Q&A Center Following Q&A center items have been published by the buying organization for Solicitation QLV27007040

Solicitation Information

Title: Fully Integrated Dual Eligible Special Needs Plan Program (FIDE-SNP)

Description:

The Rhode Island Executive Office of Health and Human Services (hereinafter referred to as “EOHHS” or “State”) is seeking proposals from qualified Bidders to administer all functions related to the Rhode Island Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Program.

For more information, a. when viewing from public bid board, click on the “print/download solicitation” button in the upper right corner of this window, or b. vendor can login to their WebProcure account to view this solicitation in full.

Delivery Terms: Free On Board Destination

Payment Terms: Vendor Specified

Contact Information State of Rhode Island

Clarisa Encarnacion

One Capitol Hill 2nd Floor Providence RI, 02908 United States

Clarisa.Encarnacion@purchasing.ri.gov

Start Date: Oct 02, 2026 11:00 AM EDT

Open Date: Nov 04, 2026 11:00 AM EST

Collaboration Start Date: Oct 02, 2026 11:15 AM EDT

Collaboration End Date: Oct 16, 2026 2:00 PM EDT

Vendor may e-mail buyer directly: No

Created: Oct 23, 2026 3:31:35 PM Page: 2

Solicitation QLV27007040, Fully Integrated Dual Eligible Special Needs Plan Program (FIDE-SNP)

Following Questions and Answers have been published:

Question Answer Date

Submitted

Date

Responded

Attachments

Question 5.7.3 requires Bidders to report, for each Medicaid contract identified in Question

5.1.1, the percentage of clean claims paid within 30 and 90 days. However, claims-processing standards and available reporting methodologies vary by state contract. For example, some contracts measure performance at 30 and 60 days rather than

30 and 90 days; some apply different standards to paper and electronic claims; and some report clean and unclean claims in a combined measure that cannot be retrospectively separated. Please confirm that, when the exact clean-claims measures requested are not maintained under a reference contract, a Bidder may provide the closest available contractually defined claims-timeliness data for that market, clearly identify the applicable timeframe, claim type, and methodology, and use "Not Available" for any requested measure that cannot be reliably derived.

If the Bidder is not able to calculate the data in alignment with the requested time periods in question 5.7.3, then the Bidder should mark the response for that contract as "not available".

Oct 16, 2026 Oct 23, 2026 Total:0

Please confirm that bidders may include tables within the applicable narrative response, rather than placing them only after the narrative, provided these elements are responsive to the requirements and included within the applicable page limits.

Tables placed within the applicable narrative response and within the applicable page limits is permitted.

Oct 16, 2026 Oct 23, 2026 Total:0

Because RFP Section 5.6.1 expressly requires a QM/QI organizational chart and the

RFA permits appendices that are exempt from narrative page limits, please confirm that bidders may submit the required organizational chart as an appendix attachment and that EOHHS will consider and score the chart as an integral part of the bidder’s response to Section 5.6.1.

The State confirms that the organizational chart may be submitted as an appendix and will be considered in the evaluation of Section

5.6.1.

Oct 13, 2026 Oct 23, 2026 Total:0

Created: Oct 23, 2026 3:31:35 PM Page: 3

The RFP states, “Attachments such as graphics, flowcharts, diagrams, and tables should follow the narrative response for each section or subsection under the specific proposal component” and that material within the counted pages must be fully responsive to the questions. Please confirm that bidders may embed graphics, flowcharts, diagrams, and tables within the applicable narrative response, rather than placing them only after the narrative, provided these elements are responsive to the requirements and included within the applicable page limits.

The State confirms that such materials may be embedded within the applicable narrative response.

Oct 13, 2026 Oct 23, 2026 Total:0

If graphics, flowcharts, diagrams, or tables are provided after the narrative response for the applicable section or subsection, please confirm that the State will consider such material when scoring that section, provided it is relevant to and illustrative of the applicable question or requirement and is included within the applicable page limits.

The State confirms that such materials will be considered as part of the evaluation.

Oct 13, 2026 Oct 23, 2026 Total:0

Given the supporting documentation required for the identified D-SNP contracts cannot reasonably be accommodated within the

RFA’s narrative response page limits, must the Bidder provide information for all D-SNP contracts held by the Bidder, its parent company, affiliates, or partners, or may it provide a representative subset? If information must be provided for all D-SNP contracts, please confirm that bidders may include the required contract documentation in an appendix or separate attachment that is exempt from the page limits and that EOHHS will consider the submitted documentation as part of its evaluation and scoring of the applicable response.

The Bidder must provide information for all D-

SNP contracts held by the Bidder, its parent company, affiliates, or partners. Bidders may include the required contract documentation in an appendix or separate attachment that is exempt from the page limits.

Oct 13, 2026 Oct 23, 2026 Total:0

If a subcontractor (who is not an MBE/WBE and/or Disability Business Enterprise) of a

Bidder's organization has a subcontractual relationship with an MBE/WBE and/or

Disability Business Enterprise, may the

Bidder submit an ISBE form for that

MBE/WBE and/or Disability Business

Enterprise? Or must the Bidder have a direct contract with the MBE/WBE and/or Disability

Business Enterprise?

If a prime vendor engages with a subcontractor who in turn engages with a

Rhode Island-certified MBE/WBE/DisBE subcontractor for the specific project being bid, this information may be represented on the prime vendor/bidder’s ISBE documentation for only the total project portion/percentage of the certified firm sub engagement. That specific figure will be taken into consideration when calculating the prime vendor/bidder’s ISBE participation rate relative to this solicitation.

Oct 15, 2026 Oct 23, 2026 Total:0

Created: Oct 23, 2026 3:31:35 PM Page: 4

Because Appendix D’s Provider Letter of

Intent Form is intended to demonstrate a

Bidder’s ability to establish a robust and diverse Provider Network, may a Bidder with an established network submit the form only for new providers it plans to add to deliver additional benefits under its existing provider network contracts?

Bidders should complete the Provider Letter of Intent Form for new providers with which they will contract with to provide additional benefits. A provider network summary table with a count of existing contracted providers should also be completed.

Oct 08, 2026 Oct 23, 2026 Total:0

Is it correct that a Bidder with an established

Provider Network is required to complete the

Appendix D Provider Letter of Intent Form only for new providers with which it will contract to provide additional benefits, rather than for providers already participating under its existing network contracts?

Bidders should complete the Provider Letter of Intent Form for new providers with which they will contract with to provide additional benefits. A provider network summary table with a count of existing contracted providers should also be completed.

Oct 08, 2026 Oct 23, 2026 Total:0

Please confirm whether Minimum

Qualifications attestation to formatting and submission requirements should be ordered in Bidder's response according as "2.8," per page 14 Section 1.3. Structure of Proposal, or as "2.1" per page 15 within Section 2.

Minimum Qualifications Requirements.

Bidders should follow the "Structure of

Proposal" outlined in Section 1.3 when ordering responses.

Oct 13, 2026 Oct 23, 2026 Total:0

Per the SFY 2027 RI state budget, EOHHS is going to increase the resource limits to

$8,000 for an individual and $12,000 for a couple for the categorically needy, medically needy, and LTSS medically needy populations. Can you please share the projected number of additional dually eligible members that will be enrolled in RI Medicaid and potentially eligible to enroll in a FIDE-

SNP due to this change?

This information is not available at this time. Oct 15, 2026 Oct 23, 2026 Total:0

If an awarded MCO is a new entrant with an existing CO D-SNP will they be allowed to crosswalk their FBDE membership to the

FIDE-SNP?

Yes. FBDEs will not be allowed to remain enrolled in a CO D-SNP if that MCO is awarded as a new entrant as a FIDE-SNP.

Oct 15, 2026 Oct 23, 2026 Total:0

Does EOHHS plan on notifying all FBDEs of the expanded MCO offerings prior to Annual and Open Enrollment periods? If yes, how will

EOHHS inform beneficiaries?

No decisions have been made at this time. Oct 15, 2026 Oct 23, 2026 Total:0

Please confirm an awarded MCO must comply with CMS regulations requiring the

Medicaid benefit to be administered by a managed care plan owned and operated by the same parent company as the D-SNP and a delegated arrangement between two unaffiliated entities is not allowed.

Medicaid benefits must be administered by a managed care plan owned and operated by the same parent company as the D-SNP.

Created: Oct 23, 2026 3:31:35 PM Page: 5

Will an awarded MCO be allowed to operate a CO-DSNP for FBDEs if their operational start date is delayed beyond 2028?

Awarded Bidders will not be allowed to operate a CO-DSNP for FBDEs regardless of any operational start date delays. Awarded

Bidders will be allowed to operate a CO-

DSNP for partial duals only.

Oct 15, 2026 Oct 23, 2026 Total:0

In questions 4.1.9 and 4.1.10 Section A

Background sections referenced should be

5.1 and 5.3 and not 6.1 and 6.3?

Correct. Section 4.1.9 should reference

Section A: Background (5.1) and Section

4.1.10 should reference Section A:

Background (5.3)

Oct 15, 2026 Oct 23, 2026 Total:0

Question 4.2 requires the bidder to sign the

Attestations in this section. Does EOHHS want this in a letter format?

Bidders may submit the signed attestations in a letter format so long that all required elements are included.

Oct 15, 2026 Oct 23, 2026 Total:0

Question 5.6.2 should bidders only submit rates that have been audited and submitted to NCQA? Please clarify for the measures listed in 5.6.2 (c – f), per NCQA requirements these measures are calculated for all ages. Is

EOHHS requesting the bidders to report the measure based only on the adult population?

Yes, only rates that have been audited and submitted to NCQA should be submitted. Per question 5.6.2, the following measures should be reported:

· Follow-Up After Hospitalization for Mental

Illness (FUH-AD), Ages 18–64, 7-Day Follow-

Up

· Follow-Up After Hospitalization for Mental

Illness (FUH-AD), Ages 18–64, 30-Day

Follow-Up

· Follow-Up After Emergency Department

Visit for Mental Illness (FUM-AD), Ages

18–64, 7-Day Follow-Up

· Follow-Up After Emergency Department

Visit for Mental Illness (FUM-AD), Ages

18–64, 30-Day Follow-Up.

Oct 15, 2026 Oct 23, 2026 Total:0

Please clarify for 5.6.2 can a bidder submitting rates for a Medicare-Medicaid demonstration plan use the MMP National

Averages given that NCQA Quality Compass percentiles do not exist for MMP?

No. Responses to question 5.6.2 should only include HEDIS scores for its Medicaid product line. While Bidders may include MMP experience in their response to question

5.1.1, MMP experience may not be used as a response to question 5.6.2.

Oct 15, 2026 Oct 23, 2026 Total:0

Under section C: Proposal Materials - Is a cover letter required?

A cover letter is not required. Oct 15, 2026 Oct 23, 2026 Total:0

Please describe how attachments should be labeled (naming convention) within each section.

There is no preference to labeling attachments as long as the attachment is easily traceable to the question.

Oct 15, 2026 Oct 23, 2026 Total:0

There are several references to requirements associated with key personnel based in

Rhode Island. Please confirm that staff fulfilling key personnel positions are allowed to be full-time remote outside the state of RI or to telecommute.

Please refer to requirements outlined in

Article 3: Scope of Work

Created: Oct 23, 2026 3:31:35 PM Page: 6

Question 5.4.1 requires bidders to submit a geo-access analysis demonstrating compliance with time and distance standards for LTSS providers. For provider types that primarily furnish services in members' homes or community settings, please clarify how

EOHHS will evaluate compliance and whether such provider categories are expected to be included in the geo-access analysis required under Question 5.4.1.

Please refer to the time and distance standards posted on the EOHHS website at the following link:

https://eohhs.ri.gov/sites/g/files/xkgbur226/file s/2026-10/FIDE-

SNP%20Time%20and%20Distance%20Stan dards_20260910.pdf

Oct 13, 2026 Oct 23, 2026 Total:0

Will CY 2027 FIDE-SNP Rate Certification be posted as an addendum on the OSP website, or will Bidders need to submit a FOIA request for that information?

Similar to the CY 2026 FIDE-SNP Rate

Certification, CY 2027 will be posted to

EOHHS' Medicaid Contracts and Polices website finalized by our Actuaries.

Oct 15, 2026 Oct 23, 2026 Total:0

Question 4.2.6, last sentence, “The Bidder shall execute a statewide Medicaid managed care plan agreement to be eligible to obtain

State authorization to operate a FIDE-SNP.”

Can you please explain the reference to a statewide Medicaid managed care plan agreement. If an awarded MCO does not have an existing statewide Medicaid managed care plan agreement what will be the procurement process to award a statewide Medicaid managed care agreement?

The Bidder must execute a direct-capitation-only Medicaid managed care arrangement with the State to operate a FIDE-SNP, but is not required to enter into a new, nor have an existing standalone, Medicaid managed care plan agreement outside the scope of a FIDE-

SNP.

Oct 15, 2026 Oct 23, 2026 Total:0

Please confirm bidders are expected to identify instances of non-renewal, early termination, and scheduled termination of government-sponsored healthcare contracts with states.

Yes, Bidders should identify all instances of non-renewal or early termination of Medicaid or Medicare healthcare contracts within the past ten (10) years.

Oct 15, 2026 Oct 23, 2026 Total:0

Question 5.4.1 requests geo-access analysis and includes the following note: "Analysis based on LOI committed providers will not be considered responsive for the purposes of scoring this question.” Please clarify: does the note mean the geo-access analysis should only be performed for providers under contract with the bidder? Please confirm that a bidder with a comprehensive network that meets all state network adequacy standards is not required to complete LOIs.

Bidders should submit a geo-access analysis for their contracted providers and not include

LOI committed providers. Bidders should complete LOIs only for new providers with which they will contract with to provide additional benefits.

Oct 15, 2026 Oct 23, 2026 Total:0

Please clarify for 5.6.2 (a) the A1C

Screening/Test Measure, this measure was retired by NCQA in MY2021. Is it acceptable to EOHHS to replace with the HEDIS measure Hemoglobin A1c Control for

Patients with Diabetes (HBD) which measures both the test being performed and the level being within the appropriate clinical range (<8).

Yes. Bidders should provide data for

Glycemic Status Assessment for Patients with Diabetes - Glycemic Status <8.0% for the requested years.

Created: Oct 23, 2026 3:31:35 PM Page: 7

For visual differentiation and ease of review, please confirm EOHHS will allow smaller than

12-point font for non-narrative related response elements such as graphics, charts, tables, figures, attachments, footnotes, headers, and footers.

This is fine. Oct 15, 2026 Oct 23, 2026 Total:0

Are there any file size limits for documents uploaded to the OSP site? If so, what is the limitation?

No page limitations. Oct 15, 2026 Oct 23, 2026 Total:0

5.1.6 of the Agency Solicitation Specifications

(SOW) requires bidders to "Disclose all noncompliance of Material subcontractors to the Bidder’s Proposal in the past five (5) years." There is no definition of "Material

Subcontractor" provided in the SOW, but there is a definition in section 1.248 of

Appendix A: Model SMAC. That definition in the SMAC states that a Material

Subcontractor is "Any entity with a Material

Subcontract with the Contractor. For the purposes of this Contract, Material

Subcontractors do not include providers in the Contractor’s provider network. Material

Subcontractors may include, without limitation, Affiliates, subsidiaries, and affiliated and unaffiliated third parties." This definition relies on a new, undefined term

"Material Subcontract." It is requested that a definition of what is meant by a "Material

Subcontract," or, alternatively, a more definitive definition of "Material

Subcontractor" that does not rely upon other undefined terms, be provided.

No specific question is being asked. Please refer to the definition of ""Subcontract"" and

""Subcontractor"" in Article 1.

Oct 11, 2026 Oct 23, 2026 Total:0