must be available during normal business hours to address any customer service or other issues related to this Contract. Vendor should list its Contract Manager and his or her contact information below.

Contract Manager:

Telephone Number:

Fax Number:

Email Address: